Lebedinskaya's classification, which is based on the main etiological factors and pathogenetic mechanisms that cause developmental delay and lead to a certain structure of the defect. Based on this criterion, 4 main forms of ZPR.

ZPR of constitutional origin (congenital). But often its origin is associated with mild metabolic and trophic disorders in the prenatal period and in the first years of life.

The child is distinguished by a special, infantile (childish) body type, he has a childish face and childish facial expressions, an infantile psyche (mental infantilism). A characteristic feature of this form of DPR is the combination immaturity of the emotional and intellectual spheres. At the same time, the emotional-volitional sphere is, as it were, at an earlier stage of development, in many ways reminiscent of the structure of the emotional makeup of younger children. In children, emotional motivation for behavior predominates, there is an increased background of mood, spontaneity and brightness of emotions while being superficial and unstable, and easy suggestibility. Their learning difficulties are associated not so much with their intellectual inadequacy as with the immaturity of the motivational sphere and personality as a whole, with the persistent predominance of gaming interests. The developmental prognosis for such children is favorable; over time, they level out in their development and reach the level of their peers under favorable conditions of education and upbringing. ZPR of somatogenic origin. It is observed in those children who suffer from serious somatic diseases for a long time and often (diabetes mellitus, bronchial asthma, cancer, diseases of the circulatory system, etc.). Before the main disease, the child’s development proceeded without any special features; his nervous system also functioned normally, since initially there was no organic damage to it. 1. The nervous system and brain suffer, since somatic illness has a harmful effect on all body systems, including the nervous system and brain (intoxication, hypoxia). 2. The child's activity time decreases, when he can play, study, communicate with other people, since this time is spent on examining and treating the child. 3. Decreased mental tone due to general painful weakness (asthenia), increased exhaustion and fatigue, therefore the child’s development opportunities are sharply limited. In independent activities, they perform less manipulations with objects compared to healthy children. General activity, and especially cognitive activity, decreases. Attention fluctuates and concentration decreases. In the most severe cases, children also experience cerebrasthenic phenomena. Cerebroasthenia syndrome manifests itself in the child not only in increased fatigue, but also in an increase in mental slowness, in deterioration of concentration and memory, in unmotivated mood disorders, tearfulness, lethargy, and drowsiness. The child has increased sensitivity to bright light, loud noise, stuffiness, and headaches. All this negatively affects educational performance. The long, painful and difficult treatment process for the child, as well as long and frequent hospitalizations, also have a pathogenic effect on the development of the child. Children are prescribed numerous prohibitions and restrictions on diet, pastime, and communication related to the nature of the disease and treatment. Gradually, the content of children’s basic needs also changes; their range of interests is built around the main disease; they are less interested in everything that healthy peers live with. The child cares and worries about his condition and the possibility of recovery. The main principle in relations between adults and children is hyperprotection, that is, excessive care. Hyperprotection in itself leads to a decrease in the child’s activity; he expects adults to do everything for him. Parents lower the level of requirements for the child, creating in him a consumer position, lack of self-confidence, and low self-esteem. Egocentrism is encouraged, the child's attention is fixed on his illness, and special significance is given to it. Children often experience a delay in emotional-volitional development associated with uncertainty, timidity, fears, and general anxiety, as the child realizes and feels his physical inferiority. Thus, in children with severe somatic diseases, developmental delays begin to gradually accumulate despite initially normal development. Asthenization (weakness, lethargy) in combination with unfavorable socio-psychological conditions leads to a distortion in the formation of the child’s personality. The prognosis of development in children with the somatogenic form directly depends on the severity, course and outcome of the underlying disease. ZPR of psychogenic origin is associated with unfavorable living conditions and raising a child, both in the family and outside the family. Mental retardation of psychogenic origin often occurs in those children who, from an early age, have been subjected to mental (deprivation of emotions, impressions) and social (deprivation of communication) deprivation, which is especially typical for children who are brought up in closed institutions (orphanages, boarding schools), in social dysfunctional families. Deprivation has long-term negative consequences, which manifest themselves in distortions in the development of the emotional-volitional, and subsequently the intellectual sphere. This form of mental retardation is of social origin and is not associated with immaturity or brain damage. But with early onset and long-term effects, psychotraumatic factors can lead to permanent changes in the child’s neuropsychic sphere. In infancy, such children have a sharply reduced need for communication, they do not form attachment relationships with close adults, and at an early age they experience apathy and inactivity, lack of initiative, a decrease in general and cognitive motivation, and delays in speech development. In preschool age, depression, decreased emotionality, passivity are noted, and empathic abilities are not formed. At primary school age, children do not develop volition, there is a lack of intellectual sphere, these children are prone to conflict and aggressive behavior. At the same time, they experience a great need for friendly attention from others, their need for communication is not satisfied. In adolescence, children experience a variety of problems in the formation of personality, its self-awareness, and develop a vague orientation towards the future, and all these features persist into adulthood. This type of mental retardation is considered quite favorable from the point of view of overcoming temporary developmental delays. With corrective work started in a timely manner (as early as possible) and corrective work carried out competently, and with the creation of adequate favorable upbringing conditions for the child, developmental delays can be overcome or significantly reduced. However, upbringing outside the family environment at a very early age cannot be completely overcome, because the child’s state of emotional distress that arises at this age persists in various forms throughout a person’s life. Children with a psychogenic form of mental retardation do not experience gross impairments of intelligence or its prerequisites (memory, attention, performance) - these functions remain relatively intact. The main factor that leads to a decrease in intellectual productivity and school failure is a decrease in motivation and distortion in the formation of the emotional-volitional sphere. This form of ZPR must be distinguished from the phenomena of pedagogical neglect. With pedagogical neglect, there is a lack of knowledge and skills of the child, a reduced range of ideas due to insufficient information and the poor environment surrounding the child. When replenishing information, the child quickly assimilates and acquires knowledge and skills, and accumulates impressions. Mental retardation of psychogenic origin is a consequence of long-term pathological conditions operating systemically, and it cannot be overcome only through the transfer of information and the creation of favorable environmental conditions. ZPR of cerebral-organic origin. The child has an organic lesion of the central nervous system. Brain damage in a child mainly occurs in the late stages of intrauterine development, during childbirth and in the first days after birth. In most cases, developmental delay in such children cannot be completely overcome; it can only be partially compensated. A more favorable option is when the child’s attention deficit and motor disinhibition come to the fore, and memory and thinking suffer to a lesser extent. Markovskaya describes two options for delayed mental development of cerebral-organic origin.1st option – with a predominance of the phenomena of organic infantilism: in children there is less severity of brain damage, the prognosis for development and overcoming developmental delays is more favorable. In children, traits of immaturity in the emotional sphere, such as organic infantilism, predominate; disorders of higher mental functions are mosaic and mostly dynamic in nature, due to low mental tone and increased exhaustion, underdevelopment of regulatory mechanisms of the psyche. There are no primary intellectual impairments: verbal and non-verbal intelligence are on average within the age norm. Reduced mental performance and attention. This variant is also observed in children with attention deficit hyperactivity disorder. For 2nd option Characterized by greater severity of brain lesions, their localization in the parietal and temporal regions of the brain, the prognosis for them is less favorable. With this option, disorders of cognitive activity, that is, memory, thinking and imagination, predominate. Observed primary deficiency higher mental functions: difficulties in perceiving complex objects, violations of visual-motor coordination, spatial orientation, phonemic hearing, auditory-verbal memory, active speech, insufficiency of verbal and logical thinking. Indicators of intelligence quotient (general, verbal and nonverbal), measured using the Wechsler test, are in the border zone between normal and mental retardation.

