Methods for diagnosing the state of fine motor skills in preschool children

Methods for diagnosing voluntary motor activity in children 1185

Currently, attention is drawn to the increased number of children with partial immaturity of higher mental functions (HMF). The same picture is noted by other specialists [7]. Modern diagnostic and correctional work pays little attention to motor activity, despite its importance for the subsequent development of the child in ontogenesis. From the first days of a child’s life, the child’s motor activity should develop intensively. The condition for the normal development of motor function is its formation according to certain laws of movement development, determined by the healthy functioning of the central nervous system in ontogenesis. Basic motor skills are developed sequentially and in stages. In order for any motor function to fully function, the child needs to go through several stages of its development. In the process of mastering each subsequent stage in the development of any mental function, the foundation of subsequent stages is laid. Thus, a missed or not fully completed stage knocks out a certain link from the basis of future functions, which is subsequently manifested by functional insufficiency of the motor sphere

In the process of development of a child’s motor functions, the sequence of stages does not follow clearly one after another. Partial layering of stages may occur. Continuing to develop a certain motor skill, the child begins to master the next one. The formation of a child’s motor skills at the initial stages of development is characterized by general undifferentiated movements, subsequently their differentiation and isolation occurs. Coordination of motor acts in the process of child development is improved from top to bottom, starting from the head, then from the head to the arms, from the arms to the torso and legs. Therefore, control over movements and position of the head is formed earlier than control over movements of the legs (for example, holding the head by an infant). The development of motor functions during the normal development of a child proceeds from the center to the periphery - from proximal to distal parts of the body. For example, control of shoulder movements becomes possible earlier than control of finger movements. Thus, insufficient development of gross motor skills is usually accompanied by impaired development of fine motor skills. All kinds of muscle disorders and tension in larger muscles or muscle groups will hinder the successful development of fine motor skills and the child’s mastery of writing, drawing, etc.

The brain support for the development of the motor sphere is characterized by a level structure. According to the works of N.A. Bernstein [1] there are five cerebral levels of movement construction. Each level has a specific morphological localization, afferentation and efferentation; dysfunction of each level is manifested by certain pathological manifestations. By the time of birth, the child’s brain is a substrate with a certain functional readiness. For its normal development, a continuous flow of information from the outside is necessary. The development of a child’s motor activity is closely related to other higher mental functions, such as spatial perception and ideas, speech, object-based activity, etc. Children may lose motivation for games and any other activity as a result of movement disorders. However, many perinatal disorders cause subsequent dysfunction of basic motor skills, which often remains unnoticed, but leads to partial immaturity of the HMF [6].

Until now, the basis of existing domestic and foreign methods for diagnosing voluntary motor activity is the method of N.N. Ozeretsky [4]. Some of these tests were included in the classic neuropsychological examination of A.R. Luria. The revised technique is used in the Lincoln–Ozeretsky scale [10], the Ozeretsky–Gelnitz technique (Germany). There is a method by N.P. Wiseman [2] taking into account the level theory of movement construction. Its modification was proposed by I.F. Markovskaya [5] for the study of children with mental retardation. Indicators of gross motor skills are used in the Bruininks Oseretsky test [4]. There are M-ABC tests [9]. As a result, the question arises about additional diagnostics of the child’s voluntary motor activity, which can complement the classical examination methods that have become widely known, and will not be familiar to the child.

The assessment of voluntary motor activity in the version we propose does not imply the use of special test materials, i.e. it can be carried out in almost any conditions, which is undoubtedly an important fact. Features of the tests include the use of a different set of tasks for the right and left hands and makes it possible to remove the influence of learning in the diagnostic process.

Description of samples.

The examination begins with the child's dominant hand. The position of the experimenter and the child during the examination is strictly opposite each other. After each test, the hands of the experimenter and the child return to their original position - hands on the table in front of them, hands straightened, back side up.

1. Kinesthetic praxis.

1.1. Repeating the position of the fingers according to a visual model. The child is offered three tests for each hand: for the left hand, the position of the fingers – a ring of fingers 1-2, 2-3 extended, a ring of fingers 1-4; for the right hand, the position of the fingers is the Latin letter V from fingers 2-3, fingers 2-4 extended, a ring of fingers 1-3.

