Mental retardation: causes, symptoms, diagnosis

Mental retardation (MDD) is a pedagogical characteristic of a child’s development, which is not a medical diagnosis (there is no such diagnosis in the International Classification of Diseases, 10th revision).

I remember the metaphor of psychiatrist G.E. Sukhareva about ZPR: “A pillow for a lazy head.”

Many children with a delay of up to 5-5.5 years write “ZPR”, “ZPRR” in their reports, including doctors, meaning that the level of development of the child’s higher mental functions does not correspond to the age norm. In the future, this characteristic will be clarified, that is, after 5 years, some of these children may already receive a medical diagnosis of “mental retardation.” In order to clearly distinguish between mild mental retardation and mental retardation, it is necessary to conduct the Wechsler test, which is carried out by a clinical psychologist.

It is typical for a child with mental retardation to:

• Immaturity of thinking operations;
• Difficulties in voluntary attention (low volume, concentration, switchability);
• Narrowing of the volume of auditory-verbal memory;
• Lack of formation of perception processes;
• The predominance of gaming interests over cognitive ones (this can be identified after the age of 7 years in a learning situation);
• The IQ indicator, according to the Wechsler test, is in the range of 80-89 points (this can only be determined after 5 years).

Types of mental retardation

According to the most common classification of ZPR, identified by Lebedinskaya K. S., there are four main types:

• constitutional ZPR;
• psychogenic mental retardation;
• somatogenic mental retardation;
• cerebral-organic mental retardation.

Constitutional mental retardation is caused by a slowdown in the maturation of the central nervous system in children; most often it is inherited. This type of developmental delay is characterized by psychological and psychophysical infantilism. With psychological infantilism, first of all, violations of the child’s behavior are observed. His behavior corresponds to the behavior of children of younger age, but at the same time, from a physiological point of view, his development corresponds to his age. With psychophysical infantilism, the emotional-volitional sphere and physical development suffer. In this case, not only the behavior, but also the physical data does not correspond to this age. Such children have frequent and sudden changes in mood, they are spontaneous, they have insufficient attention and memory, which is why they have difficulties in learning. Normally, at primary school age, educational activities should predominate in children, while play activities still predominate in children with mental retardation.

Psychogenic mental retardation. This type of mental retardation is due to the unfavorable social conditions in which the child lives. First of all, this is the family in which he is raised. Such children, as a rule, are completely healthy, their physical and physiological development corresponds to the norm, but they have a decrease in intelligence, infantile behavior, superficial and situational emotions, and have problems concentrating.

Somatogenic mental retardation is not inherited. As a rule, children are born healthy, without abnormalities. ZPR is caused by severe and long-term somatic diseases of the child at an early age, which will inevitably lead to a delay in the maturation and development of the central nervous system. Such diseases include bronchial asthma, heart and kidney failure, dystrophy, chronic asthenia, etc.

Such children quickly get tired of physical and mental stress, which leads to a decrease in learning success. They are characterized by rather low performance, less memory, superficial attention, and poorly developed operational skills.

Cerebroorganic mental retardation. This type of ZPR is the most common. And it is caused by primary mild organic damage to the brain, which occurs as a result of pregnancy pathologies (infectious diseases of the mother, alcoholism, drug addiction, etc.), birth injuries, and serious illnesses suffered at an early age. In cases of mental retardation of cerebral-organic origin, disturbances may affect certain areas of the psyche or may partially manifest themselves in various mental areas. Delayed mental development of cerebral-organic origin is characterized by immaturity of the emotional-volitional sphere and cognitive activity. Such children do not show strong and vivid emotions, they get tired quickly, their imagination is poorly developed and their level of memory and attention is reduced. They have a hard time studying at school and have difficulty building relationships with peers.

Causes of mental retardation

There are many reasons that cause mental development delays. But at their core, they can be divided into two large classes: biological and psychosocial.