ZPR is a partial (partial) underdevelopment of higher mental functions. Main features: immaturity of the emotional-volitional sphere, underdevelopment of cognitive activity. A characteristic feature is partiality, focality of the lesion, and not monotony as with mental retardation. And also the temporary nature of the disease.

Underdevelopment of the emotional-volitional sphere is usually expressed in insufficient motivation to communicate, emotions are developed at a “previous” age, increased suggestibility, rapid nervous exhaustion, shallowness of imagination, with a general impoverishment of play activity, intense emotional involvement.

Underdevelopment of the cognitive sphere is expressed in a lack of motivation to learn, lack of curiosity, searching for easy ways, offering the first solution that comes along and unwillingness/impossibility to think about other options.

With mental retardation, all functions of higher nervous activity are impaired - memory, speech, thinking, will, emotions, attention, imagination.

The causes of PPD can be divided into three groups:
1. Focal lesions of the central nervous system, central nervous system failure caused by certain problems, such as: pathology of intrauterine development (prolonged hypoxia), pathology of childbirth (premature placental abruption, use of mechanical stimulation, etc.), diseases in the first 3 years of life.
2. Chronic diseases, frequent stays in hospitals, a special regime for the preservation of physical health.
4. Long-term sociocultural deprivation - dysfunctional, asocial family or orphanhood.
5. Prolonged or excessively strong exposure to traumatic factors. Including overprotection.

According to various estimates, from 80 to 90% of all cases of mental retardation are related to cerebroorganic lesions. Those. ZPR caused by focal brain lesions. This is the most severe form of mental retardation. But it is easier to diagnose.

What do parents need to know?
Firstly the fact that mental retardation is diagnosed no earlier than 5-7 years. Before this, the diagnosis is conditional, approximate - the development of preschool children occurs spasmodically and quite significant discrepancies with the average norm are allowed. The individuality of the pace of development does not allow a specialist to make a diagnosis in early preschool age.

Moreover, the younger the child, the more difficult it is to suspect he has mental retardation. In children under three years of age, it is correct to suspect a mental retardation only if very serious, unambiguous signs are detected.

However, if a child is found to lag behind the norms or exhibit specific behavior that suggests developing mental retardation, adequate measures should be taken. It is important to understand that mental retardation never goes away “on its own,” “just with age.” These are not pubertal pimples, these are underdevelopment of brain functions.

Secondly, ZPR is not a permanent condition; with timely, competent correction, children progress up to an absolutely normal state of psyche and intellect.

Thirdly, dear parents, if your child has mental retardation, in the vast majority of cases it will be better for him to study in special classes of the Children's Educational Institution or in a special school for the first years. Your child is not like everyone else, and if you just pretend that this is not so, the problem will not resolve itself. On the contrary, it is precisely because of the obstinacy of parents that children suffer - the correction is not made on time, during a sensitive period and time is lost FOREVER.

If a child with mental retardation enters a KRO class or a special school from the first grade, in most cases by middle school he is quite ready to return to mainstream classes and a childhood diagnosis of mental retardation does not affect his future life in any way. If a child with mental retardation goes through primary school in mass classes, then intellectual and mental abilities are practically not restored. And even if by middle school parents recognize the child’s problems and send him to remedial education, the chances of restoring his abilities are minimal.

Fourthly, take care of correct and accurate diagnosis. It is not always possible for a neurologist from a district clinic to make a truly correct diagnosis of mental retardation. Contact specialists who work specifically on intellectual disabilities, and not general practitioners!

Each baby is individual. It is difficult to disagree with this famous statement. In fact, the mental and physical development of each baby can proceed differently. However, when the process of formation and development of a baby does not significantly meet established standards, this may worry parents. In such cases, some parents decide to seek help from a specialist.

With a thorough and detailed examination, the child may be diagnosed with mental retardation. What is meant by this diagnosis and what are its main features?

What is ZPR?

Mental retardation is a visible delay in the development of a small person. In other words, non-compliance with certain, generally accepted norms. Delayed mental development is observed in children of school and preschool age. There are ways to help correct and, to some extent, normalize a child’s mental development. We'll talk about them a little later.. Now let's get acquainted with the main reasons for the occurrence of mental retardation in children.

Why may mental retardation occur?

Today, several main reasons are known that contribute to the occurrence of mental retardation in children of school and preschool age. Conventionally, these reasons are divided into two groups: biological and social.

First let's find out the biological factors the appearance of developmental delay. So, these factors are:

The first group of reasons is closely related to the intrauterine development of the child, when health problems appear even during the formation of a small person.

On the social reasons for the appearance of children with mental retardation:

Most of the social causes of developmental problems in children with mental retardation are related to the educational process. Mental well-being is also influenced by the child’s relationship with his parents. If pedagogical influence turns out to be without taking into account the individual developmental characteristics of the child, this increases the risk of the occurrence and further development of such a pathology as mental retardation. In some cases, mental retardation is simultaneously caused by two factors, both biological and social. It is important to note that social under such circumstances has additional negative effects. It contributes to the further development of biological disorders, which, of course, should be actively combated.

To fight cancer correctly, it is necessary to determine the main symptoms of the pathology. Therefore, further we will talk about the main symptoms of mental retardation in children.

