Corrective activities for children with autism are stereotypical and sensory games. Child pathopsychology - Biological basis of autism

There are more children in the world with autism than with diabetes, cancer and Down syndrome combined.

Autism (translated from Latin means “self”) manifests itself as a fenced off from the world, the absence or paradoxical reactions to external influences, passivity and super-vulnerability in contact with the environment. Children with autistic traits have stereotyping, which is expressed in the desire to eat the same food, wear the same clothes, repeat the same phrases. Attempts to destroy these stereotypes cause anxiety and aggression in the child. Children with ASD begin to withdraw into themselves, become more restless and preoccupied, their character changes, they lose contact with their peers and adults. There is also a decrease in speech contact, sometimes the child completely stops using speech. Therefore, the longer children with autism remain without help, the more difficult it is to reach them, the earlier they start learning, the more successful the child will be in life!

Methods of psychological correction of children with ASD who have a lag in the formation of basic mental functions are traditionally divided into two main areas: cognitive methods focused on the formation of mental functions, methods of motor correction and body-oriented psychotherapy aimed at forming a child's contact with his own body , relieving muscle tension, improving mental well-being, developing non-verbal components of communication. One of the methods used in working with autistic people is the method of neuropsychology.

The method of “replacing ontogenesis” involves the activation of the development of all higher mental functions (HMF) through the impact on the sensorimotor level, taking into account the general patterns of ontogenesis. Since sensorimotorics is the foundation for the further development of the HMF, at the beginning of the correctional process, preference is given precisely to motor methods that activate and restore the interaction between various levels and aspects of mental activity.

Both diagnostic and corrective work are a three-level system developed in accordance with the teachings of A.R. Luria about the three functional blocks of the brain (FBM). The 1st FBM is a block for the regulation of tone and wakefulness, the 2nd FBM is a block for receiving, processing and storing information, the 3rd FBM is a block for programming, regulation and control.

The program is aimed at developing mental functions lagging behind in the formation of mental functions in a child with ASD and is applied by specialists of a preschool institution. The program is divided into 2 courses.

Each course includes 24 lessons. The duration of each lesson is 30-35 minutes, classes are held in a microgroup (2 children) or individually for 1 lesson 2-3 times a week for 3 months. The exercise program is compiled individually for each child, taking into account his characteristics and age. Only the structure of the lesson remains unchanged. It is acceptable to conduct repeated classes if the psychologist sees that the children are having difficulty performing the exercises. It should also be remembered that the quality of assignments may deteriorate in 6-8 lessons.

After passing the first course of neuropsychological correction, a dynamic neuropsychological examination of the child is carried out and the issue of the need for a second course of classes is decided.

Classes are shown to a child with the following problems:

Birth injury; increased or decreased tone;

Frequent diseases, including in the first year of life, for example, broncho-pulmonary diseases, otitis media, atopic dermatitis;

- in the anamnesis - PEP, ADHD, ZPR, ZPRR, hypertension syndrome;

- crawled little or did not crawl at all; walked on tiptoe; started talking late

- hyperactive or unnecessarily slow; impulsive, irritable, often in conflict with children;

- gets tired quickly, falls asleep with difficulty; badly remembers, compares, generalizes;

- draws with the left hand; has a formation delay fine motor skills hands; moves legs, tongue when writing and drawing (synkinesia);

- hardly sits for 15 minutes in one place; inattentive, distracted, does not bring the matter to the end;

Restrictions and contraindications:

- epilepsy; mental illness and genetic syndromes;

- exercise caution in children with dysplasia connective tissue, severe heart failure and children with bronchial asthma.

This program assumes:

preliminary neuropsychological diagnostics and dynamic diagnostic examination of children upon its completion;
mandatory home practice of the exercises used, strict compliance by their parents throughout the cycle (this requirement is one of the main conditions for the effectiveness of the program);
constant counseling of parents with a detailed explanation of the goals and objectives of formative education;
all respiratory, oculomotor, motor exercises, crawling, stretching are performed at the command of an adult at a slow pace 4-6 times.

Principles of diagnostics and evaluation of program effectiveness. Diagnostics is carried out before the child is enrolled in the program and at the end of the program. 1 hour is allotted for primary and final diagnostics.

A complex of neuropsychological diagnostic methods is used (A.V. Semenovich, Neuropsychological diagnostics and correction in childhood: Proc. Allowance for higher. textbook establishments. - M .: Publishing Center "Academy", 2002. - 232 p: ill.).

Diagnostics includes:

motor functions; tactile and somatognostic functions; visual gnosis; spatial representations; auditory gnosis; memory; speech functions; writing, reading, counting; smart features.

As a tool for assessing the effectiveness of mastering the program, in addition to the method of comparing data from incoming and outgoing neuropsychological diagnostics, a survey of parents is used in order to obtain feedback and an additional factor in assessing the effectiveness of assimilation.

Lesson structure:

Ritual of welcome and start of classes.
Warm-up.

There are 4 workout options in total. The warm-up includes exercises aimed at improving muscle tone, general energy, coordination and overall somatic balance.

A block of exercises aimed at the formation

psychomotor coordination.

The exercises in this block change every week during the program.

The main blocks of exercises aimed at the development of psychomotor coordination and their tasks.

Breathing exercises are aimed at restoring normal breathing at rest, as well as in combination with various movements, which contributes to an increased supply of oxygen to all organs and tissues of the body, optimization of muscle tone, reduction of excitability, and improvement of the general condition of the child.
Oculomotor exercises Aimed at expanding the volume of visual perception, eliminating pathological synkinesis

III. Stretching and exercises of the motor repertoire are aimed at optimizing and stabilizing the tone, developing the correct motor stereotype, and regulating autonomic disorders, mastering the space of one's own body and the space around

A block of exercises aimed at the formation of cognitive competencies.
The game.
The ritual of completing classes, summing up and farewell.

Examples of lesson plans. Lesson 1

Acquaintance. greeting ritual. Left hand markings.
Warm up

1) Stretch marks: Stretch marks for the body;

Stretching for legs, rolls;
Stretching and relaxation of the hands;
Warm-up and relaxation of the shoulders;
Stretching and relaxing the neck muscles.

2) Finger gymnastics with the use of Su-Jok therapy

Turtle;

3) Articulation gymnastics

Cowardly chick;
Shark;
Biting/scratching lips with teeth;
Simultaneous and alternate puffing of the cheeks;
Smile - kiss;
Fence - a tube;

psychomotor coordination.

1) Breathing

Balloon

2) Stretch marks:

Passive stretching;
Massage and self-massage;
Walking on hands

3) General motor repertoire

four). Oculomotor repertoire

Catch-ups with hands;
Crosses;
Convergence

Basic sensorimotor interactions based on

graphic activity

Strokes

cognitive competencies.

References:

Mikadze Yu.V. Neuropsychology of childhood. - St. Petersburg: Peter, 2008.
Semenovich A.V. Introduction to neuropsychology of childhood. – M.: Genesis, 2005.
Semenovich A.V. Neuropsychological diagnostics and correction in childhood. – M.: Academy, 2002.
Semenovich A.V. Neuropsychological correction in childhood. The method of replacement ontogenesis: Textbook. – M.: Genesis, 2010.
Semenovich A. V. Neuropsychological prevention and correction. Preschoolers. M.: Bustard, 2014.
Sirotyuk A. L. Exercises for the psychomotor development of preschoolers: A practical guide. – M.: Arkti, 2009.
Semago N. Ya. Methods of formation of spatial representations in children of preschool and primary school age. – M.: Iris, 2007.

Alibaeva Dana Zhanatovna,

psychologist of the first qualification category,

Tkachenko Lyudmila Alexandrovna,

psychologist of the second qualification category

GKKP "Nursery-garden" Batyr ",

Petropavlovsk, North Kazakhstan region

The term "autism" from (Greek autos - self) was introduced by Bleuler to denote a special kind of thinking, characterized by "isolation of associations from given experience, ignoring actual relationships." The scientist emphasized his independence from reality, freedom from logical laws, being captured by his own experiences. In 1943, L. Kanner in his work “Autistic Disorders of Affective Contact” concluded that there is a special clinical syndrome of “extreme loneliness” and called it the syndrome of early childhood autism (RAA).

G. Asperger (1944) studied this condition in children after the age of three and called it "autistic psychopathy". Mnukhin S.S. similar conditions were described in 1947. In Russia, the issues of psychological and pedagogical assistance to children with RDA began to be developed most intensively from the end of the seventies of the last century. Later, the result of the research was the original psychological classification (K.S. Lebedinskaya, V.V. Lebedinsky, O.S. Nikolskaya) 1985 - 1987.

According to the developed concept, according to the level of emotional regulation, autism can manifest itself in different forms(states from more complex ones):

as a complete detachment from what is happening;
as an active rejection of what is happening;
as a preoccupation with autistic interests;
as an extreme difficulty in organizing communication and interaction with other people.

Autism is a condition of great professional interest. When you first encounter autistic children in your work, you get the impression that nothing is of sufficient interest for them, does not evoke sufficient emotions. But in the process of work, you discover their rich inner world - everyone has their own, the palette of their emotions: everyone expresses it in their own way.

By studying the phenomenon of behavioral manifestations, one can compare how the norm differs from pathology. However, even within the framework of the so-called norm, there are various manifestations of emotional reactions: the ability to respond adequately in a given situation.

Danila is one of the first people I started working with when I first used neuropsychological technologies in working with children on the autism spectrum. It was difficult to start “getting acquainted” with a child who does not allow you to take at least half a step towards him (attacks of auto-aggression began). Thanks to attentive attitude mother to the development of the boy, small changes were quickly encouraged and introduced into the permanent life of the child. Dani's success, no doubt, motivated her mother to further pedantic implementation of the psychologist's recommendations.

Our Danka is changing, growing up. We continue to work now on the formation of those skills that we could not even dream of before: before it was impossible to use the “hand in hand” technique, since his arms instantly tightened and became straight, they could not be bent at any joint. Now Danila, with the help of adults, is following the instructions: we are striving to give him the opportunity to be useful to his environment.

I work in a team with children and I often had to become an unwitting witness to how mothers share their experiences and observations. This, in my opinion, also helps the teacher, because sometimes adults come and ask if it is possible for them to use the recommendations that were made to other children. But also such informal interaction creates an atmosphere for reflection and discussion on how to help children.

All the guys with whom I worked during the course of correctional work showed various changes, but most importantly, they began to interact with the environment, which is distinctive in the state of autism.

The best motivation in my work was and is the result. We talk together, discuss and, of course, rejoice at our achievements. You always want more - this is what makes you comprehensively study the problem of the abnormal development of the child.

In the course of my professional activity, and then research work, I became convinced of the correctness of the statements that for autistic children, switching from one type of activity to another presents enormous difficulties (Ermolaev D.V.). The same manifestations can be noted in the norm, when it is difficult for a healthy person to get rid of his long-term oppressive experiences.

The use of neuropsychological technologies in the work allows directing efforts directly to the cause of the imbalance of emotional reactions. The “Neuropsychological Correction” program presented at the program considers the option of correcting the state of various autistic manifestations in preschool children. However, I believe that such technologies are possible and are also shown to work with adults and adolescents, taking into account the selection of exercises according to age and condition.

In conclusion, I consider it necessary to emphasize once again that the presented program is based on personal observations and analysis of work with autistic preschool children in various correctional institutions in the city of Tula and the region.

Gurinova Vera Viktorovna, psychologist (Shchekino, Tula region).

Currently, there is an increase in the number of children with disabilities in mental development. One of the most common violations mental development children is infantile autism.

The term "autism" from (Greek autos - self) was introduced by Bleuler to denote a special kind of thinking, characterized by "isolation of associations from given experience, ignoring actual relationships." The scientist emphasized his independence from reality, freedom from logical laws, being captured by his own experiences. In 1943, L. Kanner, in his work “Autistic disorders of affective contact, concluded that there is a special clinical syndrome of “extreme loneliness” and called it the syndrome of early childhood autism (RAA).

Autism is a disorder of mental development, accompanied by a deficit of social interactions, difficulty in mutual contact when communicating with other people, repetitive actions and limitation of interests. The reasons for the development of the disease are not fully understood, most scientists suggest a connection with congenital brain dysfunction. Autism is usually diagnosed before the age of 3 years, the first signs may be noticeable as early as infancy. Full recovery is considered impossible, but sometimes the diagnosis is removed with age.

