Characteristics of severe mental retardation. Severe mental retardation Mental retardation disease

Moderate mental retardation (mild imbecility)

This is the average degree of mental underdevelopment, accounting for 10% of the total number of mentally retarded. Its etiology can be both hereditary defects and the consequences of the transferred organic brain lesions. It is characterized mainly by unformed cognitive processes (concrete, inconsistent, sluggish thinking) and the inability to form abstract concepts. IQ ranges from 35-49 or 54.

Static and locomotor functions... They develop with a significant delay and are not sufficiently differentiated. They have impaired coordination, accuracy and tempo of movements. Movement is slowed down, clumsy, which prevents the formation of a complex mechanism of running and jumping (kinetic apraxia). The mentally retarded can hardly reproduce even given movements or postures (posture apraxia). In this case, pathological synkinesis often appears. They have great difficulty in performing actions that require switching movements or quick changes. In some, motor underdevelopment is manifested by the monotony of movements, the slowness of their pace, lethargy, and awkwardness. In others, increased mobility is combined with lack of focus, disorder, and lack of coordination of movements. Gross defects in motor underdevelopment can impede the formation of self-care skills that require delicate finger movements: when lacing shoes, buttoning up buttons, tying ribbons (dressing apraxia). Most developmental lagging needs constant help with many household chores, and some of them also need supervision.

Attention disorders. All have impaired attention. It is difficult to attract, is characterized by instability and distraction. Extremely weak active attention hinders the achievement of the set goal. Under favorable conditions, it can be significantly improved, it is possible to achieve more active inclusion in classes with a teacher, switching in the process of performing the mastered activity.

Disorders of the processes of sensation and perception... The sensory sphere is very impaired. The development of visual, auditory and other analyzers lags behind. There are often gross visual and hearing abnormalities. However, even with their safety, many do not know how to use them. Objects and phenomena are perceived in general terms. There is no activity of perception, they do not know how to highlight the features of the perceived and compare them with the same in another object. The inability to analyze, search, and embrace fully perceived information leads to chaotic non-purposeful activity. As a result, they do not independently navigate the situation and require constant guidance. Correction of the developing abilities of the sensory sphere allows to improve the habilitation of these children.

Thought disorders... Moderately mentally retarded people have a very limited supply of information and ideas. They find it difficult to operate with the existing concepts. Their thinking is concrete, inconsistent, and rigid. The development of even visual thinking suffers. The formation of abstract concepts is either inaccessible or sharply limited to the most elementary generalizations. They can be taught to group clothes, animals. They manage to establish differences only on specific subjects. They are completely incapable of operating with abstract concepts. Conceptual generalizations are formed with great difficulty or occur at the situational level.

These disorders of thinking are manifested in an extremely inadequate use of objects when solving visual-practical tasks: everyday life, play, constructive, in which a visual or presented sample acts as a means of solution. Such patients do not know how to analyze an object, to apply methods of comparison, transfer, and purposeful search. It is difficult for them to establish links between the individual links of the task. Because of this, there is no purposefulness, speed and accuracy of reactions, switching from one action to another; they have not developed self-control.

It is not possible to compose a coherent story based on the plot of the most elementary picture: most often, individual depicted objects are named. They cannot arrange the pictures, united by a single plot, in order, and understand the sequence of what is happening. Judgments are poor, and are a repetition of the advice and recommendations heard.

Some moderately mentally retarded people learn all the letters, merge them into syllables and even read short texts. But they don't comprehend what they read. They perceive it fragmentarily and therefore convey the content in unrelated passages. They assimilate the material unconsciously, mechanically. They master the ordinal count, perform the simplest arithmetic operations on a specific material. They do not succeed in an abstract account within the first ten. They cannot solve problems: the condition of the problem is not retained in memory, and semantic connections are not established.

The main difficulties of moderate mental retardation in solving problems: 1. poor acceptance of the task due to the absence or insufficiently strong motivation, withdrawal from the task, mental passivity; 2. lack of orientation in the task, i.e. understanding the links between links; 3. inability to "meaningfully" organize their activities to accomplish the task, i. E. sequential transition from one action to another, implementation of communication between actions, inability to correctly use visual aids to solve a problem.

