When the parents are not to blame. How to raise a child with mental disabilities. Deviations of the child in social development. What periods most clearly demonstrate possible deviations in the physical and mental development of the child

CHILDREN WITH MENTAL DEFECTS

(English) children with abnormal behavior,problem children). Deviations in the mental development of the child m. caused by sensory disturbances (deafness, hearing loss, blindness, low vision), lesions of c. n. With. ( , , movement disorders, severe speech disorders). Deviations in development can also appear in various combinations.

Deviations in mental development occur from the moment the child is born, if the lesion is intrauterine, or from the moment the defect occurs, if the lesion is postnatal. The primary violation - a decrease in hearing, vision, intelligence, etc. - entails secondary deviations in development and deviations of the third order ( L.FROM.Vygotsky). With different primary reason many secondary abnormalities in infancy, early childhood, and preschool age have similar manifestations. Secondary deviations are, as a rule, systemic in nature, changing the entire structure of the child's mental development.

With any nature of the primary disorder, there is a delay in the timing of the formation of mental functions (processes) and a slow rate of their development, as well as qualitative deviations in development. Not a single type of children's activity is formed in a timely manner - object-manipulative, playful, productive (see. ). For example, object-manipulative activity in deaf and hard of hearing children becomes leading by the age of 5, in mentally retarded children - by the end preschool age. Significant deviations are observed in the development of all cognitive processes- perception, visual and verbal-logical thinking. Process development is disrupted communication; children poorly master the means of assimilation of social experience - understanding speech, meaningful imitation, actions according to the model and according to verbal instructions.

Defects speech development observed in all abnormal children. Speech may be completely absent (with deafness, severe hearing loss, alalia, mental retardation, cerebral palsy), may develop late, have significant defects - agrammatisms, violations of pronunciation, poverty of vocabulary and semantics. In some cases, formally developed speech can be. empty, empty.

It should be borne in mind that deviations in mental development m. caused by very minor, not conspicuous violations. So, hearing loss to a whisper while maintaining the perception of a voice of normal conversational volume can lead to speech underdevelopment. As a result transferred by a child harmful effects (birth trauma, severe infection, etc.), mental retardation may occur, preventing the child from learning normally at school, etc.

At the same time, the development of an abnormal child has the same tendencies, obeys the same laws as the development normal child. This is the basis for an optimistic approach to the possibilities of education and training of D. with o. in p. But in order for their developmental tendencies to be realized, and the development itself to be as close as possible (in accordance with the nature of the primary violation) to normal, a special pedagogical influence is required, which has a corrective orientation and takes into account the specifics of this defect.

Pedagogical influence is aimed primarily at overcoming and preventing secondary defects. The latter, in contrast to the primary disorders that are organic in nature and require honey. corrections are amenable to pedagogical correction. With the help of pedagogical means, m. significant - restoration or replacement of impaired function. At the same time, as domestic correctional psychology has shown, there is no spontaneous compensation for a defect: a violation of auditory perception is not compensated for by more intensive development visual function, but, on the contrary, entails underdevelopment visual perception; violation of the visual function does not lead to an increased development of tactile-motor perception, as compared to the normal one, etc.

The success of preventing, correcting and compensating deviations in mental development directly depends on the timing of the onset, content and methods. corrective work. From here it is extremely importance have early detection of developmental abnormalities and correct diagnosis of the primary defect. Cm. . (V. I. Lubovsky)

Big psychological dictionary. - M.: Prime-EVROZNAK. Ed. B.G. Meshcheryakova, acad. V.P. Zinchenko. 2003 .

See what "CHILDREN WITH MENTAL DEFECTS" are in other dictionaries:

Children with mental disabilities- Children with sensory impairments (vision, hearing), CNS lesions (mental retardation, mental retardation, movement disorders, speech disorders) or with combinations various violations. The latter can occur from the moment of birth ... ... Adaptive Physical Culture. Concise Encyclopedic Dictionary

Children in difficult life situations- children in a difficult life situation, children left without parental care; disabled children; children with handicapped health, that is, having deficiencies in physical and (or) mental development; children of victims of armed and ... ... Official terminology

CHILDREN IN DIFFICULT LIFE SITUATION.- In accordance with federal law“On the Basic Guarantees of the Rights of the Child in Russian Federation” The category of children in a difficult life situation includes: children left without parental care; children with disabilities who have disabilities in ... Terminological juvenile dictionary

abnormal children encyclopedic Dictionary

ABNORMAL CHILDREN- children with significant deviations in physical and mental development: intellectual disabilities (oligophrenia, mental retardation), speech, support locomotive system, visual analyzers (blind, blind, visually impaired), ... ... Big Encyclopedic Dictionary

1. Preservation in the psyche and behavior of an adult of the properties, traits, qualities and characteristics inherent in childhood. 2. A form of delay in passing through the stages of ontogenetic development, in which physical functions are also underdeveloped ...

Category. Violation of the general mental and intellectual development. Specificity. It is caused by insufficiency, as a rule, of the congenital, central nervous system and has a persistent, irreversible character. Types: mild mental retardation (IQ ... Great Psychological Encyclopedia

- (English mental dysontogeny, dysontogenesis) a violation of the development of the psyche as a whole or its individual components, a violation of the pace and timing of the development of individual areas of the psyche and their components. The term "dysontogeny" was first introduced by J. Schwalbe (1927) for ... ... Great Psychological Encyclopedia

- (English child neuropsychology) the science of the formation of a functional brain organization in ontogenesis. It arose at the intersection of neuropsychology, child psychoneurology, child psychology and developmental psychophysiology. As a section... ... Great Psychological Encyclopedia

A branch of psychology that studies people who are characterized by a deviation from normal mental development associated with congenital or acquired defects in the formation and functioning of the nervous system. studies various options pathology... Great Psychological Encyclopedia

After reading this article, you will be able to understand if the baby has any developmental disabilities.
The well-known German pediatrician T. Hellbrugge identified several particularly important signs in the development of a child: sitting, crawling, walking, holding an object, talking and communicating with people around him, which do not correspond to his age and should alert parents. The child may need a thorough medical examination.