Biological causes or factors cause disruption of the maturation of various parts of the brain, which is accompanied by disturbances in the mental development and activity of the child. They can appear at different stages of child development. At the prenatal stage of development, biological factors include all kinds of pregnancy pathologies. These include not only obvious factors, such as alcoholism, drug addiction and various infectious diseases suffered by the mother during pregnancy. However, healthy mothers also have a chance that a child will be born with mental retardation, since Rh conflict between mother and child, fetal hypoxia and severe toxicosis are also risk factors. At the stage of childbirth, there is also a risk of mental development delay. First of all, it increases in premature babies, and, in addition, intracranial birth injuries also become risk factors.

In the postnatal period and at an early age, various somatic diseases, for example, influenza, rickets and various neuroinfections, can serve as biological causes for the occurrence of mental retardation. Brain damage can also be caused by traumatic brain injury.

In addition, mental retardation can develop as a result of hearing or vision impairments in a child at an early age, or in the presence of severe speech defects. If children do not undergo special rehabilitation with a teacher, this violation is not compensated in any way. In this case, sensory deprivation will be expressed, sensory standards will be violated, and this will make it difficult for them to correctly perceive the world around them and will lead to difficulties in communication and interaction with others.

Another cause of mental retardation, which can be classified as biological, is a hereditary factor. If one or both parents have been diagnosed with mental retardation, there is a chance that, in the absence of other risk factors, they will have a child with the same problem.

As for the psychosocial or environmental factors in the occurrence of mental development delays, in this case we will, first of all, talk about the family in which the child grows up and is raised.

First of all, dysfunctional families are a risk factor. In such conditions, the child grows up in a state of hypoprotection and attention deficit. Parents are not involved in his development, do not encourage him to think and creative activity. The child develops incorrect ideas about social norms, which leads to disruption of adaptation in society. Such children have difficulties in learning, and their learning motivation decreases. They often remain in the second year of study, they often lack the basic knowledge and understanding necessary to master the school curriculum.

On the other hand, overprotection is also a risk factor for the development of mental retardation. In such families, the child, on the contrary, becomes the center of the family, his desires are indulged, parents try in every possible way to eliminate any obstacles or dangers, both real and imaginary. Therefore, the child does not learn to overcome obstacles and make decisions on his own. His social adaptation is disrupted, he becomes overly dependent on adults, he is self-centered and demands increased attention from everyone. Difficulties arise with the development of the volitional sphere. Under such conditions of upbringing, the child does not learn voluntariness and does not know how to regulate his behavior.

Another type of family that contributes to the development of mental retardation in children is authoritarian families, as well as families where violence, corporal punishment and rough treatment are allowed towards the child. Such parents rarely support the interests of the child; they try to impose their own on him; it seems to them that they know better what their children need. Punishments in such families are often disproportionate to the child’s offense. Under such conditions, the child may develop obsessions, neuroses or neurosis-like states. An emotionally immature personality is formed, which is characterized by fears, phobias, increased levels of anxiety, indecisiveness, lack of initiative, and possibly the development of a state of learned helplessness (this concept characterizes a person’s condition in which the individual does not make attempts to improve his condition, although he has such an opportunity) . His intellectual sphere suffers, since all the child’s activities are aimed at avoiding failure, and not achieving success. Such children are afraid to take initiative, afraid to do something new, because they are driven by the fear of not living up to expectations and showing their failure, because in this case, they have previously received condemnation from their parents or been punished. This projection is transferred to society; it seems to the child that all people will have such a reaction. And in order to avoid the negative attitude of others, he chooses the tactic of inaction.

Also, a lack of communication with peers can lead to mental retardation. In this case, children do not have the opportunity to independently learn to build relationships with people around them, except family members. The rules of behavior in society are learned much worse, the child grows up more withdrawn, fearful, and less independent.

Conclusion

Adults may experience symptoms and signs of mental retardation that were diagnosed in early childhood for certain reasons. As the patient grows older, his condition may improve or worsen, but working with qualified doctors will help cope with speech defects, improve brain activity and motor skills.

If you contact professionals in a timely manner, an individual program will be developed and therapies will be offered that will help you lead a normal life in adulthood.

Features of children with mental retardation

Disturbances in the intellectual sphere of children who have developmental delays are relatively mild, but all intellectual processes are affected: perception, attention, memory, thinking, speech.