Mental retardation in children: symptoms

Next, we will discuss what symptoms occur with sexually transmitted diseases in children. Experts identify several main symptoms that indicate the presence of mental retardation in children. All of them, one way or another affect the action of mental functions:

Not only the symptoms, but also knowledge of the types of sexually transmitted diseases will help determine the presence of this pathology. In total, there are four main types of mental retardation. Let's pay close attention to each existing species.

ZPR with cerebral-organic genesis. The first type of mental disorder is associated with damage to the vital functions of the body’s central nervous system. During such a lesion, some body functions are partially disrupted. The defeat itself is organic in nature. At the same time, such a delay in mental development does not contribute to the emergence of mental disability. Here are the main symptoms of mental retardation with cerebral-organic origin:

• Slow formation of thinking.
• Slow maturation of the emotional-volitional level.
• Problems with cognitive activity are clearly expressed.

ZPR with constitutional genesis. The next type is hereditary in nature (hereditary infantilism). At the same time, different functions of the child’s body are affected, namely psychological, physical and mental. The volitional sphere of development in this case corresponds to the level of development of a preschool child. Although the biological age of the child may be an order of magnitude higher. Children with this type of mental retardation exhibit increased emotional behavior. Being in a good mood, the child easily succumbs to emotions. But all experiences are superficial and rather unstable.

Mental retardation with psychogenic origin.

This type, unlike the previous ones, is more social in nature. The development of psychogenic genesis is facilitated by constant stress, as well as depressing and traumatic situations for the child’s psyche. At first, autonomic functions suffer, and then the pathology has a negative impact on the emotional and mental development of the child. Children with similar problems completely dependent on the external environment and its position.

Mental retardation with somatogenic genesis. But this type of mental retardation occurs for a biological reason. Such causes are infectious diseases and somatic pathologies. Often, developmental problems are caused by diseases of the baby’s mother. The main symptoms or features of this type of cancer are:

Both a decrease in mental tone and the emergence of fears negatively affect the baby’s relationships with people around him and the world as a whole.

Prevention and treatment of sexually transmitted diseases

Mental retardation must be combated without fail. Often this diagnosis is made to children of preschool age (at about 5–6 years old). In some cases, mental retardation occurs already during schooling. When such problems arise, you should decide on the use of control methods as quickly as possible. Usually, a number of pedagogical and psychological procedures are provided to help cope with mental retardation. All procedures must be carried out in a timely manner (it is important not to miss the moment) and, no less important, competently.

Where can I get this kind of help?

In most cases, work with these children is carried out in special sanatoriums and institutions. Treatment is carried out simultaneously by several experienced specialists. In this case, you cannot do without the help of a speech therapist, psychologist and psychiatrist. In order for treatment to bring the desired result, specialists and parents must become a single team, each member of which makes the maximum contribution to achieve the goal as quickly as possible. The goal of treatment and assistance from doctors is to help the preschool child adapt to the world around him and learn to get along with people.

What stages will such rehabilitation consist of? Here are the two main stages of treatment for mental retardation in school and preschool children:

Medical therapy

First of all, treatment procedures are carried out. Such procedures often include:

Correctional and pedagogical assistance. It consists of measures aimed at correcting the development process. The main factor determining rehabilitation methods is the age and other individual characteristics of the baby. At the moment, several ways to eliminate mental retardation are known. Let's pay attention to them:

Wellness technique. This technique allows you to improve and support the physical and psychological processes of a child’s formation at a certain age stage. The healing technique includes the simultaneous implementation of several important tasks, namely:

Sensory-motor sphere. This technique is more often used when working with school-age children who have deviations in sensory processes and also have problems with the musculoskeletal system. The main goal of this treatment is the formation of the sensory-motor sphere. Thanks to this technique, it is possible to identify and gradually develop creative abilities in children with mental retardation.

Working with emotional awareness. The main goal is to increase emotional awareness in a child with similar mental pathologies. By increasing the child’s awareness, specialists help him perceive and understand the feelings of people around him (including his peers). Children are taught to react correctly to extraneous emotions, and are also helped to learn to independently control their own feelings. This technique is usually used for different degrees and types of mental retardation.

Corrective-compensatory method. This type of treatment may simultaneously include several neuropsychological techniques. The neuropsychological techniques used make it possible to level and successfully hone such vital skills as the ability to write, read and perform arithmetic operations. Without these skills, a schoolchild, as is known, it is difficult to master the school curriculum. In addition, these techniques improve the cognitive skills of children suffering from mental retardation. Corrective-compensatory work allows a child to develop such a necessary quality as focus.

Working with the child’s cognitive activity. Today, the most effective in this type of treatment is considered to be a system of psychological influence, which is combined with pedagogical assistance. . The purpose of the discussed methodology- align and eliminate existing defects in mental processes.

Each technique is used according to the individual developmental characteristics of the child. Not only specialists, but also parents themselves should take an active part in treatment. Only in this case can the highest possible results be achieved. If a school-age child receives treatment, then after all the procedures, the methodological-psychological-pedagogical council must decide whether the child can study in a regular secondary school or it would be better for the child to receive education at home or in a special institution.

Mental retardation (MDD) is a violation of normal development in which a child who has reached school age continues to remain in the circle of preschool and play interests. The concept of “delay” emphasizes the temporary (discrepancy between the level of development and age) and at the same time temporary nature of the lag, which is overcome with age the more successfully the earlier adequate conditions for the learning and development of children of this category are created.

In the psychological-pedagogical, as well as medical literature, other approaches to the category of students under consideration are used: “children with learning disabilities”, “lagging behind in learning”, “nervous children”. However, the criteria on the basis of which these groups are distinguished do not contradict the understanding of the nature of mental retardation. In accordance with one socio-pedagogical approach, such children are called “children at risk” (G.F. Kumarina).

History of the study.

The problem of mild deviations in mental development arose and acquired particular importance, both in foreign and domestic science, only in the middle of the 20th century, when, due to the rapid development of various fields of science and technology and the complication of the programs of secondary schools, a large number of children appeared experiencing difficulties in training. Educators and psychologists attached great importance to analyzing the causes of this failure. Quite often it was explained by mental retardation, which was accompanied by the sending of such children to auxiliary schools that appeared in Russia in 1908 - 1910.

However, clinical examination increasingly failed to detect specific features inherent in mental retardation in many of the children who did not master the general education curriculum well. In the 50s - 60s. this problem acquired particular significance, as a result of which, under the leadership of M.S. Pevzner, a student of L.S. Vygotsky, a specialist in the field of mental retardation clinic, a comprehensive study of the causes of academic failure was begun. The sharp increase in academic failure against the backdrop of increasingly complex educational programs led her to assume the existence of some form of mental deficiency that manifests itself in conditions of increased educational demands. A comprehensive clinical, psychological, and pedagogical examination of persistently underperforming students from schools in various regions of the country and analysis of a huge array of data formed the basis for the formulated ideas about children with mental retardation (MDD).