Deviations from the norm in the development of motor skills of the child (all data are at the end of the month).

Months.

1 AT vertical position the baby cannot hold his head for a few seconds.
2 Cannot raise head a few centimeters from the surface and hold it. Makes asymmetrical, chaotic movements with legs and arms.
3 Lying on his stomach, does not hold his head for 40-60 seconds. Unable to hold his head for 30 seconds. while in a vertical position.
4 When lying on the tummy, he cannot rise, leaning on his forearms. At the time when the baby is lifted from a lying position, its head leans back. When the child is supported in an upright position under the handles, he does not even try to lean on his toes.
5 The child does not roll well from the stomach to the back. He holds his head badly, especially when he is lifted by his hands from a lying position.
6 When lying on his stomach, he does not reach the toy. If the baby is held in an upright position under the armpits, it does not sort out the legs "dancing".
7 With the support of the handles does not try to sit down.
8 Doesn't crawl back. Unable to stand with support by the arms even for a short time.
9 The child lying on his stomach cannot turn around his axis and crawl forward. When the baby is sitting, he does not keep his balance well and cannot turn around.
11 Can't crawl on all fours. Cannot sit with legs stretched forward. Cannot move while holding on to a support.
12 Does not know how to take 3-5 steps while holding the hands of an adult.

In addition to developing the ability to sit, crawl, stand and walk, the most important thing for a child in the process of exploring the surrounding space is hands, above all, grasping movements. A newborn baby is born with a grasping reflex, which manifests itself as squeezing and unclenching fingers when pressing on the palm. After some time, this reflex disappears, and conscious grasping movements are formed. To help develop good hand motor skills in a child, special classes will help, which you can read about in the article "Child Development According to the Montessori System"

Deviations of the child in the development of fine motor skills.

End of 3 months. The kid does not reach out with a half-open handle to an object of bright color that adults hold in front of him, does not examine his hands.
End of 5 months. The child cannot reach for the toy that interests him.
End of 6 months. Cannot grab and hold the cube.
End of 8 months. Can't keep between index and thumbs button-sized object.
End of 9th month. He does not try to drink from a mug himself, pull off his hat from his head.
End of 12 months. Cannot hold two small cubes with one hand, give a toy to an adult.

Among the most dangerous deviations from the norm, capable of provoking a lag in speech and cognitive development child, belong developmental hearing and vision impairments. Therefore, at the first suspicions that you have, you need to contact specialists to conduct a complete medical examination of the child.

Deviations of the child in the development of vision (data are at the end of the month).

Month.

1 The child does not follow the movements of light with his eyes (For example: a candle, a flashlight). He does not look into the eyes of the person leaning towards him.
2 Doesn't follow the toy. Does not repeat his facial expressions for an adult.
3 Does not study his hands, does not bring them to his eyes, does not touch (does not move) his fingers. The baby does not smile in response to the smile and friendly facial expressions of an adult.
5 The child does not hold out his hands and lacks the toy that interests him.
6 Can't move a toy from one hand to the other.
7 Cannot bang the dice on a table or other surface.
8 He does not take toys extended to him with two fingers.
9 Doesn't know how to knock cubes against each other.
10 Doesn't throw toys off the table or out of playpen.
12 Not interested in toys (rattles, cars, dolls). Does not try to find a toy that was hidden in front of him. Does not repeat the movements of an adult with toys (does not put a cube on a cube). Doesn't know how to line up cubes.

Deviations in the development of hearing in a child (data at the end of the month).

Month.

1 In response to an unexpected and loud sound, he does not show an inhibition reaction of sucking or motor movements (the child does not flinch, does not blink).
2 The child does not listen to the sound of the bell (which is located at a distance of 1.5 meters from him).
3 Does not search with eyes and does not turn the head to the right and left in the direction of the sounding object or sound. Does not respond to musical toys.
5 Doesn't stop crying when she hears mom singing or music.
6 Does not react to the rustling of paper that he cannot see.
7 Does not turn head towards sound or person speaking. Doesn't smile when spoken to.
8 Does not listen to the conversation of adults. Does not react (does not freeze) in response to a new unusual sound for him. The child shows no interest in music. The baby has no babbling.
9 Shows no reaction to his name. Doesn't understand the word "no", prohibition. Doesn't play "talk".
10 Does not babble, or the babble is monotonously colored. Doesn't use his voice to get attention.
12 Does not point at the request of an adult to pictures, people, animals or familiar objects. Do not repeat simple sounds, monosyllabic words after an adult. Does not respond to quiet sounds. The child does not turn either towards quiet or loud sounds. Shows no interest in surrounding sounds and music. Doesn't even try to speak.

Most parents begin to worry if the child does not speak well or does not speak at all after 2-2.5 years. In some cases, after a complete diagnosis (identifying the causes of delayed speech development), it turns out that speech disorder in a child associated with serious damage to the central nervous system or hearing organs. Specialists who work with young children know that by the nature of the pre-speech characteristics of a child's speech, by his behavior, it is possible to predict the features of speech formation. Parents should see a doctor if they notice any of the following symptoms in their child.

