Adaptation in a society with mild mental retardation. The role of parents.

As the world's population increases, people are increasingly at risk of various pathologies.
A person is born with some of them, others he acquires throughout his life. In addition to physical illnesses, there are also mental disorders of varying severity. For example, mild mental retardation in children is a deviation of the psyche, or rather, its underdevelopment, which can be lived with without isolation from society. This diagnosis is not a death sentence. Such children have the opportunity to feel like full-fledged members of society.

Mental disorders have always caused fear and misunderstanding. Let's try to understand the history of this disease and its nuances. Is everything really as terrible as it might seem at first glance?

General characteristics

Mild mental retardation in children or mental retardation is the most common pathological mental disorder among such diseases. This form of underdevelopment is also known in medical circles as debility. But this name has lost its relevance due to social unacceptability. Children who have been diagnosed with this condition, despite the prejudices imposed by the public, have every chance of leading an independent life in the future.

Qualities and skills that are usually inherent in identifying mental retardation:

• perception of basic abilities in a special education program;
• mastering writing, reading and counting skills at a basic level;
• fairly good mechanical memory;
• concrete visual methods of comprehending information;
• acquisition of certain labor skills;
• gradual progress in mental development.

Mental retardation affects the formation of cognitive processes, logical thinking and motivational influence. A mild form of deviation allows over time, although not to reach the level of one’s peers, at least to master the skills necessary for life.

Underdevelopment of the psyche and intellect can be formed due to the following reasons:

1. Heredity or genetic predisposition.
2. Intrauterine disruption of fetal development due to infection or injury. The effects of toxic drugs taken during pregnancy.
3. Trauma sustained during childbirth, pathologies of the central nervous system during premature pregnancy.
4. Acquired infections, the action of which is aimed at destroying brain cells. These may be the consequences of meningitis, syphilis, encephalitis.

Retardation can also be observed in the physical development of the child in the form of impaired motor functions, deformation of the skull, or changes in the size of the arms and legs. Although these factors are more consistent with moderate and severe mental retardation in children, in some cases they may also be present in a state of mild debility.

In other words, oligophrenia is a condition of a child’s body in which it is difficult for him to maintain the pace of mastering new skills and abilities that are age-appropriate. The child needs a correctional program, after which he will be able to feel like a full-fledged member of society.

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Mental retardation is not a painful process, but a pathological condition, the result of harmfulness that once acted and has no tendency to progress.

Previously, three degrees of severity of mental retardation were distinguished:

• Idiocy (from Greek - idiotea, ignorance).
• Imbecility (from Latin - im - without + baculus - stick, crutch, i.e. inability to do without intellectual support).
• Debility (from Latin - debilis - crippled, infirm, weak).

In the International Classification of Diseases, 10th revision (1994), mental retardation is divided by severity into four degrees: mild, moderate, severe and profound (i.e., imbecility is divided into two levels - moderate and severe mental retardation).

1. Profound mental retardation (idiocy)

Idiocy is the most severe violation of the development of cognitive abilities. People suffering from profound mental retardation are unable to master even the simplest self-care skills (get dressed, wash, use cutlery, etc.), their speech is either not formed at all, or consists of a small number of simple words, they understand little speech addressed to them, and may not recognize people caring for them (for example, a mother) cannot distinguish edible from inedible (they swallow inedible objects), often have no idea about spatial relationships (for example, about height: falling from a great height), rarely form ideas about hot, spicy, etc. (can be damaged or burned). In most cases, underdevelopment of intelligence is accompanied by motor disorders and severe somatic abnormalities. The life of such patients, who need constant care and supervision from others, is determined by the satisfaction of the simplest needs of life. The IQ of persons with severe mental retardation is below 20.

2. Severe mental retardation (severe variants of imbecility)

Cognitive activity is limited by the ability to form only the simplest ideas; abstract thinking, generalizations are not available. Patients acquire only basic self-care skills; their training is impossible. Vocabulary is limited to one to two dozen words, sufficient to communicate your basic needs. Neurological disorders are often present. Patients require constant supervision and care. The IQ of these patients ranges from 20–34.