Speech disorders... Patients develop understanding and use of speech slowly, with a delay of 3-5 years, and its final formation is limited. The development of speech usually corresponds to the degree of mental retardation. At the same time, the child understands the speech of the interlocutor very limited, satisfactorily capturing intonations, gestures and facial movements.

Later, especially under the influence of teachers, speech develops, but its understanding is ultimately determined by personal experience. Expressive speech is limited to single words or short sentences. The lexicon is poor, it consists of the most frequently used words and expressions. After several years of study, they learn the designation of household items, vegetables.

The pronouncing side of speech is defective, speech is almost devoid of modulations, pronounced inarticulateness, there are violations of the structure of many words and grammatisms. The most common prepositions are used, children confuse prepositions, replace them.

They manage to develop the ability to use their speech for communication purposes. In the process of communication, they know how to ask those around them for the objects they need, they dare to ask questions. In rare cases, the child's speech is a stream of meaningless cliches pronounced in the previously heard intonation (echolalic speech). The origin of this disorder is associated with a predominant lesion of the frontal lobe of the cerebral cortex or with hydrocephalus. In 20% of moderately mentally retarded children, speech does not appear at all due to the defeat of the speech zones of the cortex.

Memory disorders... Memory is not sufficiently developed: its volume is small, but by adolescence it can increase, reaching the level that is available in easily mentally retarded children. Long-term memory improves better than short-term memory. Distortion often occurs when reproducing captured material. Voluntary memorization is impaired. Both logical and mechanical memory suffer. Children with moderate mental retardation according to the program of the correctional school (type 8) are unteachable.

A small part of them (mainly due to their good mechanical memory) master the basic skills necessary for reading, writing and elementary counting. Educational programs (in special classes of correctional schools or boarding schools) can give them the opportunity to develop limited potential and expand the range of skills for self-care and orientation in the immediate environment. The hard-won knowledge is applied mechanically, like memorized cliches.

As a result of training through visual multiple demonstrations with a gradual complication of the task for several years, it is possible to prepare adolescents for work and life in a work collective. In addition to labor lessons, it is necessary to consolidate reading and numeracy skills associated with labor processes. Moderately mentally retarded adults, calm and amenable to guidance, are usually capable of simple practical work with constant guidance from the instructor. Independent labor activity is not available to them.

Emotional-volitional disorders... Independent living is not possible. Nevertheless, such people can be mobile, physically active and most of them show signs of social development, i.e. are able to establish contacts, communicate, participate in elementary social activities organized by educators.

The most typical personality traits of moderately mentally retarded: lack of initiative, independence, inertia of the psyche, a tendency to imitate others, a combination of suggestibility with negativism, instability in activity combined with inertia and sluggishness.

The relative preservation of their affective life is manifested in sensitivity to their evaluation by other people. Disorders of the emotional-volitional sphere include a lack of emotional diversity, an undifferentiated feeling, as well as their inertia and stiffness. Their self-esteem is distinguished by its originality: they put themselves in first place, a comrade - in second, and a teacher - in third. This can be explained by their better understanding of their peers compared to adults. As a result of the correctional process, their self-esteem is often changed. They begin to give credit to their teachers.

Incentives, even if they arise as the personality matures, are weak and quickly depleted.

Is characteristic asynchrony development of various spheres of the psyche: some have a higher level of visual-spatial skills in comparison with the results of tasks that depend on the development of speech. For others, considerable clumsiness is combined with some success in social interaction and elementary conversation. Levels of speech development vary: some patients can take part in simple conversations, others have a speech reserve sufficient only to communicate their basic needs. Some patients never master the ability to use speech, although they can understand simple instructions and learn manual signs, which to some extent compensate for the lack of their speech. Such an asymmetry in the development of different spheres of the psyche of moderately mentally retarded children, apparently, is etiologically associated with the consequences of organic brain lesions.

A small proportion of children have no need for communication. Most have developmental disorders that have a great impact on the clinical picture: some are good-natured and welcoming; others are dysphoric, spiteful, aggressive; still others are stubborn, lazy; the fourth are sluggish, spontaneous, inactive.