Deviations in the development of speech in a child (data at the end of the month).

Month.

1 Does not scream when he wants to eat, when wet or other unpleasant sensations.
4 The child does not smile when spoken to.
5 Does not know how to pronounce sounds or syllables (ba-ba-ba, dya-dya-dya, tya-tya-tya). She does not try, while in her mother's arms, to look for objects or people that she calls (“Where is grandmother?”, “Where is kitty?”)
7 The baby does not try to attract attention with any sounds.
9 In speech, the baby did not have repeated identical syllables that sound like one word (ma-ma, yum-yum, yes-yes)
10 Cannot repeat about eight different sounds or syllables after parents. Does not know how to shake his head to the side in denial (no-no), wave a pen goodbye (bye-bye).
12 Cannot pronounce more than one understandable "childish word", which the child calls the same objects, people and situations. Doesn't listen to music. Does not know how to fulfill a simple request (for example: give me a ball).

Gradually, the child masters the skills necessary for life communication with people around, simple self-service methods(learn to eat, drink, dress independently), begins to recognize himself as a person. All this in psychology is called socialization of the child. But it happens that the child cannot acquire these skills, he avoids interacting with people(and even with his mother), does not learn the simplest household procedures, does not use speech as a means of communication with people around. The child develops what are called communication disorders (communication disorders).

Deviations of the child in social development.

End of 1 month. Does not stop screaming when mom puts him to her chest or cuddles him.
End of 2 months. He does not look at his mother when she speaks to him.
End of 3 months. The child does not smile if an adult approaches him, who speaks to him or smiles at him.
End of 4 months. Doesn't enjoy being played with.
End of 5 months. Doesn't stop crying when spoken to. Does not distinguish dissatisfied intonations of an adult and benevolent.
End of 6 months. Does not ask for hands (stretching his hands to an adult).
End of 7th month. Does not show tenderness and affection towards mother or other relatives (does not press against the body, cheek).
End of month 9. Does not distinguish between relatives and strangers. Is not frightened or embarrassed by strangers, does not get upset or angry when a toy is taken from him.
End of 10th month. Does not repeat or imitate the actions that caused the laughter of others.
End of month 11. Does not support the cup when drinking. Cannot eat biscuits or crackers on his own.
End of 12 months. The child cannot eat solid food with a spoon. He does not make funny faces when he notices his reflection in the mirror.

Based on the materials of the book "Your Child" by O. Zhukova.

Moscow, "Enlightenment", 1992

BBK 74.3 M32

L. T. Vorobieva

Mastyukova E. M.

ISBN 5-09-004049-4 @ Mastyukova E. M., 1992

Causes of developmental deviations

Mental retardation

Severe violations speeches

Communication disorders

Conclusion

TYPES OF DEVELOPMENTAL DISTURBANCES

Psychomotor development is a complex dialectical process, which is characterized by a certain sequence and uneven maturation of individual functions, their qualitative transformation at a new age stage. Moreover, each subsequent stage of development is inextricably linked with the previous one.

The basis of psychomotor development is a genetic program, which is implemented under the influence of various environmental factors. Therefore, if a child lags behind in development, first of all, it is necessary to take into account the role of hereditary factors in this lag.

Various adverse effects in the prenatal period of development, during childbirth ( birth injury, asphyxia), and also after birth can lead to impaired psychomotor development of the child.

For successful treatment, correctional and pedagogical work with children with developmental disabilities, it is important to know the causes and nature of developmental disorders.

It is well known that children suffering from the same disease lag behind in development in different ways. This is due to the genotypic features of their central nervous system, various environmental influences, as well as how timely correct diagnosis and began treatment-correctional and pedagogical work.

Under cause developmental deviations understand the impact on the body of an external or internal adverse factor that determines the specifics defeat or developmental disorders psychomotor functions.

It is known that almost any more or less long-term adverse effect on developing brain child can lead to deviations in psychomotor development. Their manifestations will be different depending on the time. adverse impact, i.e., on what stage of brain development it took place, its duration, on the hereditary structure of the body and, above all, on the central nervous system, as well as on those social conditions in which the child is brought up. All these factors together determine leading defect which manifests itself in the form of insufficiency of intelligence, speech, vision, hearing, motor skills, disorders of the emotional-volitional sphere, behavior. In some cases, there may be several violations, then they talk about complicated or complex defect.

A complex defect is characterized by a combination of two or more disorders that equally determine the structure of abnormal development and the difficulties in teaching and raising a child. For example, a complex defect occurs in a child with simultaneous damage to vision and hearing, or hearing and motor skills, etc.

With a complicated defect, it is possible to single out the leading, or main, violation and complicating disorders. For example, a child with intellectual disabilities may experience mild defects in vision, hearing, musculoskeletal system, emotional and behavioral disorders.

Both a leading and a complicating defect can have the character of both damage, so underdevelopment. Often there is a combination of them.

feature child brain is that even a small lesion does not remain partial, local, as is the case in adult patients, but adversely affects the entire process of maturation of the central nervous system. Therefore, a child with impaired speech, hearing, vision, musculoskeletal system, in the absence of early corrective measures, will lag behind in mental development.

The developmental disorders described above are primary. However, along with the primary ones, there are often so-called secondary violations, the structure of which depends on the nature of the leading defect. Thus, the mental retardation in children with general systemic underdevelopment of speech will primarily manifest itself in the weakness of verbal (verbal) memory and thinking, and in children with cerebral palsy- in the insufficiency of spatial representations and constructive activity.