3. Moderate mental retardation (milder variants of imbecility)

People with mild mental retardation are able to form more and more complex ideas than people with severe mental retardation. They master self-service skills and can master the simplest labor operations by training in imitative actions. Their vocabulary is richer, they are able to express themselves in simple phrases and maintain a simple conversation. Relative adaptation of these individuals is possible only in conditions that are well known to them; any change in the situation can put them in a difficult position due to the impossibility of moving from specific (obtained through direct experience) ideas to generalizations that allow them to transfer existing experience to new situations. Such people cannot live independently and need constant guidance and control. Some of them can perform simple work in specially created conditions (for example, in occupational therapy workshops). The IQ of these patients ranges from 35–49.

4. Mild degree of mental retardation (moronicity)

Cognitive disorders in these cases consist in the difficulty of forming complex concepts and generalizations, the impossibility or difficulty of abstract thinking. Thinking is predominantly visual and figurative, everyday speech is often quite well developed (sometimes complex abstract concepts are used in it, but their meaning is not always well understood). In many cases, people with mild mental retardation can successfully perform everyday household tasks and demonstrate good practical awareness (“their skills are greater than their knowledge” - E. Kraepelin). They are capable of mastering special training programs and mastering simple work skills. Many of them graduate from specialized schools and vocational schools, work in low-skilled jobs, start families, and run their own households. However, they often experience difficulties when faced with non-standard situations and the need to change the existing stereotype of behavior. They have difficulty forming their own judgments, are often not independent in making decisions, are suggestible, and therefore easily adopt other people’s views, sometimes falling under the unhealthy influence of others (for example, they can be involved in the delusional experiences of mentally ill people with the formation of induced delusions or become a tool in the hands of attackers who manipulate them for your own benefit). When interpreting proverbs and solving logical thinking problems, they tend to give specific interpretations or random answers. IQ in cases of retardation is in the range of 50–69, which corresponds to the mental development of approximately a 9–12 year old child.

Since intelligence reflects the formation of a whole complex of cognitive functions, disruption of its development can affect various functions unevenly. For example, with Down syndrome (trisomy on chromosome 21), verbal functions suffer to the greatest extent, and with Williams syndrome (deletion of a section of chromosome 7), on the contrary, verbal intelligence suffers to a lesser extent.

As noted above, biological and social factors are involved in the formation of intelligence. In cases where it can be assumed that a child’s developmental delay is primarily associated with social factors (family and social ill-being, homelessness, forced limited social contacts, inaccessibility of education, “pedagogical neglect,” somatic diseases, etc.), they often say about “mental retardation,” thereby implying that if the impact of unfavorable factors is reduced and with appropriate training and correction, compensation for mental retardation can be observed.

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Features of behavior

Since all children differ from each other in temperament, manner of communication and behavior, it is difficult to visually determine the mental retardation of a child, and even more so to do this at an early age. But still, with a more detailed study of children's relationships, one can notice signs of mental underdevelopment. These include:

• lack of interest in animals, new, colorful objects or toys;
• weak contact with peers;
• misunderstanding of the requirements of the game;
• lack of incentives for intellectual development, characteristic of children at an early age;
• increased desire for physical activity, unfocused games;
• expression of emotions only through primitive reactions, instability of mental state;
• problems with mastering self-care skills.

Children with mild mental retardation develop weakened attention over time and have difficulty concentrating thoughts in a certain direction. Mental performance slows down, and it is difficult for the child to navigate in society. The baby gets tired quickly and doesn’t know what to do next.

The connection of a little person with reality occurs through auditory, visual, visual and other processes. Since their processing is not fully accessible to the brain, the perception of the surrounding world is distorted.

Differential diagnosis

The diagnosis of mental retardation is based on the establishment of a mental defect, the central place in which is occupied by underdevelopment of intellectual abilities, on the detection of signs of mental retardation in childhood and adolescence, as well as the absence of progression, i.e. signs of deepening mental defect. In order to determine the degree of intellectual defect, special psychological methods for assessing intelligence are used (see Chapter 7). To clarify the etiology of some forms of mental retardation, additional laboratory and instrumental studies are required. It is necessary to differentiate mental retardation from conditions caused by pedagogical neglect (cases when a healthy child is deprived of the conditions for proper mental development) and progressive mental illnesses (primarily schizophrenia and epilepsy, manifesting in early childhood).