In many, there is an increase and perversion of drives, including disinhibition of sexuality. They are prone to impulsive behavior. Epileptiform seizures are common. Moderately mentally retarded children show neurological symptoms (paresis, paralysis), as well as signs of bodily malformations: underdevelopment of limbs, fingers, head formation disorders, underdevelopment of internal organs, hypogenitalism, defects of the face, eyes, ears. Somatic manifestations of associated diseases are possible (bronchial asthma, stomach ulcer).

Most people with moderate mental retardation are able to do without assistance. The main mental disorders are sometimes complicated by another neuropsychic pathology - neuroses, psychoses. However, the limited development of their speech makes it difficult to identify it.

Lecture number 2. Forms, causes and degrees of mental retardation

3. The degree of mental retardation.

4. Forms of oligophrenia.

5. Forms of dementia.

1. Forms of mental retardation.

The first attempt at differentiating mental retardation was undertaken by Philip Pinel in 1806, who designated mental retardation with the term "idotia" and identified four types of it. It was in this systematics that the division of dementia into congenital and acquired form, which still exists today, was first outlined. Mental retardation, according to modern clinical and psychological-pedagogical concepts, can be represented by two main forms of oligophrenia and dementia... These forms differ in the time of action of the pathogenic (harmful) factor.

At oligophrenia pathogenic impact occurs in the prenatal, natal or early postnatal period (the first 2-3 years of life, when the most important mental functions are still unformed), which causes such a picture of mental development as underdevelopment, and this underdevelopment has the character of a total lag in the development of all mental functions and non-progression (no increase) of an intellectual defect. Among the forms of mental retardation, oligophrenia, or general mental underdevelopment, occurs most often. At the same time, the highest mental functions and the cognitive sphere of the personality have the greatest insufficiency, since the physiological basis of their formation is the upper layers of the cerebral cortex, which are affected. The compensatory capabilities of such children are sharply limited (although they are not completely excluded) due to the fact that organic brain damage is of a diffuse nature, i.e. the entire area of ​​the upper layers of the cerebral cortex is affected. This criterion concerns the most typical part of mental retardation, and not the entire set of these conditions. So, D.N. Isaev asserts that “... with mental retardation, totality and predominant underdevelopment of the phylo- and ontogenetically youngest brain systems do not always take place. Mental underdevelopment may be due to the prevailing defeat of more ancient deep formations, which prevents the accumulation of life experience and learning. "

At dementia the pathogenic factor acts on the central nervous system in the period after 2-3 years, when most of the brain systems have already been formed and the violation bears signs of damage to previously formed functions. At the same time, the greatest damage is received by those functions that have recently formed or are in the sensitive period of formation. Thus, another feature of the development of children with dementia is some asynchrony (unevenness) in the development of mental functions, due to the preservation of some functions and the decay of others.

If signs of underdevelopment are combined with signs of damage, they speak of dementia of oligophrenic origin .

2. Causes of mental retardation.

The causes of oligophrenia

The causes of oligophrenia can be various factors of an exogenous (external) and endogenous (internal) nature, causing organic disorders of the brain.

    Classification of brain lesions by time of occurrence:

    prenatal (before delivery);

    intrapartum (during childbirth);

    postnatal (after childbirth).

    Classification of brain lesions by pathogenic factors:

    hypoxic (due to oxygen deficiency);

    toxic (metabolic disorders);

    inflammatory (encephalitis and meningitis with rubella, toxoplasmosis);

    traumatic (accidents, as well as compression of the brain during childbirth, with hemorrhages);

    chromosomal genetic (Down's disease, Felling's disease, etc.);

    intrasecretory hormonal;

    degenerative;

    intracranial neoplasms (tumors).

Particularly noteworthy is a group of factors that also lead to mental retardation - alcoholism, drug addiction, substance abuse. First, the breakdown products of alcohol and drugs (toxins), due to the common circulatory system of the mother and the fetus, poison the developing fetus. Secondly, prolonged use of alcohol and drugs (as well as their substitutes) cause irreversible pathological changes in the genetic apparatus of the parents and are the cause of the child's chromosomal and endocrine diseases.