In children with hearing impairments, the development of understanding of addressed speech is disturbed, an active vocabulary and coherent speech are hardly formed. With visual defects, the child has difficulty in correlating the word with the designated object, he can repeat many words without understanding their meaning enough, which delays the development of the semantic side of speech and thinking.

Secondary developmental disorders primarily affect those mental functions that develop most intensively in early and preschool age. These include speech, fine differentiated motor skills, spatial representations, voluntary regulation of activity.

A major role in the occurrence of secondary deviations in development is played by the insufficiency or absence of early treatment, correctional and pedagogical measures, and especially mental deprivation. For example, an immobilized child with cerebral palsy, who has no experience of communicating with peers, is distinguished by personal and emotional-volitional immaturity, infantilism, and increased dependence on others.

Undiagnosed developmental disabilities, such as mild visual and hearing defects, primarily delay the pace of a child's mental development, and can also contribute to the formation of secondary emotional and personality abnormalities in children. Being in mass preschool institutions, not having a differentiated approach to themselves and not receiving treatment and correctional assistance, these children long time may be in a situation of failure. Under such conditions, they often develop low self-esteem, low level claims;

they begin to avoid communication with their peers, and gradually secondary violations aggravate their social maladaptation more and more.

Thus, early diagnosis, medical and psychological and pedagogical correction can achieve significant success in shaping the personality of children with developmental disabilities.

MENTAL RETARDATION

SEVERE SPEECH DISORDERS

Under alalia refers to a specific language underdevelopment that occurs as a result of damage to the corresponding parts of the cerebral cortex in the pre-speech period.

Speech underdevelopment in motor alalia always has a systemic character: it covers the phonetic-phonemic and lexical-grammatical aspects of speech and is combined with pronounced violations of its communicative function. With alalia, speech imitation is not developed, as a result of which reflected speech is disturbed, i.e., the repetition of syllables, words, and especially sentences is difficult. Violation of the organization of sound units in a linear sequence is manifested in the insufficiency or absence of babble, and later - in peculiar violations of the syllabic structure of words and in specific difficulties in constructing sentences. At each age stage, depending on the level of speech development, these disorders manifest themselves in different forms.

With motor alalia, at all age stages, there is a pronounced underdevelopment of pronunciation (expressive) speech with a better understanding of it (impressive speech).

Alalia is characterized by a violation of the rhythmic side of speech: the child speaks slowly, with pauses between syllables and words, words are often pronounced in syllables. Speech intonation is grossly disturbed. Children do not catch and reproduce by tapping or clapping the rhythmic pattern of a word or sentence.

The child cannot correctly repeat the words he hears, and various variants of distortions of the same words are characteristic.

The passive vocabulary grows very slowly, and for a long time it is limited to everyday words. Children often misunderstand the meaning of words.

Motor alalia slows down the process of formation of phrasal speech. Children with great difficulty master the grammatical structure of their native language.

Such a systemic underdevelopment of speech in alalia cannot but affect the mental development of the child.

The mental development of children suffering from motor alalia is characterized by its unevenness. At an early and preschool age, these children usually show interest in toys, games, are well oriented in everyday life, have self-service skills, their emotions are quite differentiated. At the same time, already at preschool age, a limited stock of knowledge and ideas about the environment is noted, the development of verbal and logical thinking is delayed.

Children with motor alalia are characterized by uneven development of thinking. Practical-effective and visual-figurative thinking in them significantly prevail over abstract-logical. Therefore than younger child, the more it gives the impression of intellectually safe; his intellectual deficiency is masked by the severity of the speech defect. However, with age, the inability of children to abstractions and the predominance of concrete-figurative thinking over verbal-logical thinking are increasingly revealed. Therefore, they hardly form concepts about the shape and size of objects, comparison operations, generalizations according to essential features, and counting skills.

Characteristic violations mental activity in the form of slowness of thinking, its difficult switching, pronounced exhaustion and satiety. In addition, these children are distinguished by small mental activity, weakness of motives, increased inhibition, a tendency to negativism. They refuse to perform tasks that require intellectual effort from them. Violations of the functions of active attention and memory are also frequent, with verbal (verbal) memory suffering first of all.

Speech plays a leading role in the regulation of voluntary activity. Therefore, with motor alalia, there is always a violation of voluntary regulation mental processes and the child constantly needs the organizing help of an adult.

convulsive syndrome and acute sensorimotor aphasia and alalia (Landau-Kleffner syndrome). The syndrome was first described in 1957. It is characterized by a combination of epilepsy with acute sensorimotor aphasia or with alalia.

With aphasia, the disease occurs acutely, for no apparent reason, and manifests itself in the loss of the ability to understand addressed speech and speak. Convulsive seizures in some cases precede aphasia, in others they occur after a certain period of time after the loss of speech. They may also present atypically, and their epileptic pattern can only be determined by EEG. The speech defect is persistent and is combined with specific learning difficulties, behavioral and intellectual activity disorders. In addition, motor disinhibition, affective excitability, attention disorders and speech negativism are often manifested in children.

With alalia, from the first years of life, a persistent systemic underdevelopment of speech is detected, combined with behavioral and mental performance disorders. The speech defect is accompanied seizures, which are characterized by high polymorphism.

Diagnosis of the syndrome is always based on EEG examination data.

Early diagnosis this syndrome is essential for the effective rehabilitation of these children.

Landau-Kleffner syndrome should be distinguished from deafness, early childhood autism, dementia.

