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Impaired mental function. Etiology. Classification. Differential diagnostic criteria for distinguishing between children with mental retardation and children with mental retardation. Medical and pedagogical support. Conditions of training and education.

Mental retardation (MAD) is a psychological and pedagogical definition for the most common pathology in the psychophysical development of children of senior preschool age.

The term ”mental retardation” refers to the syndromes of the temporary lag in the development of the psyche as a whole or its individual functions (motor, sensory, speech, emotional-volitional), and the slow pace of realization of the properties of the organism.



The delay of mental development is characterized by an uneven formation of the processes of cognitive activity, due to the underdevelopment of speech and thinking, as well as the presence of disorders in the emotional-volitional sphere.



The onset of developmental delays is associated with how diverse

? adverse factors of the social environment, and with different

? hereditary influences.

? In the etiology of mental retardation play a role

? constitutional factors

? chronic somatic diseases

? organic failure of the nervous system, often residual (residual) character

? Organic causes that delay the normal functioning of the central nervous system (neuroinfections, their complications, GM trauma).



K.S. Lebedinskaya was proposed etiopathogenetic systematics of mental retardation. Its main clinical types are differentiated according to the etiopathogenetic principle:

• constitutional origin,

• somatogenic origin,

• psychogenic origin

• cerebral organic origin.

1. The delay of mental development of constitutional origin - the so-called harmonic infantilism (uncomplicated mental and psychophysical infantilism, according to the classification of MS Pevzner and TA Vlasova), in which the emotional-volitional sphere is, as it were, at an earlier stage of development, much like the normal structure of the emotional stock of young children.

Characterized by the prevalence of emotional motivation behavior,

elevated mood background

spontaneity and brightness of emotions with their superficiality and instability,

light suggestibility.

Children in growth and physical development lag behind their peers by 1.5-2 years, they are characterized by

live mimicry, expressive gestures, fast impulsive movements.

He is tireless in the game and gets tired quickly when performing practical tasks.

independent and uncritical to their behavior.

In the classroom "off" and do not perform tasks, cry for nothing, quickly calm down when you switch to the game.

They love to dream, replacing and forcing out life situations that are unpleasant for them.



Emotional-volitional immaturity appears in the purest form and is often combined with an infantile body type. Such a harmony of psychophysical appearance, the presence of family cases, the non-pathological nature of mental characteristics suggest, presumably, an innate-constitutional etiology of this type of infantilism.

2. The delay in the mental development of somatogenic origin is due to the long-term somatic insufficiency of different origin:

chronic infections and allergies,

congenital and acquired malformations of the somatic sphere

? asthenia organism

? decrease in total and pt tone =>

? the formation of fearfulness, capriciousness, a sense of physical incompleteness, a regime of restrictions and prohibitions

? depletion of attention, nar. its concentration and distribution

? emotional weakness

? reduced self-esteem

? games are stereotypical harr

3. The CRA of psychogenic origin is associated with unfavorable conditions of upbringing that prevent the correct formation of the child’s personality.

This type of mental retardation should be distinguished from the phenomena of pedagogical neglect, which do not constitute a pathological phenomenon, and a lack of knowledge and skills due to a lack of intellectual information.

caused by the phenomenon of hypoopics - the conditions of neglect, in which the child is not brought up a sense of duty and responsibility, forms of behavior associated with active inhibition of affect. The development of cognitive activity, intellectual interests and attitudes is not stimulated. Therefore features

pathological immaturity of the emotional-volitional sphere

in the form of affective lability,

impulsiveness

heightened suggestibility in these children

often combined with an insufficient level of knowledge and ideas necessary for mastering school subjects.

hyper-care - pampering education, in which the child does not inculcate the features of independence, initiative, responsibility.

For this psychogenic infantilism, along

with little ability to volitional effort,

characteristic features of self-centeredness and selfishness,

dislike of work

installation for permanent assistance and care.



Adaptation in the collective of this category of children is difficult because of such character traits as egoism, opposition to the class, which leads not only to conflict situations, but also to the development of a neurotic state in a child.

? The stock of knowledge and skills of a domestic character is reduced.

? Reb does not know the letters

? Does not recognize geom.figur

? Strives for immediate satisfaction of their needs.

? Emoz-vol. Immaturity

? Game Interests

4. The delay in mental development of cerebral-organic origin occurs more often than the other types described and often has great persistence and severity of disorders both in the emotional-volitional sphere and in cognitive activity and occupies the main place in this development anomaly.


