What is the pace of mental development? Mental retardation (MDD)

INFLUENCE OF FAMILY FACTORS
TO REDUCE THE RATE OF CHILDREN'S MENTAL DEVELOPMENT

The basis of the characteristics of behavior and activity of children with a temporary “delay” mental development lies underdevelopment of personality. Here the importance of organic deficiency is usually emphasized. A number of authors (G.E. Sukhareva, N.M. Shchelovanov, D. Bowlby) additionally consider “delays” in mental development that arose as a result of insufficiency and deficiency of pedagogical influences. In some children with severe forms of “pedagogical neglect,” there is a possibility of a socially determined secondary “delay” in mental development. A decrease in the rate of mental development is a term that reflects a more dynamic concept than “delay” and is used to designate the mildest, initial forms of mental retardation. The decrease in rate may be due to the same factors as the “delay” in development. However, other aspects acquire independent significance for him, such as psychological stress in the mother before the birth of the child, severe reactive states in children, which, like mental trauma in the first years, lead to personality disintegration (E. A. Blei, I. Lauzikas). The decrease in the rate of mental development is caused primarily by a decrease in the energy activity of the growing organism (T.P. Simson) and a change in its reactivity. Intense and constant anxiety and fear experienced by a child are considered not indifferent to the development of his cognitive activity (G. Sullivan, E. A. Arkin, A. V. Klimanova).
The inhibitory phase states that underlie fear, while distinguished by their persistence, take on a stagnant character and approach parabiotic states (M.E. Maslov). Anomalies in the educational approach to a child* in the family can lead to a delay in his volitional development and the formation of an affective-hypobulic, subjective-irreal attitude, which in turn affects the development of the cognitive area (V.N. Myasishchev). Parental overprotection and dictatorship can lead to the same results (K. Leongardt). Thus, a combination of heterogeneous factors leads to a disruption in the pace of a child’s mental development. These factors are often found in various combinations with each other, with a predominance of one or another type of deficiency and psychogenic influences. Highlighting the role of each of them is of practical interest and allows us to find more accurate diagnostic criteria for differential diagnosis with mild forms of oligophrenia (D.N. Isaev). The role of the family factor is the least studied compared to the others. This determined the topic of this study.
From the general population of children with borderline conditions, a group of 14 boys aged 7-8 years who were experiencing difficulties in learning in the first grade was retrospectively examined. Common to this group were: difficulties in the cognitive area with a decrease in the rate of mental development; significant deviations in the educational approach on the part of adult family members; restoration of reduced mental functions in the process of psychotherapy.
The life history of these children is presented as follows. Heredity is not burdened. The intellectual capabilities of parents are not reduced. However, authoritarianism as a characteristic personality trait in some of them leads to inertia and rigidity of thinking. Among adult family members, fathers tend to be introverted, dependent, unstable, or, less commonly, authoritarian. At the same time, fathers are not sufficiently socialized.
Mothers are predominantly extroverts, emotionally unstable and anxious, with a need for dominance and care over others. At the same time, they are hypersocialized, rigid and authoritarian.
Grandmothers living in the family (usually on the mother's side) were the characterological prototype of their daughters. Common for them was a combination of authoritarianism, some paranoia and anxiety.
All adult family members have social adaptation without gross violations. In general, family members cannot be characterized as psychopaths. We are talking about the accentuation of their individual mental aspects.
In most families, grandmothers and mothers dominate, in the minority - fathers. The dominance style is always authoritarian, with harsh influence on another, non-dominant family member.
The socio-psychological structure of the family is formalized and tense. There is a lack of intimacy and trust in relationships. The latter are always conflicting, but at the level of “smoldering”, caused by psychological incompatibility, internal disagreements regarding dominance, upbringing, etc.
Attitudes towards the appearance of a child in a family are contradictory. One of the parents did not want him at all, the other, on the contrary, wanted him to appear. In most cases, the mother wanted to have a girl instead of a boy (partial rejection of the child). The average age of the mother at the time of birth is 30 years. First pregnancy in a row. During pregnancy and the first two years of children's lives, conflicts within the family are most pronounced. They affected a woman already during her pregnancy and lactation. Uncertainty about her family life increased the anxiety and fear of the expectant mother. At the same time, there was a strong fear of childbirth. A feeling of somatic discomfort, mild toxicosis are constant manifestations of pregnancy. All this taken together did not allow us to exclude the phenomena of mild intrauterine fetal hypoxia. Childbirth is premature or late (2-3 weeks), protracted in its course and painful for the woman. There is no asphyxia during childbirth. Active breastfeeding is shortened in time (1-2 months) due to mastitis in the mother and her anxious state. Up to one year old, children are quite calm, cheerful, with appropriate development for their age. Nevertheless, their increased reflex excitability and altered psychophysical reactivity are noteworthy. They were often sick for a long time. The mother did not have close and physical contact with the child due to not giving him due importance, fear of “spoiling” the child, and discord with her husband and her mother. Children were rarely held. The mother's facial expression is usually worried and restless.
In the first years of life, children experienced a lack of maternal influence. It is caused by their frequent stay in the hospital, early (up to a year) placement in a nursery, education by nannies, relatives, etc. The mother was replaced by a “group of educators” who sought to quickly develop the children. At the same time, the attitude of relatives was characterized by extreme inconsistency (each raised in their own way) and overprotection with the fixation of egocentric attitudes in children.
Already at two years old, boys exhibit timidity, impatience, and emotional instability. At this age, the activity and independence of children was regarded by others as a manifestation of willfulness and was repressed by cruel control. The treatment of the child was dominated by intimidation and threats. At the same time, parents were most afraid of the appearance of undesirable, from their point of view, behavioral traits in their children. This protopathic fear stemmed from their characterological characteristics and their own sense of insufficiency. Parents were irritated by troubles in any area of ​​their children’s lives. This irritation often resulted in physical punishment. Children were completely isolated from communication with peers, since parents considered themselves to be the “all-giving authority” and were skeptical about other types of extra-family information. All adult family members exhibited the children's verbal learning style with a corresponding lack of praxis. The dominance of one of the adults in the family was also manifested in upbringing and was accompanied by overprotection and prohibitions. The other, non-dominant family member was completely excluded from parenting. As a result, education was one-sided and incomplete. It should be noted the special role of grandmothers, who reduced the activity of children to a minimum with their annoying instructions, orders and prohibitions. They authoritatively propagated their understanding, their way of life. Their conviction that they were right defied logical reasoning.
In preschool age, boys experienced a lack of paternal influence due to its blocking by other adult family members, employment, immaturity, or the father’s excessive strictness and unavailability. In all cases, boys have virtually no attachment to their father. His authority for them is extremely low. The role of the father in the family is uniquely replaced by the grandmother or mother. It is to them that boys are initially attached, simultaneously suffering from their overprotectiveness and restrictive attitude.