The perception of a child with mental retardation is fragmented, slow and inaccurate. Some analyzers operate at the same level as in normally developing children, but a child with mental retardation will have difficulty forming a holistic image. Visual perception is better developed than auditory perception. This feature is important to take into account when teaching such children: they definitely need visual aids to better assimilate the material. In children with mental retardation, such properties of perception as objectivity and structure are impaired (recognizing objects from an unusual angle causes them certain difficulties), including the integrity of perception. Children with mental retardation have difficulty identifying individual elements of an object, which they perceive as a single whole, find it difficult to complete a complete object based on part of it, and find it difficult to guess what is in front of them if only part of the object is shown.

As for attention, in children with mental retardation it is unstable, short-term, and superficial. The child is distracted by any extraneous stimuli, it is difficult for him to concentrate on any one activity, so situations related to concentration cause great difficulties. In addition, their selectivity and distribution of attention are impaired. They cannot assess which stimulus is significant in order to concentrate on it and which is not. Even a small stimulus can distract them from completing the main task.

Memory in children with mental retardation is characterized by fragmented memorization of material, poor selectivity, and a predominance of visual-figurative memory over verbal memory. They remember visual stimuli better and faster than auditory ones. Their involuntary memory is more preserved. In addition, children with mental retardation have a low level of self-control in the process of memorization and reproduction, the inability to independently organize their work to memorize the necessary educational material, insufficient cognitive activity and focus when memorizing, and the inability to use memorization techniques.

As for thinking, in children with mental retardation, visual-effective thinking is more intact, while figurative thinking is more impaired due to the fact that they are characterized by inaccurate perception. As for abstract-logical thinking, its development and functioning is impossible without the help of an adult. Children with mental retardation have difficulty with analysis and synthesis, comparison, and generalization, so they cannot cope with tasks related to the ordering of events, build an inference, they cannot make a generalization and formulate conclusions based on it.

Speech in children with mental retardation also has its own specifics. They have a distortion of the articulation of many sounds, a violation of auditory differentiation. Their vocabulary is limited. Such children have a violation of control over the grammatical form of speech; it is much more difficult for them to construct coherent, literate statements. Therefore, their speech may seem quite illiterate and too simple.

With regard to written speech, children with mental retardation often experience such phenomena as dysgraphia and dyslexia. In psychoneurology, dyslexia is understood as a violation of the reading process, and dysgraphia is a violation of the writing process. Children with dyslexia make mistakes when reading: they miss sounds, add unnecessary ones, and distort the sound of words. Reading speed with dyslexia is low, children change places of letters, and sometimes miss the initial syllables of words. With dysgraphia, children have difficulty mastering writing: everything they write contains a fairly large number of grammatical errors. When writing, they do not use capital letters, punctuation marks, confuse letters with similar spellings, combined and separate spelling of prepositions and prefixes. Their handwriting, as a rule, is ugly, sloppy and incomprehensible. In middle and high school, schoolchildren try to use short phrases with a limited set of words when writing, but this does not save them from making quite serious mistakes. Such children write and read much more slowly than their peers.

The formation of the personal sphere in children with mental retardation also has a number of features. It is characterized by excessive emotional mobility, frequent mood swings, and suggestibility. They are characterized by lack of initiative and lack of will; they rarely become the life of the party, leading in any activity, but follow the lead of their peers. In addition, they may experience affective reactions, increased aggressiveness, and increased anxiety. This can lead to serious conflicts with other people.

But more often, children with mental retardation are withdrawn and uncommunicative. Unable to adapt socially, they prefer to play alone and avoid contact with peers. Their gaming activities are stereotypical and monotonous, the plot of the game is one-dimensional, very simple. They play as if according to a template, their imagination is quite stingy.

Features of the motor skills of children with mental retardation include awkwardness, clumsiness, and lack of coordination. They are often susceptible to such phenomena as hyperkinesis (pathological sudden involuntary movements in one or an entire group of muscles following an erroneous command from the brain) and tics (this is a rapid involuntary stereotypic muscle contraction).