The study of the history of children with this type of DSS in most cases shows the presence of a non-coarse organic failure of the nervous system, more often a residual (residual) character due to

pregnancy pathologies (severe toxicosis, infections, intoxication and injuries, incompatibility of the blood of the mother and the fetus for the Rh factor),

prematurity

asphyxia and trauma at birth,

postnatal neuroinfections.

Anamnestic data often indicate a slowdown in the change of the age phases of development: the delay in the formation of the statistical functions of walking, speech, tidiness, and stages of play activity.

Emotional-volitional immaturity is represented by organic infantilism.

Children lack the vitality and brightness of emotions typical of a healthy child;

characterized by a weak interest in the assessment,

low level of claims.

Suggestibility has a coarse connotation and is often accompanied by a lack of criticism.

Game activity is characterized by poverty of imagination and creativity, monotony and monotony.

For CRA cerebral-organic origin is characterized by impaired cognitive activity, due to

lack of memory, attention,

inertness of mental processes, their slowness and low switchability, as well as the insufficiency of certain cortical functions.

lack of development of phonemic hearing,

visual and tactile perception,

optical spatial synthesis,

motor and sensory side of speech,

automation of movements and actions.

poor orientation in the “right - left”,

the phenomena of specularity in writing,

difficulties in distinguishing similar graphemes.

Thus, despite the heterogeneity of the group of children with CRA, we can identify common features:

1) In case of mental retardation, violations occur early, therefore the formation of mental functions occurs unevenly, slowly.

2) For children with ZPR characteristic of uneven formation of mental processes.

3) The most disturbed are the emotional-personal sphere, general characteristics of activity, efficiency: in intellectual activity, the most striking violations occur at the level of verbal and logical thinking with a relatively higher level of development of visual forms of thinking.

DIFFERENTIAL DIAGNOSTICS In the early stages of a child’s development, the difficulty of distinguishing between cases of coarse speech underdevelopment, motor alalia, mental retardation, autism, and mental retardation.

It is especially important to distinguish between mental retardation and mental retardation of cerebral organic genesis, since in either case, children have deficiencies in cognitive activity in general and a pronounced deficiency of modal-specific functions. Here are the main distinguishing features that are significant for distinguishing between mental retardation and mental retardation.

1. For violations of cognitive activity in the case of mental retardation, partiality and mosaic development of all components of the child’s mental activity are characteristic. With mental retardation, totality and hierarchy of violations of the child’s mental activity are noted.

2. In comparison with mentally retarded children, children with PZR have a much higher potential for developing their cognitive activity, and especially higher forms of thinking - generalization, comparison, analysis, synthesis, distraction, abstraction.

4. In contrast to mental retardation, in which the actual mental functions suffer — generalization, comparison, analysis, synthesis — during mental retardation, the prerequisites of intellectual activity suffer. These include such mental processes as attention, perception, scope of ideas, visual-motor coordination, phonemic hearing and others.

5. When examining children with CRA in comfortable conditions for them and in the process of purposeful upbringing and education, children are capable of fruitful cooperation with an adult. They take the help of an adult well

6. Game presentation of tasks increases the productivity of the activities of children with CRA, while for mentally retarded preschoolers it can serve as a reason for the child to involuntarily slide off the task.

7. For children with CRA, a high brightness of emotions is characteristic, which allows them to concentrate for a longer time on the performance of tasks that cause their immediate interest. In this case, the more the child is interested in the task, the higher the results of its activities. The emotional sphere of mentally retarded preschoolers is not developed, and overly playful presentation of tasks often distracts the child from solving the task itself and makes it difficult to achieve the goal.

9. The majority of children with pre-school age children in a preschool age, to varying degrees, have a visual activity. In mentally retarded preschoolers, without visual training, visual activity does not arise. Such a child stops at the level of the prerequisites of the subject images, that is, at the level of drafting. At best, graphic stamps are noted — schematic images of houses, “cephalopods” of a person, letters, numbers randomly scattered along the plane of a sheet of paper.

10. The neurological status of children with CRA is usually not marked by gross organic manifestations, which is typical of mentally retarded preschoolers.

12. Pathological hereditary burden is more typical for the history of mentally retarded children and is practically not observed in children with CRA.
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