Difficulties in performing tests are associated with possible functional disorders or immaturity of the parietal and prefrontal cortex. Errors in execution include unclear reproduction of a pose, replacement of fingers, difficulties in motor reproduction and holding a pose. The test can be offered to children from 3 years of age. The full sample is available from 5 years of age.

1.2. Repeating the position of the fingers according to a tactile pattern. The child closes his eyes, after which the fingers of his hand are given a certain position. Next comes the “removal” of the pose. The child must reproduce the position of the fingers on the same hand. Two samples are offered for each hand. For the left hand, the position of the fingers is - finger 2 is extended, if performed satisfactorily, the fingers are folded in a cross 2 by 3. For the right hand, the positions of the fingers are - finger 5 is extended, if performed satisfactorily, the fingers are folded in a cross 3 by 2.

Difficulties in performing are associated with a violation of the body diagram and express the interest of the parietal lobes of the cortex. The first test is available for children from 4 years of age. The full sample is available to children from 7 years of age.

1.3. Test with transferring the position of the fingers from one hand to the other. Transfer from the left hand to the right. The position of the fingers of the left hand is fingers 2-5 extended. Transfer from right hand to left. The position of the fingers of the right hand is fingers 1-5 extended.

This test is sensitive to the immature joint work of the brain hemispheres. Possible mistakes include replacing fingers, repeating familiar movements. The full test is available for children from 5.5 years of age. At an earlier age, the percentage of complete successful completion reaches 50% in children 4 - 4.5 years old, 10% in children aged 3-4 years. In sample 1.3. 35% and 5% respectively.

Table 1.

2. Study of the spatial organization of movement.

2.1. Following the example. The child must repeat the poses proposed by the experimenter, and the child’s right hand must reproduce the position of the psychologist’s right hand. A) The right arm is bent at the elbow and directed vertically upward. B) The left arm is bent at the elbow, directed vertically upward, the right arm is bent at the elbow, directed to the left and the fingertips touch the left hand in the middle of the forearm. C) The left hand with a straightened hand is directed towards the child, with the thumb raised up touching the chin. D) The right arm is bent at the elbow, the hand is turned towards the experimenter and touches his chin with the fingertips. D) The left hand touches the right ear.

Errors in execution include searching for a pose, mirror reproduction of a pose, incorrect spatial positioning of hands, unclear reproduction of a pose, and violation of the intersection of the midline of the body. In these cases, errors are characteristic of impaired functioning or immaturity of the parieto-occipital regions, frontal regions and immaturity of interhemispheric interactions. The test is performed by children from 5 years of age.

2.2. Reproduction of hand poses according to verbal instructions.

A) Touch your left ear with your right hand. B) Stretch your arms forward and turn them palms up.

Possible errors are a violation of right-left perception, misunderstanding of the spatial organization of movement according to speech instructions. Difficulties relate to the immaturity of the frontal and parieto-occipital areas of the cortex. The test is performed by children aged 5.5 years. Before this age, the percentage of correct performance of these tests is 25-40% for children 4-4.5 years old and 5-10% for children 3-4 years old.

Table 2.

3. Test of serial movement organization. Starting position: the child’s hands are on the table. One hand is turned palm up and clenched into a fist. The other hand lies palm down with the wrist straightened. Next, there is a simultaneous change in the position of the hands. Initially, a specialist shows the sample 3-5 full cycles. The child reproduces the sequence of movements shown from memory.

This test allows you to identify violations of reciprocal coordination, spatial and serial organization of movement. Failure of the movement program in the test (perseverations, unnecessary movements), blurred execution during memorization and demonstration indicates the immaturity of the frontal and parietal parts of the left hemisphere. If the spatial organization of movement is incorrect, there may be disruptions in the functioning of the parieto-occipital cortex. Difficulties in simultaneously changing the position of the hands may be associated with functional disorders of the corpus callosum and immaturity of interhemispheric interactions. Clear temporal, sound, spatial separation is characteristic of brainstem dysfunctions and disruption of cortical-subcortical interactions. The test is performed by children from 5.5 years old. The full sample is available from 6.5 years of age. Before this age, the percentage of correct execution for children 3-4 years old is 20%, 4-4.5 years old – 45%.

Table 3.

4. Test of opposing the thumb to other fingers in turn. The left hand, the right hand, and both hands are examined separately. For children from 8 years old, finger numbering is introduced. The complicated second stage of this test involves performing a listening task with eyes closed, while the child is guided by the number of a finger called a specialist.

