home All hormones The leading sign of mental retardation is. Mental retardation (oligophrenia). Treatment, correction and education of children. Rehabilitation and prognosis. Finger gymnastics for the development of fine motor skills

The leading sign of mental retardation is. Mental retardation (oligophrenia). Treatment, correction and education of children. Rehabilitation and prognosis. Finger gymnastics for the development of fine motor skills

Mild mental retardation in children is a congenital or acquired in early childhood condition 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 damage to the brain. The most severe structural defects manifest themselves in underdevelopment of the brain.

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

Heredity (gene and chromosomal diseases). This group includes: various syndromes (for example, Down, Turner); forms associated with hereditary metabolic disorders, neurological diseases;
Exposure to harmful factors during intrauterine development: intrauterine infections (for example, rubella, toxoplasmosis, etc.), intoxication (alcohol intake, substances toxic to the fetus), hemolytic disease of the fetus, etc.;
Factors that were exposed during childbirth or at an early age (birth injuries, oxygen deprivation, trauma, infections);
Pedagogical neglect, which arises against the background of full-fledged brain function, but in the absence of full-fledged education and socialization;
The presence of several causes at once, mixed states.

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 officially made no earlier than 7 years of age. However, it is important to understand that there are symptoms of mild mental retardation in children, which can be used to suspect 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 up, sit down, stand up, and walk late. The baby's grasping reflex may be impaired, and at 1-1.5 years the child still does not hold objects (toys, spoon and fork);
Speech is absent or appears very late; the child has difficulty constructing phrases and coherent speech. At 2-3 years old, the baby poorly understands speech addressed to him and cannot follow basic 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, lack of restraint, excitability, irritability or, conversely, lethargy and slowness;
The child shows no interest in the world around him and seems withdrawn; His emotional-volitional sphere is “impoverished”;
There is no story game. The games are primitive in content, the toys may not be of interest to the child or he may not use them for their intended purpose.

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 occupied by 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 are also carried out, which helps not only to determine the level of development of higher mental functions of a child with mental retardation, but also to see his current and potential capabilities (those strengths that can be relied upon in the correction and treatment of mental retardation).

Mild 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 is different from another with the same diagnosis, due to the fact that each has its own characteristics of brain function, immaturity or deficiency of its structures and sections, 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 weakness of orienting activity, which underlies the child’s reduced activity and lack of interest in the world around him. A secondary defect is underdevelopment of higher mental functions. In turn, when a child finds himself in conditions of an inadequate teaching and educational environment, opportunities arise for the development of a tertiary level defect, namely, behavioral disorders and characteristics of the emotional-volitional sphere.
In addition, the following features can be highlighted:

Most authors prove that cognitive disorders in such children consist of difficulties in 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 up, all of the above is accompanied by a poverty of outlook and superficiality of thinking.

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 based on the leading defect (associated with impairment of various analyzers, frontal insufficiency, psychopathic behavior, etc.) and in several areas:

Neurocorrectional assistance. A well-structured program, taking into account the neuropsychological characteristics of the child, his strengths and “resource” sides, can help in the development of:

motor and coordination skills, fine motor skills;
development of stable interhemispheric connections, increasing the speed of processing sensory information;
visual-motor coordination, hand-eye communication, strengthening of the eye muscles and tracking eye movements (which is important, in particular, for the development of writing and reading skills);
expansion of visual fields, formation of spatial perception, development of thinking functions, which is necessary for mastering mathematics, the ability to build logical and grammatical structures, and coherent speech;
development of self-regulation, volition, attention, reduction of exhaustion;
creating opportunities to “inhibit” unwanted behavior;
improving the perception of non-speech noises, speech itself, the ability to distinguish tempo-rhythmic patterns: that is, auditory perception;

Specialized training program in kindergarten and school. Children with mild 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 work skills.
Additionally, you may need the help of a speech pathologist (development of social skills, self-care, thinking), speech therapist, or neurologist.

Prognosis of 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, and on the type of leading defect.

Mental retardation in children, the symptoms of which begin to appear around the age of 3.5 years, can be caused by various reasons. The factors causing the pathology of intellectual development are varied, but most often they are:

Organic brain damage during childbirth.
Cerebral palsy.
Genetic metabolic disorders.
Down syndrome (translocation or trisomy 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.
Endocrinopathies (dysfunction of the thyroid gland).
Rubivirus infection during pregnancy (rubella).
Comatose states caused by prolonged brain hypoxia.

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 increased pressure inside the skull. Hydrostatic pressure damages neurons and can also lead to mental retardation. In some cases, past infections of the central nervous system affect the child’s mental abilities.

Signs

Signs of mental retardation in children include a weak ability to learn, as well as the absence or weakening of the child’s reaction to the words of the parents, decreased memory, and logical thinking. The construction of connections between events in life is disrupted.

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 reading, counting, and writing skills.

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 intellectual disability of the individual child. There are several degrees of mental impairment.

Mild mental retardation

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

Children experience problems in social skills (communication, playing with other children) and feel inferior; they are dependent on their parents. The correct approach of the 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-care learning, can be corrected in type 8 special schools.

As a result, growing children, upon reaching 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 their 18th birthday, the state provides such patients with housing.

Moderate mental retardation

Moderate mental retardation (F71 according to ICD-10) is characterized by less independence from the help of other people than with a mild degree. However, social skills, with appropriate adjustments, 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 degree of retardation

In severe cases (ICD code: F72), the patient’s speech is limited to a couple of dozen words to express his own needs. There are also motor disturbances, and the gait is uncoordinated. 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 psychoneurological boarding schools.

Profound mental disability (F73) may manifest as severe motor impairment. Patients are lagging behind in physical development, their speech is not formed. Children often suffer from enuresis. In adulthood, the care of such patients is provided by psychoneurological boarding schools.

Diagnostics

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

Asperger's syndrome;
sociopedagogical neglect (Mowgli syndrome) and intense psychotrauma;
hepatic encephalopathy.

How to determine mental retardation in a child? Neuropsychiatric doctors use various methods to test a child’s intellectual abilities: assessment of everyday skills, social adaptation. Anamnesis of pregnancy (maternal rubella), previous neuroinfections, and traumatic brain injuries is studied.

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

Treatment and correction of mental retardation ( how to treat oligophrenia?)

Rehabilitation and socialization of children with mental retardation - ( video)

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases must be carried out under the supervision of a specialist. All drugs have contraindications. Consultation with a specialist is required!

Features of a child and adolescent with mental retardation ( manifestations, symptoms, signs)

For children with mental retardation ( oligophrenia) characterized by similar manifestations and signs ( disorders of attention, memory, thinking, behavior, etc.). At the same time, the severity of these disorders directly depends on the degree of mental retardation.

For mentally retarded children it is typical:

thinking disorder;
impaired concentration;
cognitive impairment;

speech disorders;
communication problems;
visual impairment;
hearing impairment;
sensory development disorders;
memory impairment;
movement disorders ( motor disorders);
mental disorders;
behavioral disorders;
disturbances of the emotional-volitional sphere.

Disorders of mental development and thinking, intellectual impairments ( main violation)

Impaired mental development is the main symptom of mental retardation. This manifests itself in the inability to think normally, make the right decisions, draw conclusions from the information received, and so on.

Impairments of mental development and thinking in oligophrenia are characterized by:

Cognitive disorders

Children with mild mental retardation are characterized by a decrease in interest in the objects, things and events around them. They do not strive to learn something new, and when learning they quickly forget what they have received ( read, heard) information. At the same time, properly conducted classes and special training programs allow them to learn simple professions. With moderate and severe mental retardation, children can solve simple problems, but they remember new information extremely difficult and only if they are taught for a long time. They themselves do not show any initiative to learn something new.

Impaired concentration

All children with mental retardation experience a decrease in the ability to concentrate, which is caused by impaired brain activity.

With a mild degree of mental retardation, it is difficult for a child to sit still and do the same thing for a long time ( for example, they cannot read a book for several minutes at a time, and after reading they cannot retell what the book was about). At the same time, an absolutely opposite phenomenon may be observed - when studying any subject ( situations) the child excessively concentrates attention on its smallest details, without appreciating the subject ( situation) generally.

With moderate mental retardation, it is extremely difficult to attract the child’s attention. If this can be done, after a few seconds the child is distracted again, switching to another activity. In severe forms of the disease, it is not possible to attract the patient’s attention at all ( Only in exceptional cases can a child react to any bright objects or loud, unusual sounds).

Speech impairment/underdevelopment and communication problems

Speech disorders may be associated with functional underdevelopment of the brain ( which is typical for a mild form of the disease). At the same time, with moderate and profound oligophrenia, organic damage to the speech apparatus may be observed, which will also create certain problems in communication.