Dementia causes

1) dementia as a result of severe trauma, brain tumors or the action of a toxic substance (for example, carbon monoxide), weak thyroid activity, encephalitis, lack of vitamin B12, AIDS, etc. that destroy brain cells develops suddenly in young people;

2) the most common reason: progressive diseases. At the same time, the disease develops slowly and affects people over 60 years of age, like senile dementia as a result of Alzheimer's disease, Pick's disease, blue dementia, Parkinson's disease (infrequently), but dementia is not a normal stage of aging, it is a severe and progressive decline in mental abilities over time. While healthy older people sometimes do not remember details, people with dementia may completely forget recent events;

3) dementia as a result of vascular disorders of the brain (in the post-stroke period);

4) dementia that develops as a result of mental illness (schizophrenia, epilepsy).

Severe mental retardation (oligophrenia in the degree of pronounced imbecility) occurs in 5-7% of children with intellectual disability. It is possible to identify the main signs of a defect already in the first months and years of life. In the International Classification of Diseases (ICD-10), severe (code F 72) refers to mental disorders with an IQ of 20 to 35.

The main signs of severe intellectual disability

  • in an adult suffering from severe mental retardation corresponds to the developmental level of a child of 3-5 years
  • The early and subsequent development of the child is impaired: he later begins to hold his head, sit, walk, talk, motor awkward, clumsy, unable to run and jump, assemble constructor sets and mosaics, write and draw
  • Speech is grossly defective, the child is able to learn about 15-20 simple words, but uses them mainly mechanically, unconsciously. More often, not the meaning of words is caught, but intonation, facial expressions and gestures related to the basic needs of the patient (cooking, censure for misconduct)
  • The motor awkwardness characteristic of children persists in adults with severe mental retardation, making it difficult to perform complex movements that require precision, coordination, and attention. But simple everyday skills - dressing (except for buttoning and tying laces), eating, carrying objects, are fixed with sufficient diligence and are performed well under the supervision of relatives or educators.
  • Thinking with oligophrenia is chaotic, unsystematic. If a child has severe mental retardation, he can sometimes distinguish well-known objects in the picture, and with prolonged training, even combine them (animals, clothes), but this memorization is purely mechanical. The child is not able to compose a story based on a plot picture, he cannot solve even the simplest problem, he does not distinguish objects by size, color, shape
  • Logical memory is absent, mechanical memory is sharply reduced.
  • The behavior of persons with severe mental retardation is usually impaired - they can be either euphoric and complacent, or angry, aggressive, disinhibited
  • If oligophrenia is diagnosed in the degree of pronounced imbecility, then socially this indicates that such patients cannot live and serve themselves independently, they need constant care, supervision, and guardianship.

Principles of care for patients with severe mental retardation

The main approaches to treatment, rehabilitation, education are similar to similar measures for. This is the treatment of concomitant diseases, and regular physical activity in the fresh air, and reflexology, and massage, and music therapy. Only with a pronounced imbecility, this approach allows you to achieve better results, master the basic skills of self-service and neatness.

Severe mental retardation is not a sentence, and a lot can be achieved with correct corrective measures. I would like to wish perseverance and patience to relatives and friends, acquaintances and strangers who, in one way or another, participate in the fate of children and adults with intellectual disabilities. Even if you have deep or severe mental retardation, you should not despair. Helping, giving a piece of ourselves to others, we become richer inwardly and spiritually, we become HUMANS.

A person can work successfully and gain new knowledge thanks to the cognitive functions of the brain. In children, especially in the first year of life, a violation of this function is often observed, which jeopardizes their normal existence. A problem associated with severe mental retardation. The course is difficult, both for the child himself and for his relatives. Knowledge of the symptoms of pathology will allow adults to notice the existing abnormalities in the baby in time and seek help from a specialist.

Causes

Mental retardation is more often found in children under 3 years of age, but in some cases, the diagnosis is made at school age.

Pathology is allocated in a separate category - oligophrenia. It manifests itself in problems with speech, motor skills, social adaptation and the ability to acquire new knowledge and skills.