Possible disorders may be associated with functional disorders of the cerebellum, as well as the premotor cortex. With a more complicated version of the test, difficulties in performing it may be associated with the functional immaturity of the frontal, temporal, parietal zones of the cerebral cortex, and memory impairment. The first part of the test is fully stable and available in children from 5 years of age. The second part of the test is available to children from 7.5 years old.

Table 4.

5. Simultaneously connect the tips of the opposite fingers with strong pressure. The test is aimed at studying spatial organization, accuracy and planning of movement, assessing the tone and muscle strength of the fingers, and identifying synkinesis. Possible errors when performing the test are difficulties in simultaneously joining the fingers, inaccurate touch, violation of the symmetry of the posture, tension in the facial muscles.

The test is sensitive to the immaturity of interhemispheric interaction (violation of conjugal movements of the hands), deficiency of stem structures (tonic disorders), disorders of the parietal-occipital zones (missing fingers), frontal cortex (failure to maintain a given pose). The test is available to children from 4 years of age.

Table 5.

6. Study of postural praxis and posture retention. In the test, the child must reproduce the pose specified by the experimenter. Starting position - the child stands with his eyes closed. The experimenter places the child's hands in the following position: the left arm is extended to the side, bent upward at a right angle, the hand is bent and the fingertips are directed at the corner of the child's eye (Level 1), without touching it; the right arm is extended to the side, bent, the hand is bent and the fingertips are directed at the child’s earlobe without touching it (Level 2). After 10 seconds, on command, the child lowers his hands and opens his eyes. Next, the child must reproduce the indicated pose. This is followed by the instruction: “Stay like that, please don’t move. I need to make a recording." After some time, the command to cancel the hold of the pose follows.

The test is aimed at identifying awareness of the body diagram, spatial organization of movement, the ability to maintain a given pose, the ability to maintain a given program, and the ability to work according to verbal instructions. Possible execution errors when reproducing the pose: the child cannot reproduce the pose, refusal to perform, the child’s hands are on the same line above the head, when reproducing the pose, the hands are straightened, the child’s hands are on the same line between levels 1 and 2, the directions of the hands are not maintained clearly. When studying posture retention, the time for children to clearly maintain a pose without learning difficulties was more than 30 seconds. Possible errors when holding a pose are body rotations, relaxation of the hands, loss of accuracy of the pose, “sliding down” of the pose, loss of the pose.

This test reveals neurodynamic disorders (stem and cortico-subcortical connections), immaturity of the parietal, fronto-parietal parts of the cortex. The full sample is available to children from 5 years of age. The time of holding the pose in children 3-5 years old is up to 5 s; 5-6 years up to 10 s.; 7-8 years – up to 15 s.; from 8 years over 30 s.

Table 6.

7. Walking on command - a) on toes; b) on the heels; c) forward, placing the heel to the toe and maintaining the direction of movement.

The test is aimed at identifying difficulties in gross motor skills, “immaturity” of movement, impulsivity, difficulties in following instructions, identifying uneven distribution of muscle tone, and imbalance. Possible causes are deficiency of stem structures, cerebellar disorders. Possible mistakes are tense arm movements, lack of coordination of arm movements when walking, inability to walk in a straight line, inability to maintain balance, running instead of walking, difficulty starting movement on command. The full sample is available from 5.5 years. Up to this age, the percentage of correct execution for children 3-4 years old is 35%.

Table 7.

8. Test of following a finger. The index finger of the child’s leading hand is brought to the specialist’s index finger, the distance between the fingers is 2-3 cm. The child leads his hand, repeating the direction of the experimenter’s movement and maintaining a given distance. The head is held in the midline of the body.

The test is aimed at identifying impulsivity, difficulties in spatial organization of movement, the ability to work according to instructions, retention of instructions, features of hand-eye visual-motor coordination, assessment of the breadth of the visual field, accuracy of movement, additional determination of the leading hand. Possible mistakes are uneven distance between fingers, failure to maintain a given distance, turning the head after the finger, slipping of the gaze, difficulty holding the hand, violation of instructions. Possible violations relate to the peculiarities of the functioning of the occipital-parietal parts of the cortex in the presence of visual-motor errors and to the immaturity of the functions of the frontal parts in case of violation of instructions and impulsivity. The full sample is available to children from 8 years of age. Before this age, the percentage of correct execution for children 3-4 years old is 10%, 4-4.5 years old – 40%.