Let's move on to consider the dynamics of the clinical picture. Against the background of children’s already altered reactivity, maternal deprivation in the first years of their life exacerbated sensitivity, impressionability and led to the appearance of anxiety in them. After the stormy “trotz” period, the age of 3-5 years looked relatively calm. All bright emotional and motor reactions of children were suppressed by parents. The general mood is somewhat depressed and sad. The activity and curiosity of children contrasts with their reluctance to remain in the dark, fear of loneliness and refusal of independence due to threats of punishment. At the age of 5-6, failures in attempts to communicate with peers led to even greater isolation of children from the outside world. The lack of paternal influence as a stabilizing factor was especially significant at this age and reinforced the elements of psychomotor impairment. In response to the current situation, the children did not have strong protest reactions or pronounced affective reactions. These reactions were involuntarily suppressed due to the assimilation of hypersocialized forms of behavior and the threat of punishment. Suppression of emotional reactions led to mental stress. The need for constant restraint (self-control), which is not typical for 5-6 year old children, resulted in headaches, irritability, and sleep disturbances for them. The personality adaptation system was disrupted. As a consequence of this, by the age of 6 in boys, the rate of mental development began to decrease, which until this age corresponded generally to the age norm. The children's activity was aimed not at mastering new things, but at avoiding unpleasant, traumatic experiences. The motivation for their behavior was more in the plane of defensive attitudes than in the cognitive-constructive area. Nevertheless, before school and in the first months of school, the children mastered the educational material offered to them, but with increasing stress. At the same time, the parents demanded and threatened more than they explained it. Parents' hypercontrol over school achievements and inadequate stimulation of their children's abilities contributed to the development of a nervous breakdown in the latter. Usually the reason itself that led to it was insignificant (transfer to another desk, bad grade). Despite this, a strong affective reaction of fear with a feeling of guilt arose. Fear was inadequately accepted big sizes in the minds of children and was accompanied by a feeling of constraint. This affect, as well as the subsequent rudiments of fear of school, is due to preliminary mental sensitization to failure due to parental threats; boys’ excessive attachment to their mother and fear of separation from her; psychosomatic intolerance and overexertion of capabilities. The parents considered their son's affective state to be pretense, self-indulgence, and unwillingness to attend school, and they strengthened their already tight control. Along with its intensification, emotional and volitional disorders increased in the form of emotional fatigue, depression, emptiness, passivity, up to a state of apathy and a peculiar state of “loss of desires” (at 5-6 years old, a state of “fear of desires”). Patients often looked thoughtfully at one point, as if they were withdrawing into themselves. Only a loud cry could bring them out of this state (phase states). Interest in all activities decreased. Preference was given to activities that did not require tension, comprehension, or search. Mental characteristics such as curiosity, curiosity, sense of humor, and flexibility of behavior in an unfamiliar situation were leveled out. The idea of ​​one’s “I” became vague and amorphous. Self-esteem was extremely low with a feeling of inability, worthlessness, even to the point of developing rudimentary ideas of self-abasement. The initially identical clinical picture in all 14 patients underwent a number of changes at the height of the reactive state. The common feature was a significant decrease in the feeling of fear and affective tension due to the development of: 1) infantilism syndrome (in 8 patients), in which personality regression occurred at the level of 2-3 years of age. Children became more active, lively, and inquisitive. But their activity was entirely focused in the gaming area. The games mostly reproduced the world of animals or consisted of building simple structures and destroying them. Images of people in drawings were replaced by images of animals. The disintegration of the overall composition of the drawing is noticeable. It became simpler, more fragmentary and at the same time more varied in color. The games were dominated by foolishness without much intensity of laughter and fun. Foolishness completely replaced the state of fear. The mother's anxiety and decreased demands on the children perpetuated their state of infantilism; 2) severe psychomotor disorders (in 4 patients): tics, stuttering, enuresis and encoping. These disorders at the physiological level represented the response of the body's adaptive (homeostatic) systems; 3) mixed syndrome of infantilism and psychomotor disorders (in 2 patients).
Despite various options clinical dynamics, a reactive state of affect and fear ultimately led to the pathocharacterological development of the hysterical circle (fear of school was replaced by reluctance to attend it). Egocentrism, neglect of one's responsibilities, and capriciousness were aimed at changing the attitude of the parents. Increasing difficulties at school were used by children as a unique way of dominating the family due to the fact that their condition was already causing concern for their parents and concessions on their part. For all 14 patients, grade 1 presented the greatest difficulties: 6 of them were retained for the second year, 8 were able to stay in school only after a course of therapy and targeted medical and pedagogical work with parents.
We see a combination of many factors leading to a decrease in the rate of mental development of children. The family factor plays a significant role, especially inadequate, strictly controlling upbringing, which does not take into account real opportunity children and exceeding their own development potential. In preschool age, maternal deprivation leads to the development of anxiety; in older preschool age, paternal deprivation increases psychomotor instability.
Fundamental to the clinical picture is anxiety, which takes the form of open fear. It is caused by somatic weakness, the attitude of parents, which is perceived as a threat to the formation of the experience of “I,” and the suppression of reciprocal emotional responses. In older preschool age, the clinical condition can be characterized as fear neurosis. The critical period is the beginning of schooling. A reactive state arises as a response to learning difficulties, a change in life pattern, and separation from the mother, to whom the child is unilaterally attached. The reactive state against the background of previous altered reactivity and minimal brain failure gives rise to developmental neurosis with the final outcome in the pathocharacterological development of the hysterical circle.
The decrease in the intellectual capabilities of children is socially determined and is temporary, but only subject to a change in the attitude towards children on the part of their family and a complex of restorative therapy. In view of this, the differential diagnosis with oligophrenia is not difficult. In the cases considered, the inadequate social situation of personality development leads to a primary violation of the affective-volitional sphere and, secondarily, to a partial violation of the cognitive sphere.
Despite the relatively slow recovery of impaired functions (1-2 years), the majority of children (11) were able to continue their education at school, 3 children were taught at home according to an individual program. In the latter cases, the most unfavorable degree of pathocharacterological development was noted due to the attitude of the parents, rigid to the doctor’s correction.
In general, clinical data do not allow it to be verified as a neurosis-like condition. We are talking about a neurotic form of personality response under unfavorable conditions of its development against the background of minimal brain failure.
From the above, it follows that it is necessary to apply a system of preventive medical and pedagogical measures to families in which the child is in pathological conditions of personal development.