Speech impairment in children with mental retardation is characterized by:

Mute. In mild forms of the disease, complete muteness is relatively rare, usually in the absence of the necessary correctional programs and activities. With imbecility ( moderately severe oligophrenia) muteness may be associated with damage to the speech apparatus or hearing impairment ( if a child is deaf, he will also not be able to learn words and pronounce them). With severe mental retardation, children usually cannot speak. Instead of words, they utter incomprehensible sounds. Even if they manage to learn a few words, they are not able to use them correctly.
Dyslalia. It is characterized by a speech disorder consisting of incorrect pronunciation of sounds. At the same time, children may not pronounce some sounds at all.
Stuttering. Characteristic of oligophrenia of mild to moderate severity.
Lack of expressive speech. In mild forms of the disease, this deficiency can be eliminated through exercise, while in more severe forms this cannot be done.
Impaired speech volume control. This can occur with hearing impairment. Normally, when a person speaks and hears his speech, he automatically controls its volume. If an oligophrenic does not hear the words he speaks, his speech will be too loud.
Difficulties in constructing long phrases. Having started to say one thing, a child can immediately switch to another phenomenon or object, as a result of which his speech will be meaningless and incomprehensible to others.

Visual impairment

In mild and moderate forms of the disease, the visual analyzer is usually developed normally. At the same time, due to impaired thought processes, the child may not distinguish between certain colors ( for example, if he is asked to choose yellow pictures among pictures of other colors, he will distinguish yellow from the rest, but it will be difficult for him to complete the task).

Severe visual impairments can be observed with deep mental retardation, which is often combined with defects in the development of the visual analyzer. In this case, the child may not distinguish colors, see objects distorted, or be completely blind.

It is also worth noting that visual impairment ( strabismus, blindness and so on) may be associated with an underlying disease that causes mental retardation ( for example, with hereditary Bardet-Biedl syndrome, in which children may be born blind).

Are there hallucinations in mental retardation?

Hallucinations are non-existent images, images, sounds or sensations that the patient sees, hears or feels. To him they seem realistic and believable, although in reality they are not.

The development of hallucinations is not typical for the classic course of mental retardation. At the same time, when oligophrenia is combined with schizophrenia, signs characteristic of the latter disease may appear, including hallucinations. Also, this symptom can be observed during psychosis, with severe mental or physical fatigue and with the use of any toxic substances ( alcoholic drinks, drugs) even in minimal quantities. The latter phenomenon is due to the inadequate development of the central nervous system and the brain in particular, as a result of which even an insignificant amount of alcohol can cause visual hallucinations and other mental disorders in the patient.

Hearing impairment ( deaf children with mental retardation)

Hearing disorders can be observed with any degree of mental retardation. The reason for this may be organic damage to the hearing aid ( for example, with congenital developmental anomalies, which is typical for children with severe mental retardation). Also, damage to the auditory analyzer can be observed with hemolytic disease of the newborn, with some genetic syndromes, and so on.

The development and learning of a deaf, mentally retarded child proceeds even more slowly, since he cannot perceive the speech of the people around him. With complete deafness, children, as a rule, cannot speak ( without hearing speech, they cannot repeat it), as a result of which, even with a mild form of the disease, they express their emotions and feelings only with a kind of mooing and screaming. With partial deafness or deafness in one ear, children can learn to speak, but during a conversation they may pronounce words incorrectly or speak too loudly, which is also associated with the inferiority of the auditory analyzer.

Sensory developmental disorders

Sensory development is the child’s ability to perceive the world around him using various senses ( primarily sight and touch). It has been scientifically proven that the majority of mentally retarded children are characterized by impairments of these functions of varying degrees of severity.

Sensory developmental disorders may manifest themselves as:

Slow visual perception. To evaluate an object seen ( understand what it is, why it is needed, and so on), a mentally retarded child needs several times more time than a normal person.
Narrowness of visual perception. Normally, older children can simultaneously perceive ( notice) up to 12 items. At the same time, patients with oligophrenia can perceive no more than 4–6 objects at the same time.
Violation of color perception. Children may not be able to distinguish between colors or shades of the same color.
Impaired sense of touch. If you close your child's eyes and give him a familiar object ( for example, his personal cup), he can easily recognize her. At the same time, if you give the same cup, but made of wood or other material, the child will not always be able to accurately answer what he has in his hands.

Memory disorders

In a healthy person, after several repetitions of the same material, certain connections are formed between the nerve cells of the brain ( synapses), which allows him to remember the information received for a long time. With mild mental retardation, the rate of formation of these synapses is impaired ( slows down), as a result of which the child must repeat certain information much longer ( more times) to remember it. At the same time, when you stop studying, the memorized data is quickly forgotten or may be distorted ( the child incorrectly retells information read or heard).

With moderate oligophrenia, the listed disorders are more pronounced. The child has difficulty remembering the information received, and when reproducing it, he may become confused about dates and other data. At the same time, with deep oligophrenia, the patient’s memory is extremely poorly developed. He can recognize the faces of those closest to him, can respond to his name or ( rarely) learn a few words, although he does not understand their meaning.

Movement disorders ( motor disorders)

Impairments in motor skills and voluntary movements are observed in almost 100% of children with mental retardation. At the same time, the severity of movement disorders also depends on the degree of the disease.

Motor disorders in mentally retarded children can manifest themselves:

Slow and clumsy movements. When trying to take an object from the table, the child may move his hand towards it very slowly, awkwardly. Such children also move very slowly, they can often stumble, their legs can get tangled, and so on.
Motor restlessness. This is another type of movement disorder in which the child does not sit still, constantly moves around, and performs simple movements with his arms and legs. At the same time, his movements are uncoordinated and senseless, abrupt and sweeping. During a conversation, such children may accompany their speech with excessively expressed gestures and facial expressions.
Impaired coordination of movements. Children with mild and moderate forms of the disease take a long time to learn to walk, pick up objects, and maintain balance in a standing position ( For some of them, these skills may not appear until adolescence.).
Inability to perform complex movements. Children with mental retardation experience significant difficulty if they need to perform two consecutive but different movements ( for example, throw a ball up and hit it with your hand). The transition from one movement to another is slower for them, as a result of which the ball thrown up will fall, and the child will not “have time” to hit it.
Impaired fine motor skills. Precise movements that require increased concentration of attention are extremely difficult for oligophrenics. For a child with a moderate form of the disease, tying his shoelaces can be a difficult and sometimes even impossible task ( he will take hold of the laces, twirl them in his hands, try to do something with them, but the final goal will never be achieved).

With deep mental retardation, movements develop very slowly and weakly ( Children can begin to walk only by the age of 10–15 years.). In extremely severe cases, movement in the limbs may be completely absent.

Disorders of mental functions and behavior

Mental disorders can manifest themselves in children with any degree of illness, which is caused by impaired functioning of the cerebral cortex and a disturbed, incorrect perception of themselves and the world around them.

Children with mental retardation may experience:

Psychomotor agitation. In this case, the child is active and can pronounce various incomprehensible sounds and words ( if he knows them), move from side to side, and so on. Moreover, all his movements and actions are devoid of any meaning, disordered, chaotic.
Impulsive actions. Being in a state of relative rest ( for example, lying on the sofa), the child may suddenly stand up, go to the window, walk around the room, or perform some similar aimless action, and then return to the previous activity ( lie back on the sofa).
Stereotypical movements. During training, the child learns certain movements ( for example, waving your hand in greeting), after which he repeats them constantly, even without obvious need ( for example, when he is indoors, when he sees an animal, bird or any inanimate object).
Repeating the actions of others. At an older age, children with mild mental retardation may begin to repeat movements and actions they have just seen ( provided that they are trained in these actions). So, for example, seeing a person pouring water into a cup, the patient can immediately take the cup and also start pouring water for himself. At the same time, due to the inferiority of thinking, he can simply imitate these movements ( at the same time, without having a jug of water in his hands) or even take a jug and start pouring water on the floor.
Repeating the words of others. If a child has a certain vocabulary, when he hears a word he knows, he can immediately repeat it. At the same time, children do not repeat unfamiliar or too long words ( instead they may utter incoherent sounds).
Complete immobility. Sometimes a child may lie absolutely motionless for several hours, after which he may also suddenly begin to perform any actions.

Violations of the emotional-volitional sphere

All children with mental retardation are characterized by a violation of motivation of varying degrees of severity, as well as a disturbance of the psycho-emotional state. This makes it much more difficult for them to stay in society, and in cases of moderate, severe and profound mental retardation, it makes it impossible for them to be independent ( without the supervision of another person) accommodation.