Table 8.

All samples can be assessed qualitatively and quantitatively. Quantitative assessment of performance in points occurs according to standard criteria: “0” - correct performance without additional explanations; “1”—minor errors are corrected practically without the participation of the experimenter; “2” - the task is completed after several attempts and prompts; “3” - the task is not available even after clarification.

Thus, in our work we use diagnostic tests composed of the most indicative neurological and neuropsychological tests, supplemented by original samples selected during practical work with children.

All tests do not require special equipment, are quick to perform, and are easily and interestingly perceived by children. They provide fairly accurate opportunities for assessing the state of the child’s praxis and the brain zones involved, for targeted identification of zones for more detailed subsequent examination. They can be used to predict a child’s possible difficulties in learning, and their use makes it possible to outline the direction of subsequent correctional work. Samples are not used in widespread practice and are not familiar to the child. They do not involve the use of special test materials; they can be carried out under any conditions.

Currently, there are several approaches to the study of motor skills: metric, neuropsychological, psychological-pedagogical, clinical.

The metric approach to the study of the motor sphere of children is most fully reflected in the methodology of N. I. Ozeretsky. In a series of works (1923-1929), he proposed and tested various versions of the motometric scale, including a method for mass assessment of motor skills, and in a joint monograph with M. O. Gurevich (1930), the scale was formulated in its final form and is intended for studying the psychomotor skills of children from 4 to 16 years old. The scale has, respectively, thirteen age series of tests of increasing complexity, each of which consists of six tests that allow you to study various components of psychomotor skills: static coordination, dynamic coordination of the body and arms, speed of movements, simultaneity of movements, clarity of their execution (absence of synkinesis). The entire scale has 78 tests of varying structure and complexity.

The method of N. I. Ozeretsky was modified several times by individual foreign researchers in accordance with the specifics of national health care systems, education, etc. Currently, the most popular are the American modification by W. Slowen and the German one by G. Gelnitsa.

In 1948, V. Slouen, later a leading psychologist at the Lincoln School in Illinois, presented his adaptation of N. I. Ozeretsky's tests. The Lincoln-Ozeretsky scale contained 46 items. Four tests were introduced by V. Slouen, the rest belonged to N. I. Ozeretsky, of which four tasks were slightly modified.

In 1955, V. Slouen made a second edition of the scale and provided guidance on its use. In the final version, the scale was “revised and newly standardized tests by N. I. Ozeretsky with simplified instructions and improved methods for assessing results” (A. Anastasi. Psychological testing: Book 1. - M. Pedagogy, 1982, p. 238). This time ten more tasks of N.I. Ozeretsky were excluded. An examination by V. Slowen (1955) of mentally retarded and normally developing children on this scale revealed significant differences in their motor skills.

The German modification of the N.I. Ozeretsky scale did not contain such significant modifications. It reduces the complexity of some tests, some of the tasks are formulated in a simpler and more accessible form (especially for the mentally retarded) without changing the content of the tasks.

The Ozeretsky-Gelnitsa technique was used by E. V. Shaginyan (1973) to identify the psychomotor characteristics of children and adolescents in the general population. In this work, the scale was subjected to statistical processing and validity testing, the need for which was dictated by the large gap between the time of its creation and this use. Analysis of the scale demonstrated full compliance of the methodology with modern textual criteria. The test showed that the scale accurately reflects the level of motor development of the subjects: the value of motor age obtained as a result of testing reveals a high degree of correlation with the value of the passport age of normally developing children. A study by E.V. Shaginyan, conducted with normal children and children with encephalopathy from five to fifteen years of age, showed that the scale can be recommended for diagnosing motor disorders and characterizing the motor sphere of children and adolescents.

When studying the motor skills of children with developmental disabilities, the metric approach is widely used. Moreover, different modifications of motor tests are used for different categories of children.

Thus, N.P. Wiseman (1976) proposed using N.A. Bernstein’s level theory of movement construction to study the psychomotor skills of mentally retarded children. He drew up a scheme for examining motor skills, consisting of 12 tests. Each test is aimed at studying the participation of one or another cerebral level of movement control in a given motor act. Using these tests, one can judge simultaneously the components and level of organization of movements, as well as motor qualities. When interpreting data, the level theory of movement construction is used and, in the aspect of the level theory, the afferent (sensitive) structure of any motor test is analyzed. This research technique allows us to identify qualitative disorders of psychomotor function in oligophrenics.

