Special child, special approach. Mild mental retardation in children Mental retardation in children symptoms in 4

Mental retardation in children, which begins to show symptoms around the age of 3.5 years, can be caused by various causes. The factors for the occurrence of the pathology of intellectual development are diverse, but most often these are:

Organic brain damage during childbirth.
Cerebral palsy.
Genetic metabolic disorders.
Down syndrome (translocation or trisomy of 21 pairs of chromosomes).
Neuroinfection, resulting in extensive damage to neurons (neurosyphilis, tuberculous meningitis, viral encephalitis).
Intoxication with heavy metals and other foreign substances, especially at an early age.
Hydrocephalus.
Endocrinopathy (dysfunction of the thyroid gland).
Rubivirus infection during pregnancy (rubella).
Coma states caused by prolonged hypoxia of the brain.

With microcephaly, a malformation of intrauterine development, the volume of the brain is reduced, and, accordingly, the number of neurons and connections between them is reduced. Hydrocephalus is swelling of the brain, accompanied by an increase in pressure inside the skull. Hydrostatic pressure damages neurons and can also lead to mental retardation. Past infections of the central nervous system in some cases, affect the mental abilities of the child.

signs

Signs of mental retardation in children are a weak ability to learn, as well as the absence or weakening of the child's reaction to the words of parents, memory loss, logical thinking. Building connections between events in life is broken.

The perception of information is difficult, which is associated with a violation of the processes of memorization, short-term and long-term memory. Speech, behavioral and hygiene skills are underdeveloped. By school age, it is extremely difficult to master the skills of reading, counting, and writing.

There is a lag in mental development, the course of which can progress, regress or be stable. The emotional sphere in young patients, as a rule, is not affected, children are able to experience both negative and positive emotions. The ability to self-care depends on the degree of mental deficiency of the individual child. There are several degrees of mental disorders.

Mild degree of mental retardation

Mild degree of mental retardation (code F70 according to ICD-10). Such children are characterized by preserved learning ability, but reduced memory potential compared to healthy children. A child with a mild degree of mental retardation may misjudge the actions and feelings of others, making the illness similar to Asperger's syndrome.

Children experience problems in social skills (communication, games with other children) and feel inferior, they are dependent on their parents. The right approach teacher in teaching such a child will improve the prognosis of the disease. Mild mental retardation, the symptoms of which do not interfere with self-service learning, can be corrected in special schools of the 8th type.

As a result, growing children, when they reach adulthood, are capable of working and mastering the simplest skills of housekeeping and writing. They have access to physical labor and monotonous work without the need to make decisions. Upon reaching the age of 18, the state provides such patients with housing.

moderate mental retardation

Moderate mental retardation (ICD-10 F71) is characterized by less independence from the help of other people than mild mental retardation. However, social skills, when appropriately adjusted, are also instilled, although children remain dependent on parents and guardians.

In adulthood, they are capable of work, mainly physical, which does not require complex coordination of actions. Signs of mental retardation in adult patients: some inhibition of thought processes, slowness in movements, lack of critical thinking.

Severe retardation

In severe cases (ICD code: F72), the patient's speech is limited to a couple of dozen words to express their own needs. There are also movement disorders, gait is discoordinated. The process of memorizing surrounding objects is difficult and requires repeated repetition. The skills of counting visible objects are instilled. Upon reaching adulthood, people are not able to fully take responsibility for themselves and need care provided by neuropsychiatric boarding schools.

Profound mental impairment (F73) may present with severe motor impairment. Patients lag behind in physical development, their speech is not formed. Children often suffer from enuresis. In adulthood, care for such patients is carried out by psycho-neurological boarding schools.

Diagnostics

Mental retardation, the symptoms of which are similar to those of other diseases of the psycho-intellectual sphere, needs differential diagnosis with such diseases as:

Asperger's syndrome;
socio-pedagogical neglect (Mowgli's syndrome) and intense psychotrauma;
hepatic encephalopathy.

How to determine mental retardation in a child? Psychoneurologists use various methods to test a child's intellectual abilities: an assessment of everyday skills, social adaptation. The history of pregnancy (, rubella in the mother), past neuroinfections, traumatic brain injuries are being studied.

A test for mental retardation (IQ) is carried out, which determines the intelligence quotient in points. An assessment is made of the child's perception of artistic images in the pictures, the ability to learn, incl. to counting and speech, the state of mental development of the child. The degree of coordination of movements is analyzed.

How does a child with mental retardation develop? How do psychiatrists diagnose this? What signs of mental retardation can people with different degrees of it show? A psychiatrist describes in detail the history of a patient with mental retardation in a popular book on various mental disorders.

He always smiled. Even when he was in pain, when he was sad, the smile never left his face. Sometimes it was a frightened smile, sometimes a guilty one. Strange, but the same guilt was in the smile when he got a stomach ache, and we sent him to surgery for appendicitis. As if he was asking her forgiveness for taking our time. Although it is unlikely that he fully understood what this word - "time" means.

He did not have a flat nose bridge and slanting eyes, and there were no other special signs of a chromosomal disease in him. Yes, it was intrauterine. He was born in the seventh month of pregnancy, and for almost two months the doctors fought for his life.

There is another form of intellectual development disorders - pedagogical neglect. It occurs against the background of full-fledged biological capabilities of the brain, but the lack of sufficient education and socialization. Such manifestations can occur in dysfunctional families leading a marginal, antisocial lifestyle.

In our clinical example, the patient had near-moderate mental retardation, which worsened after his injury. He did not have any outward manifestations of frustration, except for the prevailing smile on his face. Most likely, this is due to an indefinite adverse effect at the stage of prenatal development or genetic disorders that did not affect the functions of other organs and systems.