Autism is a disease that is characterized by movement and speech disorders, as well as stereotyping of interests and behavior, accompanied by a violation of the patient's social interactions with others. Data on the prevalence of autism vary significantly, due to different approaches to the diagnosis and classification of the disease. According to various data, 0.1-0.6% of children suffer from autism without taking into account autism spectrum disorders, 1.1-2% of children suffer from autism taking into account autism spectrum disorders. Autism is diagnosed four times less frequently in girls than in boys. In the last 25 years, this diagnosis has become much more frequent, however, it is not yet clear what this is due to - a change in diagnostic criteria or a real increase in the prevalence of the disease.

In the absence of timely diagnosis and adequate assistance, most autistic children are eventually recognized as unteachable and do not adapt socially. At the same time, as a result of timely corrective work, it is possible to overcome autistic tendencies and the child's gradual entry into society. That is, in conditions of timely diagnosis and the beginning of correction, most autistic children, despite a number of persistent mental characteristics, can be prepared for education in a public school, often revealing talent in certain areas of knowledge. At a different pace, with different results, but each autistic child can gradually move towards increasingly complex interactions with people.

The main thing is that all these activities contribute to the maximum mobilization of healthy resources for the mental development of an autistic child, the reconstruction of the emotional, cognitive, motor spheres of the personality and, in general, the social adaptation of the child.

Any correctional work can be effective only when it is based on the correct conclusion about the mental state of an autistic child.

Studies have shown that children with RDA often show structural changes in the frontal cortex, hippocampus, median temporal lobe, and cerebellum. The main function of the cerebellum is to ensure successful motor activity however, this part of the brain also influences speech, attention, thinking, emotions, and learning abilities. In many autistic people, some parts of the cerebellum are reduced. It is assumed that this circumstance may be due to the problems of children with autism when switching attention.

Median temporal lobes, the hippocampus, and the amygdala, also often affected by autism, affect memory, learning ability, and emotional self-regulation, including the emergence of a sense of pleasure when performing meaningful social actions. The researchers note that in animals with damage to these brain lobes, behavioral changes similar to autism are observed (a decrease in the need for social contacts, a deterioration in adaptation when exposed to new conditions, difficulties in recognizing danger). In addition, children with autism often show delayed maturation of the frontal lobes.

Approximately 50% of autistic people on the EEG revealed changes characteristic of memory impairment, selective and directed attention, verbal thinking and purposeful use of speech. The prevalence and severity of changes varies, with children with high-functioning autism usually having less EEG disturbances compared to children with low-functioning forms of the disease.

Overcoming autism is a long and painstaking work. Comprehensive correction of autism is needed in terms of a systems approach: this is not just a change bad behavior, not just “make him talk”, but help in understanding the child by parents, organizing the developing space around the child, help in correcting neuropsychological parameters that determine “oddities” sensory system, perception of the world, emotional-volitional problems.

Children have different initial abilities in the processing of sensory and motor information. Many children with autism have serious problems with the planning of complex actions and their consistent implementation, and these problems underlie many manifestations of stereotyping in their behavior. The most effective results are achieved using the method of neuropsychological correction.

The method of neuropsychological sensorimotor correction, developed at the Department of Child Psychiatry and Psychotherapy of Medical Psychology of the Russian medical academy postgraduate education (RMAPE) by Professor Yu.S. Shevchenko and Cand. psychol. Sciences V.A. Korneeva.

More than 80% of children's developmental problems are associated with disorders and brain damage that occurred in the early stages of development - during pregnancy, during childbirth, as a result of severe illness in the first year of a child's life. Therefore, the impact of the correctional program is initially directed not at the development of higher mental functions, but at the basal sensorimotor level, i.e. on the development of deficient functions that were damaged on early development child. And only in the final part of the corrective stage, the work moves into the field of cognitive psychotherapy.

Purpose of the method continuous non-drug activation of subcortical and stem structures of the brain, stabilization of interhemispheric interaction, formation of the optimal functional status of the anterior structures of the brain. The method of neuropsychological sensorimotor correction is available to children from 5 years of age

The method consists of a series of breathing and motor exercises that gradually become more complex, leading to the activation of the subcortical structures of the brain, contributing to the regulation of tone, the removal of local muscle clamps, the development of balance, the decoupling of synkinesis, the development of the perception of body integrity and the stabilization of the stato-kinetic balance. At the same time, the operational support of sensorimotor interaction with the outside world is restored, the processes of voluntary regulation and the meaning-forming function of psychomotor processes are stabilized, focused on the formation of the optimal functional status of the anterior lobes of the brain, the development of thinking processes, attention and memory, synesthesia and self-regulation.

Children with autism always have a disturbance in the perception of the world. The child avoids some sensations, on the contrary, strives for others, and they turn into autostimulations. In addition, the signals received from different sense organs do not add up to a single picture. It is no coincidence that a disassembled puzzle is a symbol of autism. The main task of neuropsychological sensorimotor correction is to teach the child to be aware of himself in space, to improve the perception of the world around him, the development of the child's motor, cognitive and sensory skills.

Neuropsychological sensorimotor correction is one of the effective methods of helping children to overcome: a decrease in overall performance, increased fatigue, absent-mindedness; violation of mental activity; decreased function of attention and memory; unformed spatial representations; lack of self-regulation and control in the process of learning activities.

Recovery balance between sensory and motor sphere, as well as the development of both areas is main result neuropsychological sensorimotor correction. Only after the restoration of basic functions is it possible to further develop more complex ones (speech, thinking).

Thus, the process of neuropsychological sensorimotor correction is aimed at the most complete adaptation of an autistic child to life in society, at integration from special to other types of educational institutions.

The constant work of specialists with an autistic child and, preferably, his families is the key to successful development and positive dynamics in such a child. With the same severity of early prerequisites, the fate of a child with autism can develop in completely different ways. If for many years in a row specialists of various profiles will deal with him, if his parents realize that without doing anything, it is impossible to hope for positive changes, and that he will not become different “by himself”, then this is one option. If all of the above is not present, it is completely different.

Helping an autistic child “spreads out over many years, during which the effects of days, weeks, and months can seem depressingly small or non-existent. But each step of progress, even the smallest one, is precious: from these clumsy at first steps and steps, a common path of improvement and adaptation to life is formed. Yes, not every child will have this path as long as we would like. But the child acquired along the way will remain with him and will help him live more independently and confidently ”(V.E. Kagan)

neuropsychologist

Ovchinnikova Svetlana Vladimirovna

Study of the neuropsychological status of children diagnosed with "Children's autism"

Introduction

The relevance of the problem of children's mental health has recently increased significantly due to the growth of neuropsychiatric and somatic diseases, as well as various functional disorders.

One of the most common disorders of the mental development of children is childhood autism. The problem of early childhood autism (RAA) arose in 1943. when L. Kanner from the whole variety of autistic manifestations in children singled out a special one in its own clinical signs syndrome.

In the literature devoted to this problem, there have been and are still ongoing scientific disputes on the etiology, pathogenesis, clinic, prognosis, treatment, and the right of RDA to clinical independence among an endless number of other autistic disorders.

All the defining issues of the doctrine of RDA: definition, etiology, pathogenesis - at this stage, knowledge remains contradictory, uncertain and does not contribute, but complicates the diagnostic process.

That is, the problem of RDA is so complex that it requires further research. Interest in it is due to both advances in the field of clinical study of RDA and the low resolution of urgent practical issues of therapy and psychological and pedagogical correction.

The prevalence of RDA is quite high, this syndrome occurs in about 3-6 cases per 10,000 children, being found in boys 3-4 times more often than in girls. (13)

In addition, due to the complexity of diagnosing RDA and the lack of knowledge about this developmental anomaly, it is assumed (M. Reiser, 1976) that another one out of 10 children diagnosed with mental retardation suffers from RDA. N.Tinbergen, E.Tinbergen (1983) also believe that the prevalence of this anomaly is much higher, since only children with the most severe forms of RDA come to the doctor. (7)

The frequency of violations of this kind, determined by the methods of pedagogical diagnostics, according to many authors, is increasing: on average, 15-20 out of 10,000 children have them.

In addition, the relevance of the problem under study is due to the fact that at present there is no single classification system for RDA. Despite the general logic of developmental disorders in autism, autistic children differ significantly in terms of the depth of maladjustment, the severity of problems, and the prognosis of possible development, so the development of an adequate classification has always been a pressing problem.

The existing classifications are mainly based on derivative manifestations of the disorder, when the following are put forward as criteria for classification: assessments of speech and intellectual development, the nature of social maladaptation; or the classifications are based on the etiology of the syndrome (while the etiology has not yet been elucidated).

In this regard, there are problems, both in the early diagnosis of this disease, and in the possibilities of psychological and pedagogical correction of autistic children.

Most researchers (V.M. Bashina, 1989; V.E. Kagan, 1981; O.S. Nikolskaya, 1985, etc.) believe that the mental development of a significant number of autistic children is pathological from birth. But diagnosis in the first years of life presents great difficulties, there are numerous erroneous diagnoses before the age of 5-6 years.

The main age of children at the time of seeking advice (according to the Research Institute of Defectology of the Academy of Pedagogical Sciences of Russia) is 4-9 years. (7)

In this work, children of primary school age (7 - 10 years) are studied - during this period, the most important neoplasms appear in all areas of mental development: intellect, personality, social relations are transformed, therefore the level of achievements of children at this age stage is very important for the next age period.

The specificity of primary school age lies in the fact that the goals of activity are set mainly by adults and new behavior first arises in joint activity with an adult who gives the child the means to organize such behavior, and only then does it become the child’s own individual way of acting (L.S. Vygotsky) .

According to Russian psychologists L.S. Vygotsky, A.N. Leontiev, S.L. Rubinshtein, the development of the child's psyche occurs mainly through social inheritance, the appropriation of social experience. In the process of such training in the broadest sense of the word, the true development of his psyche takes place. The child not only receives individual knowledge or skills - he undergoes a radical change in various mental processes.

Such a mental development disorder as childhood autism is characterized by a difficulty in forming a child’s emotional contacts with the outside world, and most of all with a person, characterized by a lack of communication, and, consequently, interaction with the outside world and people, which hinders his social adaptation. (16)

The health of a child is largely determined by the level of his adaptability - the innate and acquired ability to adapt, that is, to adapt to the whole variety of life under any conditions. (Garbuzov V.I.). The level of adaptability can increase under the influence of upbringing, training, conditions and lifestyle.

The factors on which mental development, social adaptation, and predicting the success of an autistic child's education depend are:

· diagnosing deviations in the early stages of a child’s development,

· timely therapy,

· psychological and pedagogical correction carried out at preschool age,

· identifying the psychological characteristics of autistic children,

· long-term clinical study of them throughout schooling (especially in the initial period),

· adequate methods and learning content. (eleven)

Any correctional work can be effective only when it is based on the correct conclusion about the mental state of an autistic child.

We believe that for the timely qualitative qualification of the defect, for adequate corrective work, which makes it possible for an autistic child to adapt in society, it is also necessary to know about his neuropsychological status, which shows the overall state of higher mental functions and behavior of an autistic child depending on funcciogenesis (functioning) different areas of the brain.

We did not find data on the neuropsychological status of autistic children in the literature concerning the problem of RDA.

Based on the foregoing, we consider an attempt to study the qualitative specifics of the disorder, an attempt to isolate a factor (a feature of the functioning of certain brain areas) and its connection with the features of the flow of higher mental functions in autistic children, relevant.

The purpose of the study is to isolate the factor (features of the functioning of certain areas of the brain) behind the observed symptoms.

The objectives of the thesis are:

1.study of the neuropsychological status of children diagnosed with childhood autism;

2.highlighting the general features of the course of higher mental functions;

.comparing them with the features of the functioning of brain structures.

The object of the study is the higher mental functions in children diagnosed with autism, which together give us the neuropsychological status of autistic children.

The subject of the study is the factor (feature of the functioning of certain areas of the brain) behind the observed symptoms.

The hypothesis that this study aims to test is: “Based on the found literature data, which state as common for autistic children: violations of voluntariness, stereotypy, perseveration (getting stuck), difficulties in capturing the whole, violations of purposefulness; a decrease in the general activation tone of mental activity, and from observations of the behavior of autistic children, we assume that there is a general violation of the factor of autistic children associated with the work of the frontal parts of the brain and brain stem structures.

To analyze the state of higher mental functions in their connection with the work of various areas of the brain, the most convenient method (developed by A.R. Luria) is the theory of systemic dynamic localization.

The neuropsychological method is based on a thorough analysis of changes in mental processes in local lesions of the brain in order to identify which complexes and systems of mental processes are violated in these lesions.

According to the theory of systemic dynamic localization of human HMF, each HMF is provided by the brain as a whole, but this whole consists of highly differentiated sections (systems, zones), each of which contributes to the implementation of the function. Not the entire mental function and not even its individual links should be correlated directly with the brain structures, but those physiological processes (factors) that are carried out in the corresponding brain structures. Violation of these physiological processes leads to the appearance of primary defects, as well as secondary defects interconnected with them, which, on the whole, constitute a natural combination of HMF disorders - a certain neuropsychological syndrome.