Diagnosis of mental retardation

In order to determine whether a child has mental retardation, it is necessary to conduct a medical and mental examination. The conclusion is made by a medical and psychological commission, which includes: a pediatrician, a neurologist, a psychologist, a psychiatrist, a speech therapist, and a defectologist. They conduct the necessary research, collect and study the child’s medical history, analyze his physiological indicators, the conditions of his development and upbringing. To identify the physiological causes of mental retardation, instrumental studies are carried out, such as taking an electroencephalogram and performing computed tomography or magnetic resonance imaging of the brain. To diagnose the mental causes of this problem, a conversation is held with the child, his intellectual abilities and emotional-volitional processes are diagnosed.

Only after the research can we say with certainty whether the child has mental development delay, what is the cause of its occurrence and what measures need to be taken to eliminate this problem.

There is no need to be scared if a child is diagnosed with mental retardation. Unlike mental retardation, mental retardation can be corrected. The sooner parents seek qualified help from specialists, the greater the likelihood that the child will be able to develop correctly. In addition, after all the child’s intellectual and mental processes have leveled out to normal levels, the diagnosis of “mental retardation” is removed.

Symptoms of mental retardation in adults

• isolation and detachment;
• indecision;
• attacks of panic and anxiety;
• aggressive behavior;
• stuttering;
• dyslalia;
• mental retardation;
• uncontrolled facial expressions and others.

The final diagnosis is made after diagnosing the whole body and consulting with highly specialized doctors. It is determined by the Psychological, Medical and Pedagogical Commission (PMPC). It consists of a speech therapist, psychologist, psychiatrist and other specialists.

What is the difference between mental retardation and mental retardation?

Mental retardation, or mental retardation, is associated with brain damage. The reasons for such a lesion can be very diverse, but they are always medical in nature. Social factors do not influence the development of mental retardation in any way, unlike mental retardation.

Children with mental retardation are able to keep no more than two or three objects in the focus of attention. Children with mental retardation are able to keep a larger number of objects in the focus of attention.

Their play activities also differ. Mentally retarded children experience stuckness at the stage of objective action. That is, the child learns to act with an object, to use it purposefully, but his imagination and transition to story-based games do not develop. In children with mental retardation, development stops at the stage of story-based games and does not move to the role-playing level without special training. That is, the child is already beginning to show imagination and come up with a story for his game, but his development does not allow him to move to a more complex and developed level of fantasy and interaction.

There are also differences in speech development in children with mental retardation and mental retardation. With mental retardation, children begin to speak late; with mental retardation, the rate of development of certain aspects of speech is delayed. In addition, mentally retarded children do not have a period of neologisms (words invented, created by the child to communicate with others); then, with mental retardation, this period begins later, and it is more protracted than in normally developing children. Normally, it ends by the time of transition from preschool to primary school age; in children with mental retardation, it can stretch until they graduate from primary school.

Another very important difference between mental retardation and mental retardation is that mental retardation is an irreversible process. Unfortunately, mentally retarded children will never be able to reach a normal level of development. With mental retardation, the situation is not so critical: with the right approach to such a child, his development may well approach normal. Children with mental retardation accept adult help well, unlike mentally retarded children, and this makes the process of developmental adjustment simpler and more accessible.

Screening and tests

Diagnosis of mental retardation can only be performed by a certified psychologist capable of administering, scoring, and interpreting an intelligence or cognition test. Screening for the disease includes tests to analyze the child's intellectual and adaptive development, including the Denver Abnormal Development Test and IQ testing (these tests are performed on children and adolescents under 18 years of age.)

Children with an IQ of less than 70 and with limitations in two or more areas of adaptive behavior (eg, motor skills, communication abilities, self-help and independent living skills, and other daily living skills) generally may be considered intellectually disabled.

Danger of mental retardation

By and large, mental retardation does not pose a threat to the life and health of either the child himself (unless it is a consequence of a serious illness) or those around him. In this case, it is more correct to talk about the difficulties and inconveniences that may arise for children with mental retardation and their environment.

Children with mental retardation find it more difficult to adapt to society and have learning difficulties. If mental retardation is not corrected, this can lead to loss of educational motivation and social maladjustment. Every year it will be more and more difficult for the child to be with peers, he will remain in the same class for the second year, his behavior will continue to remain at a low level of development.