The neuropsychological approach to the study of motor skills is most fully reflected in the widely used scheme of neuropsychological research by A. R. Luria (1973), which presents an entire section on the study of movements and actions. According to many authors, the method of A. R. Luria currently represents the most complete neuropsychological examination, which, according to T. A. Vlasova and M. S. Pevzner (1975) is “essentially a subtle neurology of the cerebral foundations of higher cortical functions” and allowing us to establish “not only a functional “map” of the pathology, but also intact links on which the teacher can rely in correctional work.”

In the neuropsychological method of A. R. Luria, movements and actions are studied using various tests, mainly related to hand movements.

A. R. Luria (1962, 1969) emphasized in his works the exceptional importance for human activity of hand movements, which have a particularly fine cortical organization. The greater the functional significance of an organ, the richer its connections and the greater its participation in the system of voluntary movements, the larger the area occupied by its projection in the cerebral cortex. Individual areas of the body are represented in the primary fields of the cortex in proportion not to their size, but to their physiological significance. For example, in the cutaneous-kinesthetic zone, the greatest extent is the areas where the skin and muscle receptions of the fingers and hands are projected, characterized by the most pronounced ability to distinguish the smallest stimuli. The projection of the fingers occupies approximately a third of the entire motor projection area. The organs of the speech apparatus also occupy a larger place in the cortical projections compared, for example, with the body as a whole.

The neuropsychological technique of A. R. Luria, developed for adults, was modified by many authors to study children and adolescents, both normally developing and those with developmental disabilities.

The use of the neuropsychological method in the study of children with mental retardation is considered by I. F. Markovskaya (1995).

As is known, with a mild degree of cerebral insufficiency, we are often talking not about the oligophrenic structure of the defect, but about the deficiency of individual “prerequisites” of intelligence: perception, memory, attention, speech, etc. Therefore, to study the cognitive activity of children with mental retardation of cerebral-organic origin I. F. Markovskaya considers this method to be the most adequate, since it allows one to analyze the state of gnosis, praxis, speech, mnestic-intellectual, as well as higher regulatory functions that provide arbitrary forms of mental activity. In the study by I.F. Markovskaya, a modification of the neuropsychological technique was used, which included quantitative and qualitative analysis. Unlike neuropsychological techniques used in the clinic of local brain lesions in adults (A. R. Luria, 1973), it takes into account the infantile characteristics of children with mental retardation. All tasks are presented in a playful form, since play is the main model of a child’s activity. Studies by many authors (E. Heisserman, 1964; B.V. Zeigarnik, 1973; R.A. Kharitonov, 1978, etc.) show that in a child psychiatric clinic, play-based psychological techniques are of particular importance, facilitating the establishment of contact with a sick child and revealing its potential.

Based on the scheme of neuropsychological research (edited by A. R. Luria, 1973), the author provides a list of tasks used in the neuropsychological study of children with mental retardation of primary school age.

The study of movements and actions in the work of I. F. Markovskaya is represented by the following tasks:

– Analysis of elementary components of movements;

– Detection of synkinesis (Zazzo tests);

– Optical-kinesthetic organization of movements (tests for praxis postures);

– Visually – spatial organization of movements (Head’s test);

– Dynamic organization of a motor act (“fingering”, reciprocal coordination of movements, “asymmetrical tapping”, graphic tests);

– Hearing – motor coordination;

– Constructive praxis;

– Execution of motor programs (graphic tests, rhythmic sequences, conditioned motor reactions).

The completion of each task is assessed using qualitative and quantitative characteristics. In a qualitative analysis of the state of higher cortical functions, I. F. Markovskaya suggests identifying the leading factor that complicates the implementation of a given psychological operation:

– neurodynamic disorders;

– violations of higher forms of regulation;

– — partial impairment of modality-specific cortical functions.

When determining the criterion for qualitative and quantitative assessment, the author proceeds from the varying degrees of severity of the identified indicators of violations of higher cortical functions. For this purpose, a five-point rating scale has been developed. When describing the content of each score, the characteristics of neurodynamic and regulatory disorders are combined.