The disease is often non-progressive, that is, it does not develop over time. But sometimes, in the absence of therapeutic measures, the pathology progresses. Against the background of the disease, other psychological disorders can also appear. Patients diagnosed with severe mental retardation share similarities with people with Down syndrome or autism.

The reasons that can lead to the onset of pathology are still not fully understood. The factors provoking the onset of pathology are divided into external and internal or endogenous and exogenous. The causes of pathology include:

Pathology can develop against the background:

  • unfavorable environmental conditions;
  • increased radiation levels;
  • parents taking drugs or alcoholic beverages;
  • low level of wealth.

In the latter case, the patient does not receive the necessary microelements from food.

Classification of the disease

With mental retardation in children, not only cognitive, but also psychological functions of the brain are affected. Therefore, it is difficult for the patient to be in organized groups. Mild degrees of pathology are difficult to diagnose until the age of one year, because at this time the child still does not know how to talk and analyze information.

The degree of pathology is usually classified according to the child's intelligence level (IQ). The intelligence assessment results are interpreted as follows:


Together with the level of intelligence, the type of his behavior and the presence of concomitant psychological disorders are determined. In children with a severe form of the disease, violations are noted:


All desires of patients with idiocy are associated with the satisfaction of natural needs. In the behavior of children with severe mental retardation, lethargy, lethargy or uncontrolled physical activity can be traced.

Idiocy is further subdivided into 3 groups:


With complete idiocy, a person lacks almost all desires, the functions of perception of the surrounding world are impaired. In behavior, they are similar to animals: they scream loudly, react inadequately to external stimuli, and cannot serve themselves.

In the typical form of the disease, the instincts of patients are more pronounced. They can communicate their desires or discomfort with the help of gestures or sounds. At the same time, speech skills are completely absent.

Speech idiots are able to respond to external stimuli and pronounce individual sounds. Cognitive skills are missing.

Programs for children

The program for children with severe mental retardation is being developed by specialists of several profiles - teachers, neurologists, psychologists, pediatricians. Orthopedists, speech therapists and physiotherapists are also involved in the treatment of children.

The main goal of therapy is to educate patients in basic self-care skills and help them adapt to the environment. For this, many specialized centers have been created in which children are taught according to a simplified scheme. Rehabilitation takes place with the help of equipment for stimulating nerve fibers, professional massage therapists and kinesiotherapists. These activities increase the chance of teaching your child the necessary skills.

Teenagers are also trained in specialized centers. The main goal of the training programs is to teach the patient to navigate in time and space, as well as independently perform elementary actions - go to the toilet, perform simple work at the computer.

People with moderate to mild dementia are able to take care of themselves and work in jobs that do not require intellectual ability.

Due to functional disorders in the brain, the life expectancy of such patients is reduced. However, constant monitoring by specialists, timely medical measures can improve the survival prognosis for children with any degree of mental retardation. Babies with severe forms of pathology, as a rule, need outside help all their lives. The more severe the symptoms of the disease, the higher the risk of death.

Therapy

Treatment of mentally retarded children will be successful only with a complex effect, that is, not only with an individual approach to learning, it is necessary to combine the intake of medications. To correct the pathological condition, children are assigned nootropics - Piracetam, Aminalon, Pantogam. The purpose of taking nootropic drugs is to speed up metabolism in brain cells. For the same purpose, patients are prescribed B vitamins and amino acids.

In case of disturbed behavior, the patient is recommended to take tranquilizers or antipsychotics. The dosage and treatment regimen with drugs of this group is determined by a psychiatrist. Instead of medications, for example, nootropics, you can use medicines of natural origin - Chinese magnolia vine, ginseng tincture. Plants activate the nervous system. However, stimulants in some cases provoke psychosis. Therefore, taking traditional medicine is possible only after consulting with doctors.

The risk of having a child with a severe mental disability can be reduced by consulting couples with a geneticist. If there is a risk of having a sick baby, then couples are recommended to undergo prenatal testing, which includes:

  • ultrasound procedure;
  • amniocentesis;
  • study of fetoprotein in the mother's blood serum.

Amniocentesis can detect genetic and metabolic abnormalities in the fetus. This analysis is mandatory for all pregnant women over 35 years of age.