COMMUNICATION DISTURBANCES

Early childhood autism (RDA) is a special variant of abnormal development, which most often manifests itself in the first 2-3 years of a child's life. Its main symptom is a violation of the child's contact with the outside world and, above all, with people. A child with autism is immersed in the world of his own experiences, fenced off from the outside world. He is closed and avoids communication with children, does not look into the eyes of others, moves away from bodily contact and affection of loved ones. He does not seem to notice other people; left to himself, he can shake his hands monotonously, jump in place or run around on his fingers in a circle, whisper, shout out individual words or sound combinations, etc.

These children are characterized by monotonous, as it were, non-purposeful motor activity, which manifests itself in jumping, clapping, tiptoeing, peculiar movements of the fingers near the outer corners of the eyes, and others. Their restlessness alternates with periods of lethargy, freezing in one position. Children with autism are characterized by peculiar fears.

Despite the fact that childhood autism was described by L. Kanner almost half a century ago (1943), many aspects of this disease still remain unclear. Currently, RDA is being studied around the world based on an integrated interdisciplinary approach, taking into account modern achievements neurophysiology, psychology, pharmacology, genetics, psychiatry and neurology. Much attention is paid to the early diagnosis of autism. The basis for diagnosing this peculiar deviation in development is the following groups of basic signs: impaired contacts with others, specific speech and emotional deviations, general specific deviations in psychomotor development. A characteristic feature of the development of a child with autism is the uneven development in general, as well as individual psychomotor functions.

One of the first signs of autism is the lack of eye contact, a “jerky” look, the predominance of peripheral vision over the central one, while the visual function as such is preserved. There are also features of auditory perception: the baby does not respond to verbal communication with him, although his hearing is normal.

In addition, in the first year of life, violations of vital functions in the absence of obvious somatic and neurological disorders attract attention. So, already from the first months of life, there may be a problem with feeding due to insufficient coordination of sucking and swallowing movements, very early the child begins to refuse the breast, later on he chews poorly, holds food in his mouth for a long time, is extremely selective in eating, refuses all new types of food; he also has pronounced sleep disturbances, and neatness skills are formed with great difficulty. But most of all, his emotional and personal development is disturbed. An important criterion early diagnosis autism is a violation of preverbal communicative behavior.

Mental capacity children with autism can be different.

Rice. 21. A child with fragile X syndrome and autism

In some cases, the intellect is preserved, but developed inharmoniously, in others, mental retardation is noted, and, finally, among such children there are gifted ones. However, in all cases, as already emphasized above, there is a kind of unevenness in their psychomotor development.

Autism occurs under the influence of various causes. But in all cases, the hereditary predisposition to such a peculiar form of abnormal development has a leading role. Autism is seen in all social classes and ethnic groups. Its average frequency is 1:10000 with a clear predominance of males (4 boys and 1 girl).

When raising children with autism, parents should be psychotherapists acting in conjunction with an educator, a psychologist and a doctor.

Separate manifestations of autism can be observed in various categories of children with developmental disabilities. For example, a combination of autism with Down's disease, phenylketonuria and other forms of mental retardation is possible. Of particular interest in this regard is the presence of autistic forms of behavior in the so-called X-linked mental retardation and, first of all, in fragile X syndrome(see fig. 21).

Intensive studies conducted in recent years in many countries have shown a high incidence of this disease, comparable only to the frequency of Down's disease, the most common form of mental retardation. According to foreign authors, its frequency among mentally retarded boys is 1.9-5.9%. On average, in the general population, the incidence of this disease is 1:1350 among boys and 1:2033 among girls, or 1:1634 among children of both sexes.

Early detection of children with a fragile X chromosome is important for timely psychological and pedagogical correctional work and treatment. In this regard, it is important for professionals and parents to know early signs this disease.

Characteristic signs of this disease are normal or excess weight and length at birth, combined with some increase in head circumference; they are usually blond bright eyes. They have an elongated face, high forehead, flattened middle part faces and some magnification mandible(see fig. 22).

Rice. 22. Appearance children with fragile X syndrome

There is an increased frequency of submucosal cleft palate or uvula. Attention is drawn to large protruding ears, deformities of the teeth, somewhat enlarged hands, increased mobility joints and skin extensibility. In some boys, already at birth, an increase in the size of the testicles with a normally developed penis can be noted.

Early diagnosis of this form of mental retardation is important for the timely implementation of therapeutic and corrective measures and for medical genetic counseling of the family, which makes it possible to prevent the further birth of children with this disease. However, the absence of pronounced congenital malformations in this syndrome complicates its early diagnosis. Therefore, in order to diagnose the disease great importance It has early detection specific deviations in physical, psychomotor and speech development.

The characteristic features include the following.

1. The trend towards more intensive intrauterine growth of the fetus and accelerated physical development in the first years of life in combination with a pronounced lag in motor, mental and speech development.

2. Among the retardation in the development of various motor skills, a mildly pronounced delay in the development of sitting and independent walking is especially noteworthy.

3. One of the most characteristic signs is a lag in the development of speech. Often this is the first complaint with which parents go to the doctor. The first words in these children appear on average by 2-2.5 years, phrasal speech is formed after 3.5 years.

Throughout the preschool period, a pronounced violation of sound pronunciation attracts attention. In addition, some children have a rough voice, a tendency to repeat individual sounds, syllables, words; sometimes there are signs of a kind of stuttering.

4. Intellectual deficiency of varying severity is combined with impaired attention, memory, behavior.

In addition, in children, even with mild intellectual disability, right-left orientation is formed with great difficulty, the development of spatial representations and constructive activity is delayed. In the future, these children hardly master the skills of counting and writing.