Children with mental retardation may experience:

Weakening motivation. The child does not show initiative for any actions, does not strive to learn new things, to get to know the world around him and himself. They do not have any “own” goals or aspirations. Everything they do is done only according to what their loved ones or people around them tell them. At the same time, they can do absolutely everything that is told to them, since they are not aware of their actions ( cannot evaluate them critically).
Easy suggestibility. Absolutely all people with mental retardation are easily influenced by others ( because they cannot distinguish between lies, jokes or sarcasm). If such a child goes to school, classmates may bully him, forcing him to do abnormal things. This can significantly traumatize the child’s psyche, leading to the development of deeper mental disorders.
Slow development of the emotional sphere. Children begin to feel something only by the age of 3–4 years or even later.
Limited feelings and emotions. Children with severe illness may experience only primitive feelings ( fear, sadness, joy), while in a deep form of oligophrenia they may also be absent. At the same time, patients with mild or moderate mental retardation may experience many more feelings and emotions ( can empathize, feel sorry for someone, and so on).
Chaotic emergence of emotions. Feelings and emotions of oligophrenics can arise and change suddenly, without any apparent reason ( The child just laughed, 10 seconds later he is already crying or behaving aggressively, and a minute later he is laughing again).
"Superficial" feelings. Some children very quickly experience any of life's joys, burdens and hardships, forgetting about them within a few hours or days.
"Intense" feelings. The other extreme in mentally retarded children is excessive distress over even the most minor problems ( for example, if a mug drops on the floor, a child may cry for several hours or even days because of this).

Is aggression characteristic of mental retardation?

Aggression and inappropriate, hostile behavior are most often observed in patients with severe mental retardation. Most of the time they can behave aggressively towards others, as well as towards themselves ( may beat themselves, scratch, bite, and even cause severe bodily harm to themselves). In this regard, their separate residence ( without constant supervision) impossible.

Children with severe illness also often have angry outbursts. They can be aggressive towards others, but they rarely injure themselves. Often their aggressive attitude can change to the completely opposite ( they become calm, quiet, friendly), however, any word, sound or image can again provoke an outbreak of aggression or even rage in them.

With moderate mental retardation, children can also be aggressive towards others. A child may shout at the “offender,” cry, or gesticulate threateningly with his hands, but this aggression extremely rarely turns into an open form ( when a child seeks to cause physical harm to someone). Outbursts of anger can be replaced by other emotions within a few minutes or hours, but in some cases the child may remain in a bad mood for a long time ( several days, weeks or even months).

In mild forms of oligophrenia, aggressive behavior is extremely rare and is usually associated with some negative emotions, experiences or events. In this case, a loved one can quickly calm the child down ( To do this, you can distract him with something fun, interesting), causing his anger to change to joy or another feeling.

Is physical development impaired in children with mental retardation?

Mental retardation itself especially mild form) does not lead to retardation in physical development. The child may be relatively tall, his muscles may be quite developed, and his musculoskeletal system may be no less strong than that of normal children ( however, only with regular physical activity and training). At the same time, with severe and profound oligophrenia, it is quite difficult to force a child to do physical exercises, and therefore such children may lag behind their peers not only in mental, but also in physical development ( even if they were born physically healthy). Also, physical underdevelopment can be observed in cases where the cause of mental retardation affected the child after his birth ( for example, severe head trauma within the first 3 years of life).

At the same time, it is worth noting that physical underdevelopment and developmental anomalies may be associated with the cause of mental retardation itself. So, for example, with mental retardation caused by alcoholism or drug addiction of the mother, a child may be born with various congenital anomalies, physical deformities, underdevelopment of certain parts of the body, and so on. The same is typical for oligophrenia caused by various intoxications, some genetic syndromes, injuries and exposure of the fetus to radiation in the early stages of intrauterine development, maternal diabetes, and so on.

As a result of long-term observations, it was noticed that the more severe the degree of oligophrenia, the higher the likelihood that the child will have certain physical anomalies in the development of the skull, chest, spine, oral cavity, external genitalia, and so on.

Signs of mental retardation in newborns

Identifying mental retardation in a newborn can be extremely difficult. The fact is that this disease is characterized by delayed mental development of the child ( compared to other children). However, this development begins only a certain time after birth, as a result of which the child must live at least several months to be diagnosed. When, during routine examinations, the doctor reveals any developmental delays, then it will be possible to talk about one or another degree of mental retardation.

At the same time, it is worth noting that the identification of certain predisposing factors and symptoms may lead the doctor to think about the child’s possible mental retardation at the very first examination ( immediately after birth).

An increased likelihood of oligophrenia may be indicated by:

Predisposing factors in the mother– alcoholism, drug use, the presence of chromosomal syndromes in close relatives ( for example, in other children), diabetes mellitus and so on.
Presence of signs of mental retardation in the mother or father– people with a mild form of the disease can start families and have children, but they are at risk of having ( their children) mental retardation is increased.
Newborn skull deformities– with microcephaly ( reduction in skull size) or with congenital hydrocephalus ( an increase in the size of the skull as a result of the accumulation of large amounts of fluid in it) the probability of a child having mental retardation is close to 100%.
Congenital malformations– defects of the limbs, face, mouth, chest or other parts of the body can also accompany severe or profound forms of mental retardation.

Diagnosis of mental retardation

Diagnosis of mental retardation, determination of its degree and clinical form is a complex and lengthy process that requires a comprehensive examination of the child and various diagnostic tests.

Which doctor diagnoses and treats mental retardation?

Since mental retardation is characterized by a predominant disturbance of the mental processes and psycho-emotional state of the patient, the diagnosis of this pathology and treatment of children with mental retardation should be addressed psychiatrist ( sign up) . It is he who can assess the extent of the disease, prescribe treatment and monitor its effectiveness, as well as determine whether a person poses a danger to others, select optimal correction programs, and so on.

At the same time, it is worth noting that in almost 100% of cases, oligophrenics have not only mental, but also other disorders ( neurological, sensory organ damage, etc.). In this regard, a psychiatrist never treats a sick child on his own, but constantly refers him to consultations with specialists from other fields of medicine, who help him choose the most adequate treatment suitable for each specific case.

When diagnosing and treating a mentally retarded child, a psychiatrist may prescribe a consultation:

neurologist ( sign up) ;
speech pathologist ( sign up) ;
psychologist ( sign up) ;
psychotherapist ( sign up) ;
ophthalmologist ( ophthalmologist) (sign up) ;
otorhinolaryngologist ( ENT doctor) (sign up) ;
dermatologist ( sign up) ;
pediatric surgeon ( sign up) ;
neurosurgeon ( sign up) ;
endocrinologist ( sign up) ;
infectious disease specialist ( sign up) ;
chiropractor ( sign up) and other specialists.

Methods for examining a child with mental retardation

Anamnesis data is used to make a diagnosis ( the doctor asks the child’s parents about everything that may be related to the existing disease). After this, he examines the patient, trying to identify certain disorders characteristic of mentally retarded people.

When interviewing parents, the doctor may ask:

Were there any mentally retarded children in the family? If there were oligophrenics among your immediate relatives, the risk of the child having this disease is increased.
Did any of your immediate family suffer from chromosomal diseases? (Down syndrome, Bardet-Biedl, Klinefelter and so on)?
Did the mother ingest any toxins while carrying the baby? If the mother smoked, drank alcohol, or took psychotropic/narcotic drugs, she has an increased risk of having a child with mental retardation.
Was the mother exposed to radiation during pregnancy? This could also contribute to the development of mental retardation in the child.
Does the child's memory suffer? The doctor may ask the baby what he ate for breakfast, what book he was read at night, or something like that. Normal child ( able to speak) will easily answer these questions, while for an oligophrenic it will be difficult.
Does your child have aggressive outbursts? Aggressive, impulsive behavior ( during which the child can hit people around him, including parents) is typical for severe or profound mental retardation.
Is it typical for a child to have frequent and causeless mood swings? This may also indicate the presence of mental retardation, although it is also observed in a number of other mental disorders.
Does the child have congenital malformations? If yes, which ones and how many of them?

After the interview, the doctor begins to examine the patient, which allows him to assess general development and identify any deviations characteristic of mental retardation.

The child's examination includes:

If during the examination the doctor suspects that the child is mentally retarded, he can conduct a number of diagnostic tests to confirm the diagnosis.

What tests may be needed to diagnose mental retardation?

As mentioned earlier, to make a diagnosis it is not enough to simply identify mental retardation in a child, but you also need to determine its degree. For this, various diagnostic tests are used, as well as instrumental studies.

