How to identify mental retardation in a child and help? Developmental delay Mental development delay in children causes

Developmental delay is a symptom of a pathological process that leads to physiological or psychological disorders. It should be noted that the delay in psycho speech development may have a hereditary etiology. In some cases, depending on the etiological factor and general condition child health is an irreversible pathological process. Early, and therefore timely, diagnosis of the disorder is quite difficult. Definitely, at the first manifestations of the clinical picture in a child, you should urgently seek medical help, and not ignore the symptom or attempt to eliminate it yourself.

Etiology

As for this pathological process, there are no single etiological factors, since each type of developmental delay has its own provoking factors. However, it should be noted that for almost all cases there is one common cause— intrauterine growth retardation (IUGR).

Speech development delay (SDD) may be caused by the following etiological factors:

• head injuries or brain tumors;
• pathologies of the nervous system;
• infectious diseases that the mother suffered during pregnancy;
• hearing impairment or complete deafness;
• social maladjustment;
• If adults do not stimulate the development of speech in a child, they understand the meaning of what was said by sounds or incorrectly pronounced words and react to it. In such cases, the child simply will not try to speak correctly, since he achieves the desired result immediately.

As a rule, delayed speech development in children is determined before the age of three. If by this age the baby has not learned to pronounce correctly and does not have a certain vocabulary that is optimal for his age, then consultation with a psychologist, neurologist and speech therapist is required.

Delay mental development(ZPR) can be caused by both pathological and social factors. The first should include:

• damage to the child’s central nervous system during the formation period. In this case, fetal development delay (FGR) is observed with all the ensuing consequences;
• bad habits mothers - smoking, drinking alcohol and narcotic drugs, frequent stress and strong nervous tension;
• infectious diseases(most often leads to this symptom);
• diseases with hereditary etiology;
• autoimmune pathological processes;
• dysfunction of sensory perception of information (vision and hearing).

Social provoking factors include the following:

• frequent psychological trauma;
• pedagogical neglect of the child;
• restriction of the child’s activities, which leads to social maladjustment.

As a rule, children with mental retardation are withdrawn and do not like to let strangers near them, including those of their own age. This diagnosis is made in early preschool and school age, when the child begins to communicate with other children.

Delayed psychomotor development has the following etiology:

• endocrine pathologies of congenital and acquired nature;
• household or chemical (typical for children in the first year of life);
• IUGR, which are of chromosomal nature -,;
• infectious diseases;
• consequences of perinatal and postnatal pathology (delayed fetal development);
• illnesses of a genetic nature.

Social reasons are no exception in this case - lack of care and nutrition, frequent and pedagogical neglect of the child.

We can talk about delayed puberty when boys by the age of 14 and girls by the age of 13 have no age-related changes. The onset of symptoms is preceded by the following factors:

• chromosomal disorders;
• oncological processes that lead to improper production of hormones;
• suffered severe infectious diseases;
• dysfunction thyroid gland;
• malnutrition.

In some cases, delayed puberty may occur in girls who are early age go in for sports - regular physical exercise change natural physiological processes.

Symptoms

Each form of developmental delay has its own characteristics clinical picture. Delayed speech development is characterized by the following symptoms:

• in the first months of life the baby does not roar;
• children as young as one year old do not respond to their name;
• the child does not recognize pictures in books, cannot carry out the simplest instructions from adults;
• at the age of 2-3 years the child does not pronounce simple sentences and meaningful phrases;
• The child asks questions less often than other children.

Disturbances in psychomotor development manifest themselves as follows:

• lack of concentration on bright objects or sounds (children from two months of age);
• there is no emotional interest in new subjects, no motor activity;
• the formation of babbling speech lags sharply behind;
• by 12 months the child does not understand speech addressed to him;
• after 15 months, aimless activity is observed;
• after two years there is no vocabulary.