5. For children, behavioral disorders in the form of motor disinhibition and impulsivity are typical. In addition, their behavior sometimes resembles autistic behavior: they, like children with RDA, avoid eye contact, make various stereotypical hand movements in the form of shaking, patting, experiencing fears, etc. However, the structure of their emotional sphere qualitatively different than in children with autism. The differential diagnosis of these diseases is carried out by a child psychiatrist.

Mastyukova Elena Mikhailovna

CHILD WITH DEVELOPMENTAL DEFECTS

Head editorial T. S. Zalyalova Editor M. A. Stepanova junior editor A. N. Sinitsyna Painter S. A. Trofimov Artistic editor L. N. Selyanov Technical editor G. V. Subocheva Corrector I. N. Peshkova

Child with Developmental Disabilities: Early Diagnosis and Correction

Moscow, "Enlightenment", 1992

BBK 74.3 M32

Reviewer methodologist I / s No. 890 Khoroshevsky district of Moscow L. T. Vorobieva

Mastyukova E. M.

M32 A child with developmental disabilities: Early diagnosis and correction.-M .: Education, 1992.-95 p.: ill.-ISBN 5-09-004049-4.

The book summarizes the data of domestic and foreign studies on the diagnosis and correction of various forms of abnormal development in young children.

The author considers abnormal development as a consequence of an organic lesion of the central nervous system. He pays special attention to the early diagnosis and correction of deviations in the cognitive sphere of children.

The book is intended for defectologists, psychologists, educators of abnormal children, it will be of interest to students of defectological faculties, parents.

М 4310010000-339, bz_92 (order according to KB-34-1991) BBK 74.3 103(03)-92

ISBN 5-09-004049-4 @ Mastyukova E. M., 1992

Types and causes of developmental disabilities in children

Causes of developmental deviations

Age patterns of psychomotor development of children in normal and pathological conditions

The main patterns of age development

Psychomotor development of a child in the first year of life

The role of speech in the mental development of the child

Features of deviations in the development of young children

Early diagnosis of developmental disabilities

Basic methods and criteria for medical diagnostics

The main forms of abnormal mental development

Mental retardation

Impaired mental function

Severe speech disorders

Sensory and movement disorders

Communication disorders

Correctional education of children with developmental disabilities

Conclusion

Early diagnosis and correction of deviations in the psychomotor development of children is the main condition for their effective education and upbringing, prevention of severe disability and social maladaptation in them.

The role of the family, the emotionally positive communication of the child with the surrounding adults for his normal mental development is known. However, for children with developmental disabilities, this is not enough: from a very early age, they need special conditions that ensure the correction of impaired functions.

The data obtained by modern medicine testify to the effectiveness of early corrective and educational measures. This is due to the fact that it is in the first years of life that the child's brain develops most intensively.

In addition, on early stages development, children learn motor, speech and behavioral stereotypes. If in a child with developmental disabilities they are initially formed and fixed incorrectly, then it is extremely difficult to correct them later.

The upbringing of children with developmental disabilities is distinguished by its originality, which lies, firstly, in its corrective orientation, and secondly, in the inseparable connection of corrective measures with the formation of practical skills and abilities. The specific features of the upbringing of such children depend on the type of abnormal development, the degree and nature of violations of various functions, as well as the compensatory and age-related capabilities of the child.

Many children with developmental disabilities in addition to right upbringing, training and correction of disturbed functions also need special treatment. All this necessitates the early diagnosis of various deviations in psychomotor development.

When diagnosing abnormal development, it is not enough just to state intellectual, speech, motor or sensory insufficiency, it is necessary to put clinical diagnosis, which would reflect the cause and mechanism of developmental disorders, would determine the school and social prognosis, and also outline the ways and methods of treatment and correction work. Therefore, specialists in medical, psychological and pedagogical consultations and employees of preschool institutions should be well versed in diagnosing various forms of abnormal development, have an idea of modern methods their treatment and psychological and pedagogical correction.

The book offered to the attention of readers is the result of summarizing the author's many years of experience with children with developmental disabilities, as well as a critical analysis of domestic and foreign literature. This made it possible to describe not only forms of abnormal development, but also such diseases of the central nervous system (CNS) in which complex defects and deviations of psychomotor development occur.

The purpose of this book is to show employees of special and general preschool institutions, as well as to parents, the structure and nature of developmental deviations in children, age-related patterns of the formation of their psyche, techniques and methods for correcting impaired functions.

Mental health is a state of well-being in which a person can fulfill their own potential, cope with the normal stresses of life, and work productively and fruitfully.

The word "norm" from the Latin rule, sample - an established measure, the average value of something.

D.B. Elkonin argued that the norm is the one highest level achievements that can happen if I start to act (if I do not act, then this will not happen).

L. Fire offers the following criteria normality. The child is considered normal:

When the level of his development corresponds to the level of most children of his age;

When a child develops in accordance with his own general direction, which determines the development of his individual properties, abilities and capabilities, striving for full development individual constituent parts and their full integration;

When a child develops in accordance with the requirements of society, which determine his actual forms of behavior.

Appeal to the problem of the norm and deviations from it is traditional for psychology. AT classical literature you can find indications that, in general, the norm and pathology (deviations) are social concepts.

The problem of normativity of development is closely related to the problem of the norm. According to L.S. Vygotsky, normativity of development should be understood as a sequence of successive age stages of ontogenetic development. When evaluating the conformity of the level of development " age norm» Three characteristics must be taken into account:

1) features of the social situation of development (type of educational institution, social circle of the child, etc.);

2) the level of formation of psychological neoplasms at this stage of age development;

3) the level of development of the leading activity as an activity that plays a decisive role in development.