Delays in the rate of mental development in children

(literature review)

YES. Emelina, I.V. Makarov

St. Petersburg Research Psychoneurological Institute named after. V.M. Bekhtereva

Summary. The review article examines various aspects of mental development delays in children - history of the issue, clinical picture, differential diagnosis, etiopathogenesis.

The authors point out the lack of research on the comorbidity of mental retardation with other psychopathological syndromes. Keywords:

mental retardation, borderline mental retardation, infantilism.

Developmental delay in children D.A.

Emelina, I.V. Makarov

St.-Petersburg V.M.Bekhterev psychoneurological research institute

Summary. The article reviews various aspects of developmental delay in children – the historical background, clinic, differential diagnostics, etiology and pathogenesis. Authors note on the small quantity of researches devoted comorbidity of developmental delay with other psychopathological syndromes.

Key

words: developmental delay, DD-borderline mental retardation, infantilism. Background The presence of patients occupying an intermediate position between normal and mild mental retardation attracted the attention of specialists back in the last century.: « To describe this group, which is quite heterogeneous in clinical manifestations, domestic and foreign authors used many"(N.A. Dobrolyubov), "children of the border line" (I. Borisov), "subnormal" (A.I. Graborov), "under-gifted" (V.P. Kashchenko; G.V. Murashov), "mentally underdeveloped” (P.P. Blonsky, 1930), “children occupying an intermediate position between “illiterate” and “abnormal” (Binet), “subnormal”, etc.(I.F. Markovskaya, 1982; E.I. Kirichenko, 1983; F.M. Gaiduk, 1988). The uniqueness of the terminology and description of this pathology by researchers in different countries is due to the specific approach to the study of these children. Thus, in the Anglo-American literature the term “minimal brain dysfunction” (MMD) is used, officially adopted in 1962 at the international conference of pediatric neurologists in Oxford (L.T. Zhurba, E.M. Mastyukova, 1978). In German literature, the psychological and pedagogical concept of “violation of relationships” (“school behavior”) was used. A characteristic feature of these children is a violation of behavior in general, which is manifested in difficulties in obeying rules, failure to follow the instructions of adults, negativism, and emotional instability. Many domestic authors highlight mild forms of mental underdevelopment caused by negative cultural influences.

The beginning of another direction in the study of delays in the rate of mental development was laid by the works of E. Lasegne and K. Larrain (G.E. Sukhareva, 1965), who were the first to describe the clinic of infantilism in children. Later, G. Anton in 1906, narrowing this group, described the clinic of mental infantilism and noted that, in addition to the immaturity of the emotional-volitional sphere, such children also show some lag in the development of cognitive abilities (not reaching the level of oligophrenia), attention, memory , which creates certain difficulties for them in learning (I.A. Yurkova, 1959).

In the domestic literature, the most widely used term is “mental retardation” (MDD), used by G.E. Sukhareva (1965, 1970). This term was adhered to by S.S. Mnukhin (1968), T.A. Vlasova (1966), E.A. Pekelis (1971), M.S. Pevzner (1972), E.I. Kirichenko (1983), F.M. Gaiduk (1988). According to many researchers, the term is unsuccessful, since mental retardation is not always temporary, but can be more or less persistent, as G.E. noted. Sukharev (1965). In addition, the term “mental retardation” is not adequate enough to describe borderline intellectual disorders in adolescents. In this regard, V.V. Kovalev (1979) considered it appropriate to combine all forms of mild intellectual disability with the concept of “borderline intellectual disability.”

Definition of the concept and boundaries of ZPR

Mental retardation is a variant of mental dysontogenesis, which includes mild intellectual disability that differs in etiology, pathogenesis, clinical manifestations and dynamics, occupying an intermediate position between the intellectual norm and mental retardation and tending to positive dynamics with well-organized rehabilitation work.
M.Sh. Vrono (1983) identified the main clinical signs characteristic of all forms of mental retardation:

1. Delay in the development of basic psychophysical functions (motor skills, speech, social behavior).

2. Emotional immaturity.

3. Uneven development of individual mental functions.

4. Functional, reversible nature of the disorders.

Children with mental retardation are not ready for learning due to the following characteristics:

1. A pronounced violation of the functions of active attention in most of them.

2. The lack of integrative activity of the brain makes it difficult to recognize non-standard images; it is difficult for children to connect individual details of a drawing into a single image.

3. Delay in the formation of spatial concepts, insufficient orientation in one’s own body.

4. Low cognitive activity.

5. Insufficient development of fine motor skills of the hands.

6. Motor disinhibition.

7. Insufficient or distorted reading and writing skills.

8. Emotional instability.

Such children have difficulty adapting to the children's group; they are characterized by mood swings and increased fatigue.

It should be noted that these diagnostic criteria can only partially be applied to children of primary preschool age. Due to the frequent combination of mental retardation with speech disorders (E.V. Maltseva, 1990; V.A. Kovshikov, 2006), children aged 3–4 years are often non-speaking, and severe attention disorders and immaturity of the emotional-volitional sphere make it impossible to use psychological techniques.

Classifications of ZPR

There are no uniform principles for the taxonomy of borderline forms of intellectual disability. Classification based on etiopathogenetic mechanisms was proposed by G.E. Sukhareva (1965):

· intellectual impairments due to unfavorable environmental and educational conditions or behavioral pathology;

· intellectual impairments in long-term asthenic conditions caused by somatic diseases;

· violations during various forms infantilism;

· secondary intellectual insufficiency in communication with hearing, vision, speech, reading and writing defects;

· functional-dynamic intellectual disorders in children in the residual stage and late period of infections and injuries of the central nervous system.

Another classification was proposed by M.S. Pevzner and T.A. Vlasova (1966), who identified 2 main options for ZPR:

mental retardation associated with mental and psychophysical infantilism;

ZPR caused by long-term cerebrovascular disease.

In 1982 K.S. Lebedinskaya presented a new clinical classification, in which variants of ZPR were differentiated according to etiopathogenetic based on the following groups:

· ZPR of constitutional origin;

· ZPR of somatogenic origin;

· mental retardation of psychogenic origin;

· ZPR of cerebral-organic origin;

· organic infantilism;

· ZPR with a predominance of functional impairments of cognitive activity and with insufficient well-formed individual cortical functions.

Subsequently, this classification was supplemented by I.F. Markovskaya (1995), who proposed dividing mental retardation of cerebral-organic origin into 2 groups:

a) group A – the structure of the defect is dominated by features of immaturity of the emotional sphere, such as organic infantilism;

b) group B – symptoms of damage dominate: persistent symptoms are identified encephalopathic disorders, partial violations of cortical functions, intellectual impairment predominates in the structure of the defect.

According to G.V. Kozlovskaya and A.V. Goryunova (1998), ZPR are divided into:

1. Primary delays of cerebral-organic origin (they are based on hypoxic, traumatic, infectious, toxic and other factors acting on the developing brain in the perinatal period, leading to mild brain damage that does not reach a clear organic defect).

2. Secondary delays in neuropsychic development occur against the background of a primarily intact brain in chronic somatic diseases.

3. A special variant of violations is delayed development with dissociation(splitting) and disharmony (unevenness) in the development of individual mental functions (with autistic syndrome).

The most complete classification of ZPR, in our opinion, was proposed by V.V. Kovalev (1979):
I. Dysontogenetic forms of borderline intellectual disability.

1. Intellectual deficiency in states of mental infantilism:

a) with simple mental infantilism;

b) with complicated mental infantilism:

· psychoorganic syndrome (organic infantilism according to G.E. Sukhareva, 1965);

· with a combination of mental infantilism with cerebrasthenic syndrome;

· with a combination of mental infantilism and neuropathic conditions;

· with a combination of mental infantilism and psychoendocrine syndrome.

2. Intellectual deficiency with a lag in the development of individual components of mental activity:

a) with speech development delays;

b) when the development of so-called school skills (reading, writing, counting) lags;

c) when the development of psychomotor skills is delayed.

3. Distorted mental development with intellectual disability (a variant of early childhood autism syndrome).

ІІ. Encephalopathic forms.