For mental retardation, the doctor may prescribe:

tests to determine the level of intelligence ( for example, Wechsler test);
tests to determine psychological age;
EEG ( electroencephalogram) (sign up);
MRI ( magnetic resonance imaging) (sign up).

Tests to determine iq and psychological age for mental retardation ( Wechsler test)

IQ ( intelligence quotient) is an indicator that allows you to numerically assess a person’s mental abilities. When diagnosing mental retardation, it is iq that is used to determine the degree of the disease.

Degree of mental retardation depending on iq

It is worth noting that healthy people should have an iq of at least 70 ( ideally more than 90).

To determine the level of iq, many methods have been proposed, the best of which is considered to be the test ( scale) Wechsler. The essence of this test is that the test taker is asked to solve several tasks ( build a series of numbers or letters, count something, find an extra or missing number/letter, perform certain actions with images, and so on). The more tasks the patient completes correctly, the higher his iq level will be.

In addition to determining iq, the doctor can also determine the psychological age of the patient ( There are also many different tests for this). Psychological age does not always correspond to biological age ( that is, the number of years that have passed since the birth of a person) and allows you to assess the degree of development of the child. The fact is that a person’s psychological maturation occurs as he learns, is introduced into society, and so on. If the child does not learn basic skills, concepts and rules of behavior in society ( what is typical for mentally retarded children), his psychological age will be below normal.

Psychological age of the patient depending on the degree of oligophrenia

Consequently, the thinking and behavior of a patient with severe mental retardation corresponds to those of a three-year-old child.

Basic diagnostic criteria for mental retardation

In order to confirm the diagnosis of mental retardation, you need to undergo a series of examinations from various specialists and pass a number of tests. At the same time, there are certain diagnostic criteria, the presence of which can be said with a high degree of probability that the child suffers from oligophrenia.

Diagnostic criteria for oligophrenia include:

Delayed psycho-emotional development and thought processes.
Decrease in iq level.
Discrepancy between biological age and psychological age ( the latter is significantly below normal).
Violation of the patient's adjustment in society.
Behavioral disorders.
The presence of a cause that led to the development of mental retardation ( not necessary).

The degree of expression of each of these criteria directly depends on the degree of mental retardation. It is also worth noting that it is not always possible to identify the cause of oligophrenia, as a result of which its absence is not a reason to doubt the diagnosis if all previous criteria are positive.

Does EEG show mental retardation?

EEG ( electroencephalography) is a special study that allows you to evaluate the activity of various parts of the patient’s brain. In some cases, this makes it possible to assess the severity of disturbances in thought processes in mental retardation.

The essence of the method is as follows. The patient comes to the doctor's office and, after a short conversation, lies down on the couch. Special electrodes are attached to his head, which will record electrical impulses emitted by brain cells. After installing the sensors, the doctor starts the recording device and leaves the room, leaving the patient alone. In this case, the patient is prohibited from standing up or speaking throughout the procedure ( unless the doctor asks for it).

During the study, the doctor can contact the patient via radio communication and ask him to perform certain actions ( raise your arm or leg, touch your finger to the tip of your nose, and so on). Also, in the room in which the patient is located, the lights may periodically turn on and off, or certain sounds and melodies may be heard. This is necessary in order to assess the reaction of individual areas of the cerebral cortex to external stimuli.

The entire procedure usually lasts no more than an hour, after which the doctor removes the electrodes and the patient can go home. Received data ( written on special paper) the doctor carefully examines, trying to identify any abnormalities characteristic of mentally retarded children.

Can MRI detect mental retardation?

MRI ( Magnetic resonance imaging) of the head does not allow one to determine mental retardation or assess the degree of its severity. At the same time, this study can be used to identify the causes of oligophrenia.

The study is carried out using a special apparatus ( magnetic resonance imaging scanner). The essence of the procedure is as follows. At the appointed time, the patient comes to the clinic where the study will be carried out. First, he lies down on a special sliding table of the tomograph so that his head is located in a strictly defined place. Next, the table moves to a special compartment of the device, where the research will be carried out. During the entire procedure ( which can last up to half an hour) the patient must lie absolutely still ( do not move your head, do not cough, do not sneeze). Any movement can distort the quality of the data obtained. After the procedure is completed, the patient can immediately go home.

The essence of the MRI method is that while the patient is in a special compartment of the machine, a strong electromagnetic field is created around his head. As a result, the tissues of various organs begin to emit a certain energy, which is recorded by special sensors. After processing the received data, the information is presented on the doctor’s monitor in the form of a detailed layer-by-layer image of the brain and all its structures, skull bones, blood vessels, and so on. Having examined the data obtained, the doctor can identify certain disorders that could cause mental retardation ( for example, lesions of the brain after injury, reduction in brain mass, reduction in the size of certain lobes of the brain, and so on).

Despite its safety, MRI has a number of contraindications. The main one is the presence of any metal objects in the patient’s body ( splinters, dentures, dental crowns and so on). The fact is that a magnetic resonance imaging scanner is a strong electromagnet. If a patient with metal objects in his body is placed in it, this can lead to very disastrous consequences ( up to damage to the patient’s internal organs and tissues).

Differential diagnosis ( differences) mental retardation and autism, dementia, mental retardation ( mental retardation, borderline mental retardation in preschool children)

Signs of mental retardation may be similar to those of a number of other mental illnesses. In order to correctly diagnose and prescribe adequate treatment, the doctor needs to know how these pathologies differ from each other.

Mental retardation should be differentiated ( differ):

Mental retardation in children with cerebral palsy

In 10–50% of children with cerebral palsy ( cerebral palsy) signs of mental retardation may be observed, and the incidence of mental retardation depends on the specific form of cerebral palsy.

The essence of cerebral palsy is a violation of the patient’s motor functions associated with damage to his brain in the prenatal period, during childbirth or immediately after birth. There can also be many reasons for the development of cerebral palsy ( injuries, intoxication, oxygen deprivation of the fetus, radiation, and so on), but all contribute to developmental impairment or damage ( destruction) certain areas of the brain.

It is worth noting that the same causative factors can lead to the development of oligophrenia. That is why identifying signs of mental retardation in patients with cerebral palsy is one of the primary tasks of a doctor.

When these two pathologies are combined, disturbances in the child’s mental, cognitive and psycho-emotional functions are more pronounced than with isolated mental retardation. Severe or profound mental retardation is most common, but even with moderate and mild degrees of the disease, patients cannot care for themselves ( due to motor dysfunction). This is why any child with cerebral palsy and mental retardation needs constant care from the moment of birth and throughout life. Such children are extremely difficult to teach, and the information they receive is quickly forgotten. Their emotions may be weakly expressed, however, with severe forms of mental retardation, unreasonable aggression towards others may occur.

Differential diagnosis of alalia and mental retardation ( mental retardation)

Alalia is a pathological condition in which a child has a speech disorder ( pronunciation of sounds, words, sentences). The cause of the disease is usually a lesion ( in case of birth trauma, as a result of intoxication, oxygen starvation, and so on) brain structure responsible for speech formation.

In medical practice, it is customary to distinguish two forms of alalia - motor ( when a person understands the speech of others, but cannot reproduce it) and sensory ( when a person does not understand the speech he heard). An important feature is the fact that with alalia the child’s hearing organ is not damaged ( that is, he normally hears the speech of others) and there are no mental disabilities ( that is, he is not mentally retarded). At the same time, speech impairment in mental retardation is associated with underdevelopment of the hearing organ ( deafness) or with the child’s inability to learn and reproduce the sounds and words he has heard.

Difference between mental retardation and schizophrenia

Schizophrenia is a mental illness characterized by impaired thinking and severe psycho-emotional disorders. If the disease manifests itself in childhood, it is referred to as childhood schizophrenia.

Childhood schizophrenia is characterized by a severe course, accompanied by delusions ( the child says incoherent words or sentences) and hallucinations ( the child sees or hears something that is not really there, which may cause him to panic, scream in fear, or be in an unreasonably good mood). The child may also have problems communicating with peers ( Children with schizophrenia are withdrawn and have poor contact with others), problems with sleep, concentration, and so on.

Many of these symptoms also occur in children with mental retardation ( especially in the atonic form of the disease), which significantly complicates differential diagnosis. In this case, signs such as delusions, hallucinations, perversion, or a complete lack of emotion may indicate schizophrenia.

It is worth noting that the onset of schizophrenia in early childhood disrupts the development of the central nervous system and the brain in particular, which can cause mental retardation. At the same time, mental retardation may be present in a child from birth ( however has not yet been diagnosed), and against its background ( at the age of 2 – 3 years) may develop schizophrenia.

Before use, you should consult a specialist.