Neuropsychological diagnostics - a battery of Luriev tests, makes it possible to study the structure of the defect and highlight the factor that led to the occurrence of a particular symptom, i.e. allows not only to identify the disturbed links of mental activity, but also those structures of the brain, the insufficiency of which plays a decisive role in their occurrence.

The main goal of applying the methods of neuropsychological diagnostics is the study of the brain organization of mental functions, the identification of features (or disorders) of their course, which indicates the features (or disorders) of the corresponding brain formations. This also applies to the general characteristics of the left and right hemispheres of the brain, to their interaction and to the definition of deficiency in the work of certain areas of the brain (cortex and subcortical formations). Neuropsychological methods diagnose the state of various brain structures - and this is their difference from other methods of psychological diagnostics.

Neuropsychological research is one of the ways to analyze the mental activity of a person, it allows you to get a lot of objective information about the lesions of the most complex, specific human brain sections and use this information for the most accurate local (or regional) diagnosis of focal brain lesions. In addition, it is necessary to develop ways to restore impaired functions.

At present, neuropsychological research methods are widely used in solving problems of school examination, evaluation special abilities, the development of differentiated recommendations in preparing children for school, the characteristics of learning ability and the so-called "school maturity". A special area of application of neuropsychological methods is their use for studying the cerebral support of mental ontogenesis and assessing the contribution of both biological and psychosocial factors to the development of a child, which also has general theoretical significance.

Research in neuropsychology has great importance and for the development of psychological science itself. Modern psychology has made great strides in studying the genesis of psychological processes, their changes in the process of development; she described the structure of human mental activity and now has clear ideas about the structure of HMF and complex conscious activity.

However, knowledge about morphological structure mental processes, about their internal mechanisms are still insufficient. modern science still knows little about the internal nature and brain structure of complex forms of conscious activity, about what factors enter into their composition, how these factors change at successive stages of mental development as they master the complex means on which these processes are based.

Based on the purpose and objectives of the study, in this work we are interested in the general mechanism, some initial defect common to all autistic children.

We examined 10 children aged 7 to 10 years old, diagnosed with RDA, who were observed in the Regional Psychoneurological Dispensary. Each child underwent a course of an initial correctional program aimed at establishing a more complete contact with the child, which made it possible to subsequently conduct a diagnostic examination to identify neuropsychological status. All children participating in the neuropsychological study do not have an organic brain disorder and, according to the classification of O.S. Nikolskaya, can be assigned to groups 2–3 of the disease.

The results of the study are presented in quantitative (see Appendix 1, protocols No. 1-10) and qualitative terms (see Chapter 3).

According to the survey, it was possible to reveal that there are the following features of the neuropsychological status of children diagnosed with autism:

Dysfunction of the frontal lobes.

Dysfunction of the diencephalic parts of the brain.

Functional insufficiency of the tertiary cortex of the TPO zone - the overlap zone of the temporal, parietal and occipital cortex.

Symptoms of a violation of cortical-subcortical connections: impulsivity, significant instability of attention, great difficulties in working on involuntary physiological reactions (respiratory, oculomotor, lingual and motor acts).

Based on the analysis of the data obtained, it can be assumed that the main deviations in the neuropsychological status of autistic children relate to:

· motivational sphere,

· spheres of phasic activity,

Analysis of the results obtained in the course of the study of the neuropsychological status of children diagnosed with autism allows us to say that there are certain features of the course of higher mental functions:

· In children diagnosed with early childhood autism in the study of higher mental functions, there are general difficulties in programming and controlling their activities and in complex integrative forms of information processing.

· In children diagnosed with early childhood autism, there are clearly pronounced psychological correlates of impaired cortical-subcortical connections.

Comparing the data on common features the course of higher mental functions with the features of the functioning of brain structures, we conclude that:

· The existing dysfunction of the diencephalic divisions is most pronounced and causes basic disturbances in the mental activity of autistic children.

· Dysfunction of the frontal regions is of a secondary nature, while the function of arbitrariness and programming is impaired indirectly by violations of the motivational sphere.

Chapter 1 Literature Review

Part 1. Early Childhood Autism Syndrome

.1.1 Current state RDA problems

The psychopathological phenomenon called "autism" was introduced by E. Bleiler as "the detachment of associations from experience data, ignoring actual relationships" (1920). Somewhat later, V.P. Osipov considered autism as “the disunity of patients with the outside world” (1931). V. A. Gilyarovsky spoke of autism as “a kind of violation of the consciousness of the Self itself and the whole personality with a violation of normal attitudes towards the environment” (1938).

Autism was originally considered within the framework of schizophrenia or schizophrenic thinking. Subsequent studies of this phenomenon led to the understanding that mental states, in some of their manifestations, similar to autism can be observed in a number of different mental illnesses and borderline conditions: schizophrenia, oligophrenia, mental retardation, depression, psychopathy, schizoid personality accentuation, neurosis, somatopsychic and psychosomatic disorders and many others. In psychology, the concepts of "autism", "autistic thinking" are often used to characterize the normal psyche.

The issue of the beginning and course of RDA remains controversial. According to one data, RDA is laid down in the prenatal period; according to other sources, it begins either immediately after birth or at the end of the first year of life, and maybe later. The psychopathological structure of RDA symptoms is interpreted in different ways, a wide range of opinions in the nosological interpretation of RDA.

Autism as a syndrome requires strict clinical differentiation in each specific case.

Currently, there are many controversial issues in the diagnosis of autistic conditions, and the solution of these issues largely depends on the position taken by the diagnostician in relation to RDA.

The opinion of various researchers of the RDA problem can be presented in the following positions.

1.This position reflects the opinion of L. Kanner that RDA is a special and independent form of autism, characterized by a specific clinical picture. Children suffering from this form of autism require special forms of psychotherapeutic work and special biological treatment. By all criteria, RDA differs from schizophrenia and other types of autism, which are only one of the manifestations in the clinical picture of some other diseases.

Partially or completely, these views are shared by such domestic researchers as V. Efroimson - the concept of the hereditary origin of RDA; in monographs by K.S. Lebedinskaya, O.S. Nikolskaya, E.R. Baenskaya, M.M. Liebling, R.K. Ulyanova, T.I. .Nikolskaya, E.R.Baenskaya, M.M.Libling (1990) RDA is considered as an independent form (in nosological terms) of the pathology of the mental development of children.

2.This position was formulated by S.S. Mnukhin, D.I. Isaev, V.E. Kagan who, considering residual childhood encephalopathy, formulate the position that the syndrome of childhood autism of residual organic origin is prefabricated and can manifest itself in the form of early infantile autism , autistic psychopathy, etc., i.e. this is a combined group of mental dysontogenesis in children.

A similar opinion is shared by V.V. Kovalev, who, in his work on the relationship between RDA and autistic psychopathy, claims that these are absolutely identical conditions that occur after encephalitis in children. The author explains the clinical peculiarity of RDA by hereditary predisposition and a special reaction to the child's illness.

3.Proponents of this position doubt or deny the importance of organic brain damage in the origin of RDA. For example, studies by G. Gaffney et al. found no specific changes in the brain in children with RDA; T. Ward, B. Hoddint on the basis of clinical, psychometric electroencephalographic study of patients exclude the possibility of organic and somatic nature of RDA.

4.This is the position that considers RDA within childhood schizophrenia (the most common approach).

.This position is reduced to the position that RDA is only one of the syndromes of childhood autism (DA) among many other autism syndromes, therefore, DA is polyetiological in origin, there are many syndromes of DA. These syndromes are considered from the standpoint of E.Krepelin. The damaging and provocative role of infections (microbial, viral, protozoan microorganisms) is analyzed. The role of the “minimum brain dysfunction» as a necessary link in a series of many causes of childhood autism.

Thus, at this stage, knowledge of the opinions of various researchers of the RDA problem remains contradictory, uncertain, which complicates the diagnostic process.

The study of the patterns of anomalies in child development of the psyche is concentrated in three areas of knowledge: child pathopsychology, defectology (special psychology and pedagogy) and child psychiatry.

When examining a mentally ill child, the pathopsychologist usually focuses on the question of the psychological qualification of the main mental disorders, their structure and severity.

In domestic pathopsychology, research methods were developed by B.V. Zeigarnik, A.R. Luria, V.N. Myasishchev, S.Ya. Rubinshtein and others.

Assessment of mental disorders in childhood should also take into account deviations from the stage of age development at which the sick child is, i.e. features of dysontogenesis caused by a painful process or its consequences.

Another area of study of developmental anomalies is child psychiatry (L. Kanner, G.E. Sukhareva, G.K. Ushakov, V.V. Kovalev, etc.). If the object of defectological research is dysontogenesis, caused, as a rule, by an already completed disease process, then child psychiatry has accumulated a number of data on the formation of developmental anomalies in the course of the current disease (schizophrenia, epilepsy), the dynamics of dysontogenetic forms of the mental constitution (various forms of psychopathy) and abnormal development personality as a result of the deforming influence of negative conditions of education.

A significant contribution to the study of developmental anomalies was made by L.S. Vygotsky, who formulated a number of general theoretical provisions that had a fundamental influence on all further study of developmental anomalies:

· The position that the development of an abnormal child is subject to the same basic laws that characterize the development of a healthy child.

· The position on the primary defect, most closely associated with damage to the nervous system, and a number of secondary defects, reflecting a violation of mental development in the conditions of the primary defect (1936). Vygotsky showed the significance of these secondary defects for the development prognosis and the possibilities of psychological and pedagogical correction.

The data obtained by child pathopsychology, defectology and the clinic illuminate various parties developmental anomalies. Research in the field of child pathopsychology and defectology has shown the connection between the mechanisms of abnormal and normal development, as well as a number of regularities in the systemogenesis of the so-called secondary disorders, which are the main ones in abnormal development. Clinicians, on the other hand, described the relationship between the symptoms of the disease and developmental anomalies in various mental illness.

Comparison of the data accumulated in these various fields of knowledge can help deepen the understanding of distorted development in childhood and systematize it. psychological patterns. (6)

1.1.2 Etiology, pathogenesis of childhood autism

At present, most authors believe that RDA is the result of a special pathology, which is based precisely on CNS insufficiency. A number of hypotheses were put forward about the nature of this insufficiency, its possible localization However, despite the intensity of research, there are currently no unambiguous conclusions. This deficiency can be caused by a wide range of reasons: genetic conditioning, chromosomal abnormalities, congenital metabolic disorders. It can also be the result of an organic lesion of the central nervous system as a result of the pathology of pregnancy and childbirth, the consequences of a neuroinfection, and an early-onset schizophrenic process.

E. Ornitz identified more than 30 different pathogenic factors that can lead to the formation of RDA. Autism can manifest itself due to a variety of diseases ( congenital rubella, tuberculosis). That is, experts point to the polyetiology (multiple causes of occurrence) of RDA and its polynosology (manifestation in the framework of various pathologies).

Most often, RDA is described in the schizophrenic process (M.Sh. Vrono, V.M. Bashina, 1975; V.M. Bashina, 1980, 1986; K.S. Lebedinskaya, I.D. 1981), less often - with organic pathology of the brain (congenital toxoplasmosis, syphilis, encephalopathy, lead intoxication, etc.) - S.S. Mnukhin, D.N. Isaev, 1969; V.E. Kagan, 1981.

RDA is described in various congenital metabolic defects, progressive degenerative diseases (eg, Rett syndrome).

M. Lebojer e. a. (1987), comparing data from genetic studies of RDA, suggested that RDA is a heterogeneous form of pathology, and that it is not autism that is inherited, but vulnerability to pathology, the spectrum of which, in addition to autism, may include mental retardation, speech disorders. (7)

Literature data on the pathogenesis and nosological nature of RDA are contradictory, some researchers consider it a psychogenic suffering, others - independent disease or a kind of psychosis, combined with oligophrenia, others - a manifestation of early childhood schizophrenia. (5)

As is known, practically any more or less long-term pathological effect on the immature brain can lead to a deviation in mental development. Its manifestations will be different depending on the etiology, location, extent and severity of the lesion, the time of its occurrence and duration of exposure, as well as social conditions in which there was a sick child. These factors also determine the main modality of mental dysontogenesis, due to whether vision, hearing, motor skills, intelligence, and the need-emotional sphere suffer primarily. (6)

The main quality (sign) of mental development disorders in childhood autism is asynchrony - a violation of the hierarchical sequence of the formation of mental functions, each of which has its own chronological formula, its own development cycle.