1. Cerebrasthenic syndromes with delayed development of school skills.

2. Psychoorganic syndromes with intellectual disability and impairment of higher cortical functions.

3. Borderline intellectual disability in cerebral palsy.

4. Intellectual deficiency with general speech underdevelopment (alalia syndromes).

III. Intellectual disability associated with defects in analyzers and sensory organs.

1. Intellectual deficiency due to congenital or early acquired deafness and hearing loss.

2. Intellectual deficiency in blindness that occurs in early childhood.

IV. Intelligent lack of communication with defects in education and lack of information from early childhood (“pedagogical neglect”).

Classification of mental retardation according to severity was proposed by F.M. Gaiduk (1988). Based on the clinical and psychological study conducted, three degrees of severity of mental retardation were identified: mild, moderate and severe (severe). In addition, according to the degree of balance in the emotional-volitional and psychomotor spheres, they identified the following types - inhibited, unstable and balanced.

Epidemiological indicators

Data on the prevalence of mental retardation are very contradictory. Clear boundaries of this group have not been defined, since they largely depend on social criteria, in particular from the requirements imposed by society on the intellectual abilities of the child (V.V. Kovalev, 1995; I.A. Korobeinikov, 1997). The peak incidence of mental retardation occurs at early school age (7–10 years), and there is little data on the prevalence of mental retardation in preschool age. In an epidemiological study undertaken in 1972–1973. Research Institute of Defectology of the Academy of Pedagogical Sciences of the USSR in a number of regions of the country, DPR was found in 5–6% of primary school students in public schools (T.A. Vlasova, K.S. Lebedinskaya, 1975; I.F. Markovskaya, 1982). Among systematically underperforming primary school students in public schools, borderline intellectual disability is observed in 52.5–79% ( I.L. Kryzhanovskaya, 1983; Z.I. Kalmykova, 1986; P.P. Ulba, 1987). Yu.S. Shevchenko (1999) believes that in 80% of cases, school failure is associated with various states of cognitive impairment, including mental retardation. Among preschool children, according to U.V. Ulyenkova (1984), 20% lag behind in mastering the program. Clinical and psychological examination of these children revealed mental retardation in 50% of them. According to O.V. Maslova et al. (2001), the prevalence of mental retardation in children under 3 years of age is 1.2% as an independent nosological condition, or 8–10% in the structure of general mental pathology. V.M. Voloshin et al. (2002) note that more than 70% of students in general secondary education institutions experience significant difficulties in mastering the basic school curriculum.

In the literature one can find data on an increase in the number of children with mental retardation over the past decade. L.M. Shipitsina (1995) notes an increase in the number of these patients, indicating that during the period from 1990 to 1995, the number of children with mental retardation doubled. According to I.Ya. Gurovich et al. (2000), the incidence of mental retardation among children and adolescents increased by 19.8% from 1994 to 1999, and the incidence of mental retardation disorders also increased significantly non-psychotic character, which includes the ZPR.

V.M. Voloshin et al. (2002) provide data that during the period from 1997 to 2002, the frequency of mental pathology among children increased by 16.7%, among adolescents - by 2.5%. The authors also note an increase in mental disorders among young children (under 3 years of age). Etiopathogenesis

ZPR

Among the causes of mental retardation, there are biological (in the broad sense) and social ones, which in most cases act in combination (V.V. Kovalev, 1995).

Biological factors are represented by a wide range of influences, including a variety of exogenous hazards (somatic, infectious, endocrine diseases of the mother, intoxication, toxicosis and pathology of pregnancy, Rh factor incompatibility, prematurity, asphyxia, parental alcoholism, mechanical injuries, neuroinfections, traumatic brain injuries in the first years of life, etc.), acting in the ante-, intra- and perinatal periods. They are noted in the anamnesis in 60–72% of children with mental retardation.

According to a number of authors, the degree of pathogenicity of an unfavorable factor depends on its specificity, intensity, severity, pace, time of exposure and stage of fetal development. It is believed that the most significant exogenies are those that act in the first trimester of pregnancy. F.M. Gaiduk (1988), having studied the anamnesis of 222 children with mental retardation, came to the conclusion that the main cause of the cerebral-organic variant of the disease is perinatal pathology, which was noted in the anamnesis in 49% of cases. As noted by L.I. Pasechnik (1989), children born in complicated births had lower intellectual scores in comparison with their peers from the group of children from normal births. Children in families burdened by parental alcoholism are significantly more likely to have mental retardation according to

encephalopathic type. In 26–35% of cases, parents suffering from alcohol addiction give birth to children with mental retardation (M.V. Romanova, I.S. Romanov, 1978).. F.M. Gaiduk (1988) noted that unfavorable family conditions occurred in the majority of children with mental retardation. K.S. Lebedinskaya (1982) believed that a significant role in fixing emotional-volitional immaturity belonged to incorrect conditions of upbringing. According to many authors, the majority of children with mental retardation were raised in conditions of family disharmony, emotional and mental deprivation, in families with a low cultural, educational and social level. V.M. Voloshin et al. (2002) note that the formation of mental disorders largely depends on social parameters. In 62% of children brought up in boarding schools, from early childhood, delayed mental maturation with intellectual impairment is detected. In considering the etiology of mental retardation, the role of postnatal hazards is not rejected (G.E. Sukhareva, 1965; V.V. Kovalev, 1979), however, they account for only a small part of children with mental retardation. I.V. Dobryakov (1989), analyzing the dynamics of neuropsychic disorders in school-age children with the consequences of neuroinfections, came to the conclusion that based on

cerebrasthenic In this case, cognitive dysfunction may also develop. Many researchers have pointed out the importance of genetic factors in the genesis of mental retardation. Research on the significance of various factors influencing the formation of mental retardation, carried out by M.V. Zlokazova (2004), showed that most often the etiology of ZPR has multifactorial character with a significant influence of heredity, perinatal pathology and social factors. Perinatal pathology in the formation of mental retardation can play a leading role in the case of significant exposure to pathogenic perinatal factors, but in most cases it is not the main and only cause

retarded development. brain, relating mainly to the frontal regions of the cerebral cortex, which ensure the implementation of conscious acts of human behavior and activity. According to V.V. Kovalev (1979), in some cases the mechanism of delaying the rate of development of the youngest functional systems of the brain predominates, in others, associated with more persistent intellectual failure, the mechanism of mild organic damage to the brain with loss of structural and functional elements necessary for the implementation of a higher level intellectual processes.

Clinical manifestations and nosological affiliation of ZPR

A number of works show a tendency to identify two main forms among children with mental retardation: dysontogenetic And encephalopathic .

The dysontogenetic form of mental retardation includes infantilism syndromes. With simple mental infantilism (V.V. Kovalev, 1979), which also includes the one identified by G.E. Sukhareva (1959) harmonious infantilism, mental immaturity covers all spheres of a child’s activity, including intellectual, but the phenomena of emotional-volitional immaturity predominate. In most children, intellectual disability is of a secondary nature, determined mainly by a lag in the maturation of the components of the developing personality.

