MENTAL RETARDATION

What is mental retardation?

Child mental retardation is attributed to lag of all processes of mental development, which manifests itself in a low level of intelligence, when the child is not able to explore the surrounding world, to learn, to acquire knowledge in accordance with his biological age. According to inborn or acquired factors, such children can develop up to a certain limit of their possibilities. In the medical sphere, the disease is called "oligophrenia." The sooner parents of a child with mental retardation accept his individual characteristics, the faster they can begin special and supportive activities.

The inhibited perception of individual objects requires not only more time, but also does not allow for a proper interconnection between them. Graphic objects, letters, numbers, similar in sounding words, in addition to a slow and limited perception, are confused to children with this diagnosis. A child can not perceive important information, snatching only fragments. He cannot give an analysis or description of a picture or an object. Having paid attention to a certain subject, the child does not pass to the study of the next, so he needs to be urged to action.

The main difference from healthy children is the complexity of reproducing the information received due to impaired mental activity and speech defect. Mastering reading and writing is a rather complex process. Children with this disease are inattentive, unable to finish what they have begun. Underdevelopment is also displayed on the emotional sphere, when emotions are absent or limited, and various experiences are not manifested. Violent processes are violated, children are not active. They later begin to hold the head, crawl, walk, show interest in objects and distinguish them, recognize relatives or strangers.

According to the International Classification of Diseases, there are the following types of mental retardation:

Mild mental retardation. Outwardly, such people may not differ from healthy people. Usually they have difficulties in learning because of the reduced ability to concentrate. At the same time, their memory is quite good. The vast majority of them also achieve complete independence in the care of themselves and in practical and home skills, even if the development is much slower than normal. 

The main difficulties are usually observed in the field of school performance. Nevertheless, in mild mental retardation, considerable assistance can be provided by education intended for the development of the kids skills and manifestations of compensatory possibilities. In most favorable cases of mild mental retardation, employment is possible, requiring abilities not so much to abstract thinking as to practical activity. 

Experience shows that children who survived the trauma of loss of the parents, who are brought up in orphanages subjected to violence. In such cases it is often difficult to distinguish between symptoms of mental retardation and socio-pedagogical neglect. When living conditions change to more favorable, these children tend to give good dynamics in development and their diagnosis can be withdrawn or revised.

Moderate mental retardation. People with this diagnosis are able to experience attachments, to distinguish between praise and punishment, they can be taught basic skills of self-service, and sometimes reading, writing, simple account. Educational programs can give them opportunities to develop their limited potential and acquire some basic skills. 

In adulthood, persons with moderate mental retardation are usually capable of simple practical work with careful construction of tasks and providing qualified support. Completely independent living is rarely achieved. Nevertheless, such people are completely mobile and physically active in general and most of them show signs of social development, which is the ability to establish contacts, communicate with other people and participate in basic social activities.

Severe mental retardation. People with this diagnosis can partially master speech and learn basic skills to serve themselves. Vocabulary is meager, sometimes it does not exceed ten or twenty words, thinking is very specific, chaotic and unsystematic. Almost all children of this category are marked by large motor disorders.

Deep mental retardation. In people with deep brain damage, the structures of the internal organs are often broken. Their speech does not develop, it is completely broken. Since their earliest childhood, their developmental lag is noticeable, the kids start to sit up and hold the head late. Children with deep form of mental retardation are inactive. The first place should be given to the medical care of a child, the services of a social nurse.

Primary manifestations of mental deficiency in children usually include such symptoms and signs as lag of intellect, infantile behavior, lack of self-service skills. Such a backlog becomes very noticeable to preschool age. However, with mild mental retardation, such symptoms may not appear before school age. A much earlier backwardness of the intellect is diagnosed in the presence of a moderate and severe degree of this disorder, and also when the backwardness of mental development is combined with developmental defects and physical defects. Among pre-school children, a clear sign is the presence of a reduced level of IQ in combination with the limited manifestation of adaptive behavioral skills. Although the individual characteristics of this disorder may change, more often in children with intellectual deficiency, gradual progress rather than a complete arrest of development is noted.