This is how a new category of abnormal children appeared, who are not subject to being sent to a auxiliary school and make up a significant part (about 50%) of underachieving students in the general education system. The work of M.S. Pevzner “Children with developmental disabilities: distinguishing oligophrenia from similar conditions” (1966) and the book “To the teacher about children with developmental disabilities,” written together with T.A. Vlasova (1967), are the first in a series psychological and pedagogical publications devoted to the study and correction of mental retardation.

Thus, a set of studies of this developmental anomaly, begun at the Research Institute of Defectology of the Academy of Pedagogical Sciences of the USSR in the 1960s. under the leadership of T.A. Vlasova and M.S. Pevzner, was dictated by the urgent needs of life: on the one hand, the need to establish the causes of academic failure in public schools and search for ways to combat it, on the other hand, the need for further differentiation of mental retardation and other clinical disorders cognitive activity.

Comprehensive psychological and pedagogical studies of children with diagnosed mental retardation over the next 15 years have allowed us to accumulate a large amount of data characterizing the unique mental development of children in this category. According to all studied indicators of psychosocial development, children in this category are qualitatively different from other dysontogenetic disorders, on the one hand, and from “normal” development, on the other, occupying an intermediate position in terms of mental development between mentally retarded and normally developing peers. Thus, according to the level of intellectual development, diagnosed using the Wechsler test, children with mental retardation often find themselves in the zone of so-called borderline mental retardation (IQ from 70 to 90 conventional units).

According to the International Classification, mental retardation is defined as a “general disorder of psychological development.”

In foreign literature, children with mental retardation are considered either from a purely pedagogical perspective and are usually described as children with learning difficulties, or are defined as maladapted, mainly due to unfavorable living conditions, pedagogically neglected, and subjected to social and cultural deprivation. This group of children also includes children with behavioral disorders. Other authors, according to the idea that developmental delays, manifested in learning difficulties, are associated with residual (residual) organic brain damage, children in this category are called children with minimal brain damage or children with minimal (mild) brain dysfunction. The term “children with attention deficit hyperactivity disorder” (ADHD) is widely used to describe children with specific partial learning difficulties.

Despite the rather large heterogeneity of dysontogenetic disorders related to this type, they can be given the following definition.

Children with mental retardation include children who do not have pronounced developmental disabilities (mental retardation, severe speech underdevelopment, severe primary deficiencies in the functioning of individual analytical systems - hearing, vision, motor system). Children in this category experience adaptation difficulties, including school ones, due to various biosocial reasons (residual effects of mild damage to the central nervous system or its functional immaturity, somatic weakness, cerebrasthenic conditions, immaturity of the emotional-volitional sphere such as psychophysical infantilism, as well as pedagogical neglect in as a result of unfavorable social and pedagogical conditions in the early stages of a child’s ontogenesis). The difficulties experienced by children with mental retardation may be due to deficiencies both in the regulatory component of mental activity (lack of attention, immaturity of the motivational sphere, general cognitive passivity and reduced self-control) and in its operational component (reduced level of development of individual mental processes, motor disorders , performance disorders). The characteristics listed above do not prevent children from mastering general educational development programs, but they necessitate a certain adaptation to the psychophysical characteristics of the child.

With the timely provision of a system of correctional pedagogical, and in some cases, medical care, it is possible to partially and sometimes completely overcome this developmental deviation.

For the mental sphere of a child with mental retardation, a combination of deficient functions and intact functions is typical. Partial (partial) deficiency of higher mental functions may be accompanied by infantile personality traits and behavior of the child. At the same time, in some cases the child’s ability to work suffers, in other cases - arbitrariness in organizing activities, in others - motivation for various types of cognitive activity, etc.

Mental retardation in children is a complex polymorphic disorder in which different children suffer from different components of their mental, psychological and physical activity.

In order to understand what is the primary disorder in the structure of this deviation, it is necessary to recall the structural-functional model of brain function (according to A. R. Luria). In accordance with this model, three blocks are distinguished - the energy block, the block for receiving, processing and storing information, and the block for programming, regulation and control. The coordinated work of these three blocks ensures the integrative activity of the brain and the constant mutual enrichment of all its functional systems.

It is known that in childhood, functional systems with a short period of development show a greater tendency to damage. This is typical, in particular, for the medulla oblongata and midbrain systems. Signs of functional immaturity are shown by systems with a longer postnatal period of development - the tertiary fields of the analyzers and the formations of the frontal region. Since the functional systems of the brain mature heterochronically, a pathogenic factor that acts at different stages of the prenatal or early postnatal period of a child’s development can cause a complex combination of symptoms, both mild damage and functional immaturity of various parts of the cerebral cortex.

Subcortical systems provide optimal energy tone of the cerebral cortex and regulate its activity. With non-functional or organic inferiority, children experience neurodynamic disorders - lability (instability) and exhaustion of mental tone, impaired concentration, balance and mobility of the processes of excitation and inhibition, the phenomenon of vegetative-vascular dystonia, metabolic and trophic disorders, affective disorders. (10)

Tertiary fields of analyzers refer to the block for receiving, processing and storing information coming from the external and internal environment. The morpho-functional dysfunction of these areas leads to a deficiency of modality-specific functions, which include praxis, gnosis, speech, visual and auditory memory.

The formations of the frontal region belong to the block of programming, regulation and control. Together with the tertiary zones of the analyzers, they carry out complex integrative brain activity - they organize the joint participation of various functional subsystems of the brain for the construction and implementation of the most complex mental operations, cognitive activity and conscious behavior. The immaturity of these functions leads to the emergence of mental infantilism in children, immaturity of voluntary forms of mental activity, and disruption of interanalyzer cortico-cortical and cortico-subcortical connections.

Structural-functional analysis shows that in case of ZPR, both individual above-mentioned structures and their main functions in various combinations can be primarily disrupted. In this case, the depth of damage and (or) the degree of immaturity may vary. This is what determines the variety of mental manifestations found in children with mental retardation. Various secondary layers further enhance within-group dispersion within a given category.

Causes of mental retardation.

The causes of mental retardation are varied. Risk factors for the development of mental retardation in a child can be divided into main groups: biological and social.

