Today, the term "mental retardation", applied to children's mental illnesses, is used mainly in medicine. In pedagogical practice, it is customary to use the corresponding concept of “intellectual failure” to determine this state. This primarily refers to children whose condition is in the intermediate stage between the manifestations of oligophrenia and the intellectual norm. The broader meaning of this concept refers to mental retardation (MOP).
The boundaries of this state are not clearly defined and depend on the requirements of the surrounding society. Borderline intellectual deficiency is considered a fairly common form of mental pathologies of childhood and usually manifests itself in the older groups of kindergarten or in the process of learning in primary school.
What it is
Borderline intellectual deficiency is a phenomenon characterized by a slow pace of mental development, personal immaturity and minor cognitive impairment. When creating the conditions for special training and education, this pathological process most often has a tendency to compensation and reverse development. However, it is necessary to distinguish between cases of persistent intellectual impairment and cases adjacent to the norm.
Etiology
The conditions and causes for the emergence of various forms of intellectual disability are ambiguous. In the pathogenesis of these conditions, biological factors (pathologies of pregnancy and childbirth, infection, intoxication, metabolic and trophic disorders, craniocerebral injuries and other causes) can be present that cause disturbances in the development of brain mechanisms or provoke cerebral injuries.
In addition, social factors leading to intellectual disability are also known. These may be unfavorable conditions of upbringing, insufficient amount of information conveyed, pedagogical neglect, etc. Far from last is a genetic predisposition that affects the formation of various types of impaired intelligence.
Pathogenesis
In the pathogenesis of intellectual deficiency of preschool children with borderline manifestations, the underdevelopment of the frontal lobes and the defeat of their connections with other parts of the brain are of great importance. In addition, this pathology is caused by lesions of the parietal, temporal and occipital cortex and a delay in the formation of adrenergic substance of the brain.
Characteristics of Intellectual Disability
There is currently no universally recognized Russian classification of intellectual disabilities. However, the development of well-known psychiatrists and psychoneurologists is widely used in modern medicine. So, for example, G.E. Sukhareva, based on the etiopathogenetic principle, identifies forms of intellectual disorders in children with ZPR by type of origin:
- Constitutional.
- Somatogenic.
- Psychogenic.
- Cerebral-organic.
In this interpretation, the proposed options differ in structural features and the specificity of the ratio of the components of the considered anomaly: the type and nature of the disorder.
I.F. Markovskaya identifies two options for delaying intelligence, which are characterized by the ratio of the features of organic immaturity and damage to the central nervous system.
According to her interpretation, the underdevelopment of the emotional sphere is due to the types of organic infantilism. Encephalopathic manifestations are represented by coarse cerebrosthenic and neurosis-like disorders. The main features of disorders of higher mental functions manifest themselves in dynamics and are due to their insufficient maturity and increased exhaustion.
According to the second variant, the damage traits dominate in the activity of the central nervous system of preschool children with intellectual insufficiency: pronounced encephalopathic disorders, manifested in the form of cerebrosthenic, neurosis-like, psychopathic, subclinical epileptiform and apathetic-asthenic syndromes. As a rule, neurodynamic disturbances and manifestations of cortical function deficiency are present in the pathogenesis.
However, the most widespread classification developed by V.V. Kovalev, according to which there are four groups:
- Dysontogenetic forms of borderline intellectual failure. These may be manifestations of mental infantilism: immaturity of a person with a predominant lag in the development of the emotional-volitional sphere in combination with various neuropathic conditions. In addition, this disorder may be a variant of early childhood autism syndrome. Children's features with intellectual disability include the lag in the development of some components of mental activity: speech, motor skills, reading, counting and writing.
- Encephalopathic forms in some cerebrosthenic and psycho-organic conditions and cerebral palsy.
- Intellectual impairment caused by defects in analyzers and sensory organs.
- Intellectual insufficiency caused by adverse educational conditions and lack of information.
International classification
At present, it is customary to use an international system for determining the coefficient of intelligence (from the English IQ - intelligence quotient) to assess intellectual deficiency. According to this technique, using certain tests, the level of intelligence of the subject is determined relative to the level of an average person of the same age.
The retardation rate is divided into the following forms:
- Borderline intellectual failure is characterized by an IQ level in the range of 80-90.
- Easy when the IQ level is in the range of 50-69.
- Moderate, in which the IQ is 35-49.
- Severe, in which the IQ level is in the range of 20-34.
- Deep - with an IQ level below 20.
Problems of adaptation in society
Thanks to family and social interactions and influences, normally developing children adapt spontaneously in the social environment. However, in the presence of intellectual insufficiency, the features of the child's adaptation in society are such moments as:
- Inability to self-analyze the social environment.
- Rejection by peers due to defects in speech development or physical disability.
- Rejection and misunderstanding by society.
- Lack of conditions necessary for full rehabilitation in the family and public institutions.
- The inability of parents to provide a properly organized approach to raising a child with intellectual pathology. As a result, dependent children have fixed dependent forms of behavior, which complicates not only its adaptation in society, but also interaction with loved ones.
The purpose of working with children with intellectual disabilities is to diversify personality. The child must become socially adapted to the conditions of interaction with the environment.