The concept of developmental disabilities

The next key issue of the topic is the concept of "deviation". In different sources there are different approaches to the use of terminology. Trying to resolve, many authors prefer to use the terms "anomaly", "pathology", "developmental disorders", etc. But in general, the terms used are intended to focus on the deviation from different kind norms. One way or another, but at the moment there is no single generally accepted approach to terminology. In general, impaired development is commonly called dysontogenesis. Any developmental disorder has a cause, but that cause itself may remain unknown or not fully understood. Knowledge of the causes and mechanisms of impaired development is key moment prevention, prevention of a wide variety of variants of deviations in development in children.

Reasons include the following groups:

1. Perinatal period - pathology of the hereditary apparatus, unfavorable course of pregnancy: toxicosis, infectious and viral diseases mother, and the incompatibility of the blood of the mother and fetus, etc.

2. postnatal period- A variety of infectious and viral diseases, along with traumatic brain injuries, can cause a variety of developmental disorders.

3. Socio-psychological factors are no less diverse and dangerous. These include separation of the child from the mother or persons replacing her, lack of emotional warmth, sensory-poor environment, improper upbringing, soulless and cruel attitude, etc.

Types of deviations:

Psychological and pedagogical correction and rehabilitation of children with developmental problems is possible if the nature of the violation is determined normal development child. Currently, in special psychology and correctional pedagogy, there are various classifications of developmental disorders (V.V. Lebedinsky, V.A. Lapshin, B.P. Puzanov, O.N. Usanova). In our opinion, the studies of V.V. Lebedinsky, who considers the problems of mental dysontogenesis, which means various forms ontogenesis disorders, i.e. development of the individual in contrast to the development of the species (phylogenesis). They are presented with the following variants of dysontogenesis:

1. Dysontogenesis according to the type of general persistent underdevelopment. For this variant, the early time of the lesion is typical, when pronounced immaturity is observed. brain systems. A typical example of persistent underdevelopment is oligophrenia.

2. Arrested development. It is characterized by a slow pace of formation of cognitive activity and the emotional sphere with their temporary fixation at earlier ages.

3. Damaged development. At the heart of the damaged development are hereditary diseases, intrauterine, birth and postnatal infections, intoxications and injuries of the central nervous system. However, the pathological effect on the brain occurs at later stages of development (2-3 years).

4. Deficit development. This type is associated with severe disorders of individual analyzer systems (vision, hearing, speech, musculoskeletal system).

5. Distorted development. A typical example is early childhood autism (RAA). Autism manifests itself in the absence or significant reduction contacts, in "withdrawal" to your inner world.

6. Disharmonious development. With this option, there is a congenital or early acquired persistent disproportion of mental development in the emotional-volitional sphere. A characteristic model of disharmonious development is psychopathy and pathological personality formation.

Have you ever wondered where children with developmental disabilities come from: deaf, blind, children with mental retardation, children with cerebral palsy, autistic children?..

I think that if you are happy parents of a healthy child, then such thoughts do not visit you. Each of us is sure that this can happen to anyone, but not to me, anywhere, but not in my family.

Or maybe you think that children with disabilities are born only to drug addicts and alcoholics? If yes, then you are deeply mistaken.

The tragedy of the situation is that children with developmental disabilities are mostly born to ordinary, normal, healthy parents.
The tragedy of the situation is that there are a lot of reasons for the birth of children with developmental disabilities, both social and purely physiological. And if we have no power over genetic failures (Such as, for example, Down syndrome. Although the relationship between the age of the parents and the manifestation of this anomaly in the development of the child has now been proven.), then at least it is possible and necessary to fight the rest of the risks.
The tragedy of the situation is that more and more children are born with developmental disabilities every year.

The body of the child is formed mainly in the first 3-4 months prenatal development, it is at this time that the nervous system is actively formed. From 3 to 9 weeks - the heart is formed; 5 to 9 weeks - arms and legs; from 8 to 12 weeks - face, eyes, ears, nose; from 5 to 16 weeks - kidneys. Any "harm" in initial period fetal development can cause congenital anomalies development. Moreover, it has been established that the earlier the fetus is damaged, the more severe and irreversible the consequences are.

Physiological causes of deviations in the development of the child

Everyone knows that during pregnancy it is strictly forbidden to drink alcohol (and even more so drugs) and smoke, that you cannot continue to work for hazardous industries that you need to be very careful with drugs, as they can accumulate in the body of the fetus, causing mental retardation.

High blood pressure during pregnancy, cardiovascular insufficiency, kidney disease, diabetes can also cause mental retardation in a child. Very dangerous infectious diseases suffered by the expectant mother, some of them (for example, rubella) can even become an indication for abortion in order to avoid the birth of mentally and physically handicapped children.

Another common cause of developmental disabilities is pathology. labor activity, for example, fast, rapid labor or, conversely, prolonged labor with stimulation. The result of rapid labor may be hemorrhage due to the rapid change in intrauterine pressure to atmospheric; entwining the child with the umbilical cord leads to birth in asphyxia (suffocation, respiratory arrest); at prolonged labor caused by incorrect position of the fetus, damage to the shoulder nerve plexus and as a consequence - paralysis of the hand.

Social causes of deviations in the development of the child

No less dangerous and adverse social influences during pregnancy. Any negative social situations in which it is future mom, or thoughts and actions directed against the child himself (the desire to terminate the pregnancy, doubts or anxiety associated with future motherhood) lay the basic matrix of emotional experience that can become instead full-fledged basis for the normal mental development of the child - a pathogenic base.