Thanks to the rubella vaccine included in the national vaccination schedule, it was possible to eliminate one of the causes of severe mental illness. Currently, a vaccination against cytomegalovirus infection, which in some cases also leads to dementia, is being actively developed.

Severe mental retardation is an incurable diagnosis. Children and adults with this disease need outside help all their lives, because they cannot fully cope with self-care skills, like people with mild to moderate illness. There are several forms of dementia: complete, verbal and typical. In the first case, patients do not lend themselves to learning and cannot express their desires with the help of facial expressions and gestures, and their life expectancy is much shorter than that of healthy people.

Characteristics of mental retardation

Plan

1. Signs of mental retardation

2. Types of mental retardation

3. The degree of mental retardation

1. Signs of mental retardation

Mental retardation is a pronounced, irreversible systemic impairment of cognitive activity that occurs as a result of diffuse organic damage to the cerebral cortex.

In this definition, the presence of three features should be emphasized:

1) organic diffuse damage to the cerebral cortex;

2) systemic impairment of intelligence;

3) the severity and irreversibility of this violation.

The lack of at least one of these signs will indicate that we are not dealing with mental retardation, but with some other type of dysontogenesis. Really:

Underdevelopment of mental activity in the absence of organic damage to the cerebral cortex is a sign of pedagogical neglect, which can be corrected;

Local brain damage can cause loss or disorders of one or another mental function (hearing, speech, spatial gnosis, visual perception, etc.), but the intellect as a whole is preserved and there is a possibility of compensation for the defect;

Functional disorders of the brain structures can lead to defects in cognitive activity of a temporary nature, which, under certain conditions, can be eliminated;

An inexpressive decrease in intelligence limits a person's ability to master certain types of complex cognitive activity, but does not affect the success of an individual's independent social adaptation;

Organic brain damage does not necessarily cause impairment of cognitive functions, but can lead to disorders of the emotional-volitional sphere and disharmonious development.

It should be noted that not all defectologists agree with this definition. For example, L.M. Shipitsyna believes that with mild mental retardation, organic damage to the brain does not always take place. Some scientists expand the concept of mental retardation due to those cases when developmental lag is predetermined by unfavorable social conditions, deprivation, and pedagogical neglect. Indeed, pedagogical neglect can be so deep that it leads to irreversible changes in higher nervous activity.

The child skips the sensitive periods of the formation of the most important higher mental functions, in particular speech, and actually stops at the natural stage of development.

According to D.M. Isaevata (2005), mental retardation is a combination of etiologically different (hereditary, congenital, acquired in the first years of life), non-progressive pathological conditions that turn out to be in general mental underdevelopment with a predominance of an intellectual defect and lead to a complication of social adaptation.

2. Types of mental retardation

Depending on the time of occurrence, mental retardation is divided into two types - oligophrenia and dementia.

Oligophrenia- This is a type of mental retardation that occurs as a result of organic brain damage in the prenatal, natal or early (up to three years) period of childhood and is in total mental underdevelopment.

It is important to note that oligophrenia is determined not by etiological factors, but by the early influence of these factors on the brain. That is, a very diverse hereditary, congenital, acquired harmfulness in the prenatal and early postnatal periods predetermine the general mental underdevelopment. The clinical manifestations of oligophrenia do not depend on the causes of its occurrence, in contrast to dementia, in which the structure of the defect is to a certain extent determined by etiological factors.

For example, the pathogenesis and psychological characteristics of children with traumatic dementia and dementia, which arose as a result of neuroinfection, differ significantly, while oligophrenia, predetermined by trauma or infection, have the same symptoms.

As you know, the brain of a newborn child has not yet completed its formation. The formation of cork structures, the establishment of connections between the neurons of the cortex, the myelination of nerve fibers are carried out in parallel with the mental development of the individual and largely depend on the experience that the child acquires.

Through a harmful effect on the cerebral cortex in the early period, neurons are immature or blocked and cannot fully perform their functions, which complicates the process of forming connections between them. Neurodynamics in oligophrenia is characterized by a weakness of the obturator function of the cerebral cortex, instability of connections, inertia and weakness of nervous processes, insufficiency of internal inhibition, excessive irradiation of excitation, difficulties in the formation of complex conditioned reflexes.