Thus, the technique presented by I.F. Markovskaya allows not only to determine the degree of partial violations of modality-specific mental functions in children with mental retardation, but also those general nonspecific disorders of brain activity, reflecting the discoordination of cortico-subcortical functional relationships, which also cause learning difficulties for children this category. This is important not only for clarifying the structure of cognitive impairment in a child, but is also extremely important when addressing issues of prognosis and individualization of psychological and pedagogical correction.

The psychological and pedagogical approach to the study of the motor sphere of children involves the use of basic and additional research methods for a more complete and adequate assessment of the development of the child’s mental functions, including motor ones (O. N. Usanova, 1995; S. D. Zabramnaya, 1995; E. M. Mastyukova, 1997; E. A. Strebeleva, 1998, etc.).

The observation method is one of the main ones when studying children with developmental disabilities (S. D. Zabramnaya, 1995).

N. S. Zhukova and E. M. Mastyukova (1993) in their work “If your child is lagging behind in development” give advice to parents and teachers on monitoring the development of a child in early and preschool age, and also describe the standards for the normal mental development of a child from 0 to 6 years.

Speaking about the development of movements, the authors emphasize the need to monitor the development of a child’s motor functions from the first months of life. If a child in the first year of life has a pronounced lag in the development of motor skills, especially when combined with an increase in muscle tone, the presence of violent movements, the authors advise parents to be sure to show the child to a pediatric neurologist. The need to be especially attentive is emphasized when the development of the child’s motor skills occurred normally, and then, by the age of 9-12 months, movement disorders began to appear in the form of low muscle tone, impaired coordination of movements with a gradual loss of motor activity, since such conditions are characteristic of many diseases of the nervous system. systems.

The authors note that many children with developmental disabilities have significantly delayed development of joint functioning of the hand and eye (visual-motor coordination) and motor activity of the hands.

When directly studying a child during a psychological and pedagogical examination, observation begins from the first moment of meeting the child and continues throughout the entire duration of the examination. Observation must be carried out purposefully, its materials must be recorded (S. D. Zabramnaya, 1995).

His general appearance can tell a lot about a child. This is his posture, gait, coordination of movements, gaze, facial expressions, etc. With many developmental disorders, the child’s appearance is often unfavorable. An expressionless, mask-like, amicable face is noted as deviations from the normal appearance; the presence of asymmetry and dysplasticity; lack of gaze fixation, wandering gaze; salivation; strabismus; irregular shape or non-standard size of the head; Impaired accuracy and coordination of movements when walking. Deviations from normal appearance may indicate the presence of developmental disorders.

E. M. Mastyukova (1997) also notes the importance of the teacher learning to professionally assess the child’s appearance, identifying micro- or macrocephaly, the presence of obesity, etc.

When examining children of preschool and primary school age, observing the child’s play is of great importance. Among other things, during the game all the shortcomings in the child’s motor development are revealed. You can see features of both fine and gross motor skills.

In children with organic lesions of the nervous system, there is a lag in the development of manipulative function (N. S. Zhukova, E. M. Mastyukova, 1993). Hand movements are poorly coordinated, inaccurate, the child is awkward, tries to grab an object with the whole hand, and tenses up. In some forms of mental pathology, a child may not show interest in toys, but prefer to “play” with his hands, making monotonous, monotonous movements with them in his field of vision.

S. D. Zabramnaya (1995) devotes a significant place when studying a child to observing his play. She notes the need to monitor the coordination of movements during the manipulations performed by the child, the state of motor skills,

E. M. Mastyukova (1997) also notes the need to observe the child’s free play and activity. It is important to pay attention to the characteristics of the child’s behavior, the development of his motor skills and speech, noting the stability of his gait, the specifics of manipulative activity of the hands, the presence of violent movements, and assessing the leading hand.

Particular attention is paid to the child’s behavior, contact, the adequacy of his facial expressions and gestures. Attention is drawn to the child’s increased exhaustion and satiety during spontaneous play, and reactions to approvals and comments are assessed.

When studying the motor skills of children with developmental disorders of preschool age, additional methods are also important: collecting anamnestic data, studying the child’s documentation, talking with parents, studying the products of the child’s activity, etc.