As for others, if a child with mental retardation ends up in a regular class of a general education school, and no corrective measures are applied to him, then this may interfere with the learning process of other children. Children with mental retardation are often distracted in class and can distract the teacher and other children. They may play during class or get up and walk around the room without the teacher's permission. All this complicates the educational process and can cause a negative attitude towards such a student both from teachers and from classmates.

That is why it is recommended to send the child either to special classes, or to carry out correctional measures before the start of education, so that the child himself can easily adapt to the school environment and does not complicate the learning process of other children.

Correction of mental retardation

Methods for correcting mental retardation are very diverse and depend primarily on the causes of its occurrence.

If the reasons are medical in nature, correction must be carried out under the supervision of doctors. If necessary, they will prescribe the necessary drug treatment in accordance with the identified somatic diseases and disorders of the central nervous system, and if necessary, the doctor may prescribe physical therapy. In this case, children’s education usually takes place in a hospital or sanatorium to provide the child with proper medical care. If special care is not required, then it is up to the parents to monitor compliance with doctors’ orders.

Physically healthy children also need a special approach. Typically, children with mental retardation attend specialized preschool educational institutions or specialized groups at general preschool educational institutions, Type VII schools or correctional classes in general education schools. In the process of teaching such children, it is important to observe certain features. Due to the fact that their visual perception prevails over auditory perception, it is necessary to rely on visual aids and demonstration of educational material. In addition, children with mental retardation suffer from concentration and arbitrariness, and therefore educational material must be dosed, and frequent changes of activities are also important. Due to memory impairments, when teaching such children, it is important to take into account such an aspect as repeated repetition of educational material, and therefore the number of teaching hours should be increased when studying complex sections of the program. Training can be carried out in a game format, this will help increase their interest in learning and motivation. Only in this case, the educational process for children with mental retardation will benefit them, and the educational material will be well learned.

As a rule, correctional classes maintain a small class size. This allows the teacher to find an individual approach to all students.

When working with the emotional sphere, psychologists often use techniques such as play therapy and various types of art therapy. This develops the child’s creative abilities, provides an opportunity to express feelings, increases the level of self-control and helps facilitate the adaptation process. Gradually, the child will learn to control his behavior, express his emotions, they will become more vivid and multifaceted. Any drawing art therapy also develops the child’s imagination and artistic abilities.

In case of speech disorders, correctional classes are conducted with a speech therapist.

If the child’s developmental problems stem from his family and upbringing, then consultation with a psychologist is necessary not only for the child, but also for his parents.

A psychologist will help you find out the cause of mental retardation, tell you what mistakes were made in upbringing and how they contributed to the child’s developmental delay. Based on this knowledge, the psychologist, together with the child’s parents, will develop a new upbringing strategy, taking into account previous mistakes, the psychologist will tell you what measures in this case the parents can take on their own. Perhaps adults themselves will need psychotherapy or consultations with a family psychologist in order to solve their internal and family problems and conflicts, which in turn are reflected in the development of the child.

Literature

1. K. S. Lebedinskaya chapter “Basic issues of the clinic and taxonomy of mental retardation”
2. N. Yu. Boryakova - article “Clinical and psychological-pedagogical characteristics of children with mental retardation.”
3. Bufetov, D.V. The role of attitude in the development of interpersonal competence of children with impaired mental development [Text] // Practical psychology and speech therapy. - 2004. - No. 1. - P. 63 - 68.
4. Vinogradova, O. A. Development of speech communication in preschoolers with mental retardation [Text] // Practical psychology and speech therapy. - 2006. - No. 2. - P.53 - 54.
5. Zaitsev, D.V. Development of communication skills in children with intellectual disabilities in the family [Text] // Bulletin of psychosocial and correctional rehabilitation work. - 2006. - No. 1. - P. 62 - 65.
6. Nikishina, V. B. Practical psychology in working with children with mental retardation: a manual for psychologists and teachers [Text] // M.: VLADOS, 2004. - 126 p.
7. Fundamentals of special psychology: Proc. aid for students avg. ped. textbook establishments [Text] / Ed. Kuznetsova L.V. - M.: Academy, 2003. - 480 p.
8. Anokhin, P.K. Emotions [Text] // Psychology of emotions. - M.: Education, 1993. - 209 p.