Pathological processes in mental development have the following clinical picture:

• slow, often inaccurate perception;
• superficial, unstable attention;
• violation of figurative and abstract thinking - the child cannot express his thoughts;
• limited vocabulary, speech impairment.

Disturbances in the development of puberty appear only at the age of 13-15 and have the following symptoms:

• girls by the age of 14 do not have periods and there is no enlargement of the mammary glands;
• By the age of 14, boys have not developed their genitals;
• No pubic hair by age 15.

The manifestation of any type of developmental delay requires consultation with a specialized medical specialist.

Diagnostics

The diagnostic program may include the following methods:

• standard laboratory research(blood and urine collection);
• determination of blood hormone levels;
• immunological studies;
• CT and MRI of the brain;
• psychological tests;
• consultations with related specialists (depending on the type of developmental delay and the current clinical picture).

Treatment should only be prescribed by a doctor; you should not do anything on your own in such cases, as this can only worsen the condition.

Treatment

As for drug therapy, it will be purely individual, as it will depend on the underlying factor. Almost always, treatment involves the child and parents working with or. If we are talking about speech development disorders, then consultations and classes with. In more complex cases, doctors recommend continuous education of the child in specialized educational institutions, where the program is adapted for them.

Parents are sometimes discouraged when their child is diagnosed with mental development delay (MDD). Most often, this disorder is well corrected with the right approach parents and teachers. But to do this, it is necessary to identify this deviation from the norm early in the child. The tests in the article will help you do this, and a unique table will help you determine the type of mental retardation in a child. This material also provides advice for parents of delayed children. psychological development.

What does the diagnosis of mental retardation mean? Who is diagnosed with delayed psychological development and when?

Mental retardation (MDD) is a violation of the normal development of the psyche, which is characterized by a lag in the development of certain mental functions (thinking, memory, attention).

The diagnosis of mental retardation is usually made in children under 8 years of age. In newborn children, mental retardation cannot be detected because it is normal. When a child grows up, parents do not always pay attention to limiting his mental abilities or attribute it to being young. But some children may be diagnosed in infancy. He points to some disorders in the functioning of the brain, which in adulthood can manifest themselves in the form of mental retardation.

When attending kindergarten, it is not always possible to diagnose mental retardation in a child, since there the child is not required to engage in any intensive mental activity. But When entering school, a child with mental retardation will clearly stand out from other children because he:

• hard to sit in class;
• hard to obey the teacher;
• concentrate your attention on mental activity;
• is not easy to learn as he strives to play and have fun.

Children with mental retardation are physically healthy; the main difficulty for them is social adaptation. In children with mental retardation, developmental delay may predominate or emotional sphere, or intelligence.

• With delayed development of the emotional sphere Children's mental abilities are relatively normal. The emotional development of such children does not correspond to their age and corresponds to the psyche of a younger child. These children can play tirelessly, they are not independent and any mental activity is very tiring for them. Thus, while attending school, it is difficult for them to concentrate on their studies, obey the teacher and obey discipline in the classroom.

• If the child has hslow development of the intellectual sphere , then, on the contrary, he will sit calmly and patiently in class, listen to the teacher and obey his elders. Such children are very timid, shy and take any difficulties to heart. They are referred to a psychologist not because of disciplinary violations, but because of learning difficulties.

Tests to identify mental retardation - 6 ways to determine mental retardation in a child

If parents have doubts about mental development their child, then there are some tests that will help determine mental development disorders.

You should not interpret the results of these tests yourself, since this should only be done by a specialist.

Test No. 1 (up to 1 year)

The physical and psychological development of a child must correspond to his age. He should begin to hold his head no later than 1.5 months, roll over from back to stomach - at 3-5 months, sit and stand up - at 8-10 months. It is also worth paying attention to. A child should babble at 6-8 months and pronounce the word “mom” by 1 year.