Types of diagnostics

Some experts believe that determining a child’s mental retardation as a diagnosis before the age of seven is impossible. Only after this period can we talk about any developmental deviations, since the child’s psyche can be formed in a completely unpredictable way.

Periods of active development are followed by long pauses, and these cycles can be repeated regularly. You should seek help from specialists when violations are noticeable in areas such as:

• memory;
• intelligence;
• thinking;
• emotional sphere;
• cognitive functions;
• volitional manifestations;
• coordination and plasticity of movements;
• ability to fix attention.

The degree of mental retardation is diagnosed according to three criteria:

1. Clinical picture indicated by damage to brain centers.
2. Persistent psychological disturbance of the desire for cognitive activity.
3. Low level of learning ability.

A very important factor when performing diagnostic procedures to determine oligophrenia is an ophthalmological examination and X-ray computed tomography of the brain. An eye examination allows you to recognize at the early stages of development such concomitant diseases as:

• retinal pigment degeneration;
• glaucoma;
• cataract;
• microdisturbances of visual nerve endings;
• intracranial hypertension.

A tomograph helps to determine hidden deviations in the structure of the skull, the presence of intracranial pressure, and brain pathologies.

Determining the level of development

Children diagnosed with retardation are able to adapt quite quickly to those around them. It is possible for them to attend kindergarten or primary school on general terms, without a special program. Of course, they are not able to achieve any special success, but mastering the necessary minimum of knowledge is quite possible.

However, psychiatrists still recommend training children with mild retardation in specialized educational institutions. Now they are called schools of the eighth type, and their program fully corresponds to this intellectual level.

A child with a slight mental retardation commits actions that lack any purpose or motivation. His behavior is dominated by:

• the desire to imitate, copy actions;
• lack of independence, naivety and suggestibility;
• depending on the situation or circumstances.

Many parents are afraid to send a child with such disabilities to a special school, explaining that the child will be better off in a calm family environment. By expressing such judgments, they reassure themselves, while depriving the child of a chance for a full existence in society.

Work with mentally retarded children should be carried out by specialists together with parents and be aimed at activating the main lines of intellectual development. To do this, parents need to thoroughly study the baby’s behavior in various situations, his habits and characteristics. Based on these observations, the level of development is established.

General condition of the child

Unexpressed mental retardation may have virtually no effect on physical development. Children with intellectual pathologies are able to achieve success in many sports disciplines. By directing their efforts in the right direction and not focusing on shortcomings, they will be able to take their place in society.

The emotional background in mental retardation is very unstable; it is difficult for a child to control his feelings, or rather, the transitions from one state to another. According to his age, he experiences different sensations:

• joy;
• delight;
• sadness;
• irritation;
• anger, etc.

Such children lack a sense of compassion and spiritual understanding of the emotions of others. They cannot think about events or their consequences in the future. The life of a child with mild mental retardation happens here and now. He doesn't worry about what will happen tomorrow.

Such a child has weak manifestations of volitional efforts. In other words, it is as if he agreed to some action, but cannot bring himself to do it, while he himself cannot explain the reason for his behavior.

Formation of the speech apparatus

It is by speech disorders that the degree of mental retardation in children can be determined. The easy form assumes a fairly large vocabulary, although it is used with a violation of the semantic load. The conversation consists of short, monosyllabic phrases that the child hears most often in his environment. It is possible to use individual words and expressions only out of habit, at random.

Memorizing new words and definitions must be accompanied by visual or tactile confirmation. But still, this happens slowly and not fully.

Speech development directly depends on the degree of mental retardation of the child. The mild form is characterized by incorrect pronunciation of some letters of the alphabet. The presence of speech defects such as:

• dysarthria;
• stuttering;
• tongue-tied.