Clinical picture
Manifestations of intellectual deficiency are a variety of clinical and psychophysiological conditions, depending on a number of factors. Such violations are manifested in the form of weak curiosity and slow learning. Such children have practically no susceptibility to the new. In this case, primary violations are observed already from the first days of a child's life:
- no reaction to external stimuli;
- interest in the world around is late;
- lethargy and drowsiness prevail in the behavior of such a baby, however this does not exclude loudness and anxiety;
- the baby does not know how to distinguish between his own and strangers;
- does not show keen interest in communicating with adults;
- does not show interest in toys suspended above the crib, and does not respond to toys in the hands of an adult.
Children of the first year of life with various forms of impaired intelligence have long lacked a grab reflex. Only by the age of two or three do they have a certain shift in mastery of manipulation skills, however, intellectual deficiency is manifested in behavior and game activity.
For a long time, children cannot self-service themselves, do not show a lively interest in anything, and do not show curiosity. Rarely arising interest quickly disappears. In the process of games, such a child is limited to elementary manipulation, has little contact with surrounding peers, and does not move much.
In older preschool age, he is characterized by a lack of interest in intellectual pursuits. In games with peers, such children are independent and do not show initiative, while copying the surrounding children.
In communication with peers, they never have leadership status. These children are much more willing to play with younger children, and tend to be overly active and make the game disorganized.
Intellectual disorders come to the fore at school age: they are especially noticeable in educational fields of activity and behavior. The perception of new information is slow, and educational material is assimilated in a narrow volume. Students with intellectual disabilities cannot highlight the main or the general in the picture or in the text and do not understand the relationship between the parts. They do not perceive the logic of events, and when retelling the plot or describing the picture, the reproduction is meaningless.
Most children in this category are characterized by local disturbances, expressed by difficulties in perceiving such concepts as “right-left”, “above-under”, and mastering school skills. Some children with similar pathologies do not distinguish between the right and the left side even by the age of nine, often are not able to find their class. Many of them have difficulties in determining the time on the clock, days of the week, months and seasons.
Very often, such children suffer from phonetic-phonemic underdevelopment of speech and are not able to correctly reproduce the lexical-grammatical structure of the sentence. They are characterized by the scarcity of vocabulary, so they experience difficulties in expressing their decisions and actions. Questions are usually answered impulsively, without thinking about the answer. In the development of children with intellectual disability, there is a violation of the attention function, frequent distraction and quick exhaustion.
Teaching children with intellectual disabilities
In children with impaired intelligence , the mechanisms responsible for concentration are affected during the learning process. Some of them often experience a decrease in RAM, memory and playback of the information received. In contrast to normally developing children, for whom the motive for memorization is educational, children with intellectual disabilities can remember the information presented mainly in a playful way.
Not all children with manifestations of this pathology may have changes in thinking: some of them are able to think at the level of abstract and generalized categories, while others do not have these abilities. However, as they develop, such students develop the ability to think purposefully, solve similar examples, form generic names, and the like. In general, children with intellectual disabilities studying in a mass school may show a high level of practical solutions to the problem, but low verbal-logical abilities prevent such children from fully expressing themselves.
In the speech of children with intellectual disabilities there are practically no prepositions expressing the spatio-temporal relationship. When writing, they hold the line poorly, often make mistakes, skipping or not adding letters and syllables. Sometimes they begin to give the letters a mirrored style and confuse similar spelling characters (for example, “n” and “p”), when translating a word, they begin to write it first and do not separate sentences with periods.
When reading, such children experience errors similar to those encountered in writing: they read inexplicably and hastily, distorting words and skipping individual syllables. They do not always correctly understand the measures of length, weight and time; they cannot build lexical and grammatical structures that reflect spatial relations.
The peculiarities of children with intellectual disabilities include difficulties in calculating in the mind or when moving to the next ten. They may confuse similar spelling numbers (for example, 6 and 9 or 35 and 53). Such children often cannot correctly choose the correct arithmetic action (they subtract it instead of addition), they poorly hold the conditions of the problem in mind and are mistaken when writing down the answer.
Diagnostics
In order to conduct a differential diagnosis and determine a child’s borderline intellectual failure or oligophrenia, a whole range of clinical, psychological and pedagogical examinations is needed. Some cases require long-term follow-up.
The differences between intellectual failure and oligophrenia are that the second group of children has a pronounced inertia and stiffness of thinking. However, children belonging to the first group are more quick-witted, able to perform non-verbal tests well, and are happy to accept help.
Edge Correction
Correction of borderline intellectual insufficiency is carried out using pedagogical influence. In the Russian Federation, there are special schools and correction classes for children with mental retardation. Education and upbringing of children with intellectual disabilities in such institutions is carried out according to the program of ordinary schools, but for a longer period according to specially developed methods. For deeper intellectual defects, training with permanent residence in specialized boarding schools may be recommended.
Treatment and prevention
As rehabilitation effects, drug therapy is used. The use of certain treatment regimens depends on the clinical manifestations and the severity of the pathology. The most commonly used nootropic drugs. Children with symptoms of intellectual disability are recommended to receive treatment twice a year in a neuropsychiatric dispensary.
The main prevention of such conditions is the timely prevention of pathologies of pregnancy and childbirth, neuroinfections and head injuries.