KID-R scale for assessing child development from 2 to 16 months - and

Test No. 2 (9-12 months)

At this age, the child begins to develop simple thinking skills. For example, you can hide a toy under a box in front of a child and ask in surprise, “Where is the toy?” The child should respond by removing the box and showing with delight that he found the toy. The child must understand that a toy cannot disappear without a trace.

Test No. 3 (1-1.5 years)

At this age, the baby shows interest in the world around him. He is interested in learning something new, trying new toys by touch, and showing joy when he sees his mother. If such activity is not observed in the baby, this should raise suspicion.

RCDI-2000 scale for assessing the development of children aged 14 months to 3.5 years - download the questionnaire form in PDF format and instructions for parents on how to fill it out

Test No. 4 (2-3 years)

There is a children's game where you need to insert figures into their corresponding holes. At the age of two or three years, the baby should be able to do this without problems.

Test No. 5 (3-5 years)

At this age, a child’s horizons begin to form. He calls a spade a spade. A child can explain what a machine is or what kind of robot a doctor makes. At this age, you shouldn’t demand a lot of information from your child, but nevertheless, a narrow vocabulary and limited horizons should raise suspicions.

Test No. 6 (5-7 years old)

At this age, the baby can freely count to 10 and perform computational operations within these numbers. He can freely name the names of geometric shapes and understands where there is one object and where there are many. Also, the child must clearly know and name the primary colors. It is very important to pay attention to his creative activity: children at this age should draw, sculpt or design something.

Factors causing PVD

There may be several reasons for delayed mental development in children. Sometimes these are social factors, and in other situations the cause of mental retardation is congenital pathologies brain, which are determined using various examinations (for example,).

• To the social factors of ZPR include inappropriate conditions for raising a child. Such children often do not have parental or maternal love and care. Their families may be antisocial, dysfunctional, or these children are raised in orphanages. This leaves a heavy mark on the child’s psyche and often affects his mental health in the future.
• To the physiological causes of mental retardation include heredity, congenital diseases, severe pregnancy of the mother, or illnesses suffered in early childhood that affected the normal development of the brain. In this case, the child’s mental health suffers due to brain damage.

Four types of psychological development delay in children

Table 1. Types of mental retardation in children

In most situations, parents perceive the diagnosis of mental retardation very painfully, often not understanding its meaning. It is important to realize that mental retardation does not mean that the child is mentally ill. ZPR means that the child is developing normally, only slightly behind his peers.

With the right approach to this diagnosis, by the age of 10, all manifestations of mental retardation can be eliminated.

• Research this disease scientifically. Read medical articles, consult a psychiatrist or psychologist. Parents will find the articles useful: O.A. Vinogradova “Development of speech communication in preschool children with mental retardation”, N.Yu. Boryakova “Clinical and psychological-pedagogical characteristics of children with mental retardation”, D.V. Zaitsev “Development of communication skills in children with intellectual disabilities in the family.”
• Contact the specialists. Children with mental retardation need consultation with a neurologist, psychoneurologist, as well as the help of a speech pathologist, educational psychologist, and speech therapist.
• It will be useful to use in training didactic games . Such games should be selected based on the child’s age and mental abilities; they should not be difficult or incomprehensible for the child.
• Children of senior preschool or primary school age must attend FEMP classes(formation of elementary mathematical concepts). This will help them prepare for mastering mathematics and the exact sciences, improve logical thinking and memory.
• Highlight a specific time (20-30 min) to complete lessons and sit down with your child for homework every day at this time. Initially, help him, and then gradually teach him to be independent.
• Find like-minded people. For example, on thematic forums you can find parents with the same problem and maintain communication with them, exchanging your experiences and advice.

It is important for parents to understand that a child with mental retardation is not considered mentally retarded, since he perfectly understands the essence of the events taking place and consciously performs assigned tasks. With the right approach, in most cases, the child’s intellectual and social functions return to normal over time.

One of the most common mental disorders found in children is mental retardation (MDD). In this state, the child’s psyche, his thinking, perception and memory develop with a significant deviation from the norm accepted for children of a particular age.