V.V. Lebedinsky identifies the following main manifestations of asynchrony:

1.the phenomenon of retardation - incompleteness separate periods development, lack of involution of earlier forms;

2.phenomena of pathological acceleration of individual functions, for example, extremely early (up to 1 year) and isolated development of speech in early childhood autism;

.a combination of phenomena of pathological acceleration and retardation of mental functions, for example, a combination early onset speech with severe underdevelopment of the sensory and motor spheres with RDA. (6)

In domestic defectology, the approach to the problem of RDA is characterized by the complexity of research - the use of the clinical-psychological-pedagogical method, both in the study of developmental anomalies, and in the formation of a system of corrective measures.

Studies of domestic defectologists proceed from the assessment of RDA as an integral clinical and dysontogenetic structure in which the signs of a particular disease are combined with a specific developmental anomaly (and often overlap with the latter). The similarity in the structure of developmental anomalies in different nosological forms of the disease can be explained by the commonality of some link in the pathogenesis of these diseases or genetic prerequisites.

Depending on the nosological affiliation of RDA (schizophrenia, chromosomal deficiency, hereditary malformations of the central nervous system, organic brain damage), signs of dysontogenesis according to the type of RDA can be combined with specific symptoms of the disease (for example, delusional ideas in schizophrenia, etc.). In the acute course of the disease, the signs of the disease process will prevail in the clinical picture; in the case of a sluggish course, the phenomena of dysontogenesis and developmental anomalies may come to the fore. (7)

1.1.3 Classification of childhood autism

Autistic children differ significantly in the depth of maladjustment, the severity of problems, the prognosis of possible development, therefore, the development of an adequate classification has always been an urgent problem.

The following were put forward as criteria for classification: assessments of speech and intellectual development; the nature of social maladjustment (L. Wing), where derivative manifestations of the disorder are taken as a basis.

There have been attempts at clinical classification based on the etiology of the syndrome, the distinction between forms of biological pathology that determines development.

D.I.Isaev, V.E.Kagan distinguish the following number of groups of childhood autism:

Autistic psychopathy - a history of indications of late age parents, mild toxicosis and asphyxia during childbirth, mother's psychotrauma during pregnancy, weakness of labor, diseases of the first year of life (vaccination reactions, otitis media, etc.). Manifestations begin from 2 - 3 years against the background of high-quality and quantitative change environmental requirements (settlement in a kindergarten, change in family environment, place of residence). The intellect is high, the way of thinking is problematic, speech develops before walking. Difficulties in communication due to inability to establish contact, observe subordination, generally accepted rules, motor awkwardness.

Organic autistic psychopathy - in the anamnesis, ante- and intranatal hazards, severe somatic diseases in the first year of life are detected. Characteristic: pronounced motor awkwardness, clumsy demeanor and a strange form of communication with others, intelligence can be average or borderline, a tendency to florid speech, lack of mental stress, dependence of behavior on external stimuli, inability to deep emotional contacts with others.

Autistic syndrome in oligophrenia - inferiority is associated with gross embryopathy and internal hazards, with serious illnesses (encephalitis, head injuries, severe complications of vaccinations in early childhood). Attention is drawn to the strangeness and eccentricity in behavior, the inability to express mental stress, monotonous activity like getting stuck, disturbances in the sphere of instinctive manifestations, awkward motor skills. They warmly relate to their parents, but are practically not capable of emotional contacts with their peers. Extreme difficulties in learning and everyday adaptation due to gross violations of spatio-temporal coordination and orientation.

Autism in children with epileptic seizures - violations of behavior and intelligence are more often associated with intrauterine hazards. At the same time, the lack of intelligence is covered by autistic manifestations. These are clumsy children with awkward motor skills, they memorize long poems and fairy tales well. instinctive and emotional manifestations they are poor. They are prone to reasoning, fantasizing, sophistication.

Autistic reactions and pathological development of the personality according to the autistic type - here, within the framework of a single pathogenesis, various factors operate: psychogenic, somatogenic and the factor of the duration of a personal response, depending on a number of conditions (defect in appearance, long-term diseases and conditions that limit motor abilities, etc.) , all this leads to a decrease in the flow of information and makes communication difficult. In the formation, age crises, environmental characteristics and the nature of the reaction of the reference group to the manifestation of the child's characteristics and his own attitude towards them are important. (5)

In modern clinical classifications childhood autism is included in the pervasive group, i.e. pervasive disorders, manifested in the violation of almost all aspects of the psyche: cognitive and affective spheres, sensory and motor skills, attention, memory, speech, thinking.

O. S. Nikolskaya (1985-1987) proposes a classification, the main criterion of which is the accessibility of the child to certain ways of interacting with the environment and people and the quality of the forms of protective hypercompensation developed by him - autism, stereotypy, autostimulation.

In children of group 1, we are talking about detachment from the external environment, 2 - its rejection, 3 - its replacement and 4 - the child's overinhibition by his environment.

Children of the first group are characterized by the most profound affective pathology, the most severe disorders of mental tone and voluntary activity. These kids are dumb. The most severe manifestations of autism: children do not have the need for contacts. There are also no active forms of affective protection from the environment, stereotyped actions that drown out unpleasant impressions from the outside, striving for habitual constancy environment. Children in this group have the worst developmental prognosis and need constant care and supervision. In conditions of intensive psychological and pedagogical correction, they can develop elementary self-service skills; they can master writing, elementary counting, and even silent reading, but their social adaptation is difficult even at home.

Children of the second group are characterized by a certain ability to deal with anxiety and numerous fears due to autostimulation of positive sensations with the help of numerous stereotypes: motor (jumping, running, etc.), speech (chanting words, poems, etc.), sensory (self-irritation sight, hearing, touch), etc.

These children are usually inaccessible to contact, they spontaneously develop the simplest stereotypical reactions to the environment, stereotypical everyday skills. They have a primitive, but extremely close "symbiotic" relationship with the mother.

With adequate long-term correction, they can be prepared for schooling (more often - mass, less often - auxiliary).

Children of the third group are characterized by greater arbitrariness in confronting their affective pathology, primarily fears. These children have more complex forms of affective defense, manifested in the formation of pathological inclinations, compensatory fantasies, often with an aggressive storyline, spontaneously played out by the child as a spontaneous psychodrama that removes his frightening experiences and fears. The external pattern of their behavior is closer to psychopathic. Characterized by extended speech, more high level cognitive development. These children are less affectively dependent on their mother, therefore their emotional ties with loved ones are insufficient, their ability to empathize is low.

The nosological qualification of this group presents certain difficulties. Here it is impossible to exclude the option of self-dysontogeny.

Prognosis - these children, with active medical, psychological and pedagogical correction, can be prepared for education in a mass school.

Children of the fourth group are characterized by hyperinhibition. They have a less deep autistic barrier, less pathology of the affective and sensory spheres. In their status, neurosis-like disorders are in the foreground: extreme inhibition, timidity, fearfulness, especially in contacts, a sense of their own inadequacy, which increases social maladaptation. A significant part of protective formations is not hypercompensatory, but adequate, compensatory in nature: in case of poor contact with peers, they actively seek protection from relatives; maintain the constancy of the environment due to the active assimilation of behavioral stamps that form patterns of the correct social behavior; trying to fulfill the requirements of loved ones. They have not a vital, but an emotional symbiosis with their mother, with a constant affective "infection" from her.

These children can be prepared to study in a mass school, and in a small part of cases, study in it without prior special training.

The selected clinical and psychological variants of RDA reflect various pathogenetic mechanisms formation of this developmental anomaly, perhaps a different degree of intensity and extensiveness of the pathogenetic factor (as evidenced by the possibility of their transition into each other towards deterioration with endogenous fluctuations, exogenous or psychogenic provocation and, conversely, improvement, more often with the effectiveness of medical corrective measures, and sometimes spontaneously), the different nature of the genetic pathogenic complex, the features of the "soil", both constitutional and pathological. (7)

1.1.4 Features of the mental development of an autistic child

L. Kanner (1943), describing abnormal children, whose development differed sharply from the development of children with known forms of mental dysontogenesis, indicates that the main thing for these children was "extreme loneliness" with a desire for ritual, stereotypical forms of behavior, violations or complete absence speech, mannerisms of movements, inadequate responses to sensory stimuli.

Similar cases were described by G. Asperger (1944) as milder forms of RDA, characterized by a lesser depth of autism, the use of speech as a means of communication, frequent giftedness in various fields of knowledge and art, which are called a syndrome; and domestic researcher S.S. Mnukhin (1947).

Today, RDA has a reputation as one of the most mysterious developmental disorders, here we are not talking about a violation of a single function, but about pathological change the whole style of interaction with the world, difficulties in organizing active adaptive behavior, in using knowledge and skills to interact with the environment and people.

O. S. Nikolskaya believes that this is due to a violation of the development of the system of affective organization of consciousness and behavior, its main mechanisms - experiences and meanings that determine a person's view of the world and ways of interacting with it.

The primary disorders in RDA include a characteristic combination of two factors that create pathological conditions for its development (V.V. Lebedinsky, O.S. Nikolskaya, 1985):

1.violation of the ability to actively interact with the environment, which makes itself felt through a specific lack of general, including mental tone, and through difficulties in organizing active relations with the world;

2.lowering the threshold of affective discomfort in contacts with the world, manifesting itself as a special sensory and emotional hyperesthesia, i.e. painful reaction to ordinary light, sound, touch, and hypersensitivity, vulnerability in contact with another person.

The first factor is disturbances manifested primarily in very low mental activity with severe satiety, which causes discreteness in the perception of the environment, difficulties in covering the whole, difficulties in concentrating active attention, gross violations of purposefulness, arbitrariness. These conditions prevent proper formation higher mental functions. The underdevelopment of higher mental functions is one of the reasons for poor orientation in the environment, the perception of it as incomplete and therefore largely incomprehensible.

At the heart of this pathological factor lies the initial, often congenital insufficiency of the unconditioned reflex fund (unconditioned reflex reactions - orienting, food, self-defense, etc.), the most important stem apparatus, possibly the reticular formation, which negatively affects the formation of cortical activity, which makes children's behavior amorphous, chaotic, disorganized , and themselves - almost defenseless and helpless.

The cerebral cortex of these children registers well and passively and captures everything that accidentally falls into their field of vision, but loses the ability to actively, selectively relate to environmental phenomena.

It is likely that in the cerebral cortex of these children, against the background of the experimentally established (S.S. Mnukhin) predominance of the inhibitory process, there are hypnoid phases - paradoxical and ultraparadoxical. In this regard, apparently, any strong stimuli of the real situation are ineffective and traces of past impressions and perceptions are very active, imitating "fencing off", "autism", etc. (12)

The second factor is the most significant cause of the main disorders of the affective sphere, manifested in general anxiety with a readiness for diffuse fears. For such a child, low endurance in dealing with the world, a quick and painfully experienced satiety with even pleasant contacts with the environment, are common. Most of these children tend to fixate on unpleasant impressions for a long time, form a rigid negative selectivity in contacts, create a whole system of fears, prohibitions, and restrictions.

These primary disorders belong to the circle of painful, productive symptoms and have a special, at the present level of our knowledge, an unclear mechanism of formation.

Both factors act in the same direction, hindering the development of active interaction with the environment and creating the prerequisites for strengthening self-defense.

Secondary formations related to the manifestations of specific autistic dysontogenesis are closely related to the primary ones - these are hypercompensatory manifestations: autism and autostimulatory actions.

At present, the main clinical and psychological structure of RDA, in the period of its greatest severity (at the age of 3 to 5 years), is presented as follows - it is a stable combination of two types of disorders: 1) autism; 2) stereotypical behavior.

Autism (from the Latin word authos - itself) manifests itself as a detachment from reality, isolation from the world, the absence or paradoxical reactions to external influences, passivity and super-vulnerability in contacts with the environment as a whole. (7)

Autism is a low tolerance for contacts with the environment and people, forced self-isolation in conditions of an insufficiently understandable and frightening outside world. First of all, autism is associated with a violation of adequate emotional connection with people.

Stereotypical behavior - is expressed in the desire to maintain the usual constancy in the environment: eat the same food; wear the same clothes; repeat the same movements, words, phrases; get the same impressions; focus on the same interests; the tendency to make contact with the environment and interact with people in the same habitual way. The destruction of stereotypical living conditions causes diffuse anxiety, aggression or self-aggression in the child.

In conditions of discomfort, an autistic child necessarily develops special pathological forms compensatory autostimulation, which allow such a child to raise his tone and drown out discomfort. These are motor, speech, intellectual phenomena, behavioral stereotypes that compensate for the lack of positive stimuli from the outside and are a powerful means of protecting against traumatic impressions.