Among biological factors, two groups are distinguished: medical-biological and hereditary.

Medical and biological causes include early organic lesions of the central nervous system. Most children have a history of a burdened perinatal period, associated primarily with an unfavorable course of pregnancy and childbirth.

According to neurophysiologists, active growth and maturation of the human brain is formed in the second half of pregnancy and the first 20 weeks after birth. This same period is critical, since the structures of the central nervous system become most sensitive to pathogenic influences that retard growth and prevent the active development of the brain.

Risk factors for intrauterine pathology include:

Old or very young age of the mother,

The mother is burdened with chronic somatic or obstetric pathology before or during pregnancy.

All this can manifest itself in the child’s low body weight at birth, in syndromes of increased neuro-reflex excitability, in sleep and wakefulness disorders, in increased muscle tone in the first weeks of life.

Often, mental retardation can be caused by infectious diseases in infancy, traumatic brain injuries, and severe somatic diseases.

A number of authors identify hereditary factors of mental retardation, which include congenital and, among other things, hereditary inferiority of the child’s central nervous system. It is often observed in children with a delay of cerebral-organic genesis, with minimal brain dysfunction. For example, according to clinicians, 37% of patients diagnosed with MMD have brothers and sisters, cousins, and parents with signs of MMD. In addition, 30% of children with locomotor defects and 70% of children with speech defects have relatives with similar disorders on the female or male side.

The literature emphasizes the predominance of boys among patients with mental retardation, which can be explained by a number of reasons:

Higher vulnerability of the male fetus to pathological influences during pregnancy and childbirth;

A relatively lower degree of functional interhemispheric asymmetry in girls compared to boys, which determines a greater reserve of compensatory capabilities in case of damage to brain systems that provide higher mental activity.

Most often in the literature there are indications of the following unfavorable psychosocial conditions that aggravate mental retardation in children. This:

Unwanted pregnancy;

Single mother or growing up in single-parent families;

Frequent conflicts and inconsistency of approaches to education;

Presence of a criminal environment;

Low level of education of parents;

Living in conditions of insufficient material security and poor living conditions;

Big city factors: noise, long commute to work and home, unfavorable environmental factors.

Features and types of family education;

Early mental and social deprivation of the child;

Prolonged stressful situations in which the child is, etc.

However, a combination of biological and social factors plays an important role in the development of mental retardation. For example, an unfavorable social environment (extra- and intrafamily) provokes and aggravates the influence of residual organic and hereditary factors on the intellectual and emotional development of a child.

Indicators of the incidence of mental retardation in children are heterogeneous. For example, according to the Russian Ministry of Education (1997), among first-graders, over 60% are at risk of school, somatic and psychophysical maladjustment. Of these, about 35% are those who were already diagnosed with obvious neuropsychiatric disorders in the younger groups of kindergarten.

The number of primary school students who cannot cope with the requirements of the standard school curriculum has increased by 2-2.5 times over the past 20 years, reaching 30% or more. According to medical statistics, the deterioration in the health of students over 10 years of study (in 1994, only 15% of school-age children were considered healthy) becomes one of the reasons for the difficulties in their adaptation to school loads. The intense regime of school life leads to a sharp deterioration in the somatic and psychoneurological health of a weakened child.

The prevalence of mental retardation, according to clinicians, ranges from 2 to 20% in the population; according to some data, it reaches 47%.

This scatter is primarily due to the lack of uniform methodological approaches to formulating the diagnosis of mental retardation. With the introduction of a comprehensive medical and psychological system for diagnosing mental retardation, its prevalence rates are limited to 3-5% among the child population. (5;6)

Clinical and psychological characteristics of children with mental retardation.

Clinical characteristics of mental retardation.

Several classifications of mental retardation are presented in the clinical and psychological-pedagogical literature.

The outstanding child psychiatrist G. E. Sukhareva, studying children suffering from persistent school failure, emphasized that the disorders diagnosed in them must be distinguished from mild forms of mental retardation. In addition, as the author noted, mental retardation should not be equated with a retarded rate of mental development. Mental retardation is a more persistent intellectual disability, while mental retardation is a reversible condition. Based on the etiological criterion, that is, the reasons for the occurrence of mental retardation, G. E. Sukhareva identified the following forms:

intellectual disability due to unfavorable environmental conditions, education or behavioral pathology;

intellectual impairments in long-term asthenic conditions caused by somatic diseases;

intellectual impairments in various forms of infantilism;

secondary intellectual disability due to hearing, vision, speech, reading and writing defects;

5) functional-dynamic intellectual disorders in children in the residual stage and late period of infections and injuries of the central nervous system. (25)

Research by M. S. Pevzner and T. A. Vlasova made it possible to identify two main forms of mental retardation

delayed mental development caused by mental and psychophysical infantilism (uncomplicated and complicated underdevelopment of cognitive activity and speech, where the main place is occupied by underdevelopment of the emotional-volitional sphere)

mental retardation caused by long-term asthenic and cerebrasthenic conditions. (18)

V.V. Kovalev identifies four main forms of ZPR. (5)

dysontogenetic form of mental retardation, in which the deficiency is caused by mechanisms of delayed or distorted mental development of the child;

encephalopathic form of mental retardation, which is based on organic damage to brain mechanisms in the early stages of ontogenesis;

Mental retardation due to underdevelopment of analyzers (blindness, deafness, underdevelopment of speech, etc.), caused by the action of the mechanism of sensory deprivation;

Mental retardation caused by defects in education and information deficit from early childhood (pedagogical neglect).

Table. Classification of forms of borderline forms of intellectual disability according to V.V. Kovalev

Classification V.V. Kovaleva is of great importance in the diagnosis of children and adolescents with mental retardation. However, it is necessary to take into account that the author considers the problem of mental retardation not as an independent nosological group, but as a syndrome with various forms of dysontogenesis (cerebral palsy, speech impairment, etc.).

The most informative for psychologists and teachers is the classification of K.S. Lebedinskaya. Based on a comprehensive clinical, psychological and pedagogical study of underachieving primary schoolchildren, the author developed a clinical taxonomy of mental retardation.

Just like the classification of V.V. Kovalev, classification by K.S. Lebedinskaya is based on the etiological principle and includes four main options for mental retardation: (6)

Delayed mental development of constitutional origin;

Delayed mental development of somatogenic origin;

Mental retardation of psychogenic origin;

Delayed mental development of cerebral-organic origin.