The child is not like his peers - his general development lags behind the norm, he cannot cope with what is easy for other children. It is now customary to talk about such children as “special children.” Of course, children with intellectual disabilities are a great challenge for parents. It is sad and painful to realize that a child may turn out to be an outcast in society. However, quite often mental retardation can be corrected.

Is it lagging behind or developing differently?

Children develop in different ways. The standards according to which the mental development of children is diagnosed are quite arbitrary and are average indicators. If a child develops at a different pace, this is not yet a reason to believe that the baby has severe intellectual disabilities. Cases where at an early age a person showed a discrepancy with the norms of mental and intellectual development, and at an older age he showed outstanding results in the field of cognition are not uncommon. Even a speech delay is not evidence of a child’s retardation - many children do not speak at all until the age of two, but at this time they are developing a passive vocabulary - after two such children immediately begin to speak well and a lot. Therefore, if there are one or two deviations from age norms, do not panic. The alarm should be sounded when a complex of signs of mental retardation is observed.

Let's define what mental retardation is. First of all, the development of children with mental retardation occurs against the background of quite strong deviations in the conditioned reflex activity of the brain. They have an imbalance in the processes of inhibition and excitation; the brain's signaling system also works with disturbances. This greatly affects cognitive abilities - children have no or weakly expressed attention, curiosity (craving for knowledge), there is underdevelopment of cognitive interests and will.
It is worth distinguishing between mental retardation itself and mental retardation. Mental retardation implies more severe violations of the intellectual and psycho-emotional sphere. In severe cases, correction of such disorders is practically impossible - we are talking about severe cases of cretinism, mental retardation. But, it must be said that in reality such cases are quite rare. Children with mental retardation are distinguished by a number of characteristics, and correction of their development is not only possible, but also quite successful: in some cases, children can catch up with their peers in their development.

Causes of mental retardation

There is a whole complex of reasons that, together or separately, can lead to developmental delays. Often children with intellectual disabilities suffer from birth defects in hearing, vision, and speech apparatus. With such defects, the child’s intellectual abilities could initially be within normal limits, but they did not develop from the first days of life due to reduced hearing and vision. Accordingly, mental retardation arose. The correction in this case is very successful.

Very often, the causes of mental retardation are a difficult pregnancy, during which there was prolonged oxygen starvation of the fetus; birth injuries, birth asphyxia; some infectious and somatic diseases of a child at an early age, intoxication, genetic damage due to alcoholism or drug addiction of parents.

In a very large percentage of mild cases of mental retardation, education, or rather its complete absence, is to blame. It is known that mental retardation occurs if parents do not engage with the child and do not talk to him; if for some reason the child was isolated from his mother at an early age. Here, too, the correction is successful in most cases.

Development of mentally retarded children

Mentally retarded children need more time to comprehend material. Difficulties in identifying the main thing, in understanding cause-and-effect relationships, and a slow pace of recognizing what is known affect the child’s learning ability, slowing down and complicating the learning process.

But this does not mean that the development of mentally retarded children is impossible or unnecessary. On the contrary, such children must be approached in a special way and developmental activities, which must be more intensive, must be very carefully organized. But a different kind of intensity is required here.

First of all, parents need to be patient and have faith in their child. The most important thing is to never compare your child with other children. Even for a healthy child with intellectual development within the normal range, comparison is harmful - for special children it is catastrophically dangerous! As a result, the child withdraws into himself, begins to consider himself hopeless, falls into neurosis or becomes aggressive.

In order to successfully correct the lag in intellectual development, testing should be carried out regularly. The so-called diagnostics of mental development of children is a set of special tests-standards that a child should normally cope with upon reaching a certain age. Small deviations in one direction or another should not cause concern to parents. If the child clearly does not reach the norm, corrective classes in this area are necessary. Remember that mental development occurs unevenly and there is a chance to develop intelligence and psycho-emotional sphere by adulthood. But overcoming mental retardation, even in a weak form, can take years and you need to be prepared for this.

Of course, the development of mentally retarded children is daily painstaking work that requires great love, patience, and self-sacrifice. Parents need to constantly tell their child about the world, the interconnection of things, provide food for the mind, and encourage them to use knowledge in practice. Scientists believe that a child with mental retardation should be surprised as much as possible - this awakens curiosity and a desire to learn. You shouldn’t even think about the fact that the child won’t understand - you need to talk to him about everything, tell him why it happens this way and not otherwise, show him.

Distraction of attention, inability and inability to concentrate on one thing is one of the main causes of mental retardation. By constantly training mindfulness, stimulating it in all ways within physiological periods (when the process of brain formation is underway - up to 3-6 years), you can restore broken connections and bring them back to normal. Cultivating attention is so important that the rule applies here: if a child is busy with something, classes are being conducted with him, he is focused on the game - he cannot be distracted even by eating, sleeping, etc. For children with mental retardation, it is extremely important to protect their developing focus and concentration.

In parallel with developmental activities, it is useful to take medications that strengthen the nervous system and stimulate its development. From this point of view, a decoction of stinging nettle, eleutherococcus extract, royal jelly, strawberries, blueberries, and B vitamins are useful.

Rehabilitation and socialization of children with mental retardation - ( video)

Exercise therapy) for children with mental retardation - ( video)
Recommendations for parents regarding the labor education of children with mental retardation - ( video)

Prognosis for mental retardation - ( video)

Is a child given a disability group for mental retardation? - ( video)
Life expectancy of children and adults with oligophrenia

Treatment and correction of mental retardation ( how to treat oligophrenia?)

Treatment and correction mental retardation ( mental retardation) - a complex process that requires a lot of attention, effort and time. However, with the right approach, you can achieve certain positive results within a few months after the start of treatment.

Is it possible to cure mental retardation? remove the diagnosis of mental retardation)?

Oligophrenia is incurable. This is due to the fact that when exposed to causal factors ( provoking the disease) factors cause damage to certain parts of the brain. As is known, the nervous system ( especially its central section, that is, the brain and spinal cord) develop in the prenatal period. After birth, the cells of the nervous system practically do not divide, that is, the ability of the brain to regenerate ( recovery after damage) is almost minimal. Once damaged neurons ( nerve cells) will never be restored, as a result of which once developed mental retardation will remain in the child until the end of his life.

At the same time, children with a mild form of the disease respond well to treatment and correctional measures, as a result of which they can receive a minimum education, learn self-care skills, and even get a simple job.

It is also worth noting that in some cases the goal of treatment is not to cure mental retardation as such, but to eliminate its cause, which will prevent the progression of the disease. Such treatment should be carried out immediately after identifying a risk factor ( for example, when examining the mother before, during or after childbirth), since the longer the causative factor affects the baby’s body, the more profound disorders of thinking he may develop in the future.

Treatment for the cause of mental retardation can be carried out:

For congenital infections– for syphilis, cytomegalovirus infection, rubella and other infections, antiviral and antibacterial drugs can be prescribed.
With diabetes mellitus in the mother.
For metabolic disorders– for example, with phenylketonuria ( violation of the metabolism of the amino acid phenylalanine in the body) eliminating foods containing phenylalanine from your diet may help solve the problem.
For hydrocephalus– surgery immediately after identifying pathology can prevent the development of mental retardation.

Finger gymnastics for the development of fine motor skills

One of the disorders that occurs with mental retardation is impaired fine motor skills of the fingers. At the same time, it is difficult for children to perform precise, targeted movements ( for example, holding a pen or pencil, tying shoelaces, etc.). Finger gymnastics, the purpose of which is to develop fine motor skills in children, will help correct this deficiency. The mechanism of action of the method is that frequently performed finger movements are “remembered” by the child’s nervous system, as a result of which in the future ( after repeated training) the child can perform them more accurately, while spending less effort.

Finger gymnastics may include:

Exercise 1 (counting fingers). Suitable for children with mild mental retardation who are learning to count. First you need to fold your hand into a fist, and then straighten 1 finger at a time and count them ( aloud). Then you need to bend your fingers back, also counting them.
Exercise 2. First, the child should spread the fingers of both palms and place them in front of each other so that only the pads of the fingers touch each other. Then he needs to bring his palms together ( so that they also touch), and then return to the starting position.
Exercise 3. During this exercise, the child should clasp his hands, with the thumb of one hand on top first, and then the thumb of the other hand.
Exercise 4. First, the child should spread his fingers, and then bring them together so that the tips of all five fingers are gathered at one point. The exercise can be repeated many times.
Exercise 5. During this exercise, the child needs to clench his hands into fists, and then straighten his fingers and spread them, repeating these actions several times.

It is also worth noting that the development of fine motor skills of the fingers is facilitated by regular exercises with plasticine and drawing ( even if the child just runs a pencil on paper), rearranging small objects ( for example, multi-colored buttons, but you need to make sure that the child does not swallow one of them) and so on.