The most harmful are prolonged negative experiences of the mother. At this time, anxiety hormones are produced and released into the amniotic fluid, they contribute to fetal vasoconstriction, which makes it difficult for oxygen to reach the brain cells, the fetus develops under conditions of hypoxia, placental abruption and premature birth may begin.

No less dangerous are the strong short-term stress- shocks, fears, experiences. At the 5th month, the fetus feels an increase in the heart rate of the excited mother. He tenses when the mother is restless, relaxes when the mother is calm. At 6-7 months, the fetus reacts to any sudden change in the position of the mother's body. As a result, there is a risk of the birth of a child with congenital childhood nervousness.

Neuropathy is diagnosed already in the first year of life. It manifests itself in frequent regurgitation, temperature fluctuations, restless sleep, "rolling" when crying. If the child is helped in time (general strengthening massage, hardening, close communication with parents, etc.), then with age, the signs of neuropathy may decrease; and under adverse circumstances, if for some reason the child is left without parents and their care, then neuropathy becomes the basis for the development of chronic disorders and somatic diseases.

And in conclusion - a small fairy tale about "special" children. Try reading and discussing it with your child. Kindness, tolerance, understanding also need to be learned.

What happened to the crocodile? (M. Moskvina)

Well, it's hot today! yawned the crocodile. - Even out of the water to get out of reluctance. But you must!
And he swam to the shore. There, in the sand, a few days ago, he buried an egg and kept running around to watch when a crocodile son would hatch from it. But as time went on, other crocodiles had babies swimming in the river, and with him ... And now the crocodile dug up a whole egg, turned it in his paws in a distressed way, and raised it to his ear. Suddenly he hears: knock-knock!
- Someone is! - the crocodile was delighted. - Yes Yes! Come in! Oh, I mean, get out!
- Help, right? - crawled grandmother-crocodile.
- Knock Knock! - as if someone from within was knocking with a hammer.
The shell cracked and a head popped out of the hole. The crocodile froze.

Here! - and a wet yellow-mouthed chick fell onto the grass from a split egg.
- Pf-f! - hissed the grandmother crocodile. - What is this news?
Crocodile shrugged. And the chick looked around with curiosity and galloped, at first quietly, and then more and more cheerfully and confidently - to the crocodile.

Listen, - the green toothy old woman came to her senses. I lived long life I've seen a lot, but never like this. Do you want to know my opinion? Pretend like no one was born to you.
- And he? - the crocodile asked confused.
- He needs to be eaten. Am! And no. And then the crocodiles will laugh at you.
“Perhaps, indeed, I’ll eat it, and that’s it, otherwise you won’t get into trouble!” thought the crocodile. But he could not even open his mouth, the yellow-mouthed one was so trusting.
- Swallow like a pill, then drink it! - hissed the crocodile.
But when the chick rubbed itself against the rough cheek of the crocodile and squeaked “Paaa-pa!” , he suddenly realized: he could not eat it. Can't, that's all.
After all, it was HIS baby.

Ah well?! - and the crocodile blabbed about the chick to all the crocodiles in the river.
And although there was a terrible heat, the crocodiles all got out of the water, surrounded the crocodile, graze their own and let's laugh! The chick got scared and hid behind the crocodile. Then the crocodile said:
- Listen, well, you were born according to all the rules, as expected. What if someone doesn't look like you? So let's laugh at him, tease him, and even better - swallow him! Is that how it works?
Everyone fell silent.
- And I warn you: this crocodile ... um ... or whatever it is ... will live with me. If anyone touches him, blame yourself.

So they lived together. The crocodile built a house for the chick, dragged worms and midges there for him. If the chick disappeared somewhere, the crocodile got worried, looked for it everywhere, asked its relatives:
Have you seen my chick? Did the chick run?
And they almost burst with the desire to burst out laughing, but, remembering the threat of the crocodile, they restrained themselves. But behind the eyes of the grandmother-crocodile gossip:
- Think, the pigalitsa was covered with fluff! ..
- And on the wings of this scumbag, you see, feathers have grown ...
- Did you hear the news? Pigalitsa jumped over the bush! Ah, what an event! The crocodile did not sleep all night from happiness! Nuts! Look at him!!!

The crocodile stood with his head up and watched his chick fly over the forest.
- Where are you going? Don't you dare fly! You will fall! Come back! - the excited crocodile shouted that there is urine.
And heard in response:
- I won't fall! I'm a bird! Real bird! I'm no longer a chick!
- Be careful! That is ... careful, - the crocodile shouted again.

Teach you to fly, dad? - rang in the air.
- Yes! Yes! - the crocodile was delighted, and he thought: “Then I can protect you everywhere, even in the sky. But how can I fly? I don't have wings..."
- Crazy! - lamented the crocodile. - There was a normal crocodile. And suddenly - bang-bang! - wanted to fly.
“Yes, he won’t succeed,” the young crocodiles clamored enviously.

The bird landed on the head of the crocodile and whispered something in his ear.
The crocodiles pricked up their ears too, but she spoke very quietly.
- Hey! Can't it be louder there? - someone could not stand it.
"No," replied the bird. - This is our family secret. OK, try! she smiled at her crocodile.
- Try! Try! - gaped mouths laughed from the river.

They certainly did not believe that the crocodile could fly. And he ran up, pushed his tail off the ground and - floated through the air like a balloon. At first he was surprised, then delighted, and when he soared too high, he was frightened. But at that very moment I heard a voice:
- It's all right, dad! Move, move your paws, as if you are swimming in water...

No one else in those parts saw a small gray bird and a flying crocodile. And the story about them has long turned into a fairy tale that animals in the jungle tell their kids.