Child mental retardation: diagnosis, correction, treatment. Delayed psychomotor development, motor development

Causes of mental retardation

Biological

• pathology of pregnancy - severe toxicosis, intrauterine hypoxia, infection, intoxication;
• prematurity;
• asphyxia and trauma during childbirth;
• diseases of an infectious, toxic and traumatic nature in the early stages of child development;
• genetic conditioning.

Social

• long-term restriction of a child’s life activity;
• unfavorable upbringing conditions, frequent traumatic situations in a child’s life.

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 most often are:

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

Diagnosis of mental retardation

Mental retardation can only be diagnosed as a result of a comprehensive examination of the child by a child psychologist, speech therapist, speech pathologist, pediatrician, child neurologist, or psychiatrist. Diagnostics may also include EEG, CT and MRI studies of the brain. Based on the diagnosis and information about the child’s development, doctors make a conclusion about the presence of mental retardation, give recommendations for treatment and organization of the child’s upbringing and education.

Forecasts and consequences: what to expect?

The effectiveness of treatment depends on many factors. The main ones are the age of the small patient, the severity of the delay in the child’s mental speech development and primary diseases.

Unfortunately, with deep-seated disorders or therapy started in 5-6 year old children, one cannot expect great results. Only in 0.2% of cases out of 100% is it possible that he will start talking. If a child has not mastered speech at the age of 7, he will never speak again.

If the parents turned for help when the baby was 2–3 years old, then there is every chance of a full recovery. In this case, everything depends on the degree of underdevelopment, the participation of parents and the methods used for treatment.

If parents expect that the child will speak on his own sooner or later, they are only wasting time. If this is not the individual pace of development of a particular baby, but really a problem, it will not go away on its own. Against the background of mental and speech underdevelopment, children suffer from poor memory and thinking, perceive and process information distortedly, and cannot concentrate attention. In the future, this leads to changes in personality - the child becomes irritable, closed, uncommunicative, and develops a feeling of inferiority.

Forecast for treatment of mental retardation (MDD)

Children with mental retardation need medication, physiotherapy and correctional treatment. The use of transcranial micropolarization together with the method of bioacoustic correction in combination in the treatment of mental retardation enhances the effect of physiotherapeutic treatment and corrective exercises. Treatment at our medical center helps reduce the gap between a child and his peers and improve his social adaptation.

Children with mental retardation are teachable, and with properly organized correctional work, positive dynamics are observed 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 planning of pregnancy, avoidance of adverse effects on the fetus, prevention of infectious and somatic diseases in young children, and provision of favorable conditions for upbringing and development. If a child is lagging behind in psychomotor development, an immediate examination by specialists and the organization of corrective work are necessary.

Delayed speech development (SDD)

Speech is unique to humans and is the basis of overall development. It is this that is recognized as the leading indicator of how a child perceives the world around him and reflects his readiness to interact with it. Therefore, the occurrence of its violations is a reason for immediate action. But we must not forget that each child develops at his own pace and you should not look for problems where there are none.

The criterion for assessing the degree of speech development can be considered generally accepted norms developed for each age, i.e. the minimum, the presence of which is an indicator of normal development. If parents notice that the baby’s speech does not reach the norm in many respects, they should definitely make an appointment for a consultation with a specialist. But it is extremely rare that speech development delay occurs in isolation. This is usually accompanied by a lag in mental development, i.e. the child is diagnosed with psychospeech developmental delay (PSRD).

In most cases, speech delays in children are detected before the age of 4 years.

When correcting disorders of psycho-speech development, applied behavior analysis or ABA therapy is also used. The point is that any behavior of a child leads to certain consequences. By influencing these consequences it is possible to correct the child’s behavior.

ZRR can occur as a result of:

• damage to the central nervous system: aphasia - a violation of already formed speech, which is observed with brain damage (not only the speaking function may suffer, but also understanding the speech of another person);

• alalia – complete absence or severe underdevelopment of speech;

• dysarthria - incorrect pronunciation or difficulty pronouncing certain sounds and letters.

• mutism – lack of response to questions addressed to the child, although the ability to speak and understand others is preserved;

• Sudromutism is a functional, i.e., reversible loss of speech.

• mechanical dysplasia - changes in the structure of organs involved in the pronunciation of sounds.

Very often it is not possible to fully determine which factor caused the delay in speech development. However, today it is believed that RRD can be caused by:

• birth injuries of various kinds;
• pregnancy pathologies;
• diseases of the brain, including developmental anomalies, ischemic events, leukodystrophy, tumors;
• hearing impairment;
• head injuries;
• disorders of the development of facial and oral muscles.