Medicines ( drugs, tablets) with mental retardation ( nootropics, vitamins, antipsychotics)

The goal of drug treatment for oligophrenia is to improve metabolism at the brain level, as well as stimulate the development of nerve cells. In addition, medications may be prescribed to treat specific symptoms of the disease, which may be expressed differently in different children. In any case, the treatment regimen must be selected for each child individually, taking into account the severity of the underlying disease, its clinical form and other features.

Drug treatment of mental retardation

Group of drugs	Representatives	Mechanism of therapeutic action
*Nootropics and drugs that improve cerebral circulation*	*Piracetam*	Improves metabolism at the neuronal level ( nerve cells) of the brain, increasing the rate at which they use oxygen. This may promote the patient's learning and mental development.
	*Phenibut*
	*Vinpocetine*
	*Glycine*
	*Aminalon*
	*Pantogam*
	*Cerebrolysin*
	*Oxybral*
*Vitamins*	*Vitamin B1*	Necessary for the normal development and functioning of the central nervous system.
	*Vitamin B6*	Necessary for the normal process of transmission of nerve impulses in the central nervous system. With its deficiency, such a sign of mental retardation as inhibition of thinking can progress.
	*Vitamin B12*	With a lack of this vitamin in the body, accelerated death of nerve cells may occur ( including at the level of the brain), which may contribute to the progression of mental retardation.
	*Vitamin E*	Protects the central nervous system and other tissues from damage by various harmful factors ( in particular with a lack of oxygen, with intoxication, with irradiation).
	*Vitamin A*	If it is deficient, the functioning of the visual analyzer may be disrupted.
*Neuroleptics*	*Sonapax*	They inhibit brain activity, making it possible to eliminate such manifestations of oligophrenia as aggressiveness and severe psychomotor agitation.
	*Haloperidol*
	*Neuleptil*
*Tranquilizers*	*Tazepam*	They also inhibit the activity of the central nervous system, helping to eliminate aggressiveness, as well as anxiety, increased excitability and mobility.
	*Nozepam*
	*Adaptol*
*Antidepressants*	*Trittico*	Prescribed for depression of the child’s psycho-emotional state that persists for a long time ( more than 3 – 6 months in a row). It is important to note that maintaining this condition for a long time significantly reduces the child’s ability to learn in the future.
	*Amitriptyline*
	*Paxil*

It is worth noting that the dosage, frequency and duration of use of each of the listed drugs is also determined by the attending physician depending on many factors ( in particular, on the general condition of the patient, the prevalence of certain symptoms, the effectiveness of the treatment, possible side effects, and so on).

Objectives of massage for mental retardation

Neck and head massage is part of the comprehensive treatment of mentally retarded children. At the same time, a full body massage can stimulate the development of the musculoskeletal system, improve the patient’s overall well-being, and improve his mood.

The objectives of massage for mental retardation are:

Improving blood microcirculation in the massaged tissues, which will improve the delivery of oxygen and nutrients to the nerve cells of the brain.
Improved lymphatic drainage, which will improve the process of removing toxins and metabolic byproducts from brain tissue.
Improving microcirculation in the muscles, which helps to increase their tone.
Stimulates nerve endings in the fingers and palms, which can help develop fine motor skills in the hands.
Creation of positive emotions that have a beneficial effect on the general condition of the patient.

The influence of music on children with mental retardation

Playing music or simply listening to it has a positive effect on the course of mental retardation. That is why almost all children with mild to moderate forms of the disease are recommended to include music in correctional programs. At the same time, it is worth noting that with a more severe degree of mental retardation, children do not perceive music and do not understand its meaning ( for them it's just a set of sounds), and therefore they will not be able to achieve a positive effect.

Music lessons allow you to:

Develop the child’s speech apparatus (while singing songs). In particular, children improve their pronunciation of individual letters, syllables and words.
Develop a child's hearing. In the process of listening to music or singing, the patient learns to distinguish sounds by their tonality.
Develop intellectual abilities. To sing a song, a child needs to perform several sequential actions at once ( take a deep breath before the next verse, wait for the right melody, choose the right voice volume and singing speed). All this stimulates the thought processes that are disturbed in children with mental retardation.
Develop cognitive activity. In the process of listening to music, a child can learn new musical instruments, evaluate and remember the nature of their sound, and then recognize ( determine) them by sound alone.
Teach your child to play musical instruments. This is possible only with a mild form of oligophrenia.

Education of persons with mental retardation

Despite mental retardation, almost all patients with mental retardation ( except deep form) may be amenable to certain training. At the same time, the general education programs of regular schools may not be suitable for all children. It is extremely important to choose the right place and type of education, which will allow the child to develop his abilities to the maximum.

Regular and correctional schools, boarding schools and classes for schoolchildren with mental retardation ( PMPC recommendations)

In order for a child to develop as intensively as possible, you need to choose the right educational institution to send him to.

Education for mentally retarded children can be carried out:

In secondary schools. This method is suitable for children with mild mental retardation. In some cases, mentally retarded children can successfully complete the first 1–2 grades of school, and no differences between them and ordinary children will be noticeable. At the same time, it is worth noting that as children grow older and the school curriculum becomes more difficult, they will begin to lag behind their peers in academic performance, which can cause certain difficulties ( low mood, fear of failure, etc.).
In correctional schools or boarding schools for mentally retarded persons. A special school for children with mental retardation has both its pros and cons. On the one hand, educating a child in a boarding school allows him to receive much more attention from teachers than when he attends a regular school. In the boarding school, teachers and educators are trained to work with such children, as a result of which it is easier to establish contact with them, find an individual approach to them in teaching, and so on. The main disadvantage of such training is the social isolation of the sick child, who practically does not communicate with normal people ( healthy) children. Moreover, during their stay in the boarding school, children are constantly monitored and carefully cared for, to which they become accustomed. After graduating from boarding school, they may simply be unprepared for life in society, as a result of which they will need constant care for the rest of their lives.
In special correctional schools or classes. Some general education schools have classes for mentally retarded children, in which they are taught a simplified school curriculum. This allows children to receive the necessary minimum knowledge, as well as to be among “normal” peers, which contributes to their integration into society in the future. This teaching method is suitable only for patients with mild mental retardation.

Sending a child to general education or special ( correctional) the school is run by the so-called psychological-medical-pedagogical commission ( PMPC). The doctors, psychologists and teachers included in the commission conduct a short conversation with the child, assessing his general and mental condition and trying to identify signs of mental retardation or mental retardation.

During the PMP examination, the child may be asked:

What's his name?
How old is he?
Where does he live?
How many people are in his family ( may be asked to briefly describe each family member)?
Are there any pets at home?
What games does your child like?
What dishes does he prefer for breakfast, lunch or dinner?
Can the child sing? they may be asked to sing a song or recite a short rhyme)?

After these and some other questions, the child may be asked to complete several simple tasks ( arrange pictures into groups, name the colors you see, draw something, and so on). If, during the examination, specialists identify any delays in mental or mental development, they may recommend sending the child to a special ( correctional) school. If the mental retardation is slight ( for a given age), a child can attend a regular school, but remain under the supervision of psychiatrists and teachers.

Federal State Educational Standard OVZ ( federal state educational standard

Federal State Educational Standard is a generally recognized standard of education that all educational institutions in the country must adhere to ( for preschoolers, schoolchildren, students and so on). This standard regulates the work of an educational institution, material, technical and other equipment of the educational institution ( what personnel and how many should work there?), as well as control of training, availability of training programs, and so on.

FSES OVZ is a federal state educational standard for students with disabilities. It regulates the educational process for children and adolescents with various physical or mental disabilities, including mentally retarded patients.

Adapted basic general education programs ( AOOP) for preschoolers and schoolchildren with mental retardation

These programs are part of the Federal State Educational Standard for Physical Education and represent the optimal method of teaching people with mental retardation in preschool institutions and schools.

The main objectives of the AOOP for children with mental retardation are:

Creation of conditions for the education of mentally retarded children in general education schools, as well as in special boarding schools.
Creation of similar educational programs for children with mental retardation who could master these programs.
Creation of educational programs for mentally retarded children to receive preschool and general education.
Development of special programs for children with varying degrees of mental retardation.
Organization of the educational process taking into account the behavioral and mental characteristics of children with varying degrees of mental retardation.
Quality control of educational programs.
Monitoring the assimilation of information by students.

The use of AOOP allows:

Maximize the mental abilities of each individual child with mental retardation.
Teach mentally retarded children self-care ( if possible), performing simple work and other necessary skills.
Teach children to behave correctly in society and interact with it.
Develop students' interest in learning.
Eliminate or smooth out shortcomings and defects that a mentally retarded child may have.
Teach parents of a mentally retarded child to behave correctly with him and so on.