It is important to remember that rehabilitation should begin as soon as posible. Also, the main task is to identify the disease earlier. However, the problem is that it is very difficult to diagnose mental retardation in the early stages of a child's development. As a rule, suspicions of parents arise from two years, when the child does not speak or has problems with speaking. And only closer to three-four years, the diagnosis of "mental retardation" is diagnosed, since the problem becomes obvious.

Parents should pay attention to:

  • how well and confidently the child holds the head;
  • when he learned to sit alone;
  • how the child crawl;
  • how he says the first sounds, babbles.

Attention! If there is a suspicion that the child has mental retardation, you should contact a doctor immediately.

Signs of mental retardation in children under 1 year old

Children with mental retardation before the age of 1 year old are identified when examined by doctors, based on the lag in the psychomotor development or the detection of signs of hereditary (chromosomal and genetic) syndromes. Parents often can only point out that the child does not begin to concentrate his sight, grows poorly, does not try to talk, and so on.

The main and indirect signs of mental retardation in children up to the year:

  • Characteristic morphological features of hereditary syndromes
  • Inadequate reaction to feeding, spontaneous change in emotions(for no apparent reason).
  • Absence of "eye contact" and tracking movement by them when the baby reaches the age of over 4 months old.
  • Preservation of congenital reflexes and their spontaneous appearance.
  • Convulsive seizures.
  • No attempts to crawl and sit down.
  • The lack of attempts of babbling.
  • Phenomena of self-harm.

Unfortunately, it is difficult to get a complete picture of the violation of cognitive functions in a child with signs of slowing development, including mental one, due to age, unformed speech and restriction of other communicative possibilities.

Therefore, the diagnosis of such pathology requires an integrated approach and the following surveys and consultations:

  • Inspection of the neonatologist or pediatrician, the establishment of signs of hereditary syndromes or general developmental lag.
  • Consultation of children's neurologist. Evaluation of the functional state of the central nervous system, the MRI of the brain for the detection of organic pathology.
  • Genetic analysis and karyotype evaluation to confirm the diagnosis of hereditary syndromes in a newborn.
  • Consultation of a child infectious disease specialist in case of suspected infectious cause of mental retardation. 
  • Consultation of a hematologist with severe hemolytic disease.

Further, such children are observed by a pediatrician on a regular basis (with a certain regularity) in order to assess the degree of mental retardation, to timely resolve the issue of assigning a disability group and the appointment of specialized treatment (if necessary). Unfortunately, at this age it is rather difficult to determine the exact prognosis regarding the severity of mental deficiency that will form in a child in the future.

 

Signs of mental retardation in children older than 1 year

 

In young patients who are already examined at the age of more than 1 year, the establishment of an exact cause and the degree of cognitive impairment is much easier. Also in the preschool period, non-severe forms of mental retardation are revealed, which consist in the inability to synthesize and analyze the information received, to associative and logical thinking.

Thus, the signs of mental retardation in children are:

  • Violation of speech development and ability to communicate with adults and peers. Pretty poor vocabulary. Often, these children are struggling to learn writing and reading.
  • Unrestrained, sometimes aggressive behavior, arising spontaneously or as an inadequate reaction to the world around us.
  • Psychological and pedagogical characteristics of children with mental retardation in the preschool period indicate their ability to learn new information with difficulty, their self-service violations are detected. Almost in 50% of cases there are signs of mental disorders that require consultation of relevant specialists.
  • The characteristics of tests for intellectual level, ability to logical and associative thinking reveal the presence of varying degrees of mental retardation.
  • Aggressiveness to yourself or others, unrelated to obvious causes.

A survey of such children should take into account need not only to establish the alleged cause of mental retardation, but also to give an objective assessment of the degree of pathology progression. If it is established that the symptoms of developmental lag were observed from the moment of birth, the doctor examines in depth mother's pregnancy, details of her working and the diseases of the first year of the baby’s life took place. 

Usually the most common hereditary syndromes at this age have a clear clinical picture, and there is no need to carry out the analysis of the karyotype (the structure and number of chromosomes in the nuclei of cells).