Therefore, the mental development of an oligophrenic child is carried out on an abnormal basis. The early period of damage to the cerebral cortex leads to a more expressive underdevelopment of functions that have a longer maturation period, which, in turn, determines the hierarchy, in which regulatory systems and the highest level of organization of any mental function are affected first of all. The primary defect in oligophrenia is associated with total underdevelopment of the brain, especially phylogenetically the youngest associative zones.

Secondary defect in oligophrenia, for V.V. Lebedinsky, has a circular character, predetermined by two coordinates of underdevelopment: "from bottom to top" - the lack of elementary mental functions creates an unfavorable basis for the genesis of verbal-logical thinking; "from top to bottom" - the underdevelopment of the higher forms of thinking prevents the restructuring of elementary mental processes, in particular, the formation of logical memory, voluntary attention, reference perception, and the like. The formation of a secondary defect is predetermined by cultural deprivation.

In the structure of dysontogenesis in oligophrenia, there is a violation of inter-analyzer connections and, accordingly, the isolation of individual functions. A characteristic feature of oligophrenic children is the isolation of speech from action, comprehension, understanding of the material from memorization.

Oligophrenia has a residual (non-progressive) character, that is, it does not have a tendency to progress - to deepen the degree of severity. This circumstance and the relative preservation with a mild degree of motivation-need, emotional-volitional sphere, purposefulness of activity, absence of encephalopathic and psychotic disorders provide the possibility of satisfactory dynamics of development and the effectiveness of pedagogical influence. But with oligophrenia in the dynamics of mental development at all stages, the phenomena of underdevelopment are observed.

There are the following main signs of oligophrenia:

The presence of an intellectual defect, which combines with violations of motor skills, broadcasting, perception, memory, attention, emotional sphere, arbitrary forms of behavior;

Totality of intellectual inadequacy, that is, underdevelopment of all neuropsychic functions, impaired mobility of mental processes;

The hierarchy of the intellectual defect, that is, the overwhelming insufficiency of abstract forms of thinking against the background of the underdevelopment of all neuropsychic processes. Underdevelopment of thinking is reflected in the course of all mental processes: perception, memory, attention. First of all, all the functions of abstraction and generalization, comparison by essential characteristics, understanding of figurative meaning suffer; the components of mental activity associated with analytic-synthetic activity of the brain are disrupted.

At the same time, the higher mental functions, which are formed later and are characterized by arbitrariness, are less developed than the elementary ones. In the emotional-volitional sphere, this turns out to be in the underdevelopment of complex emotions and arbitrary forms of behavior. Consequently, oligophrenia is characterized by non-progression, totality and hierarchy of mental development disorders, relative preservation of the personal aspect of cognitive activity. This marked type of mental retardation differs from dementia.

Dementia- This is a type of mental retardation that occurs as a result of damage to the cerebral cortex in the period after two to three years and turns out to be in an expressive decrease in intellectual capabilities and in a partial disintegration of already formed mental functions.

Since the formation of the cerebral cortex is mainly completed at the age of 16-18, the phenomena of degradation are accompanied by mental underdevelopment.

The nature of desontogenesis in dementia is determined by the combination of a gross violation of a number of formed mental functions with the underdevelopment of ontogenetic early formations (frontal systems), as a result, the frontal-subcortical interaction suffers. Along with the partial loss of individual cortical functions, first of all, there are disorders of the emotional sphere, often with disinhibited trains, severe violations of purposeful activity and personality in general.

Damage leads to the phenomena of isolation of individual systems, the disintegration of complex hierarchical relationships, often with a gross regression of intelligence and behavior.

Dementia is characterized by the partial impairment of mental functions. This means that some of them are damaged more, while others are less. Complication of cognitive activity is predetermined not so much by thinking disorders as by gross disorders of focus, attention, memory, perception, emotions, as well as extremely low intensity of striving for achievements. With dementia, neurodynamic processes are significantly affected, as a result of which inertia of thinking, rapid exhaustion, and disorganization of mental activity in general are observed.

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