The dynamics of the described states are favorable. With age, especially with properly organized upbringing and training, manifestations of mental infantilism can sometimes be smoothed out to the point of complete disappearance, and intellectual deficiency can be compensated. psychoorganic With complicated mental infantilism, the clinical picture shows a combination of mental infantilism with other psychopathological manifestations. There are several options in this group. The first option is the most difficult to differentiate - “organic infantilism”, described by domestic psychiatrists. With organic infantilism, mental infantilism is combined with syndrome. This type of infantilism most often occurs in connection with the consequences of early organic brain damage of various origins. In this regard, it represents an intermediate form of pathology between dysontogenetic and encephalopathic The dynamics of organic infantilism are less favorable (G.E. Sukhareva, 1965; I.A. Yurkova, 1971; I.L. Kryzhanovskaya, 1982). In children of this group, intellectual disability becomes more pronounced with age, which leads to persistent poor performance in secondary school. In some of them, during puberty and prepuberty, psychopathic behavioral disorders, aggressiveness, pathology of drives. According to V.V. Kovalev (1979), some cases can be attributed to mental retardation, and some to borderline intellectual disability.

Variants of complicated infantilism include the quite common cerebrasthenic option (V.V. Kovalev, 1979, 1995). In this variant, mental infantilism is combined with cerebrasthenic syndrome, which is manifested by symptoms of irritable weakness: increased excitability combined with exhaustion, severe instability of attention, moodiness, motor disinhibition and various somato-vegetative disorders (sleep disorders, appetite, vasovegetative manifestations). Close to cerebrasthenic neuropathic variant of infantilism (V.V. Kovalev, 1979), in which mental infantilism is combined with the manifestation of neuropathy syndrome. In the personality structure of children with this variant, along with emotional-volitional immaturity, asthenic traits are also expressed - increased inhibition, timidity, fearfulness, impressionability, lack of independence, excessive attachment to the mother, inability to stand up for oneself, difficulties in adaptation in the conditions of children's institutions. Intellectual impairments and school failure with this option tend to be compensated (I.L. Kryzhanovskaya, 1982).

With endocrine variants of mental infantilism, the clinical picture is determined by a combination of features of infantilism with mental characteristics typical of a particular endocrine psychosyndrome (G.E. Sukhareva, 1965; V.V. Kovalev, 1979). In general, the prognosis for organic infantilism is less favorable than for uncomplicated infantilism.

The next large group is formed by encephalopathic ZPR forms. The main etiological factor predominant in this group is residual-organic brain damage, in connection with which many authors designate this group of delays as mental retardation of cerebral-organic origin. In contrast to more severe and less reversible disorders in organic dementia, the conditions described in this group are more reversible in nature, which allows them to be included in the group of borderline forms of intellectual disability. The most common variants of ZPR are of cerebral-organic origin, in the occurrence of which the leading role belongs to the hazards of the perinatal period.

Taking into account the fact that the balance of the emotional-volitional and psychomotor spheres has a great influence on the degree of use of potential intellectual abilities and the level of maladaptation, F.M. Gaiduk (1988) considered it necessary to distinguish types of ZPR: inhibited, unstable and balanced.

The unstable type of mental retardation was more common than others – in 65% of those examined. Children with an unstable type of mental retardation were characterized by increased motor activity, affective explosiveness, mood instability, a tendency to active forms of protest and reactions of an aggressive-defensive nature, sometimes they had a euphoric background mood. TO braked type 26% of children were classified as having mental retardation. They experienced a decrease in mood, mental and motor activity, as well as the rate of work capacity. The children were characterized by uncertainty, timidity, shyness, and a tendency to reactions of a passive-defensive nature. The rarest type was the one with emotional-volitional balance - in 9% of children. These children were sociable and active. The mood was generally stable. The pace of activity is smooth. Pathocharacterological

there were no reactions, and characterological ones were rare, short-term and psychologically understandable.

Another broad group of mental retardation disorders is identified, caused by a partial disruption of the rate of maturation of individual neurophysiological systems: brain mechanisms of speech, psychomotor skills, mechanisms that determine the development of so-called school skills - reading, writing, counting.

Differential diagnosis

The works of many domestic scientists are devoted to the issues of differential diagnosis of mental retardation and similar conditions. In preschool age, mental retardation most often has to be differentiated from alalia syndromes, autism and mental retardation. The differential diagnosis between mental retardation and infantilism has been studied(A.F. Melnikova, 1936; I.A. Yurkova, 1959; M.S. Pevzner, 1966). In the clinical picture of uncomplicated infantilism, in contrast to mental retardation, there is greater mental alertness, increased interest in the environment, vividness of emotions, greater initiative and lack of inertia, and a higher level of logical processes.

Differential diagnosis of organic infantilism is much more difficult, since these patients show the main signs of oligophrenia - a reduced level of generalization and an inability to think abstractly. However, clinicians emphasize a different hierarchy of the structure of cognitive impairment in cases of organic infantilism than in mental retardation: the greatest deficiency is not in thinking as such (the ability to abstract and generalize), but in the deficiency of the “preconditions” for thinking.

Differential diagnosis of intellectual disorders in asthenia and oligophrenia usually does not cause difficulties. With a careful study of the data on the child’s somatic and mental state, it can be established that intellectual productivity is reduced due to an unstable tone of attention and an inability to endure prolonged mental stress.

It is especially important to distinguish between mental retardation and mental retardation of cerebral-organic origin. The main distinctive features are described in the works of many authors. Disorders of cognitive activity with mental retardation are characterized by partiality and patchiness in the development of all components of the child’s mental activity. Compared to mentally retarded children, children with mental retardation have much higher potential for the development of their cognitive activity, and especially higher forms of thinking - generalization, comparison, analysis, synthesis, distraction, abstraction. With mental retardation, the prerequisites for intellectual activity suffer to a greater extent. Children with mental retardation respond well to the help of an adult and even the help of a more advanced peer. The play activity of children with mental retardation is more developed and is more emotional in nature. Playful presentation of tasks increases the productivity of children with mental retardation, while for mentally retarded preschoolers it can serve as a reason for the child to involuntarily slip from completing the task. Children with mental retardation are characterized by greater intensity of emotions, which allows them to concentrate for a longer period of time on completing tasks that arouse their immediate interest. The somatic appearance of children with mental retardation is mostly absent dysplasticity, and the neurological status usually does not show gross organic manifestations.

It is particularly difficult to distinguish between mental retardation and severe speech disorders of cortical origin (motor and sensory alalia). For differential diagnosis, it is important to know that a child with motor alalia has extremely low speech activity (V.A.Kovshikov, 2006). In addition, it must be remembered that with motor alalia, sound pronunciation and phrasal speech are most affected, and the ability to assimilate norms native language persistently violated. A child with sensory alalia has disturbances in voluntary attention caused by depleted auditory function; Children do not know how to “listen”, get tired quickly, and lose interest. Often the child comes into contact only with close people, which is due to such features in communication as pronounced intonation and gestural accompaniment of the mother’s speech. At the stage of increasing speech activity, which takes on the character of communication, manifestations of echolalia become pronounced. At the same time, a child with sensorimotor alalia can participate in outdoor games with peers that do not require verbalization.