In the structure of RDA, tertiary formations can also be distinguished - truly neurotic, due to a sense of one's own inferiority. The unsuccessful experience of contacts of an autistic child with people around him, the child's understanding of his condition as painful - all this, joining endogenous anxiety and fears, undermines his self-confidence, aggravates the autistic formation of his personality.

The ratio of these dysontogenetic formations can explain the formation of an anomaly of mental development in RDA precisely according to the “distorted” type. With a combination of potentially full-fledged or even high intellectual prerequisites with a low mental tone that prevents the correct formation of higher mental functions, sensory and emotional hyperesthesia leading to autism, mental ontogenesis changes its direction and is carried out mainly in an affective channel, providing the momentary needs of autostimulation and thereby blocking the channels socially oriented activity.

In the case of distorted development, it is impossible to separate the affective and cognitive components: this is one knot of problems. The distortion of the development of cognitive and mental functions is a consequence of violations in the affective sphere.

The emerging attitudes of autism, stereotypes, hypercompensatory autostimulation, all these disorders lead to deformation of the basic mechanisms of affective organization of behavior, those mechanisms that allow normal child build an active and flexible dialogue with the environment, determine their needs and habits, establish emotional contacts with people and arbitrarily organize their behavior. At the same time, the pathological development of defense mechanisms is forced.

In motor skills, the formation of everyday adaptation skills is delayed, instead, manipulations with objects appear that allow you to receive the necessary stimulating impressions associated with contact, a change in body position in space, etc. Pretentious postures, movements, facial expressions, tiptoe walking, running in circles, stereotypical actions with objects are characteristic. Movements are clumsy, angular, slow, poorly coordinated, devoid of plasticity, they combine slowness with impulsivity.

In the development of perception, the sensations of light, color, and the shape of one's body acquire intrinsic value. Normally, they are a means for organizing motor activity, and for autistic children they become a source of autostimulation.

Speech disorders in these children are peculiar: speech can be poor, containing a set of short cliches, individual words, echolalia (often set aside for days, hours and months), or it can be literary; may be devoid of intonation or, conversely, reproducing them accentuated, with the scanning of individual words or sounds. In speech, the pronoun “I” may be absent for a long time, i.e. talking about yourself in the second and third person. Often there is mutism and regression of already established speech. But in a state of passion, a tormented child can suddenly utter a whole phrase that is adequate to the situation that has excited him.

All speech disorders are united by the fact that this is a stereotyped speech, consisting of numerous repetitions, and also by the fact that this speech is autonomous, egocentric, used not for dialogue, communication or knowledge of the world, but a monologue addressed to no one, reflecting the pleasure of manipulating the word or your own experiences.

In the development of thinking, we are not talking about the absence of individual abilities (in generalization, in the limited awareness of the subtext of what is happening, in understanding the development of the situation in time, in understanding the logic of another person), but about the inability of the child to actively process information, use their abilities in order to adapt to a changing environment.

Behavioral problems are the child's reactions to their own maladaptation. These include: negativism, i.e. refusal of the child to do something together with an adult, avoiding the situation of learning, arbitrary organization; fears associated with special sensory vulnerability; “generalized aggression” (its manifestations can be very intense), i.e. aggression, as it were, against the whole world, which occurs when such a child feels bad; self-aggression as an extreme manifestation of despair and hopelessness, representing a physical danger to the child.

The most difficult period, aggravated by a maximum of behavioral problems - self-isolation, excessive stereotyping of behavior, fears, aggression and self-aggression - is a period from 3 to 5 - 6 years. In the future, the brightness and variety of clinical symptoms decreases and the social inability of the child comes to the fore.

According to L. Eisenberg, L. Kanner (1966), good social adaptation (providing for oneself, the ability to have sufficient social contacts) is noted only in 5% of cases, satisfactory (partial adaptation with the need for additional care) - in 22%, the impossibility of existence out of family care or special institutions- in 73%. VM Bashina (1986) notes a higher percentage of adaptation.

Currently, most researchers of the RDA problem adhere to the criteria formulated by M. Rutter (1978):

· special deep violations in social development, manifested out of connection with the intellectual level of the child;

· delay and disturbance in the development of speech out of connection with the intellectual level;

· the desire for constancy, manifested as stereotyped occupations, over-addiction to objects, or resistance to changes in the environment;

· manifestation of pathology up to 30 months of age (since 1984 - amendment -48 months). (7)

E.S. Ivanov distinguishes the following nuclear symptoms in the clinic of RDA syndrome: the first signs immediately after birth; lack of need for communication and lack of purposeful behavior; the desire to preserve the stability of the environment; peculiar fears; originality of motor skills; symptoms of a violation of the phasing and hierarchy of mental and physical development; originality of speech and its formation; frequent absence of babbling, cooing, difficulty in isolating the semantic side of speech (language coding); difficulties in expressive speech, gestural speech, in facial expressions and pantomime; a peculiar combination of higher and lower emotions; intellectual unevenness; stereotypy in behavior, motor skills, speech, play; violation of the sleep formula; insufficiency or lack of response to distant stimuli; violation of the differentiation of animate and inanimate objects; the ability to relative compensation in the sphere of everyday life in the presence of an outside assistant; the possibility of regression of mental functions in the absence of the correct psychotherapeutic approach or late initiation of treatment. (four)

1.1.5 The importance of early diagnosis and psychological and pedagogical correction of autistic children

The mental development and social adaptation of a child with early childhood autism largely depend on the earliest diagnosis of this developmental anomaly. When working with abnormal children, the following tasks are solved:

· Identify and systematize pathological systematics and give a psychological qualification;

· Conduct a structural analysis of disorders, identify primary symptoms associated with the disease, and secondary, due to impaired development in the conditions of the disease;

· Develop a program of corrective measures, differentiated depending on the nature, nature and mechanism of the formation of violations and aimed at their prevention, removal or mitigation;

· Conduct rehabilitation education for children with impaired higher mental functions that occur with local brain damage. (eight)

But the diagnosis of RDA in the first years of life presents great difficulties, there are numerous erroneous diagnoses before the age of 5-6 years of the child, associated with the following factors:

1.Fuzziness of parental complaints, lack of parental experience.

2.Ignorance of doctors in the RDA clinic, hypnosis of advancing the development of a number of mental functions that impede the diagnosis of pathology.

.Frequent presence autistic children have mild neurological signs - minimal brain dysfunction, non-specific age-related symptoms that lead diagnostics to the usual course of early cerebro-organic pathology. (7)

In the absence of early special psychological and pedagogical assistance, a rather gross and specific secondary retardation of intellectual development may occur, and an experiment with a non-contacting child during testing leads to biased data and erroneous opinion about the mental underdevelopment of such children.

Childhood autism manifests itself in very different forms, at different levels of intellectual and speech development, so a child with autism can be found both in a special and in a regular children's educational institution. And everywhere such children experience great difficulties in interacting with other people, in communication and social adaptation and require special support. However, instead of this, they often meet with misunderstanding, hostility and even rejection, and receive severe mental trauma.

An autistic child outwardly can give the impression of simply spoiled, capricious, ill-mannered, and misunderstanding and condemnation of others can lead to the formation of secondary autism of the child and his family.

The development of the child's psyche occurs mainly through social inheritance, the appropriation of social experience (L.S. Vygotsky, A.N. Leontiev, S.L. Rubinshtein). And for children diagnosed with autism, it is characteristic that the child’s emotional contacts with the outside world and, most of all, with a person, are difficult to form, communication is disrupted, which sharply distorts the course of the entire mental development of the child, violates his social adaptation. (16)

In the absence of timely diagnosis and adequate psychological and pedagogical correction, a significant part of autistic children become unteachable and unadapted to life in society. And, conversely, under the conditions of the timely start of correction, most of these children can study at school, often revealing talent in certain areas of knowledge and art.

Early diagnosis is also necessary for early psychotherapy of the family, prevention of its disintegration, the threat of which is often due to the fact that the originality of an autistic child is mistakenly perceived by the father as a result of a defect in education coming from the mother.

Knowledge of the early symptoms of RDA is necessary for the doctor for timely diagnosis and timely start. adequate therapy.

At present, abroad and in our country, an active search is underway for various approaches - medical and, first of all, psychological and pedagogical, aimed at correcting autistic dysontogenesis, normalizing the mental development of such a child.

The timely start of "supportive" drug therapy, the early psychological and pedagogical correction with long-term follow-up show that the majority of autistic children, despite a number of persistent mental characteristics, can be prepared for education in a mass school.

However, it is now becoming clear that childhood autism is not only a problem of childhood. Difficulties in communication and socialization change form, but do not go away over the years, and therefore help and support should accompany a person with autism all his life.

The experience of many specialists shows that, despite the severity of violations, in some cases (according to some sources, in a quarter, according to others - in a third) of cases, successful socialization of such people is possible - acquiring independent living skills and mastering rather complex professions. (13)

1.1.6 Features of the mental development of a child of primary school age (7-10 years old) are normal

Primary school age is a period of further physical and psychophysiological development of the child, when the work of the brain and nervous system is improved. By the age of 7, the cerebral cortex is already largely mature, however, the most important, specifically human parts of the brain responsible for programming, regulating and controlling complex forms of mental activity, in children of this age have not yet completed their formation (development of the frontal parts of the brain ends by the age of 12), as a result of which the regulatory and inhibitory effect of the cortex on the subcortical structures is insufficient, which is manifested in the characteristics of behavior, organization of activity and the emotional sphere characteristic of children of this age.

This is an age period accompanied by increased fatigue, neuropsychic vulnerability of the child, instability of mental performance, low resistance to fatigue, although these parameters increase with age.

The beginning of a child's education leads to a change in the social situation of development - the child becomes a "social" subject, he has socially significant duties, the whole system of his life values is rebuilt.

The leading activity at this age is educational activity, which determines the changes taking place in the development of the child's psyche. Within the framework of educational activity, psychological neoplasms are formed, which are the basis for ensuring the development of the child at the next age stage.

Primary school age is a period of intensive development and qualitative transformation of cognitive processes: they begin to acquire an indirect character and become conscious and arbitrary. The child gradually masters his mental processes, learns to control attention, memory, thinking. (fourteen)

At the age of 7-11 years, an intensive process of development of the child's motor functions continues, there is an increase in many indicators of motor development (muscle endurance, spatial orientation of movements, visual-motor coordination).

Higher cortical levels of movement organization begin to come into operation, which ensures the progressive development of precise and power movements, and also creates the necessary conditions for mastering new motor skills and subject manual manipulations.

All this is important for the overall mental development of the child. After all, all movements, motor acts, being an external manifestation of any mental activity (I.M. Sechenov), have a mutually inverse effect on the development of brain structures. The level of development of fine and gross motor skills plays an important role in mastering learning skills, especially writing.

During this period, the ability to voluntarily regulate behavior changes qualitatively. The “loss of childish immediacy” (L.S. Vygotsky) that occurs at this age characterizes a new level of development of the motivational-need sphere, which allows the child not to act directly, but to be guided by conscious goals, socially developed norms, rules and ways of behavior.

The ability to act arbitrarily is formed gradually, throughout the entire primary school age. Like all higher forms of mental activity, voluntary behavior obeys the basic law of their formation: new behavior first arises in joint activity with an adult who gives the child the means to organize such behavior, and only then becomes the child’s own individual mode of action (L.S. Vygotsky) .

The specificity of primary school age is that the goals of the activity are set mainly by adults, and the set goal should be included in the motivational context that is most significant for children. this child. “As a result, the child develops the ability to set goals himself and, in accordance with them, independently control his behavior and activities” (1). It is this skill that is fundamental for the development of arbitrariness.

During the primary school age, a new type of relationship with other people begins to take shape, peers begin to acquire more and more importance for the child, and the role of the children's community increases.

The central neoplasms of primary school age are:

· A qualitatively new level of development of arbitrary regulation of behavior and activity;

· Reflection, analysis, internal action plan;

· Development of a new cognitive attitude to reality;

· Peer orientation. (fifteen)

A child at this age has wide opportunities for development, because this age is sensitive for:

· Formation of learning motives, development of sustainable cognitive needs and interests;

· Development of productive methods and skills of educational work, "ability to learn";

· Disclosure of individual characteristics and abilities;

· Development of skills of self-control, self-organization and self-regulation;

· The formation of adequate self-esteem, the development of criticality in relation to oneself and others;

· Assimilation of social norms, moral development;

· Development of communication skills with peers, establishing strong friendly contacts.

The most important new formations arise in all spheres of mental development: the intellect, personality, social relations are transformed.