Most often, the diagnosis of mental retardation is made in children aged 4 to 5 years. If signs of underdevelopment of certain mental functions persist in schoolchildren, then the diagnosis can be revised towards constitutional infantilism or mental retardation.

Why children may experience developmental delays

All reasons that can lead to delays in the formation of a child’s mental functions can be divided into two categories. The first includes damage to the central nervous system of organic origin that is local in nature. As a result of such defects, some parts of the brain are inhibited in their maturation.

Biological causes are most often:

• pregnancy pathologies caused by intrauterine infections, Rh conflict, alcohol abuse, smoking, etc.;
• injuries received by the child during childbirth or prematurity;
• serious illnesses and injuries suffered by a newborn child. Anesthesia can lead to developmental delays if operations were performed in early childhood;
• delayed maturation of the central nervous system due to the constitution of the child;
• psychological trauma.

In some cases, mental retardation may be hereditary. There are cases where this diagnosis was present in several generations of relatives.

Developmental delays can also be caused by social reasons:

1. Excessive guardianship of a child leads to the fact that everything that could bring even minor harm to him is eliminated from his living space. As a result, the child lags behind in development, since his life activities are limited.

2. Lack of attention and lack of communication.

3. Negative emotional climate in the family, violence, antisocial lifestyle of parents.

Developmental delays caused by social reasons are characterized by pedagogical neglect.

Peculiarities of behavior and perception in children with mental retardation

Delays in mental development must be diagnosed by a specialist with appropriate qualifications. It is necessary to observe the child for a certain period of time to recognize mental disorders.

Since children with delayed development have underdeveloped nervous system, they are not able to perceive information as quickly as their peers who do not have similar deviations. This can manifest itself in such moments:

• the need for more time to receive and comprehend information;
• children with developmental delays have insufficient and often fragmented knowledge about the world around them;
• inability to recognize familiar objects located unusually in space. Images made in the form of diagrams or outline drawings are also poorly perceived;
• Objects that have similar features are often perceived by children with mental retardation as the same. As a result, they have difficulty recognizing letters that are similar in style;
• difficulty remembering, unstable memory. Information in to a greater extent preserved by involuntary memory, while better perception of visual images is noted;
• instability of the emotional sphere. If a child who has a developmental delay finds himself in a stressful situation, he withdraws and withdraws into himself.

Most children with developmental delays have a noticeably reduced need to communicate with other people. This applies to both peers and adults.

But a diagnosis of mental retardation is not a death sentence. There are many examples in history when children who were considered weak-minded in childhood reached considerable heights in science and art. Among such people is Albert Einstein, who began speaking at the age of 3. Doctors assumed that the future Nobel laureate has congenital mental disability.

Isaac Newton, Thomas Edison and Konstantin Tsiolkovsky had similar problems, but they were all able to cope with their problems with the support of loved ones and doctors of the time.

Do not delay contacting the specialists of the Psychoendocrinological Center, and perhaps your child will also become an outstanding scientist and recognized genius!

Treatment of mental retardation in children

The parents of the child play a major role in correcting such mental disorders as developmental delay. First of all, they must realize that difficulties in learning are not associated with the child’s natural laziness or simple reluctance to work, but with the peculiarities of the development of his nervous system.

Shouldn't be ignored alarming symptoms, this can lead to even more severe mental disorders. In order for a child with mental retardation to become a learner, be able to graduate from secondary school and get a profession, it is necessary to seek help from specialists as early as possible.

The Psychoendocrinological Center employs specialists who adhere to the latest methods and developments when correcting mental retardation in children. At the entire stage of treatment, pediatricians, child psychologists and neurologists, as well as psychiatrists, speech therapists and defectologists work with the child. In this case, the main part of the correction is carried out using psychotherapeutic methods. Drug treatment prescribed in rare cases.