Not the least role in the occurrence of mental retardation is played by heredity and mental disorders. Sometimes the reasons for speech problems lie in psychological pressure on the child and gross mistakes in upbringing. But in any case, the problem should be dealt with and measures should be taken to resolve it as quickly as possible. Otherwise, delayed speech development may cause problems in the child’s communication with peers, not to mention poor performance at school and problems with future employment.

When to see a doctor

The following signs should be considered as a reason to contact a specialist:

• lack of an emotional reaction to what is happening around in the 4th month of life, in particular, the child does not smile at his parents, does not perk up when they appear, etc.;
• does not coo and does not try to make repeated sounds like “ba-ba-ba” at 8-9 months and generally gives the impression of being quiet;
• difficulty chewing at 18 months, which may result in the child choking when trying to eat a piece of apple;
• the child does not speak simple words at 1.5 years old or does not try to learn new ones at 2 years old if he has managed to master several simple ones;
• a child’s active vocabulary at 2.5 years is less than 20 words, he cannot name parts of the body or familiar objects, and cannot form phrases of 2 or more words;
• at 3 years old he speaks completely unintelligibly even for his parents, cannot construct a sentence of several words, does not understand simple stories, explanations from parents, or speaks very slowly, stretching out the endings of words, or, on the contrary, speaks too quickly, swallowing endings; sometimes children with developmental disabilities cannot construct sentences on their own, and express themselves using phrases from cartoons heard from adults.

With psychospeech developmental delay, children usually have an infantile appearance and poorly developed muscles. They are little emotional, have memory and thinking disorders, have weak imagination and tend to perform monotonous actions. Since all mental processes proceed slowly, which makes it difficult for children with mental retardation to switch from one thought to another.

CPRD is often combined with cerebral palsy.

Diagnostics of ZRR

To effectively influence a problem, you need to determine its cause and severity. For these purposes, a complex of studies is carried out, including:

• assessment of the level of speech development and the degree of deviation from the norm;
• examination by an otolaryngologist and a hearing test by an audiologist;
• tests aimed at assessing the degree of speech understanding;
• psychological tests and analysis of the nature of interaction between adults and children;
• CT;
• MRI;
• EEG;
• electromyography;
• Ultrasound with Doppler of the brain, etc.

However, it is often not possible to accurately determine the cause of RRD. In such situations, the nature of therapy is based only on the nature of existing deviations from the norm and complex treatment is carried out aimed at improving the functioning of the nervous system.

Treatment of ZRR

The earlier a delay in speech development is detected, the easier and more productive the correction will be and the child will have a greater chance of full recovery. In all cases, therapy is complex, but it is always developed individually in accordance with the nature of the problems detected.

Components of treatment for speech delay may include:

• Drug therapy - specific drugs and their dosages are selected based on the diagnosis and age of the child by a neurologist and sometimes a psychiatrist. The main goal of drug treatment in most cases is to stimulate and ensure normal nutrition of brain cells. Therefore, complex vitamin preparations, amino acids and others are usually prescribed.
• Physiotherapy – the main types of physical influence indicated for cerebral renal development are magnetotherapy and reflexology. With their help, it is possible to activate the work of the relevant parts of the brain and improve the quality of speech. In particular, magnetic therapy sessions contribute to the formation of new functional connections.
• Work with a speech pathologist and speech therapist - classes are always conducted individually and are aimed at eliminating speech deficiencies. They are organized in a playful way, which allows the child to perceive them not as an element of treatment, but as a pleasant pastime. As part of working with a speech therapist, a special massage is performed, the nature of which depends on the pronunciation of which sounds are affected.

Hippotherapy, dolphin therapy and other similar types of work with animals are indicated for children with developmental delays.

A very effective way to overcome the problem of RDD is manual therapy with elements of osteopathy.

Classification and symptoms of delay

There are different options for classifying mental retardation, but experts often resort to the Lebedinskaya classification.

What types of ZPR exist:

1. Psychogenic. The main reason is raising a child in negative conditions.
2. Somatogenic. The reason is insufficient development of the central nervous system, which was a consequence of diseases suffered at an early age. If a child is in the hospital for a long period of time, there is no communication with peers, which also causes communication problems. Such children are inhibited and fearful, have insufficient memory capacity, and are hyperactive.
3. Constitutional. The processes of development of the central nervous system slow down, as a result of which gaming activity significantly prevails over cognitive activity. The child’s behavior no longer corresponds to his age, inattention develops, and memory deteriorates.
4. Cerebral-organic. The type of ZPR that occurs most often. The main reason is primary organic brain damage. Children with this type of mental retardation are often inhibited, they lack lively emotions, and their imagination is poor.