The level of achievements made by each child at this age stage is very important, because in the future (outside the sensitive period) it will be much more difficult to feel the joy of learning, acquire the ability to learn, learn to make friends, gain confidence in one's abilities and capabilities and will require disproportionately higher mental and physical costs. All positive acquisitions of a younger student are a necessary basis for the following adolescence.

Part 2. Neuropsychological diagnostic method (A.R. Luria)

.2.1 Theory of systemic dynamic localization of higher mental functions

The methodological foundations of Russian neuropsychology are based on a general philosophical system of explanatory principles, which include the postulates of the cultural and historical conditioning of the human psyche, the fundamental formation of mental processes under the influence of social factors, the mediated nature of mental processes, the leading role of speech in their organization, the dependence of the structure of mental processes on ways of their formation, etc.

Domestic neuropsychology was formed on the basis of the provisions of the general psychological theory developed in Soviet psychology by L.S. Vygotsky and his followers - A.N. Leontiev, A.R. Luria, P.Ya.

The concept of "higher mental functions" (HMF) - central to neuropsychology - was introduced in general psychology and into neuropsychology by L.S. Vygotsky, and then developed in detail by A.R. Luria. As A.R. Luria pointed out, HMFs, understood as complex forms of conscious mental activity, have three main characteristics: they are formed in vivo, under the influence of social factors, they are mediated in their psychological structure (mainly with the help of the speech system) and are arbitrary in terms of the method of implementation ( Luria A.R., 1969, 1973; Leontiev A.N., 1972).

That is, HMF are complex systemic formations that are qualitatively different from other mental phenomena. HMFs are complex "psychological systems" that are created "by building new formations over the old ones while preserving the old formations in the form of subordinate layers within the new whole" (Vygotsky L.S., 1960).

HMF as systems have great plasticity, interchangeability of their components. Immutable (invariant) in them are the task (a conscious goal or program of activity) and the final result, while the means by which this task is realized are very variable and differ on different stages and with different ways and ways of forming a function.

In the future, the idea of higher mental functions as complex psychological systems was supplemented by the idea of HMF as functional systems.

In domestic neuropsychology, HMF localization is considered as a systemic process. This means that mental function correlates with the brain as a certain multi-component, multi-link system, the various links of which are associated with the work of various brain structures.

The HMF localization is characterized by dynamism and variability. This principle of function localization follows from the basic quality of the functional systems that mediate the HMF, their plasticity, variability, and interchangeability of links.

A fundamental contribution to the study of the problem of localization of brain functions was made by the teachings of I.P. Pavlov about the complex dynamic organization of brain structures that underlie mental activity and the theory of functional systems by P.K. Anokhin, which later formed the basis of the theory of brain organization of the HMF.

The localization of functions, according to I.P. Pavlov, is “... the formation of complex and “dynamic structures” or “combination centers”, which consist of a “mosaic” of far-distant points of the nervous system, united in a common work” (Pavlov I.P. Poln collected works, 1940, vol. III, p. 253). This doctrine was subsequently developed in the works of physiologists P.K. Anokhin (1940, 1971) and N.A. Bernstein (1947, 1966).

"Function", as P.K. Anokhin, in essence, is a functional system aimed at the implementation of a known biological task and provided by a whole complex of interrelated acts that ultimately lead to the achievement of the corresponding biological effect.

A functional system in neuropsychology is understood as the psychophysiological basis of higher mental functions. A functional system is a wide functional combination of a significant number of physiological components (differently localized structures and processes) with constant signaling of the result of an action in order to obtain a certain adaptive effect that is necessary at the moment in the interests of the whole organism.

The most significant features of such functional systems are that they are based on a complex dynamic structure of individual links located at different levels of the nervous system, and that these links involved in the implementation of a particular adaptive task can change, while the task itself - remain unchanged.

The functional system includes the following components: afferent synthesis, decision making, action result acceptor, efferent synthesis, useful system result, back afferentation about the parameters of the obtained real result.

Afferent synthesis - processes of processing and synthesis of information that is necessary in order to perform the most adequate act under given conditions. The neurophysiological mechanism of this stage is carried out with the obligatory participation of an orienting-exploratory reaction, as well as due to the convergence of excitations of various modalities on the neurons of the cerebral cortex. Information processing is facilitated by the cortical-subcortical organization of excitation.

Decision making is the transition from the excitation of individual neurons to the integration of neurons into a single system.

The acceptor of the result of an action is the prediction of signs of a future result. The parameters of the result are compared using back afferentation with the excitation of the neurons of the acceptor of the result of the action. That is, an image of the result is formed in the CNS. In the process of achieving the result, the action result acceptor mechanism adjusts the result obtained and its prototype.

Efferent synthesis - the formation of central mechanisms that provide receiving certain result.

Feedback afferentation (feedback) - contributes to the evaluation of the actual results obtained with the results of the action programmed in the acceptor. If the actual result corresponds to the predicted one, then the organism proceeds to the next stage of activity.

Thus, HMF, or complex forms of conscious mental activity, are systems in their psychological structure and have a complex psychophysiological basis as functional multicomponent systems.

Functional systems are multidimensional, have different levels of interaction between their elements and obey the principles of hierarchy (Lomov BF, 1984). When we talk about the localization of functions, we mean, first of all, the systemic activity of the brain, which determines the paths of movement and the places of interaction of the nervous processes that underlie this or that function. In this sense, mental functions are confined to brain structures, but at the same time, the same brain centers can be included in various “working” constellations, and the same function in different conditions is implemented in a different way and relies on brain centers that are different in localization. mechanisms.

Such mental processes as perception and memorization, gnosis and praxis, speech and thinking, writing and counting, are not isolated and indecomposable "abilities" and cannot be considered as direct functions of limited cell groups localized in certain areas of the brain. (ten)

That is why HMF, as complex functional systems, cannot be localized in narrow areas of the cerebral cortex, but must cover complex systems of jointly working areas, each of which contributes to the implementation of complex mental processes and which can be located in completely different, sometimes far distant from each other. other areas of the brain.

In cases of violation of higher mental processes, damage to each of the areas of the brain can lead to the disintegration of the entire functional system, in the implementation of which these areas are involved, and, thus, the symptom (violation or loss of a particular function) still does not say anything about its localization .

In order to move from the establishment of a symptom to the localization of the corresponding mental activity, it is necessary to carry out a detailed psychological analysis of the structure of the violation that occurs and to clarify those immediate causes due to which the functional system fell apart, i.e. give a thorough qualification of the observed symptom.

The most important position of domestic neuropsychology is the position that the HMF should be compared not with the morphological substrate, but with the physiological processes that take place in certain brain structures during the implementation of the function. To designate these physiological processes, A.R. Luria introduced the concept of “factor”. Only work leading to the isolation of the main factor behind the observed symptom allows us to come to a conclusion about the localization of the disorder underlying the defect.

The main path of neuropsychological research is the structural analysis of the syndrome, in order to find a common basis (factor) that explains the origin of various neuropsychological symptoms. (ten)

1.2.2 General structural and functional model of the brain

Since human mental processes are complex functional systems that are not localized in narrow, limited areas of the brain, but are carried out with the participation of complex complexes of jointly working brain apparatuses, it is necessary to understand what basic functional units the human brain consists of and what role each of them plays in the implementation complex forms of mental activity.

AR Luria (1973) proposed a general structural and functional model of the brain. This model characterizes the most general patterns of the brain as a whole and is the basis for explaining its integrative activity. According to this model, the entire brain can be divided into three main structural and functional blocks:

· I-th block - energy, or a block of regulation of the level of brain activity;

· II-nd block - reception, processing and storage of exteroceptive (i.e., outgoing) information;

· III block - programming, regulation and control over the course of mental activity.

Each higher mental function (or a complex form of conscious mental activity) is carried out with the participation of all three blocks of the brain that contribute to its implementation. (ten)

Block of regulation of tone and wakefulness.

For the full provision of mental processes, an optimal tone of the cerebral cortex is necessary. The cerebral cortex is the highest department of the central nervous system, providing, on the basis of congenital and acquired functions in ontogenesis, the most perfect organization of the body's behavior. The functions of the cortex are realized by the interaction of the processes of excitation and inhibition.

In a state of reduced tone of the cortex, the normal ratio of excitatory and inhibitory processes and the mobility of the nervous system, which is necessary for the flow of every normal mental activity, are disturbed.

The apparatuses that provide the tone of the cortex do not lie in the cortex itself, but in the underlying stem and subcortical regions of the brain and are in a dual relationship with the cortex, toning it and experiencing its regulatory influence. This block includes: reticular formation, hypothalamic apparatus, thalamic apparatus Functions of the thalamus - processing and integration of all signals going to the cerebral cortex from neurons of the spinal cord, midbrain, cerebellum, basal ganglia; regulation of the functional states of the body.

This block causes an awakening reaction, increases excitability, sharpens sensitivity and thus has a general activating effect on the cerebral cortex. This block is located mainly within the brain stem, the formation of the diencephalon and the medial cortex. In this block are concentrated: the respiratory center, the vasomotor center, the oculomotor center.

Block of reception, processing and storage of information.

This block is located in the outer sections of the neocortex and occupies its posterior sections, including the apparatuses of the visual (occipital), auditory (temporal) and general sensitive (parietal) regions.

The basis of this block is formed by the primary or projection zones of the cortex, consisting of neurons with the highest specificity. Primary or projection zones of the cortex form the basis of this block. They are surrounded by apparatuses of secondary cortical zones built on top of them. They include associative neurons in their composition, which allow combining incoming excitations into certain functional patterns and thus performing a synthetic function.

However, human cognitive activity never proceeds based on one isolated modality (touch, sight, hearing). Any objective perception, and even more so representation, is systemic, it is the result of polymodal activity, which is first expanded and then collapsed. Therefore, it is quite natural that it should be based on the joint work of the whole system of zones of the cerebral cortex.

The function of ensuring such joint work of a whole group of analyzers is carried out by the tertiary zones of the second block: the overlap zones of the cortical sections of various analyzers, located on the border of the occipital, temporal and posterior central cortex. Their main part is the formation of the lower parietal region. They carry out the function of integrating excitations coming from different analyzers.

Work tertiary zones the posterior cortex is necessary not only for the successful synthesis of visual information reaching a person, but also for the transition from direct, visual syntheses to the level of symbolic processes - for operations with the meanings of words, complex grammatical and logical structures, systems of numbers and abstract relationships.

Block of programming, regulation and control of activity.

The reception, processing and storage of information constitute only one side of a person's conscious life. Its other side is the organization of active, conscious, purposeful activity. It is provided by the third functional block of the brain. A person not only passively reacts to the signals reaching him. He creates plans, forms plans and programs for his actions, monitors their implementation, regulates his behavior, bringing it into line with plans and programs, he controls his conscious activity, comparing the effect of actions with the original intentions and correcting the mistakes made.

The devices of the third head block are located in the anterior sections of the cerebral hemispheres. This block itself does not contain a set of modal-specific zones representing separate analyzers, but consists entirely of apparatuses of the efferent (motor) type and is itself under the constant influence of the apparatuses of the afferent (second) block.

The role of the main zone of the block is played by the premotor parts of the frontal region. Irritation of this part of the cortex causes whole complexes of movements that are systemically organized in nature (turns of the eyes, head and whole body, grasping movements of the hands).

The most significant part of the third functional block of the brain is the frontal lobes, or rather, the prefrontal parts of the brain. It is these sections of the brain that play a decisive role in the formation of intentions and programs, in the regulation and control of the most complex forms of human behavior. The prefrontal regions of the cortex play a significant role in regulating the state of activity, changing it in accordance with the most complex intentions and intentions formulated with the help of speech. The prefrontal cortex is in close connection with almost all major areas of the cerebral cortex.

The frontal lobes of the brain play an essential role in the directional assessment of external impressions and the expedient, directional selection of movements, in accordance with this assessment.

Violation of the prefrontal cortex leads to a profound disruption of complex behavioral programs and to a pronounced disinhibition of direct reactions to side stimuli, making the implementation of complex behavioral programs inaccessible.

The interaction of the three main functional blocks of the brain.

Any conscious activity is always a complex functional system and is carried out based on the joint work of all three blocks of the brain, each of which contributes to its implementation.

According to modern concepts, each mental activity has a strictly defined structure: it begins with a phase of motives, intentions, plans, which then turn into a specific program (or “image of the result”) of activity, including ideas about how to implement it, after which it continues as an implementation phase this program through certain operations. Mental activity ends with the phase of comparison of the obtained results with the initial “image of the result”. In case of discrepancy between these data, mental activity continues until the desired result is obtained. This scheme (or psychological structure) of mental activity, repeatedly described in the works of A.N. Leontiev (1972) and other domestic and foreign psychologists (V.P. Zinchenko, 1967; K. Pribram, 1975, etc.), model of "three blocks" can be correlated with the brain in the following way.