The ultimate goal of all of the above points is the most effective education of the child, which would allow him to lead the most fulfilling life in the family and in society.

Work programs for children with mental retardation

Based on basic general education programs ( regulating the general principles of teaching mentally retarded children) work programs are being developed designed for children with various degrees and forms of mental retardation. The advantage of this approach is that the work program takes into account as much as possible the individual characteristics of the child, his ability to learn, perceive new information and communicate in society.

For example, a work program for children with a mild form of mental retardation may include training in self-care, reading, writing, mathematics, and so on. At the same time, children with a severe form of the disease are not able to read, write and count in principle, as a result of which their work programs will include only general self-care skills, learning to control emotions and other simple activities.

Corrective classes for mental retardation

Correctional classes are selected for each child individually, depending on his mental disorders, behavior, thinking, and so on. These classes can be conducted in special schools ( professionals) or at home.

The goals of correctional classes are:

Teaching your child basic school skills- reading, writing, simple counting.
Teaching children how to behave in society– Group classes are used for this.
Speech development– especially in children who have impaired pronunciation of sounds or other similar defects.
Teach your child to look after himself– at the same time, the teacher should focus on the dangers and risks that may await the child in everyday life ( for example, the child must learn that there is no need to grab hot or sharp objects, as this will hurt).
Develop attention and perseverance– especially important for children with impaired ability to concentrate.
Teach your child to control their emotions– especially if he has attacks of anger or rage.
Develop fine motor skills of hands- if it is broken.
Develop memory– learn words, phrases, sentences or even poems.

It is worth noting that this is not a complete list of defects that can be corrected during correctional classes. It is important to remember that a positive result can only be achieved after long-term training, since the ability of mentally retarded children to learn and master new skills is significantly reduced. At the same time, with properly selected exercises and regular classes, a child can develop, learn self-care, perform simple work, and so on.

CIPRs for children with mental retardation

SIPR is a special individual development program, selected for each specific mentally retarded child individually. The objectives of this program are similar to those of correctional classes and adapted programs, however, when developing SIPR, not only the degree of mental retardation and its form are taken into account, but also all the features of the disease that the child has, the degree of their severity, and so on.

To develop a CIPR, a child must undergo a full examination by many specialists ( from a psychiatrist, psychologist, neurologist, speech therapist, etc.). During the examination, doctors will identify dysfunctions of various organs ( for example, memory impairment, fine motor skills, difficulty concentrating) and evaluate their severity. Based on the data obtained, a CIPR will be drawn up, designed to correct, first of all, those violations that are most pronounced in the child.

So, for example, if a child with mental retardation has problems with speech, hearing and concentration, but there are no motor disorders, there is no point in prescribing him many hours of classes to improve fine motor skills. In this case, classes with a speech therapist should come to the fore ( to improve the pronunciation of sounds and words), classes to improve the ability to concentrate, and so on. At the same time, there is no point in wasting time teaching a child with severe mental retardation to read or write, since he will still not master these skills.

Methods of teaching literacy ( reading) children with mental retardation

With a mild form of the disease, the child can learn to read, understand the meaning of the text read, or even partially retell it. With a moderate form of mental retardation, children can also learn to read words and sentences, but their text reading is not meaningful ( they read, but don’t understand what they’re talking about). They are also unable to retell what they read. In severe and profound forms of mental retardation, the child cannot read.

Teaching reading to mentally retarded children allows:

Teach your child to recognize letters, words and sentences.
Learn to read expressively ( with intonation).
Learn to understand the meaning of the text you read.
Develop speech ( while reading aloud).
Create the prerequisites for teaching writing.

To teach reading to mentally retarded children, you need to select simple texts that do not contain complex phrases, long words and sentences. It is also not recommended to use texts with a large number of abstract concepts, proverbs, metaphors and other similar elements. The fact is that a mentally retarded child has poorly developed ( or completely absent) abstract thinking. As a result, even after correctly reading a proverb, he can understand all the words, but will not be able to explain its essence, which can negatively affect the desire to learn in the future.

Teaching writing

Only children with mild illness can learn to write. With moderate mental retardation, children may try to pick up a pen, write letters or words, but will not be able to write anything meaningful.

It is extremely important that before starting school, the child learns to read at least to a minimal extent. After this, he should be taught to draw simple geometric shapes ( circles, rectangles, squares, straight lines and so on). When he masters this, you can move on to writing letters and memorizing them. Then you can start writing words and sentences.

It is worth noting that for a mentally retarded child, the difficulty lies not only in mastering writing, but also in understanding the meaning of what is written. At the same time, some children have a pronounced impairment of fine motor skills, which prevents them from mastering writing. In this case, it is recommended to combine grammar teaching with corrective exercises that allow the development of motor activity in the fingers.

Mathematics for children with mental retardation

Teaching mathematics to children with mild mental retardation promotes the development of thinking and social behavior. At the same time, it is worth noting that the mathematical abilities of children with imbecility ( moderate degree of oligophrenia) are very limited - they can perform simple mathematical operations ( add, subtract), however, it is not able to solve more complex problems. Children with severe and profound mental retardation do not understand mathematics in principle.

Children with mild mental retardation may:

Count natural numbers.
Learn the concepts of “fraction”, “proportion”, “area” and others.
Master the basic units of measurement of mass, length, speed and learn to apply them in everyday life.
Learn to shop, calculate the cost of several items at once and the amount of change required.
Learn to use measuring and calculating instruments ( ruler, compass, calculator, abacus, clock, scales).

It is important to note that studying mathematics should not consist of banal memorization of information. Children must understand what they are learning and immediately learn to put it into practice. To achieve this, each lesson can end with a situational task ( for example, give children “money” and play “store” with them, where they will have to buy some things, pay and take change from the seller).

Pictograms for children with mental retardation

Pictograms are unique schematic pictures that depict certain objects or actions. Pictograms allow you to establish contact with a mentally retarded child and teach him in cases where it is impossible to communicate with him through speech ( for example, if he is deaf, and also if he does not understand the words of others).

The essence of the pictogram technique is to associate a certain image in the child ( picture) with any specific action. For example, a picture of a toilet can be associated with the desire to go to the toilet. At the same time, a picture depicting a bath or shower can be associated with water procedures. In the future, these pictures can be attached to the doors of the corresponding rooms, as a result of which the child will better navigate the house ( if he wants to go to the toilet, he will independently find the door through which he needs to enter for this).

On the other hand, pictograms can also be used to communicate with a child. So, for example, in the kitchen you can keep pictures of a cup ( jug) with water, plates of food, fruits and vegetables. When a child feels thirsty, he can point to water, while pointing at a picture of food will help others understand that the child is hungry.

The above were just some examples of the use of pictograms, but using this technique you can teach a mentally retarded child a wide variety of activities ( brush your teeth in the morning, make and spread your bed yourself, fold things, etc.). However, it is worth noting that this technique will be most effective for mild mental retardation and only partially effective for moderate degrees of the disease. At the same time, children with severe and profound mental retardation are practically not amenable to learning using pictograms ( due to a complete lack of associative thinking).

Extracurricular activities for children with mental retardation

Extracurricular activities are activities that take place outside of class ( like all lessons), and in a different setting and according to a different plan ( in the form of games, competitions, travel, etc.). Changing the method of presenting information to mentally retarded children allows them to stimulate the development of intelligence and cognitive activity, which has a beneficial effect on the course of the disease.

The goals of extracurricular activities can be:

adaptation of the child in society;
application of acquired skills and knowledge in practice;
speech development;
physical ( sports) child development;
development of logical thinking;
developing the ability to navigate in unfamiliar areas;
psycho-emotional development of the child;
the child’s acquisition of new experiences;
development of creative abilities ( for example, while hiking, playing in the park, in the forest, etc.).

Homeschooling children with mental retardation

Education for mentally retarded children can be done at home. Both parents themselves and specialists can take a direct part in this ( speech therapist, psychiatrist, teachers who know how to work with such children, and so on).

On the one hand, this teaching method has its advantages, since the child receives much more attention than when teaching in groups ( classes). At the same time, during the learning process, the child does not have contact with peers, does not acquire the communication and behavior skills he needs, as a result of which in the future it will be much more difficult for him to integrate into society and become a part of it. Therefore, teaching mentally retarded children exclusively at home is not recommended. It is best to combine both methods, when the child attends an educational institution during the day, and in the afternoon the parents study with him at home.