With such problems, classes with a speech therapist have a positive dynamic, but the recovery process is very difficult and lengthy.

Causes of mild mental retardation in children

The cause of any mental retardation is damage to the brain. The most severe structural defects manifest themselves in underdevelopment of the brain.

The main reasons causing the development of mental retardation in children can be grouped into the following groups:

• Heredity (gene and chromosomal diseases). This group includes: various syndromes (for example, Down, Turner); forms associated with hereditary metabolic disorders, neurological diseases;
• Exposure to harmful factors during intrauterine development: intrauterine infections (for example, rubella, toxoplasmosis, etc.), intoxication (alcohol intake, substances toxic to the fetus), hemolytic disease of the fetus, etc.;
• Factors that were exposed during childbirth or at an early age (birth injuries, oxygen deprivation, trauma, infections);
• Pedagogical neglect , which occurs against the background of full-fledged brain function, but in the absence of full education and socialization;
• The presence of several causes at once, mixed states.

Alcoholism in pregnant women, according to a number of authors, is the most common cause of mild mental retardation in children.

Mental retardation in children under 3 years of age, symptoms and psychological characteristics of children with mental retardation

The diagnosis of mental retardation in children can be officially made no earlier than 7 years of age. However, it is important to understand that there are symptoms of mild mental retardation in children, which can be used to suspect its presence in early childhood, up to 3 years.

Mild mental retardation in children, signs:

• The child lags behind in motor development: he begins to hold his head up, sit down, stand up, and walk late. The baby's grasping reflex may be impaired, and at 1-1.5 years the child still does not hold objects (toys, spoon and fork);
• Speech is absent or appears very late; the child has difficulty constructing phrases and coherent speech. At 2-3 years old, the baby poorly understands speech addressed to him and cannot follow basic instructions;
• Mild mental retardation in children is characterized by an imbalance in the processes of nervous excitation and inhibition; This is expressed in excessive impulsiveness, lack of restraint, excitability, irritability or, conversely, lethargy and slowness;
• The child shows no interest in the world around him and seems withdrawn; His emotional-volitional sphere is “impoverished”;
• There is no story game. The games are primitive in content, the toys may not be of interest to the child or he may not use them for their intended purpose.

Intelligence level

The intellectual development quotient, as a rule, ranges from 69 to 50 points. This is quite high, whereas mild mental retardation in children allows them to have an IQ of 49 to 35.

Having a sense of humor is a big problem. Such children perceive everything concretely and literally. Metaphors and aphorisms used by the interlocutor in a conversation are just words without meaning for them.

The main sign of a child with mental retardation is the absence of abstract logical thinking. How is this expressed?

• inability to highlight the main thing and cut off the unnecessary;
• the impossibility of classification and generalization;
• primitiveness of thinking.

Quite simple questions drive the child into a dead end; there is practically no logic in the reasoning. By repeating actions many times, he can grasp the pattern and, by analogy, continue the thought. However, the slightest deviation from the pattern causes difficulties.

Features of mental development and thinking in children with mental retardation

Any child with mental retardation is different from another with the same diagnosis, due to the fact that each has its own characteristics of brain function, immaturity or deficiency of its structures and sections, as well as intact links.

L.S. Vygotsky believed that the primary defect of mental retardation is inertia, stiffness of the main nervous processes, as well as weakness of orienting activity, which underlies the child’s reduced activity and lack of interest in the world around him. A secondary defect is underdevelopment of higher mental functions. In turn, when a child finds himself in conditions of an inadequate teaching and educational environment, opportunities arise for the development of a tertiary level defect, namely, behavioral disorders and characteristics of the emotional-volitional sphere. In addition, the following features can be highlighted:

• Most authors prove that cognitive disorders in such children consist of difficulties in forming concepts and generalizations, difficulty in abstract thinking;
• A child with mental retardation is poorly taught; it is difficult for him to perceive any new information;
• As the child grows up, all of the above is accompanied by a poverty of outlook and superficiality of thinking.