When exposed to additional harmful factors, such as traumatic brain injury, the degree of intellectual defect may be aggravated. There may be an improvement - with good care and upbringing, patients with a mild degree of mental retardation are adapted to lead a full-fledged social life: they start families, work and are practically indistinguishable from other people. Severe and profound mental retardation, unfortunately, is difficult to correct, and such patients need help and care from other people.

Mild mental retardation in children is a congenital or acquired in early childhood state of mental retardation or underdevelopment, the central defect of which is a decrease in intellectual functions.

Causes of mild mental retardation in children

The cause of any mental retardation is brain damage. The grossest structural defects manifest themselves in the underdevelopment of the brain.

The main reasons for the development of mental retardation in children can be grouped into main groups:

Heredity (gene and chromosomal diseases). This group includes: various syndromes(for example, Down, Turner); forms associated with hereditary disorders metabolic processes, neurological diseases;
Exposure to harmful factors during fetal development: intrauterine infections (for example, rubella, toxoplasmosis, etc.), intoxication (alcohol intake, toxic substances for the fetus), fetal hemolytic disease, etc .;
Factors, the impact of which took place during childbirth or at an early age (birth trauma, oxygen starvation, trauma, infection);
Pedagogical neglect, arising against the background of the full-fledged possibilities of the brain, but in the absence of a full-fledged upbringing and socialization;
The presence of several causes at once, mixed conditions.

Mental retardation in children under 3 years of age, symptoms andpsychological characteristics of children with mental retardation

The diagnosis of mental retardation in children can be made officially no earlier than 7 years. However, it is important to understand that there is mild symptoms mental retardation in children, which can be suspected of its presence in early childhood, up to 3 years.

Mild mental retardation in children, signs:

The child lags behind in motor development: he begins to hold his head, sit down, stand up, walk late. The baby may have a grasping reflex, and at 1-1.5 years old, the child still does not hold objects (toys, a spoon and a fork);
Speech is absent or appears very late; the child has difficulty in constructing a phrase, coherent speech. At 2-3 years old, the baby does not understand well the speech addressed to him, cannot follow elementary instructions;
Mild mental retardation in children is characterized by an imbalance in the processes of nervous excitation and inhibition; This is expressed in excessive impulsiveness, incontinence, excitability, irritability, or, conversely, lethargy and slowness;
The child does not show interest in the world around him, seems closed in himself; His emotional-volitional sphere is "depleted";
Missing story game. Games are primitive in content, toys may not interest the child or he uses them for other purposes.

Diagnosis of mild mental retardation in children

The diagnosis of mental retardation is based on the establishment of a mental defect, the main place in which is the underdevelopment of intellectual and higher mental functions, as well as the absence of signs of progression of underdevelopment.

In order to determine the severity of a mental defect and its leading link, special psychological methods for assessing intelligence are used. Neuropsychological diagnostics is also carried out, which helps not only to determine the level of development of the higher mental functions of a child with mental retardation, but also to see its actual and potential capabilities (those strengths that it will be possible to rely on in the correction and treatment of mental retardation).

A mild degree of mental retardation must be distinguished from diagnoses caused by mental illness (for example, schizophrenia) and severe pedagogical neglect.

Features of mental development and thinking in children with mental retardation

Any child with mental retardation differs from another with the same diagnosis, due to the fact that each has its own characteristics of the brain, immaturity or deficiency of its structures and departments, as well as intact links.

L.S. Vygotsky believed that the primary defect of mental retardation is inertia, stiffness of the main nervous processes, as well as the weakness of orienting activity, which underlies the child's reduced activity and lack of interest in the world around him. The secondary defect is the underdevelopment of higher mental functions. In turn, when a child enters the conditions of an inadequate teaching and upbringing environment, there are opportunities for the development of a defect of the tertiary level, namely, behavioral disorders and features of the emotional-volitional sphere.
In addition, the following features can be distinguished:

Most authors argue that cognitive disorders in such children are in the difficulties of forming concepts and generalizations, difficulty in abstract thinking;
A child with mental retardation is poorly taught, it is difficult for him to perceive any new information;
As the child grows older, poverty of outlook, superficiality of thinking joins all of the above.

Treatment and correction of children with mild mental retardation. Features of teaching children with mental retardation

Correction of children with mild mental retardation is carried out on the basis of the leading defect (associated with a violation of various analyzers, with frontal insufficiency, with psychopathic behavior, etc.) and in several areas:

Neurocorrectional help. A well-designed program, taking into account the neuropsychological characteristics of the child, his strengths, "resource" sides, can help in the development of:

motor and coordinating skills, fine motor skills;
the development of stable interhemispheric connections, an increase in the speed of processing sensory information;
hand-eye coordination, eye muscle strengthening and eye tracking (which is important, in particular, for the formation of writing and reading skills);
expanding the fields of vision, the formation of spatial perception, the development of thinking functions, which is necessary for the assimilation of mathematics, the ability to build logical and grammatical structures, coherent speech;
development of self-regulation, arbitrariness, attention, reduction of exhaustion;
formation of opportunities for "braking" undesirable behavior;
improving the perception of non-speech noises, speech itself, the ability to distinguish between tempo-rhythmic patterns: that is, auditory perception;

Specialized training program in kindergarten and school. Children with a mild degree of mental retardation are capable of mastering special programs based on concrete-visual learning, which is carried out at a slow pace, as well as the ability to master simple labor skills.
Additionally, the help of a defectologist (development of social skills, self-service, thinking), a speech therapist, and a neurologist may be required.

Prognosis for a child with mild mental retardation

The prognosis of children with mild mental retardation depends on the degree of damage or immaturity of the brain, on the type of leading defect.