Rehabilitation and socialization of children with mental retardation

If the diagnosis of mental retardation is confirmed, it is extremely important to start working with the child in a timely manner, which, in mild forms of the disease, will allow him to get along in society and become a full member of it. At the same time, special attention should be paid to the development of mental, mental, emotional and other functions that are impaired in children with oligophrenia.

Classes with a psychologist ( psychocorrection)

The primary task of a psychologist when working with a mentally retarded child is to establish friendly, trusting relationships with him. After this, in the process of communicating with the child, the doctor identifies certain mental and psychological disorders that predominate in this particular patient ( for example, instability of the emotional sphere, frequent tearfulness, aggressive behavior, inexplicable joy, difficulties in communicating with others, etc.). Having established the main disorders, the doctor tries to help the child get rid of them, thereby speeding up the learning process and improving his quality of life.

Psychocorrection may include:

psychological education of the child;
help in realizing your “I”;
social education ( teaching rules and norms of behavior in society);
assistance in experiencing psycho-emotional trauma;
creation of favorable ( friendly) family situation;
improving communication skills;
teaching a child to control emotions;
learning skills to overcome difficult life situations and problems.

Speech therapy classes ( with a speech pathologist)

Speech disorders and underdevelopment can be observed in children with varying degrees of mental retardation. To correct them, classes are prescribed with a speech therapist who will help children develop speech abilities.

Classes with a speech therapist allow you to:

Teach children to pronounce sounds and words correctly. To do this, the speech therapist uses various exercises, during which children have to repeatedly repeat those sounds and letters that they pronounce worst of all.
Teach your child to form sentences correctly. This is also achieved through sessions during which the speech therapist communicates with the child orally or in writing.
Improve your child's performance in school. Speech underdevelopment can be the cause of poor performance in many subjects.
Stimulate the overall development of the child. While learning to speak and pronounce words correctly, the child simultaneously remembers new information.
Improve the child's position in society. If a student learns to speak correctly and correctly, it will be easier for him to communicate with classmates and make friends.
Develop the child's ability to concentrate. During classes, the speech therapist may have the child read aloud increasingly longer texts, which will require longer concentration of attention.
Expand your child's vocabulary.
Improve understanding of spoken and written language.
Develop abstract thinking and imagination of the child. To do this, the doctor may give the child books with fairy tales or fictional stories to read aloud, and then discuss the plot with him.

Didactic games for children with mental retardation

During observations of mentally retarded children, it was noted that they are reluctant to study any new information, but with great pleasure they can play all kinds of games. Based on this, a didactic methodology was developed ( teaching) games, during which the teacher conveys certain information to the child in a playful way. The main advantage of this method is that the child, without realizing it, develops mentally, mentally and physically, learns to communicate with other people and acquires certain skills that he will need in later life.

For educational purposes you can use:

Games with pictures- children are offered a set of pictures and asked to choose from them animals, cars, birds, and so on.
Games with numbers– if the child already knows how to count in various objects ( for blocks, books or toys) you can stick the numbers from 1 to 10 and mix them up, and then ask the child to put them in order.
Games with animal sounds– the child is shown a series of pictures with images of animals and asked to demonstrate what sounds each of them makes.
Games that promote the development of fine motor skills– you can draw letters on small cubes, and then ask the child to assemble a word from them ( name of animal, bird, city, etc.).

Exercises and physical therapy ( Exercise therapy) for children with mental retardation

The purpose of exercise therapy ( physical therapy) is a general strengthening of the body, as well as correction of physical defects that a mentally retarded child may have. A physical exercise program should be selected individually or by combining children with similar problems into groups of 3 to 5 people, which will allow the instructor to pay enough attention to each of them.

The goals of exercise therapy for oligophrenia may be:

Development of fine motor skills of the hands. Since this disorder is most common in mentally retarded children, exercises to correct it should be included in every training program. Some of the exercises include clenching and unclenching your hands into fists, spreading and closing your fingers, touching your fingertips to each other, alternately bending and straightening each finger separately, and so on.
Correction of spinal deformities. This disorder occurs in children with severe mental retardation. To correct it, exercises are used that develop the muscles of the back and abdomen, joints of the spine, water procedures, exercises on the horizontal bar and others.
Correction of movement disorders. If a child has paresis ( in which he weakly moves his arms or legs), exercises should be aimed at developing the affected limbs ( flexion and extension of arms and legs, rotational movements of them, and so on).
Development of movement coordination. To do this, you can perform exercises such as jumping on one leg, long jumps ( after the jump, the child must maintain balance and remain on his feet), throwing a ball.
Development of mental functions. To do this, you can perform exercises consisting of several successive parts ( for example, put your hands on your belt, then sit down, stretch your arms forward, and then do the same in reverse order).

It is also worth noting that children with mild or moderate illness can participate in active sports, but only with the constant supervision of an instructor or another adult ( healthy) person.

To play sports, mentally retarded children are recommended to:

Swimming. This helps them learn to solve complex sequential problems ( come to the pool, change clothes, wash, swim, wash and get dressed again), and also forms a normal attitude towards water and water procedures.
Skiing. Develop motor activity and the ability to coordinate the movements of arms and legs.
Biking. Helps develop balance, concentration and the ability to quickly switch from one task to another.
Trips ( tourism). A change of environment stimulates the development of cognitive activity in a mentally retarded patient. At the same time, when traveling, physical development and strengthening of the body occurs.

Recommendations for parents regarding the labor education of children with mental retardation

Labor education of a mentally retarded child is one of the key points in the treatment of this pathology. After all, it is the ability for self-care and work that determines whether a person will be able to live independently or will need the care of strangers throughout his life. The labor education of a child should be carried out not only by teachers at school, but also by parents at home.

The development of work activity in a child with mental retardation may include:

Self-care training– the child needs to be taught to dress independently, observe personal hygiene rules, take care of his appearance, eat food, and so on.
Training for feasible work– from an early age, children can independently lay out things, sweep the street, vacuum, feed pets or clean up after them.
Teamwork training– if parents go to do some simple work ( for example, picking mushrooms or apples, watering the garden), the child should be taken with you, explaining and clearly demonstrating to him all the nuances of the work being performed, as well as actively cooperating with him ( for example, instruct him to fetch water while watering the garden).
Versatile training– parents should teach their child a variety of types of work ( even if at first he is unable to do any work).
The child’s awareness of the benefits of his work– parents should explain to the child that after watering the garden, vegetables and fruits will grow there, which the child can then eat.

Prognosis for mental retardation

The prognosis for this pathology directly depends on the severity of the disease, as well as on the correctness and timeliness of the therapeutic and corrective measures taken. So, for example, if you regularly and intensively work with a child who has been diagnosed with a moderate degree of mental retardation, he can learn to speak, read, communicate with peers, and so on. At the same time, the absence of any training sessions can provoke a deterioration in the patient’s condition, as a result of which even a mild degree of oligophrenia can progress, turning into moderate or even severe.

Is a child given a disability group for mental retardation?

Since the ability for self-care and a full life of a mentally retarded child is impaired, he can receive a disability group, which will allow him to enjoy certain advantages in society. At the same time, one or another disability group is assigned depending on the degree of oligophrenia and the general condition of the patient.

Children with mental retardation may be assigned:

3 disability group. Issued to children with mild mental retardation who can take care of themselves, are amenable to learning and can attend regular schools, but require increased attention from the family, others and teachers.
Disability group 2. Issued to children with moderate mental retardation who are forced to attend special correctional schools. They are difficult to train, do not get along well in society, have little control over their actions and cannot be responsible for some of them, and therefore often need constant care, as well as the creation of special living conditions.
1st disability group. Issued to children with severe and profound mental retardation, who are practically unable to learn or care for themselves, and therefore require continuous care and guardianship.

Life expectancy of children and adults with oligophrenia

In the absence of other diseases and developmental defects, the life expectancy of mentally retarded people directly depends on the ability to self-care or on the care they receive from others.

Healthy ( physically) people with mild mental retardation can take care of themselves, are easy to train, and can even get a job, earning money to feed themselves. In this regard, their average life expectancy and causes of death are practically no different from those among healthy people. The same can be said about patients with moderate mental retardation, who, however, are also trainable.

At the same time, patients with severe forms of the disease live much shorter than ordinary people. First of all, this may be due to multiple defects and congenital developmental anomalies, which can lead to the death of children during the first years of life. Another reason for premature death may be a person’s inability to critically evaluate his actions and the environment. In this case, patients may be in dangerous proximity to fire, operating electrical appliances or poisons, or fall into the pool ( while not knowing how to swim), get hit by a car ( accidentally running out onto the road) and so on. That is why the duration and quality of their lives directly depend on the attention from others.

Before use, you should consult a specialist.