Sometimes, mental retardation phenomena come along with other pathologies. This can be signs of rare genetic diseases that require complex, often expensive diagnostics for setting an accurate diagnosis. It is also important for the doctor to determine whether respiratory infections were accompanied by complications from the central nervous system (meningitis, encephalitis and so on).

For this, the following diagnostic techniques are used, which help in establishing the cause of mental retardation:

  • Studying the medical card of the child, identifying the presence of serious injuries or infections.
  • MRI or CT of the brain.
  • Immunological tests for the detection of antibodies to the causative agents of sexually transmitted diseases, which can be transmitted from the mother, meningococcal and other infections.
  • Evaluation of wave activity of the cortex.
  • Consultation of children's neurologist.

 

What to do if a child is diagnosed "mentally retardation"?

Step 1. Address a neurologist who has experience with this disease (to get free services in state centers, you need to take a referral from a district neurologist).

Step 2. Consult a psychiatrist.

Step 3. Carry out a full health diagnosis for concomitant disease.

Step 4. In the case of moderate and severe mental retardation, register the necessary disability group and enter everything needed in the Individual Rehabilitation Plan.

Step 5. Start rehabilitation, classes with a defectologist, speech therapist, psychologist.

Resources for parents

It is important to start rehabilitation as soon as possible!

The main role in rehabilitation of children with mental retardation belongs to the pedagogical process. It is necessary to get help and support of qualified specialists. A key factor in progress is the contact of parents with doctors, teachers and psychologists. Parents should understand that the best adaptation is possible only if the training program is appropriate to the child's capabilities. The key to the successful treatment of mental retardation is a complex impact including not only medicines, but also individual approach to training, classes with specialists. All this is necessary for more successful adaptation of the child in the surrounding world.

The main medical recommendations for parents of children with mental retardation are the following:

  • Immediately get medical help and find out the cause and degree of progression of mental disability.
  • Regularly conduct educational and developmental activities with a child. Correction of behavioral abnormalities should be carried out with a special child psychologist.
  • Try not to isolate the child from peers and adults, despite all the fears.
  • Social adaptation of children with mental retardation should become the basis of education and upbringing. Only the achievement of independence in everyday life, speech and writing skills, as well as skills of simple professions will allow in adult life to be a full-fledged member of society and not require outside help.
  • Do not overstate the expectations for these children. Often, character features, low self-esteem and experience of failures nullify all the results achieved. On the other hand, it is not necessary to indulge the child's laziness or to stop at the supposedly acceptable result. This is often manifested in the teaching of communication - parents understand the child's desires for sounds or distorted words, but this is not enough for social adaptation and communication with other people.

General information:

About treatment:


Where to go

State Medical Centers

The center is more than 250 years old. The Center is structured in a way that it solves both multidisciplinary issues of prevention, diagnosis, treatment, high-tech treatment and rehabilitation in scientific and in practical terms. In the conditions of a round-the-clock stay, a day hospital and a consultative-diagnostic center, all types of medical assistance are provided, including specialized and high-tech help. New medical and organizational forms of work allowed to increase the number of patients who received treatment annually by 1.5 times.

Address: Moscow, Lomonosov Avenue, 2, building 1
Tel -.: +7 (495) 967-14-20
E-mail: info@nczd.ru

 

A large research and clinical institution in which highly qualified specialists (doctors and PHD) work in the field of neurology, psychiatry, child psychiatry, neurosurgery, narcology, gerontopsychiatry. Employees of the Institute provide consultations on family relationships, psychological aspects of the education and upbringing of children, as well as professional selection, career guidance and recruitment. The Institute carries out a wide range of diagnostic examinations.

Address: St. Petersburg, str. Bekhterev, 3
Tel.: +7 (812) 670-02-34
E-mail: deti@bekhterev.ru

 

Non-state Medical Centers

 

It was created in 1989 on the initiative of parents and teachers to help children with various developmental problems. The Center for Curative Education deals with children with autism, epilepsy, genetic syndromes, mental development disorders, learning difficulties and other problems.

Address: Moscow, st. Stroiteley, d. 17B
Tel.: +7 (499) 131-06-83, 133-84-47, +7 (495) 646-50-66, 930-00-01
E-mail: ccpmain@ccp.org.ru

 

 


CHILDREN ABOVE ALL