Each of these types of mental retardation has its own clinical and psychological structure, its own characteristics of emotional immaturity and cognitive impairment, and is often complicated by a number of painful symptoms - somatic, encephalopathic, neurological. In many cases, these painful signs cannot be regarded only as complicating ones, since they play a significant pathogenetic role in the formation of the ZPR itself.

The presented clinical types of the most persistent forms of mental retardation mainly differ from each other precisely in the peculiarities of the structure and the nature of the relationship between the two main components of this developmental anomaly: the structure of infantilism and the characteristics of the development of mental functions.

Clinical and psychological characteristics of children with mental retardation

Mental retardation of constitutional origin

Delayed mental development of constitutional origin is diagnosed in children with manifestations of mental and psychophysical infantilism. In the psychological literature, it means developmental retardation, manifested by the preservation in adulthood of the physical structure or character traits inherent in childhood.

The prevalence of mental infantilism, according to some authors, is 1.6% among the child population.

Its causes are most often relatively mild brain lesions: infectious, toxic and others, including trauma and fetal asphyxia.

In clinical practice, two forms of mental infantilism are distinguished: simple and complicated. In further studies, four main variants were identified: harmonic (simple), disharmonic, organic and psychogenic infantilism.

Harmonic (simple) infantilism manifests itself in a uniform delay in the pace of physical and mental development of the individual, expressed in the immaturity of the emotional-volitional sphere, affecting the child’s behavior and his social adaptation. The name “harmonic infantilism” was proposed by G.E. Sukhareva. (25; 26)

His clinical picture is characterized by features of immaturity, “childishness” in somatic and mental appearance. Children are 1.5-2 years behind their peers in terms of height and physical development; they are characterized by lively facial expressions, expressive gestures, and fast, impetuous movements. Tirelessness in the game and rapid fatigue when performing practical tasks come to the fore. They especially quickly get bored with monotonous tasks that require maintaining focused attention for quite a long time (drawing, counting, reading, writing). With full intelligence, insufficiently expressed interests in writing, reading, and arithmetic are noted.

Children are characterized by a weak ability for mental stress, increased imitation, and suggestibility. However, by the age of 6-7 years, the child already understands quite well and regulates his behavior depending on the need to perform this or that work.

Children with infantile behavioral traits are not independent and uncritical of their behavior. During lessons they “switch off” and do not complete assignments. They may cry over trifles, but quickly calm down when they switch their attention to a game or something that gives them pleasure. They love to fantasize, replacing and displacing life situations that are unpleasant for them with their fictions.

Disharmonic infantilism may be associated with endocrine diseases. Thus, with insufficient production of adrenal hormones and gonadal hormones at the age of 12-13 years, there may be a delay in puberty in both boys and girls. At the same time, peculiar features of the adolescent’s psyche are formed, characteristic of the so-called hypogenital infantilism. More often, traits of immaturity appear in boys. Teenagers are slow, get tired quickly, and their performance is very uneven - higher in the first half of the day. Memory loss is detected. Attention quickly dissipates, so the student makes many mistakes. The interests of adolescents with the hypogenital form of infantilism are unique: for example, boys are more interested in quiet activities. Motor skills and abilities are underdeveloped, they are clumsy, slow and clumsy. These children have good intelligence and are distinguished by great erudition, but they cannot always use their knowledge in class, as they are very absent-minded and inattentive. They are prone to fruitless discussions on any topic. They are very touchy and painfully experience their failures in school and difficulties in communicating with peers. I feel better in the company of adults, where they are considered erudites. Signs of hypogenital infantilism in the appearance of a teenager are short stature, plumpness, a “moon-shaped” face, and a squeaky voice.

Endocrine forms of infantilism also include pituitary dwarfism (dwarfism). Such children exhibit a combination of signs of an immature child’s psyche with traits of old age, pedantry, and a tendency to reason and teach. School failure is often a consequence of weakness of willpower, slowness, disturbance of attention and logical memory. The child cannot concentrate for a long time and is distracted, which often leads to mistakes in tasks. Slowly learns new material, but having mastered it, he is good at using the rules, the multiplication table, reads at a sufficient pace, and has a good mechanical memory. Children suffering from pituitary dwarfism show some lack of independence and require the care of elders. Sometimes such children experience undesirable reactions: a persistent decrease in mood, sleep disturbances, limited communication with peers, decreased academic performance, and refusal to attend school. If this condition does not go away after a short period of time, you need to contact a neuropsychiatrist.

The neuropathic variant of complicated infantilism is characterized by the presence of weak mental traits. Usually these children are very timid, fearful, dependent, overly attached to their mother, and difficult to adapt to child care institutions. From birth, such children fall asleep with great difficulty and have restless sleep. Timid and shy in nature, they find it difficult to get used to children's groups. They are very passive in class and do not answer questions in front of strangers. In their intellectual abilities they are sometimes ahead of their peers, but they do not know how to demonstrate their knowledge - uncertainty is felt in the answers, which worsens the teacher’s understanding of their true knowledge. Such children often have a fear of giving an oral answer. Their performance is quickly depleted. Infantility also manifests itself in complete practical inability. Motor skills are marked by angularity and slowness.

Against the background of these mental traits, so-called school neuroses may arise. The child is very reluctant to attend school. Any physical illness is greeted with joy, as it provides the opportunity to stay at home. This is not laziness, but a fear of separation from the usual environment, the mother. The difficulty of adapting to school leads to a decrease in the assimilation of educational material, memory and attention deteriorate. The child becomes lethargic and distracted.

Psychogenic infantilism, as a special variant of infantilism, has not been studied enough in Russian psychiatry and psychology. This option is considered as an expression of abnormal personality formation under conditions of improper upbringing. (5) It usually happens in families where there is one child who is cared for by several adults. This often prevents the child from developing independence, will, ability, and then the desire to overcome the slightest difficulties.

With normal intellectual development, such a child learns unevenly, because he is not accustomed to work and does not want to independently complete and check assignments.

Adaptation in a group of this category of children is difficult due to character traits such as selfishness and opposition to the class, which leads not only to conflict situations, but also to the development of a neurotic state in the child.