AT initial stage the formation of motives in any conscious mental activity (gnostic, mnestic, intellectual) takes part mainly in the first block of the brain. It also provides an optimal general level of brain activity and the implementation of selective, selective forms of activity necessary for the flow of specific types of mental activity. The first block of the brain is mainly responsible for the emotional "reinforcement" of mental activity (the experience of success - failure). The stage of formation of goals, programs of activity is mainly associated with the work of the third block of the brain, as well as the stage of control over the implementation of the program. The operational stage of activity is realized mainly with the help of the second block of the brain. The defeat of one of the three blocks (or its department) is reflected in any mental activity, as it leads to a violation of the corresponding stage (phase, stage) of its implementation. This general scheme of the functioning of the brain finds concrete confirmation in the neuropsychological analysis of disorders of higher mental functions that occur as a result of local lesions of the brain.

Thus, various stages of voluntary, speech-mediated, conscious mental activity are carried out with the obligatory participation of all three blocks of the brain, and this is consistent with the theory of systemic dynamic localization of the HMF and the general structural-functional model of the brain and is the main position in neuropsychological diagnostics. Its consequence is the principle of the obligatory participation of the frontal parts of the cerebral cortex in the brain supply of the HMF, which is true for the brain organization of all forms of conscious human mental activity.

The distribution of functions across brain regions is not absolute. All these are manifestations of dynamic localization of functions that allow compensating for dysfunction.

training autistic child correction

1.2.3 Methods of neuropsychological research in children

Modern neuropsychology, as one of the fundamental sciences of the brain, makes a huge contribution to solving complex problems of the relationship between the brain and the human psyche.

The factors that determine the need for the theory and methods of neuropsychological diagnostics (despite the technicalization of the diagnostic process - methods of neuroradiology, ultrasonic scanning, etc.) are the tasks of examination, restorative education and rehabilitation. Childhood neuropsychology, which is one of the most important areas of applied psychology, is closely related to these tasks.

The study of the HMF by psychological methods sometimes does not make it possible to identify the causes of a child's failure in school, since it does not reveal the primary defect and its structure. But it is the primary defect that is often the cause of the child's failure in school.

Based on the knowledge of neuropsychology about the systemic structure of higher mental functions, their heterochromic (i.e., multi-temporal) maturation, it is possible to identify not only the current level of development of mental functions (the zone of actual development), but also temporarily detect silent links (zone of proximal development), as well as to predict the further development of mental processes.

As the experience of specialists has shown, the neuropsychological approach, which takes into account the dynamic localization of HMF in the cerebral cortex, their different structure and features of formation, is the most adequate for diagnosing and predicting the development of HMF.

In addition, neuropsychological techniques make it possible to make not only a quantitative, but also a qualitative analysis of the functioning of the higher cortical structures of the brain, which makes it possible to apply statistical methods for processing the data obtained.

With the disintegration of a separate link of a functional system, the entire activity as a whole may suffer, but the loss of a particular function does not yet give grounds to judge its localization. In order to move from the symptom to the localization of the function, a detailed psychological analysis of the structure of the disorder is required, with the identification of the main cause of the breakdown of the functional system. This is possible only with the neuropsychological "qualification" of the symptoms of violations of higher mental functions.

Central task neuropsychological research - determination of the qualitative specifics of the violation. Qualitative analysis of mental dysfunction (“qualitative qualification” of a symptom) is carried out using a special set of techniques - Luriev tests based on clinical data.

The methods of neuropsychological diagnostics proposed by A.R. Luria were originally used as psychological methods for diagnosing local brain lesions, while they surpassed all other psychological methods in terms of the accuracy of topical diagnosis. Over time, it turned out that the scope of these methods is much wider, now they are used in various clinics, as well as to study the variants of the norm. (2)

In connection with the specifics of mental disorders in children with local brain lesions, there was a need for a special study of "children's" neuropsychological symptoms and syndromes, the accumulation and generalization of facts. This required special work to adapt neuropsychological research methods to childhood and standardize them.

The research data of E.G. Simernitskaya show that at different stages of ontogenesis, the lesion of the same part of the brain manifests itself differently. She distinguishes three age groups (5-7, 7-12, 12-15 years), each of which is characterized by its own symptoms. The maximum difference from the "adult" symptoms is found in children of the first age group.

Restoration of the HMF can only be achieved by restructuring the disturbed functional systems, as a result of which the compensated mental function begins to be carried out with the help of a new “set” of psychological means, which also implies its new brain organization.

Neuropsychological diagnostics consists of a number of stages: collecting a medical and psychological history, analyzing the materials of the disease, monitoring the patient, and actually experimental psychological examination using not only targeted neuropsychological tests and tasks, but also, if necessary, pathopsychological and test methods.

Chapter 2. Materials and methods of research

.1 Description of examination procedure

We examined 10 children aged 7 to 10 years with a diagnosis of RDA who were observed in the Regional Psychoneurological Dispensary and underwent an initial correctional course with a psychologist at the Department of Clinical Psychology of the PPF KRASGU for a year.

The need for initial corrective work before the examination of autistic children is dictated by the fact that the difficulty of communicative contact with such children can distort the results of the tests. Childhood autism is such an anomaly of mental development, in which the formation of emotional contacts is difficult, a violation of communication is characteristic, and, consequently, interaction with the outside world and people, therefore, the initial remedial course involved work to establish a more complete emotional contact with autistic children, which later allowed conduct a diagnostic neuropsychological examination most effectively.

Each child underwent a neuropsychological examination to determine the neuropsychological status.

All children participating in the neuropsychological study do not have an organic brain disorder and, according to the classification of O.S. Nikolskaya, can be assigned to groups 2–3 of the disease.

2.2 Methods of neuropsychological research

Neuropsychological diagnostics, which includes a complex of neuropsychological tests and tasks, is a special section of psychological diagnostics, on the basis of which topical diagnostic decisions are made.

Neuropsychological diagnostics is carried out on a multidimensional, individual factor basis, in which it is necessary to take into account the unity (relationship, interdependence) of qualitative and quantitative approaches. Being multidimensional and multidimensional, neuropsychological research consists in assessing the state of the HMF, the features of the functional asymmetry of the hemispheres and cognitive processes.

Neuropsychological study involves the assessment of right-left-handedness and dominance of the hemispheres in speech. It is believed that the final type of dominance is established in ontogenesis by 3-5 years - this is a kind of milestone, after which the possibility of compensating for impaired functions due to a healthy hemisphere is sharply reduced (Simernitskaya E.G., 1985).

In the course of the study, the data obtained are refined, and the final decision on the specifics of hemispheric asymmetry is made on the basis of the integration of all sources of information available for analysis (anamnesis, questioning, samples, etc.).

Assessment of speech status is the most important prerequisite for communicative activity. The analysis takes into account the child's ability to understand the task, facial expressions, gestures, the nature of the answers: their monosyllabic or extended nature, features of the pronunciation side of speech, the presence of echolalia, speed, etc.

The study of motor skills allows you to get a comprehensive description of the motor analyzer as a whole.

The specificity of neuropsychological diagnostics in childhood lies in the fact that the evaluation of the results of the performance of any task requires knowledge of the age standards for its implementation. In addition, the age accessibility of the testing procedure itself should be taken into account. Usually, the younger the child, the more clearly the results of the task are affected by general psychological factors, including intellectual maturity.

Neuropsychological research is preceded by an acquaintance with the medical history, a brief conversation with parents to obtain preliminary information about the child's speech status, right-handedness, his emotional-expressive features, the level of awareness of the disease, attitude towards it.

The pace of presentation of samples and tasks is individual; the duration of the latent period before the test is taken into account, difficulties in engaging in action and the need for additional stimulation, impulsivity, impaired voluntary attention, its exhaustion, etc.

The results of the neuropsychological study are recorded in the examination protocol, drawings.

The success of each task is conditionally ranked according to a 4-point system - 0, 1, 2, 3, while the ratings are:

· 0 - no errors or errors "non-specific" for a particular sample;

· 1 - mild violations;

· 2 - violations of the average degree;

· 3 - gross disorders.

Neuropsychological examination was carried out using Luria's methods of neuropsychological diagnostics, the following methods were used in the study:

Evaluation of the lateral organization of functions.

Luriev samples

Finger Interlacing

"Pose of Napoleon"

Applause

Fist to fist

Leg to leg

Visual asymmetry

Aiming

Study of visual and visual-spatial gnosis.

1.subject gnosis

Recognition of real images

Recognition of crossed out images

Recognition of overlay images

Recognition of underdrawn images

2.Color gnosis

Color identification

3.Visual-spatial gnosis.

Self-drawing (cube)

Taylor figure

The study of somatosensory gnosis.

Touch localization test

Test for discrimination

Study of auditory-motor coordination and auditory gnosis.

Playing Rhythms on a Pattern

Recognition of household noises

Movement research.

Head samples

Dynamic praxis (palm-fist-rib)

Reciprocal coordination (rhythm, synchrony of movements is assessed)

Reproduction of the pose of the fingers (praxis of poses)

Conditional reactions

Convergence study

The study of speech.

1.Automated speech

Numeric row from 1 to 10

Days of the week from Monday to Sunday

2.Disautomated speech

Numeric row from 10 to 1

Days of the week from Sunday to Monday

3. Reflected speech

Repetition of the syllables "bi - ba - bo"

Differentiation of similar-sounding phonemes (selection by speech instruction)

Repetition of words: colonel, admirer, ladle; shipbuilding, shipwreck; Mongolia, magnolia

repeating tongue twisters

4.Understanding logical-grammatical constructions

Understanding prepositions (relationships between objects expressed by a preposition)

Understanding inverted designs (autumn before winter, spring after summer, etc.)

5.Spontaneous extended speech

Story based picture

Memory research.

Method of memorizing 10 words

Interference test (2 groups of three words)

Attention research.

Correction test (Anfimov's letter tests)

Study of the activation background

Schulte table (digital test)

Study of the counting system.

Performing simple counting operations

Understanding the structure of a bit number

Study of cognitive processes.

Understanding stories

Understanding the meaning of plot pictures

Understanding the meaning of proverbs

"Exclusion of the superfluous" (subject variant)

The data on the performance of tests by each examined child are recorded in the protocols of the neuropsychological examination (see Appendix 1).

The scheme of neuropsychological research developed by A.R. Luria includes pathopsychological methods for the study of attention, memory, thinking, which can be useful for clarifying the features of a mental disorder. (2)

In this work, pathopsychological methods were used:

Table R. Schulte. This is a modification of the methodology of E. Kraepelin (1895) for the study of fatigue and performance (the task is to add in columns consisting of only two digits). A special form is required for the experiment. The subject is instructed to add pairs of single-digit numbers printed one under the other, and write the result of the addition under them. At the same time, he is warned that every 15 seconds the “Stop!” command will sound, after which he must continue adding in the next line. When processing the results, the number of additions and mistakes made for every 15 seconds is calculated and a performance graph is built that reflects the uniformity and pace of the task, reveals the presence of exhaustion, workability, and attention disorders.

V.Ya.Anfimov's letter tables are a technique aimed at identifying the level of working capacity and concentration of attention (the task is to cross out the letters "X" and "I", and underline the BX and EI at the instructor's command in the second part of the work). The task is performed on a special form, designed for 4 minutes and consists of 2 parts. When processing the data, the total number of signs viewed by the child is calculated - this is a quantitative indicator of working capacity, and also qualitative indicators of working capacity are established, general errors and errors in differentiation are identified.

As the experience of specialists has shown, the neuropsychological method is the most adequate for diagnosing the level of development of higher mental functions, in addition, neuropsychological methods make it possible to make not only a quantitative, but also a qualitative analysis of the functioning of the higher cortical structures of the brain, as well as the use of Luriev's methods, allows you to see which factor is damaged.

The samples included in the methodology make it possible to obtain data on the degree of functional formation of the studied structures, as well as to predict their further development.

Chapter 3. Results of the study

Qualitative description of the results.

The results of the study are presented in quantitative terms (see Appendix 1, protocols No. 1-10), with a qualitative analysis of the results of the studies, the following errors were identified:

When studying the function of programming and control in tests for understanding the meaning of plot pictures, stories, proverbs, the difficulties of a holistic perception of the meaning of plot pictures, the meaning of stories and the inaccessibility of understanding the meaning of proverbs were revealed;

In the tests of dynamic praxis, conditioned reactions - difficulties in maintaining the program were revealed. The noted violation of the program caused the failure of the execution of sample No. 37 - the exclusion of the fourth superfluous one, since the subjects slipped on side insignificant signs during generalization.