With the joint work of specialists, parents and teachers, mental retardation can be successfully corrected in most cases.

Impaired mental function(ZPR) is a lag in the development of mental processes and immaturity of the emotional-volitional sphere in children, which can potentially be overcome with the help of specially organized training and upbringing. Mental retardation is characterized by an insufficient level of development of motor skills, speech, attention, memory, thinking, regulation and self-regulation of behavior, primitiveness and instability of emotions, and poor school performance. Diagnosis of mental retardation is carried out jointly by a commission consisting of medical specialists, teachers and psychologists. Children with mental retardation need specially organized correctional and developmental education and medical support.

General information

Mental retardation (MDD) is a reversible disorder of the intellectual, emotional and volitional sphere, accompanied by specific learning difficulties. The number of people with mental retardation reaches 15-16% in the child population. ZPR is largely a psychological and pedagogical category, but it may be based on organic disorders Therefore, this condition is also considered by medical disciplines - primarily pediatrics and child neurology.

Since the development of various mental functions in children occurs unevenly, usually the conclusion “mental retardation” is established for preschool children no earlier than 4-5 years old, and in practice - more often during schooling.

Causes of mental retardation

The etiological basis of mental retardation is biological and socio-psychological factors that lead to a delay in the child’s intellectual and emotional development.

1. Biological factors(non-severe organic damage to the central nervous system of a local nature and their residual effects) cause disruption of the maturation of various parts of the brain, which is accompanied by partial disturbances in the mental development and activity of the child. Among the biological causes that act in the perinatal period and cause mental retardation are: highest value have:

• pathology of pregnancy (severe toxicosis, Rh conflict, fetal hypoxia, etc.), intrauterine infections, intracranial birth injuries, prematurity, kernicterus of newborns, FAS, etc., leading to the so-called perinatal encephalopathy.
• severe somatic diseases of the child (hypotrophy, influenza, neuroinfections, rickets), traumatic brain injuries, epilepsy and epileptic encephalopathy, etc., arising in the postnatal period and early childhood.
• ZPR sometimes has a hereditary nature and in some families it is diagnosed from generation to generation.

2. Social factors. Mental retardation can occur under the influence of environmental (social) factors, which, however, does not exclude the presence of an initial organic basis for the disorder. Most often, children with mental retardation grow up in conditions of hypo-care (neglect) or hyper-care, authoritarian upbringing, social deprivation, and lack of communication with peers and adults.

Secondary mental retardation can develop when early disorders hearing and vision, speech defects due to severe deficits in sensory information and communication.

Classification

The group of children with mental retardation is heterogeneous. In special psychology, many classifications of mental retardation have been proposed. Let's consider the etiopathogenetic classification proposed by K. S. Lebedinskaya, which identifies 4 clinical types of mental retardation.

1. ZPR of constitutional origin due to slower maturation of the central nervous system. Characterized by harmonious mental and psychophysical infantilism. With mental infantilism, the child behaves like a younger person; with psycho-physical infantilism, the emotional-volitional sphere and physical development suffer. Anthropometric data and behavior of such children do not correspond to their chronological age. They are emotionally labile, spontaneous, and have insufficient attention and memory. Even at school age, their gaming interests predominate.
2. ZPR of somatogenic origin is caused by severe and long-term somatic diseases of the child at an early age, which inevitably delay the maturation and development of the central nervous system. The history of children with somatogenic mental retardation often includes bronchial asthma, chronic dyspepsia, cardiovascular and renal failure, pneumonia, etc. Usually such children for a long time are treated in hospitals, which in addition causes sensory deprivation. ZPR of somatogenic genesis is manifested by asthenic syndrome, low performance of the child, less memory, superficial attention, poorly developed activity skills, hyperactivity or lethargy due to overwork.
3. ZPR of psychogenic origin is caused by unfavorable social conditions in which the child lives (neglect, overprotection, abuse). Lack of attention to the child creates mental instability, impulsiveness, and retardation in intellectual development. Excessive care fosters in a child lack of initiative, egocentrism, lack of will, and lack of purposefulness.
4. ZPR of cerebral-organic origin occurs most often. Caused by primary non-rough organic damage brain. In this case, disorders may affect individual areas of the psyche or manifest themselves mosaically in different mental areas. Delayed mental development of cerebral-organic origin is characterized by immaturity of the emotional-volitional sphere and cognitive activity: lack of liveliness and brightness of emotions, low level claims, pronounced suggestibility, poverty of imagination, motor disinhibition, etc.