Difficulties for diagnosis are the distinction between mental retardation and autism. In the group of mental retardation disorders of cerebral-organic origin, in many cases there are individual manifestations of autistic behavior (motor stereotypies, hypoprosexia, primitive, monotonous games, etc.), which, however, unlike autism as an anomaly of mental development, are fragmented in nature and they lack the main manifestation of autism - lack of formation needs for communication with others (K.S. Lebedinskaya, O.S. Nikolskaya, 1989). All children with organic damage to the central nervous system strive to communicate with others, they are not fenced off from the outside world, do not avoid eye contact and do not show special dissociated behavior characteristic of early childhood autism.

The main difficulties that arise in the differential diagnosis of mental retardation and mental retardation are associated with the need for a complete and accurate assessment of the structure and level of impairment of the child’s intellectual activity. In addition, the qualitative heterogeneity of children with mental retardation requires internal differentiation, which should be considered as a prerequisite for optimal choice forms and methods of psychological, pedagogical and medical correction. In any case, the diagnosis of delayed mental development cannot remain later than 11–13 or, in extreme cases, 12–14 years (I.V. Makarov, 2007; N.G. Neznanov, I.V. Makarov, 2009).

Conclusion
It can be stated that today there are no unified principles for the systematics of ZPR. A common point of view regarding the independence of this diagnosis has not been developed. Based on the data of leading researchers, it is most advisable to consider ZPR as a combined group of syndromes of different etiology and pathogenesis that have a similar clinical picture. In this case, the question remains open about the nosological affiliation of mental infantilism. Unfortunately, there are no clear criteria for diagnosis in the group of children of primary and preschool age. The peak of detection occurs at primary school age (7–10 years), which is too late for effective rehabilitation. There is no consensus on the age at which the diagnosis of mental retardation is appropriate. Data on the prevalence of various syndromes in mental retardation are contradictory; there is insufficient research on psychopathological conditions comorbid with mental retardation in a group of children of primary and preschool age.

Work in this area would be of great importance, since often the clinical picture and prognosis are determined not only by signs of delayed development, but also by the totality of all syndromes included in the structure of the disease. This would also make it possible to individualize the tactics of therapeutic management of patients with mental retardation and increase the effectiveness of treatment and rehabilitation.

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Yurkova
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Rate of mental development
RATE OF MENTAL DEVELOPMENT - the degree of speed of a person’s personal changes. constantly changing and developing. This is a diochronic (dio - through, chronos - time) system. This includes, for example, the natural sequence of development of intelligence described by the Swiss psychologist J. Piaget (1896-1980). In the process of mental development, stages of increasing functions alternate with stages of stabilization. This is how the transition of quantitative changes into qualitative occurs. The process of development of different aspects of a holistic personality, its levels individual consciousness also occurs unevenly. Therefore, a personality can combine maturity in some respects and infantilism in others. An integral characteristic of physical and mental development is the speed of change. According to this criterion, people can be divided into three groups: 1) with accelerated (approximately 25%), 2) uniform (50%) and 3) slow development (25%).

List of random tags:
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Aspiration - Aspiration is a motive that is not presented to the subject in its objective content, due to which the dynamic side of activity comes to the fore.
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Practice and internship of students - PRACTICE AND INTERNSHIP OF STUDENTS - types of their professional training. During the period of practice and internship, the educational, social and scientific activities of students are continued directly in the conditions of their future professional work. During practice, students solve real professional problems, replenish their knowledge, skills, abilities, professionally improve important qualities, and gain leadership experience. At the same time, the practice and internship of students makes it possible to determine positive sides and shortcomings in professional training, to better understand the complexity and responsibility of duties in the specialty, the importance of independence, mental, communicative, organizational, pedagogical qualities and abilities. The more thoroughly the business and psychological preparation for them is carried out, the stronger the influence of practice and internship on the professional and general development of trainees.
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Preventive psychology - PREVENTIVE PSYCHOLOGY is a branch of applied psychology. Its main task is to equip a wide range of practitioners (teachers, educators, employees of inspections and commissions on juvenile affairs, social workers, practical psychologists) with psychological knowledge to prevent, diagnose and correct deviant behavior of minors, as well as improve the conditions of their family and public education. For preventive psychology, it is important to determine the scope and psychological tools that allow solving one’s own specific problems in preventing and correcting deviant behavior of children and adolescents. Among the various, interrelated factors that determine the genesis of antisocial behavior, we can distinguish: individual factor, psychological and pedagogical factor, socio-psychological factor, personal factor and social factor.

The concept of the pace of mental development. This is a characteristic of a person’s level of development in relation to the level of development of his peers. The norm here is different (broad). But nevertheless, we can talk about a delay in development. It can be: partial (some functions) and total. Developmental delay – infantilism.

Retardation and asynchrony of development. All forms of mental disorders are divided into two large classes. Retardation, delay or suspension of mental development of any origin; underdevelopment in various forms of mental retardation. There are two types of retardation: total and partial. In the latter case, we are talking about the immaturity of individual functions, aspects of the psyche in particular, school skills - reading, writing or personality traits. Asynchrony, some functions are ahead of others in development, which leads to disharmony in the structure of the psyche, its distortion and disproportion. For example, the development of speech is ahead of the development of motor skills. Abstract thinking is visual and effective. general characteristics Mental retardation and causes of developmental delays. Mental retardation is a group of disorders, different in etiology, pathogenesis and clinical manifestations, which are expressed in a state of mild intellectual disability and occupy an intermediate position between oligophrenia and the intellectual norm. Comparative characteristics with oligophrenia:

1. The causes of mental retardation may be similar to mental retardation. Weaker effects, shorter duration.
2. If oligophrenia is persistent underdevelopment, then mental retardation is a decrease in the rate of development.
3. With oligophrenia, the defect does not go away; with mental retardation, positive dynamics are possible, leveling off is possible, up to reaching the age norm.
4. With oligophrenia, signs of the disorder are visible everywhere; with mental retardation, they are detected only upon entering school.
5. With oligophrenia, the totality of the defect, with mental retardation, the lag will not necessarily affect all areas.

Causes of developmental delays: organic damage; functional failure of the central nervous system; disorders in intrauterine development; during childbirth; in the first years of life; chronic somatic diseases; long-term deprivation; acquired. One of the characteristic features of children with mental retardation is the uneven development of different aspects of the child’s mental activity. Approaches to identifying types of mental retardation and classification of disorders borderline with oligophrenia, common and different aspects of them. (Sukhareva G. E., Kovalev V. V., Demyanov Yu. G., ICD).

Classification of ZPR according to Kovalev:

1. Dysontogenetic forms of borderline intellectual disability (psychophysical infantilism, delayed speech development, school skills; developmental delay in RDA).
2. Encephalopathic (cerebrovascular disease, psychoorganic syndrome with insufficiency of cortical functions, cerebral palsy, etc.).
3. ZPR in case of defective analyzers.
4. Mental retardation in cases of education defects and information deficit in childhood.

Classification of ZPR according to Sukhareva:

1. Delay in the rate of development of children due to disturbances in upbringing, learning, and behavior.
2. ZPR in asthenic conditions.
3. Secondary mental retardation with defects in vision, hearing, musculoskeletal system, and speech.