In addition, functional insufficiency of the tertiary cortex (TPO zone) was revealed, which manifests itself in difficulties in performing the following tests: No. 6 - independent drawing, No. 26 - understanding of inverted structures.

All the examined children were characterized by a decrease in the phasic activation of mental activity and an increased interference of traces short term memory, which indicates functional insufficiency of the diencephalic parts of the brain.

The decrease in phasic activity significantly exceeded the change in the general activation background associated with the work of the stem sections.

Often, during the examination, the violation of the functioning of the frontal lobes of the brain was of a secondary nature, and was caused by a lack of phasic activity and motivational influences, which is associated with dysfunction of the diencephalic parts of the brain.

Tests for visual and somatosensory gnosis did not cause pronounced difficulties.

Tests for the study of the counting system - showed the availability of simple counting operations for the surveyed and significant difficulties in understanding the structure of the bit number, which is associated with dysfunction of the tertiary cortex (TPO zone).

In the study of speech, difficulties were caused by tests requiring spontaneous expanded speech; in some children, clichés, stereotypes were detected in speech, less often echolalia.

Violations of expressive speech manifested themselves at the level of inner speech in the form of difficulty in compiling a successive statement.

Chapter 4. Discussion of the results of the study

According to the survey, it was possible to identify the following features of the neuropsychological status of children diagnosed with autism:

). Based on the analysis of literary sources, which speak about violations of volition, stereotypes, perseverations, difficulties in covering the whole, violations of purposefulness, etc., common for such children, we suggested that all this may be associated with impaired functioning of the frontal parts of the brain. brain.

The “forehead brain” in humans, being a substratum of arbitrary complexly programmable forms of behavior, undergoes tremendous development in ontogeny and, as it matures, is included in the implementation of all higher mental functions as one of the most important links in functional systems.

Block III of the brain - a block of programming, regulation and control over the course of mental activity - includes the motor, premotor and prefrontal sections of the cortex of the frontal lobes of the brain. The frontal lobes are characterized by a large number of bilateral connections with many cortical and subcortical structures.

And for patients with damage to the frontal lobes of the brain, disturbances in the voluntary regulation of various higher mental functions - motor, gnostic, mnestic, intellectual - are characteristic. With the preservation of individual private operations (motor skills, "mental actions", etc.), they violate the very structure of conscious, arbitrarily regulated mental activity, which is manifested in the difficulties in the formation and implementation of programs, violations of control over current and final results of activity . All these defects occur against the background of personality disorders - violations of motives and intentions to perform activities. A. R. Luria pointed out that the frontal lobes of the brain are an apparatus that ensures the formation of persistent intentions that determine the conscious behavior of a person. Moreover, with damage to the frontal lobes of the brain, those forms of conscious activity and behavior in general, which are directed by motives mediated by the speech system, are mainly violated. Conscious, purposeful behavior in such patients breaks down and is replaced by simpler forms of behavior or inert stereotypes.

Almost all the children who were examined revealed dysfunction of the frontal lobes of the brain, which caused difficulties in programming and controlling their activities, as well as perseveration in the motor and intellectual spheres. It is difficult for such children to keep a given program, their purposefulness of activity is disturbed. Samples were taken for processing: dynamic praxis, conditioned reactions; understanding the meaning of plot pictures, stories, proverbs (see Appendix 1; 2, tab. 2.1).

The results obtained confirmed our assumption about the presence of a general impairment of the factor of autistic children associated with the work of the frontal parts of the brain, expressed as a dysfunction of the frontal lobes.

). Further, based on the data of literary sources, which speak of a reduced mental tone in autistic children, we assumed the presence of a general impairment of the factor of autistic children associated with the work of brain stem structures.

The functional significance of block I in providing mental functions consists, first of all, in the regulation of activation processes, in providing a general activation background, in maintaining the general tone of the central nervous system, which is necessary for any mental activity. The energy block of the brain regulates two types of activation processes:

· general (generalized) changes in brain activation, which are the basis of various functional states;

· local (selective) activation changes necessary for the implementation of specific higher cortical functions in a given period of time.

The first class of activation processes is associated with long-term tonic shifts in the activation mode of the brain with a change in the level of wakefulness and is provided by the lower levels of the nonspecific system (the reticular parts of the midbrain stem).

The second class of activation processes are short-term phasic changes in the work of individual brain structures, which are provided by the diencephalic, limbic, and, especially, cortical levels of the nonspecific system.

In the children examined by us, an insignificant change in the general activation background associated with the work of the stem sections was found, samples were taken for processing: Schulte table, convergence test (see Appendix 2, tab. 2.2).

Insignificant changes in the general activation background associated with the work of the stem regions were combined with a significant decrease in phasic activity due to the work of the diencephalic regions of the brain.

A feature of mental dysfunctions caused by the work of the diencephalic departments is the increased inhibition of traces that occur under conditions of interference, however, it is possible to achieve a compensating effect with an increase in the motivation for mnestic activity or the semantic organization of the material. (9)

In the children examined by us, similar disorders of the emotional sphere were revealed - emotional reactions (reactive, unstable and unregulated), which is typical for dysfunction of the diencephalic parts of the brain.

Samples were taken for processing: interference study, indicators of phasic activity (see Appendix 2, tab. 2.3), which revealed a decrease in phasic activation of mental activity associated with functional insufficiency of the diencephalic parts of the brain.

Thus, the presence of a general impairment of the factor of autistic children associated with the work of the brain stem structures that we assumed was not confirmed, but there is a dysfunction of the diencephalic regions.

). When analyzing the study data, functional insufficiency of the tertiary cortex of the TPO zone was revealed - the zone of overlap of the temporal, parietal and occipital cortex.

The functional significance of the tertiary fields of the cortex is diverse. With their participation, complex types of mental activity are carried out - symbolic, speech, intellectual. The TPO zone among the tertiary fields has the most complex integrative functions.

The TPO zone is connected with the II block of the brain - the block for receiving, processing and storing exteroceptive information. The work of this block provides modal-specific processes, as well as complex integrative forms of information processing necessary for the implementation of the HMF.

Significant difficulties in performing tests No. 6 - an independent drawing, No. 26 - understanding of inverted structures, No. 33 - understanding the structure of the bit number by the examined children, give us reason to assume the presence of a general violation of the factor of autistic children associated with the work of the tertiary cortex - the TPO zone, i.e. e. we are talking about functional insufficiency of the TPE zone.

All the children examined by us showed symptoms of violations of cortical-subcortical connections: impulsivity, significant instability of attention, great difficulties in arbitrating involuntary physiological reactions (respiratory, oculomotor, lingual-motor and motor acts).

When analyzing the data obtained, the revealed manifestation of dysfunction of the diencephalic regions was much more pronounced than the dysfunction of the frontal regions of the brain.

With a certain number of remedial classes in programs for the development of voluntariness and programming, the examined children learn to work according to the program, finding in diagnostic tests more successful completion of tests for voluntariness and programming, but these changes do not have a clear effect on the nature of their mental activity in the direction of improvement.

When working on the regulation of involuntary physiological reactions (the mechanism of which is the development of cortical-subcortical connections), work with the motivational sphere (from the psychologist joining the stereotypical emotional choices preferred by the child to expanding the zone of emotional response) significantly increases the effectiveness of psychological influences on the examined children.

Based on the above observations and the quantitative results of our survey, correlating the level of difficulties in performing tests that show the functional viability of the diencephalic regions and the frontal regions of the brain, it can be assumed that the main deviations in the neuropsychological status of autistic children relate to:

· motivational sphere,

· spheres of phasic activity,

· spheres of emotional support of activity,

· and deviations in the field of arbitrariness and programming are secondary.

We believe that it makes sense to further study the neuropsychological characteristics of autistic children on a larger sample, in the direction of a deeper study of the features of the functioning of the diencephalic parts of the brain (thalamic zone), the features of the development of cortical-subcortical connections in order to be able to build more effective correctional programs.

The data obtained from the neuropsychological examination of autistic children are presented in the form of tables (see Appendix 2) and diagrams (see Appendix 3) clearly reflecting the success of neuropsychological tests that reveal the level of HMF development due to work: prefrontal frontal lobes, stem and diencephalic parts of the brain.

conclusions

1.We have identified the following features of the flow of higher mental functions:

a). In children diagnosed with early childhood autism in the study of higher mental functions, there are general difficulties in programming and controlling their activities and in complex integrative forms of information processing.

b). In children diagnosed with early childhood autism, there are clearly pronounced psychological correlates of impaired cortical-subcortical connections.

2.According to the study, the following features of the neuropsychological status of children diagnosed with autism take place: dysfunctions of the frontal parts of the brain, the TPO zone and the diencephalic parts of the brain.

3.Comparing the data obtained as a result of the study on the general features of the course of higher mental functions with the features of the functioning of brain structures, we conclude that:

a). The existing dysfunction of the diencephalic divisions is most pronounced and causes basic disturbances in the mental activity of autistic children.

b). Dysfunction of the frontal regions is of a secondary nature, while the function of arbitrariness and programming is impaired indirectly by violations of the motivational sphere.

Thus, the results of the study only partially confirmed the hypothesis put forward by us earlier - suggesting the presence of a general impairment of the factor of autistic children associated with the work of the frontal parts of the brain.

And the analysis of the data obtained allows us to say that there is a dysfunction not of the stem (as was supposed in the hypothesis), but of the diencephalic parts of the brain, which is much more pronounced than the dysfunction of the frontal parts of the brain.

Obviously, therefore, the ongoing correctional program for the development of the functions of volitionality and programming, although it has an impact on the success of autistic children in performing diagnostic tests for volitionality and programming, does not have a clear effect on the nature of their mental activity in the direction of improvement.

Bibliography

1. L.I. Bozhovich, Personality and its formation in childhood, M., 1968. - 273p.

2.L.I. Wasserman, S.A. Dorofeeva, Ya.A. Meyerson. Methods of neuropsychological diagnostics. St. Petersburg, Stroylespechat, 1997. - 303 p.

Children with communication disorders: Early childhood autism / Lebedinskaya K.S., Nikolskaya O.S., Baenskaya E.R. and others - M .: Education, 1989. - 95s.

Children's autism. Reader. SPb., Peter, 1997.

D.N.Isaev, V.E.Kagan, Autistic syndromes in children and adolescents: mechanisms of behavioral disorders // Anomalous development of the child (psychology), textbook, 2v, M: Che Ro: Higher. Shk., Publishing house. Moscow State University, 2002 - p. 466-473

VV Lebedinsky Disorders of mental development in children, M., Moscow State University, 1985. - 145s.

K.S. Lebedinskaya, O.S. Nikolskaya Diagnosis of early childhood autism: Initial manifestations. - M: Enlightenment, 1991. - 96s.

A.N. Leontiev, A.R. Luria, A.A. Smirnov “On diagnostic methods of psychological research of schoolchildren” // Reader, Psychodiagnostics and correction of children with developmental disorders and deviations, St. Petersburg, 2002.

V.Ya.Lubovsky. Psychological problems of diagnosing abnormal development of children / Nauch. research Institute of Defectology Acad. ped. sciences of the USSR. - M.: Pedagogy, 1989.

A.R. Luria. Fundamentals of Neuropsychology: Textbook for Higher Students. Proc. Institutions - 3rd ed., M: Publishing House. Center Academy, 2004. - 384s.

I.F.Markovskaya. Prognostic value of a comprehensive clinical and neuropsychological study // Reader, Psychodiagnostics and correction of children with developmental disorders and deviations, St. Petersburg, 2002.

S.S. Mnukhin, A.E. Zelenetskaya, D.N. Isaev, On the syndrome of "early childhood autism", or Kanner's syndrome in children // Abnormal development of the child (psychology), textbook, 2v, M: Che Ro: Higher Shk., Publishing house. Moscow State University, 2002 - p. 458-465

O. S. Nikolskaya, E. R. Baenskaya, M. M. Liebling Autistic child (ways of help), M., Terevinf, 1997. - 341 p.

V.P. Petrunek, L.N. Taran, Junior schoolboy, M., 1981, - 265p.

Practical psychology of education / ed. I.V. Dubrovina, M., Enlightenment, 2003. - 480s.

Development of communication between children and peers / ed. A.G. Ruzskaya; Scientific research Institute of general and ped. Psychology Acad. Ped. Sciences of the USSR. - M .: Pedagogy, 1989. - 265 p.

E.D. Khomskaya. Neuropsychology. M., Moscow State University, 1987. - 288s.

I.V. Shapovalenko. Age-related psychology. - M.: Gardariki, 2004. - 349 p.