Characteristics of children with mental retardation

Intellectual sphere

Emotional sphere

The personal sphere in children with mental retardation is characterized by emotional lability, easy mood swings, suggestibility, lack of initiative, lack of will, and immaturity of the personality as a whole. Affective reactions, aggressiveness, conflict, and increased anxiety may be observed. Children with mental retardation are often withdrawn, prefer to play alone, and do not seek contact with peers. The play activities of children with mental retardation are characterized by monotony and stereotyping, lack of a detailed plot, lack of imagination, and non-compliance with game rules. Features of motor skills include motor clumsiness, lack of coordination, and often hyperkinesis and tics.

A feature of mental retardation is that compensation and reversibility of disorders are possible only under conditions of special training and education.

Diagnostics

Mental retardation can only be diagnosed as a result of a comprehensive examination of the child by a psychological-medical-pedagogical commission (PMPC) consisting of a child psychologist, speech therapist, speech pathologist, pediatrician, child neurologist, psychiatrist, etc. In this case, the following is performed:

• collection and study of anamnesis, analysis of living conditions;
• studying the child’s medical records;
• conversation with the child, study of intellectual processes and emotional-volitional qualities.

Based on information about the child’s development, members of the PMPC make a conclusion about the presence of mental retardation and give recommendations on organizing the upbringing and education of the child in special educational institutions.

In order to identify the organic substrate of mental development delay, the child needs to be examined by medical specialists, primarily a pediatrician and a pediatric neurologist. Instrumental diagnostics may include conducting an EEG, CT and MRI of the child’s brain, etc. Differential diagnosis mental retardation should be carried out with mental retardation and autism.

Correction of mental retardation

Working with children with mental retardation requires a multidisciplinary approach and the active participation of pediatricians, child neurologists, child psychologists, psychiatrists, speech therapists, and speech pathologists. Correction of mental retardation should begin with preschool age and lasts for a long time.

Children with mental retardation must attend specialized preschool educational institutions (or groups), Type VII schools or correctional classes in general education schools. Peculiarities of teaching children with mental retardation include dosage educational material, reliance on visibility, repeated repetition, frequent change of activities, use of health-saving technologies.

When working with such children, special attention is paid to the development of:

• cognitive processes (perception, attention, memory, thinking);
• emotional, sensory and motor spheres with the help of fairy tale therapy.
• correction of speech disorders within individual and group speech therapy sessions.

Together with teachers, correctional work on teaching students with mental retardation is carried out by special education teachers, psychologists, and social educators. Health care children with mental retardation includes drug therapy in accordance with the identified somatic and cerebral-organic disorders, physiotherapy, exercise therapy, massage, hydrotherapy.

Prognosis and prevention

The lag in the rate of mental development of a child from age norms can and must be overcome. Children with mental retardation are teachable even with properly organized correctional work There is a positive trend in their development. With the help of teachers, they are able to acquire knowledge, skills and abilities that their normally developing peers master on their own. After graduating from school, they can continue their education at vocational schools, colleges and even universities.

Prevention of mental retardation in a child involves careful pregnancy planning, avoidance of adverse effects on the fetus, prevention of infectious and somatic diseases in young children, providing favorable conditions for education and development. If a child is lagging behind in psychomotor development, an immediate examination by specialists and the organization of corrective work are necessary.