Particular attention should be paid to children with so-called microsocial neglect. These children have an insufficient level of development of skills, abilities and knowledge against the background of a full-fledged nervous system due to prolonged exposure to a lack of information, not only intellectual, but also very often emotional. Unfavorable conditions of upbringing (with chronic alcoholism of parents, in conditions of neglect, etc.) cause a slow formation of the communicative and cognitive activity of children at an early age. L.S. Vygotsky repeatedly emphasized that the process of formation of a child’s psyche is determined by the social situation of development, which is understood as the relationship between the child and the social reality around him. (2; 3) In dysfunctional families, the child experiences a lack of communication. This problem arises with all its severity at school age in connection with school adaptation. With intact intelligence, these children cannot independently organize their activities: they experience difficulties in planning and identifying its stages, and they are unable to adequately evaluate the results. There is a pronounced lack of attention, impulsiveness, and lack of interest in improving one’s performance. Tasks are especially difficult when they need to be completed according to verbal instructions. On the one hand, they experience increased fatigue, and on the other, they are very irritable, prone to affective outbursts and conflicts.

With appropriate training, children with infantilism are able to receive secondary or incomplete secondary education; they have access to vocational education, secondary specialized education and even higher education. However, in the presence of unfavorable environmental factors, negative dynamics are possible, especially with complicated infantilism, which can manifest itself in mental and social maladaptation of children and adolescents.

So, if we evaluate the dynamics of the mental development of children with infantilism in general, then it is predominantly favorable. As experience shows, the manifestation of pronounced personal emotional-volitional immaturity tends to decrease with age.

Mental retardation of somatogenic origin

The causes of this type of mental development delay are various chronic diseases, infections, childhood neuroses, congenital and acquired malformations of the somatic system. With this form of mental retardation, children may have a persistent asthenic manifestation, which reduces not only the physical status, but also the psychological balance of the child. Children are characterized by fearfulness, shyness, and lack of self-confidence. Children in this category of mental retardation have little contact with their peers due to the guardianship of their parents, who try to protect their children from what they think is unnecessary communication, so they have a low threshold for interpersonal connections. With this type of mental retardation, children need treatment in special sanatoriums. The further development and education of these children depends on their state of health.

Mental retardation of psychogenic origin

Its appearance is due to unfavorable conditions of upbringing and education, which prevent the correct formation of the child’s personality. We are talking about the so-called social genesis, when unfavorable conditions of the social environment arise very early, have a long-term effect, traumatizing the child’s psyche, accompanied by psychosomatic disorders and autonomic disorders. K. S. Lebedinskaya emphasizes that this type of mental retardation should be distinguished from pedagogical neglect, which is largely due to shortcomings in the child’s learning process in kindergarten or school. (6)

The development of the personality of a child with mental retardation of psychogenic origin follows three main options.

The first option is mental instability, which arises as a consequence of hypoprotection. The child is brought up in conditions of neglect. Disadvantages of upbringing are manifested in the absence of a sense of duty, responsibility, and adequate forms of social behavior when, for example, in difficult situations he fails to cope with affect. The family as a whole does not stimulate the child’s mental development and does not support his cognitive interests. Against the background of insufficient knowledge and ideas about the surrounding reality, which prevents the assimilation of school knowledge, these children display features of pathological immaturity of the emotional and volitional spheres: affective lability, impulsiveness, increased suggestibility.

The second option - in which overprotection is expressed - pampering upbringing, when the child is not instilled with the traits of independence, initiative, responsibility, and conscientiousness. This often happens with late-born children. Against the background of psychogenic infantilism, in addition to the inability to exert volition, the child is characterized by egocentrism, reluctance to work systematically, an attitude towards constant help, and the desire to always be looked after.

The third option is an unstable parenting style with elements of emotional and physical violence in the family. Its occurrence is provoked by the parents themselves, who rudely and cruelly treat the child. One or both parents may be oppressive and aggressive towards their own son or daughter. Against the background of such intrafamily relationships, pathological personality traits of a child with mental retardation are gradually formed: timidity, fearfulness, anxiety, indecisiveness, lack of independence, lack of initiative, deceit, resourcefulness and, often, insensitivity to the grief of others, which leads to significant problems of socialization.

Delayed mental development of cerebral-organic origin. The last type of mental retardation among those considered occupies the main place within the boundaries of this deviation. It occurs most often in children and it also causes in children the most pronounced disturbances in their emotional-volitional and cognitive activity in general.

This type combines signs of immaturity of the child’s nervous system and signs of partial damage to a number of mental functions. She identifies two main clinical and psychological options for mental retardation of cerebral-organic origin.

In the first option, traits of immaturity in the emotional sphere, such as organic infantilism, predominate. If encephalopathic symptoms are noted, they are represented by mild cerebrasthenic and neurosis-like disorders. Higher mental functions are insufficiently formed, depleted and deficient in the control of voluntary activity.

In the second option, symptoms of damage dominate: “there are persistent encephalopathic disorders, partial disorders of cortical functions and severe neurodynamic disorders (inertia, tendency to perseveration). The regulation of the child’s mental activity is disrupted not only in the area of ​​control, but also in the area of ​​programming cognitive activity. This leads to a low level of mastery of all types of voluntary activities. The child’s development of object-manipulative, speech, play, productive and educational activities is delayed.

The prognosis of mental retardation of cerebral-organic origin largely depends on the state of higher cortical functions and the type of age-related dynamics of its development. As noted by I.F. Markovskaya, with the predominance of general neurodynamic disorders, the prognosis is quite favorable. (11) When they are combined with a pronounced deficiency of individual cortical functions, massive psychological and pedagogical correction is required, carried out in a specialized kindergarten. Primary persistent and extensive disorders of programming, control and initiation of voluntary types of mental activity require distinguishing them from mental retardation and other serious mental disorders.

Differential diagnosis of mental retardation and similar conditions

Many domestic scientists have dealt with the issues of differential diagnosis of mental retardation and similar conditions (M. S. Pevzner, G. E. Sukhareva, I. A. Yurkova, V. I. Lubovsky, S. D. Zabramnaya, E. M. Mastyukova, G. B. Shaumarov, O. Monkyavichene, K. Novakova and others).

In the early stages of a child’s development, it is difficult to distinguish between cases of severe speech underdevelopment, motor alalia, mental retardation, mutism and delayed speech development.

It is especially important to distinguish between mental retardation and mental retardation of cerebral-organic origin, since in both cases children have deficiencies in cognitive activity in general and a pronounced deficiency of modality-specific functions.

Let us dwell on the main distinguishing features that are significant for distinguishing between mental retardation and mental retardation.

1. Disorders of cognitive activity in mental retardation are characterized by partiality and patchiness in the development of all components of the child’s mental activity. With mental retardation, there is a totality and hierarchy of disturbances in the child’s mental activity. A number of authors use the definition of “diffuse, diffuse damage” to the cerebral cortex to characterize mental retardation.