Classification of ZPR according to Demyanov:

1. ZPR with cerebrasthenic syndrome.
2. Psychophysical infantilism.
3. ZPR with neuropathic syndrome.
4. Mental retardation with psychopathic symptoms.
5. ZPR in cerebral palsy.
6. ZPR with general speech underdevelopment.
7. ZPR with severe hearing and vision defects.
8. ZPR with family and household neglect.

These classifications are united by the fact that ZPR can be primary and secondary. In ICD - 10 (international classification of diseases):

1. Organic and symptomatic mental disorders. These include those disorders that are associated with traumatic brain injuries, etc.
2. Mental and behavioral disorders caused by the use of mentally active substances (alcohol, cocaine, hallucinogens, poppy preparations, volatile solvents, sleeping pills, tobacco).
3. Schizophrenia, schizotic and delusional disorders.
4. Affective disorders.
5. Neurotic, stress-related and somatomorphic disorders (acute reaction to stress; post-traumatic syndrome).
6. Behavioral disorders associated with physiological factors (sleep disturbances, sexual function, food disturbances).
7. Personality and behavior disorder in adults (sexual perversions, violation of habits, inclinations).
8. Mental retardation in the form of the formation of persistent mental underdevelopment in early childhood.

Variety of clinical manifestations of mental retardation. ZPR of constitutional origin. ZPR of cerebral-organic origin. The main clinical groups of mental retardation are differentiated according to the etiopathogenetic principle (Lebedinsky classification):

1. ZPR of constitutional origin;
2. ZPR of somatogenic origin;
3. mental retardation of psychogenic origin;
4. ZPR of cerebral-organic origin.

Each of these types of mental retardation has its own clinical and psychological structure, its own characteristics of emotional immaturity and cognitive impairment, and is often complicated by a number of painful symptoms - somatic, encephalopathic, neurological. In many cases, these painful signs cannot be regarded only as complicating ones, since they play a significant pathogenetic role in the formation of the ZPR itself. The presented clinical types of the most persistent forms of mental retardation mainly differ from each other precisely in the structural features and nature of the relationship between the two main components of this developmental anomaly: the structure of infantilism and the nature of neurodynamic disorders. In the slow pace of formation of cognitive activity, insufficiency of intellectual motivation and volition is associated with infantilism, and the tone and mobility of mental processes are associated with neurodynamic disorders.

I. ZPR of constitutional origin. 3 subspecies:

1). Harmonic psychophysical infantilism. The basis is hereditary factors or a disease in early childhood. In terms of their physical development, they are 2–3 years behind. Characterized by good speech development; bright expressive emotions; friendliness; friendliness; attraction to older people. There are no gross cognitive impairments noted. When they come to school they become underachievers. There is no personal readiness for school. Gaming interests predominate. Transforms a learning situation into a game one. In conversations he openly talks about his reluctance to learn. It is advisable to return them to kindergarten until they mature. Favorable dynamics. Features of hysterical accentuation may increase (the need to be in the center of attention, etc.).

2). Disharmonic psychophysical infantilism. Non-severe brain damage at an early stage of development. Retarded physical development. There is a violation of cognitive activity (immaturity of mental operations, narrowed memory capacity, difficulties in analyzing spatial relationships). High fatigue, reduced mental performance. Attention is unstable, or its pathological inertia, stuckness. Disharmony in the emotional-volitional sphere, in communication. Hot temper, affective instability, pugnaciousness, etc. Indifference to comments. The dynamics are less favorable for leveling.

3). Psychophysical infantilism in endocrine insufficiency. Violation of metabolic processes. Retarded physical development. Body dysplasticity and impaired coordination of movements. Creates difficulties for communication. Complexes, anxiety, etc. They have a slowness in all mental processes. No brightness of imagination, no initiative (low academic performance). Mood fluctuations with a predominance of the depressive component. The appearance of neurotic symptoms (fertile soil). These features can be smoothed out. Positive dynamics.

II. ZPR of somatogenic origin. Based on the presence of chronic diseases internal organs. He is weakened by all sorts of diseases. This is due to overprotection; excessive desire of adults to protect the child from some other harm. The child is brought up in greenhouse conditions. A large number of prohibitions. In cognitive development, he may even be ahead of his peers. Personal immaturity (uncertainty; lack of initiative; timidity; inability to make decisions; timidity). Lagging behind in physical development and active forms of behavior. Diseases intensify and become aggravated under conditions of overprotection.

III. ZPR of psychogenic origin. Deprivation situation (see above). Separation is the painful separation of a child from his mother. This can lead to negative social attitudes. Increased feelings of anxiety and higher aggressiveness. Extreme exposures do not so much affect development as a whole, but being exposed to them for a long time affects development more significantly (under 3 years of age, children experience underdevelopment; older children experience retardation). Afterwards, aggression towards peers was noted. Infantilism. Education in conditions of neglect (in terms of cognitive development; lack of formation of moral and ethical standards and arbitrary regulation of behavior; unstable type of character, etc.). Overprotection. Personal development is inhibited; no responsibility, sense of duty; hysterical character; egocentrism, etc. Lack of initiative, independence, tendency to lie, uncertainty, fears (the “hedgehog” type of education).

IV. Lesions of the cerebral-organic origin. There is a need for medical and pedagogical correction here. Damages during childbirth, infections, intoxications. Damage to the central nervous system in the early stages. The scale of the damage matters. It has similarities for reasons with mental retardation. Detected much earlier.

Unlike other types of ZPR, this type shows signs of lag in almost all areas. Retarded physical development – ​​more than 30%; motor functions – about 70%; in speech development – ​​more than 60%; in the formation of neatness skills - about 40%. The lag in the emotional-volitional sphere is striking. Organic infantilism. Primitiveness, scarcity of emotions; gross suggestibility; reduced criticality; poor differentiation of emotions; lack of liveliness, brightness, expressiveness. Memory, attention, spatial analysis lag behind in development. No educational interests. Lack of creativity and initiative in gaming activities. Low level of activity and independence. Either the euphoric background of the mood predominates, or the dysphoric (lowered) background of the mood.

Differential diagnosis of congenital mental retardation and clinical manifestations bordering on it

The problem of differential diagnosis in connection with the staffing of institutions for mentally retarded children was the subject of discussion at the International Conference held in 1964 in Copenhagen. Even then, it was pointed out that only psychometric assessments were insufficient in diagnosing mental retardation, and tasks were set to develop research methods and criteria for distinguishing mental retardation from borderline conditions similar to it. As a rule, the reason for questioning the usefulness of the intellect of a school-age child is his underachievement, which is revealed in the learning process. Equating academic failure with mental retardation is a gross and dangerous theoretical and practical mistake. In the works of teachers and psychologists Z. I. Kalmykova, N. A. Menchinskaya, A. M. Gelmont, L. S. Slavina and others, devoted to the study of the causes of academic failure, it is indicated that in most cases, academic failure is not caused by impairments in cognitive activity, but is caused by other reasons. It is necessary to establish the causes of academic failure (inability to learn, gaps in knowledge, negative attitude towards learning, conflict situations at school, in the family, etc.) and eliminate them, developing the child’s potential capabilities. The most difficult in diagnostic terms are children with mental retardation (MDD), who also turn out to be unsuccessful already in the first years of education.