Attention and memory disorder

All healthy children have semantic and mechanical memory. In a state of mental retardation, a child simply does not have a semantic memory, while the mechanical one is well developed. Without semantic memory it is impossible to perform the following actions:

• remembering the essence;
• summarizing the information received;
• retelling the text in your own words.

At the same time, the formed mechanical memory allows you to remember large amounts of information, but since this is done unconsciously, the child cannot use it.

In order to somehow develop the semantic perception of information, you need to be patient and explain to your child several times what he cannot understand. Noticeable progress in memorization can be achieved by clearly showing the cause-and-effect relationships of objects and actions. It is much easier for a child with mild mental retardation to remember simple and understandable things than those whose meaning and purpose are unknown to him.

PREVENTION AND TREATMENT

In order to prevent the development of mental retardation in the womb, pregnant women who have an unfavorable history (physiological indicators, predisposition) are recommended to undergo a more thorough examination. Doctors place women under special observation who suffered from viral diseases during pregnancy.

Birth injuries received by newborns, as well as infectious diseases they suffered at an early age, can lead to brain damage.

A child with mild mental retardation has the opportunity to develop and learn within the limits of his biological capabilities. This pathology is incurable, but its timely and competent correction will make it possible for such a person to become a full-fledged member of society, albeit with limited abilities. A special role in this case is played by the environment and perception. There is no doubt that such people require increased attention.

Mental retardation requires close contact with loved ones, teachers, doctors, and psychologists. The doctor selects specialized institutions for children with mental development problems taking into account the child’s capabilities and abilities. Additionally, the psychotherapist can prescribe medication support using pharmacological drugs. Medical and educational measures and labor training for the mentally retarded show good results.

It is always important to remember that any mental illness is not a death sentence. The main thing is to contact a specialist in time, who will help make your stay in society as comfortable and fruitful as possible for the patient.

In the case of mild oligophrenia, experts give a relatively favorable prognosis. This applies to cases not burdened with concomitant psychopathological and somatoneurological disorders. People with such deviations are quite capable of mastering certain types of professions, can adapt to independent living, and even create families.

Specifics of education

It is very important to find the right approach to a child with such a disease. Usually this is not difficult to do, since such children are simple-minded and kind. The main task of parents is to correctly set priorities in raising a special child. The amount of acquired knowledge here fades into the background, and preference should be given to completely different values:

• creating a comfortable, favorable, calm environment in the family;
• the desire for love and understanding;
• devoting a large amount of time to communicating with the child;
• the formation of a socially adapted personality, ready for independent life outside the home.

In suitable conditions, such children successfully master the basics of reading, writing and counting, and learn basic work skills. They are happy to carry out simple tasks, help with household chores, and do handicrafts.

With mild retardation, good results are achieved by friendly conversations with the child, educational games, and reading books. Constant communication and systematic intellectual activities protect the brain from degradation and stimulate the development of intellectual activity. The baby enjoys such activities and over time takes the initiative.

The correct behavior of the mother plays a huge role in raising a child. Having discovered any abnormalities in their own child, any normal parent will be horrified and begin to panic. This, as you know, does not give any results, so the best solution would be to contact a specialist. Correcting the moral and psychological state of the mother is the key to a happy future child.

If parents are interested in the maximum development of their mentally retarded child, then they must make every effort to find the necessary methods and techniques for interacting with his psyche. In any case, you will need the help of specialists: both for training and for establishing contacts with others.

Diagnostics

Diagnosis of this disease requires a special approach. Very often, mental retardation is determined at the intrauterine level. This is possible if the cause of the disease is a genetic factor. Based on the results of special blood tests of the mother, the disease can be detected in the unborn child.

If no pathologies are detected at the prenatal stage, the first signs appear in the first months of life. You need to pay attention to the child’s motor skills, his reactions to sound, light, and the mother’s voice. The fact of when and how a child begins to speak is very important.

If suspicious signs are found, diagnostic measures are used for young children in the form of blood tests, urine tests and an encephalogram. Older children are tested for IQ level depending on age. In addition, a DNA test may be ordered. Diagnosis and treatment of mental retardation is carried out by a neurologist, psychiatrist and psychologist.