2. In comparison with mentally retarded children, children with mental retardation have much higher potential for the development of their cognitive activity, and especially higher forms of thinking - generalization, comparison, analysis, synthesis, distraction, abstraction. However, it must be remembered that some children with mental retardation, like their mentally retarded peers, find it difficult to establish cause-and-effect relationships and have imperfect generalization functions.

3. The development of all forms of mental activity in children with mental retardation is characterized by spasmodic dynamics. While this phenomenon has not been experimentally identified in mentally retarded children.

Unlike mental retardation, in which the mental functions themselves suffer - generalization, comparison, analysis, synthesis - with mental retardation, the prerequisites for intellectual activity suffer. These include such mental processes as attention, perception, the sphere of images and representations, visual-motor coordination, phonemic hearing and others.

When examining children with mental retardation in conditions that are comfortable for them and in the process of targeted education and training, children are capable of fruitful cooperation with adults. They accept the help of an adult and even the help of a more advanced peer well. This support is even more effective if it is in the form of play tasks and is focused on the child’s involuntary interest in the activities being carried out.

Playful presentation of tasks increases the productivity of children with mental retardation, while for mentally retarded preschoolers it can serve as a reason for the child to involuntarily slip from completing the task. This happens especially often if the proposed task is at the limit of the capabilities of a mentally retarded child.

Children with mental retardation have an interest in object-manipulative and play activities. The play activity of children with mental retardation, in contrast to that of mentally retarded preschoolers, is more emotional in nature. Motives are determined by the goals of the activity, the correct ways to achieve the goal are chosen, but the content of the game is not developed. It lacks its own plan, imagination, and the ability to imagine the situation mentally. Unlike normally developing preschoolers, children with mental retardation do not move to the level of story-based role play without special training, but “get stuck” at the level of story-based play. At the same time, their mentally retarded peers remain at the level of object-game actions.

Children with mental retardation are characterized by greater intensity of emotions, which allows them to concentrate for a longer period of time on completing tasks that arouse their immediate interest. Moreover, the more the child is interested in completing the task, the higher the results of his activity. A similar phenomenon is not observed in mentally retarded children. The emotional sphere of mentally retarded preschoolers is not developed, and excessively playful presentation of tasks (including during a diagnostic examination), as already mentioned, often distracts the child from solving the task itself and makes it difficult to achieve the goal.

Most children with mental retardation of preschool age are proficient in visual arts to varying degrees. Mentally retarded preschoolers do not develop visual activity without special training. Such a child stops at the level of prerequisites for object images, i.e., at the level of scribbling. At best, some children have graphic stamps - schematic images of houses, “cephalopod” images of a person, letters, numbers, randomly scattered across the plane of a sheet of paper.

The somatic appearance of children with mental retardation generally lacks dysplasticity. While in mentally retarded preschoolers it is observed quite often.

The neurological status of children with mental retardation usually does not show gross organic manifestations, which is typical for mentally retarded preschool children. However, even in children with delay, neurological microsymptoms can be seen: a venous network expressed on the temples and bridge of the nose, slight asymmetry of facial innervation, hypotrophy of individual parts of the tongue with its deviation to the right or left, revitalization of tendon and periosteal reflexes.

Pathological hereditary burden is more typical for the history of mentally retarded children and is practically not observed in children with mental retardation.

Of course, these are not all the distinctive features taken into account when distinguishing between mental retardation and mental retardation. Not all of them are equal in importance. However, knowledge of these above-mentioned signs allows one to clearly differentiate both conditions under consideration.

Sometimes it is necessary to differentiate between mental retardation and mild organic dementia. With mental retardation, there is no such disorder in activity, personal disintegration, gross uncriticality and complete loss of functions that are observed in children with organic dementia, which is a differential sign.

Particular difficulties arise in distinguishing between mental retardation and severe speech disorders of cortical origin (motor and sensory alalia, early childhood aphasia). These difficulties are due to the fact that in both conditions there are similar external signs and it is necessary to identify the primary defect - whether it is a speech disorder or intellectual disability. This is difficult, since both speech and intelligence belong to the cognitive sphere of human activity. In addition, in their development they are inextricably linked with each other. Even in the works of L. S. Vygotsky, when indicating the age of 2.5-3 years, it is said that it is during this period that “speech becomes meaningful, and thinking becomes verbal.” (2; 3)

Therefore, if a pathogenic factor acts during these periods, it always affects both of these areas of the child’s cognitive activity. But even in the early stages of a child’s development, a primary lesion can delay or disrupt the development of cognitive activity as a whole.

For differential diagnosis, it is important to know that a child with motor alalia, unlike a child with mental retardation, has extremely low speech activity. When trying to make contact with him, he often shows negativism. In addition, it must be remembered that with motor alalia, sound pronunciation and phrasal speech suffer the most, and the ability to assimilate the norms of the native language is persistently impaired. Communication difficulties in a child increase more and more as, with age, speech activity requires increasing automation of the speech process. (13)

Difficulties for diagnosis are the distinction between mental retardation and autism. A child with early childhood autism (ECA), as a rule, has impaired all forms of preverbal, nonverbal and verbal communication. Such a baby differs from a child with mental retardation in his inexpressive facial expressions, lack of eye contact (“eye to eye”) with the interlocutor, excessive timidity and fear of novelty. In addition, in the actions of children with RDA, there is a pathological stuckness on stereotypical movements, a refusal to act with toys, and an unwillingness to cooperate with adults and children.

Conclusion. Mental retardation (MDD) is one of the most common forms of mental disorders. This is a violation of the normal pace of mental development. The term “delay” emphasizes the temporary nature of the disorder, that is, the level of psychophysical development as a whole may not correspond to the child’s passport age.(1)

Specific manifestations of mental retardation in a child depend on the causes and time of its occurrence, the degree of deformation of the affected function, and its significance in the overall system of mental development.

Thus, we can identify the following most important groups of reasons that can cause PPD:

Biological reasons that prevent normal and timely maturation of the brain;

A general lack of communication with others, causing a delay in the child’s assimilation of social experience;

Lack of full-fledged, age-appropriate activities that give the child the opportunity to effectively “appropriate” social experience and timely formation of internal mental actions;

Social deprivation that prevents timely mental development.

All deviations in such children from the nervous system are variable and diffuse and are temporary. Unlike mental retardation, with mental retardation, the intellectual defect is reversible.

This definition reflects both biological and social factors of the emergence and development of such a state in which the full development of the organism is hampered, the formation of a personally developed individual is delayed, and the formation of a socially mature personality is ambiguous.