Currently, this category of children has been deeply and comprehensively studied both from the clinical and psychological-pedagogical sides. Here we do not dwell in detail on the etiology and main signs, but indicate only the most significant features of the mental activity of children with developmental delays for differential diagnosis. Depending on the origin (cerebral, constitutional, somatogenic, psychogenic), the time of exposure of the child’s body to harmful factors, mental retardation results different variants deviations in the emotional-volitional sphere and in cognitive activity. Mental retardation of cerebral origin due to chromosomal abnormalities, intrauterine lesions, and birth injuries are more common than others and pose the greatest difficulty in distinguishing them from mental retardation.

Studies by defectologists (V.I. Lubovsky, K.S. Lebedinskaya, M.S. Pevzner, N.A. Tsypina, etc.) indicate that when mental development is delayed, there is uneven formation of mental functions, and both damage and and underdevelopment of individual mental processes. In oligophrenia, the totality and hierarchy of the lesion are characteristic. Scientists who studied mental processes and learning opportunities for children with mental retardation (T. V. Egorova, G. I. Zharenkova, V. I. Lubovsky, N. A. Nikashina, R. D. Triger, N. A. Tsypina, S. G. Shevchenko, U. V. Ulienkova, etc.), identified a number of specific features in their cognitive, personal, emotional-volitional sphere and behavior. The following main features of children with mental retardation are noted: increased exhaustion and, as a result, low performance, immaturity of emotions, weakness of will, psychopathic behavior, limited reserve general information and ideas, poor vocabulary, difficulties sound analysis, lack of development of intellectual skills.

Game activity is also not fully formed. Perception is characterized by slowness. In thinking, a lack of verbal and logical operations is revealed. When a task is presented in a visually effective way, the quality of its implementation improves significantly. To assess the level of development of thinking during a psychological and pedagogical examination, it is necessary to compare the results of the child’s work with verbal, logical and visually effective material. These children suffer from all types of memory and lack the ability to use aids for memorization.

A longer period is required to receive and process sensory information. Attention is unstable. In addition, there is a low skill of self-control, which is especially evident in the process of activity. By the beginning of school, these children, as a rule, have not formed the basic mental operations - analysis, synthesis, comparison, generalization; they do not know how to navigate the task, do not plan their activities, and do not retain the terms of the task. But, unlike the mentally retarded, they have higher learning ability, they use help better and are able to apply the shown method of action when performing similar tasks.

When examining reading, writing, and counting, they often reveal errors of the same type as the mentally retarded, but nevertheless they have qualitative differences. Thus, with poor reading technique, children with mental retardation always try to understand what they read, resorting, if necessary, to repeated reading. People with mental retardation have no desire to understand, so their retelling may be inconsistent and illogical. The letter notes unsatisfactory calligraphy skills, negligence, etc., which, according to experts, may be due to underdevelopment of motor skills and spatial perception. Sound analysis is difficult for children with mental retardation.

In the mentally retarded, all these shortcomings are more severely expressed. In mathematics, there are difficulties in mastering the composition of numbers, counting by passing through ten, in solving problems with indirect questions, etc., but the help here is more effective than for the mentally retarded. Taking this into account, when making differentiated diagnostics, it is necessary to conduct an examination of children in the form of a teaching experiment. These are some of the characteristics of children with mental retardation, who are often referred to medical and pedagogical commissions. An apparent similarity with mental retardation may also occur when the activity of the analyzers is disrupted.

These disorders create certain difficulties in the cognitive activity of children, and in a school environment they give rise to poor performance. Therefore, distinguishing these disorders from mental retardation is an urgent task. Even minor dysfunctions of the analyzers can lead to an incomplete and sometimes distorted reflection of the outside world, to an impoverishment of the range of ideas, inappropriate behavior, unless the compensatory capabilities of the central nervous system and special technical means (hearing aids, glasses, etc.) are used. Thus, hearing loss can cause certain difficulties when a child is studying at school, especially when mastering literacy. Children with reduced vision do not see lines, confuse images that are similar in outline, etc. Inappropriate requirements quickly tire the child, make learning unsuccessful in normal school conditions, worsening his general condition. Children with visual and hearing defects find themselves helpless in simple situations and give the impression of being mentally retarded. But if you offer a hearing-impaired person a task of a logical nature that does not require perfect hearing from him (classification, arranging pictures taking into account cause-and-effect relationships, etc.), and the visually impaired person is offered corresponding oral tasks, then they complete them.

When distinguishing conditions caused by disturbances of analyzers from mental retardation, it is necessary to find out what primarily dominates the lag: mental retardation is the leading and primary defect, and decreased hearing and vision only accompany it, or the lag occurred as a result of dysfunction of the analyzers. It is important to consider the time of damage to the analyzer. The earlier the disease process occurs, the more severe the consequences. Depending on the diagnosis, the question of what special school the child needs will be decided. In addition, it is very important to separate normal children with speech disorders from mentally retarded children, for whom speech disorders are one of the characteristic features. There are different types of speech disorders that have varying degrees of severity depending on the strength and time of the lesion.

These are children with normal intelligence, but who have difficulty mastering reading and writing, and some of them have general underdevelopment of speech. While the auditory analyzer is intact, these children suffer from phonemic hearing, which leads to learning difficulties (they do not clearly perceive spoken speech, do not differentiate similar sounds, so sound-letter analysis is difficult, etc.).

In case of severe impairment of phonemic hearing, underdevelopment of the entire speech function occurs. Pronunciation problems also affect literacy acquisition. All this should be taken into account when conducting a speech therapy examination. The preservation of the intelligence of children with speech impairments is clearly visible when performing tasks that do not require the participation of speech (visual techniques with “non-speech” instructions). These children have a lively reaction and adequate behavior. This is what primarily distinguishes them from the mentally retarded. All of the listed temporary difficulties in cognitive activity and disorders of the central nervous system, if the attention of the school and family is not promptly drawn to them, can lead to the so-called pedagogical neglect, which is most often identified with mental retardation.

The difficulty in determining mental retardation lies in the fact that, unlike other anomalies (deafness, blindness), for mental retardation there is no absolutely objective criterion, no scale by which it could be measured.

Specifics of development in the preschool period and typical difficulties in the initial period of schooling. In children of primary school age with mental retardation, playing according to the rules consisted of separate, poorly connected fragments. The complication of the rules of the game and their intellectualization often led to its collapse. When completing the task, the children paid attention not to the content of the task, but to the facial expressions and gestures of the teacher. The process was interrupted by questions about the proposed mark. The most attractive tasks for them were those in a playful form. During lessons, these children are restless, do not obey the requirements of discipline, in response to comments they promise to improve, but immediately forget. In conversation they easily and openly express a negative attitude towards school.

Further dynamics of development and learning at school; prognostically favorable factors. The situation of systematic failure, which children with mental retardation find themselves in when entering a public school, aggravates the mental retardation, negatively affects their further intellectual development, and contributes to their abnormal personality formation.