E. M. Mastyukova (1997) speaks about the need for a thorough study of the anamnesis. Pedagogical diagnosis should be preceded by the teacher’s familiarization with anamnesis data regarding the child’s development, starting from the first months of life. It is known that various adverse effects, both in the prenatal period and during childbirth (trauma, asphyxia), as well as in the first years of a child’s life, can lead to deviations in mental development. When assessing the medical history, it is important to pay attention to hereditary pathology in the family, to note the possibility of adverse effects on the development of the child of various harmful factors during intrauterine development or after birth. You should carefully read the medical examination data.

Subsequently, all this information can make an invaluable contribution not only in qualifying the structure of violations, but also in determining ways of pedagogical correction.

Many authors point to the need to study early psychomotor development and the formation of self-care skills (O. N. Usanova, E. M. Mastyukova, N. S. Zhukova, S. D. Zabramnaya, etc.).

As a rule, the most complete information about early psychomotor development and the formation of self-service skills in a child can be gleaned from a conversation with parents, teachers and other persons involved in raising the child,

The study of the development of motor skills and self-care skills, notes O. N. Usanova (1990), is focused on diagnostics and the use of the data obtained to substantiate the pedagogical process. Characteristics of the level of self-care are one of the important indicators of the general mental and motor development of the child, and also play an important role in determining the possibility of enrolling the child in a special educational institution. When talking with parents, it is important to find out at what age the child learned to undress and dress himself, wash his hands, put away his toys, use cutlery, etc., and how quickly and skillfully he does this. A particularly indicative factor is the child’s activity in achieving self-service results (whether the child asks for help when he can’t cope on his own; whether he takes part in certain operations available to him; whether he is persistent or quickly stops trying to act). Parents often report that self-care skills have been developed with significant assistance from adults. By comparing this information with the results of further examination, one can get an idea of ​​the pace of formation and transfer of these skills in the child and the impact of motor difficulties on the development process.

From a conversation with parents you can also learn about the early development of the child. It is necessary to remember that the assessment of the level of psychomotor development of a child in early and preschool age should be differentiated, taking into account the features of the development of gross motor skills, fine motor skills of the hands, visual-motor coordination, perception, speech, as well as socio-emotional development (N.S. Zhukova, E.M. Mastyukova, 1993). A conversation with parents can be quite informative, but any information received from parents is considered reliable if it is confirmed in documents or during examination of the child.

Therefore, the study of documentation is an integral part in assessing a child’s motor development. It is necessary to analyze medical documentation (medical record or extract from it, conclusions of specialists, results of laboratory and instrumental studies, etc.). By analyzing the documentation, you can obtain valuable information about the child: an indication of the causes of the lesion, the clinical diagnosis and the time of its establishment, features of psychomotor development in the first year of life, changes in diagnosis as the child develops, time and place of treatment, the most effective types of treatment, etc.

When studying pedagogical documentation (characteristics, conclusions based on the results of a psychological examination, speech cards), it is necessary to pay attention to the features of the development of the child’s general, fine and articulatory motor skills at different age periods; analyze the dynamics of the child’s psychomotor development; assess the influence of a child’s motor development on his overall mental development.

S. D. Zabramnaya (1995) also notes the importance of the method of studying children’s drawings when conducting a psychological and pedagogical examination, since drawing is an important differential diagnostic indicator when studying children. Analysis of children's drawings and the nature of drawing can give an idea of ​​the development of the child's grapho-motor skills, his spatial orientation, the development of visual-motor coordination, fine movements of the hand and fingers.

A clinical approach to the study of motor skills involves a comprehensive medical study of the child, since many deviations in the development of the motor sphere of children are associated with the presence in children of certain somatic, neurological or mental diseases that cause developmental deviations.

The clinical research method involves an integrated approach, including assessment of the etiology, pathogenesis, structure of the leading defect and the disorders complicating it, analysis of the relationship between psychopathological and neurological disorders (E. M. Mastyukova, 1997; N. P. Weisman, 1997).

Medical diagnosis of developmental disorders in children of early and preschool age includes a general examination, analysis of anamnestic data, assessment of somatic, neurological and mental states. The clinical diagnostic process is divided into several stages. Neurophysiological, biochemical, genetic and other examination methods are important for clinical diagnosis. Clinical diagnosis is based on knowledge of the basic patterns of age-related development of neuropsychic functions.

Thus, the combination of a qualitative and quantitative assessment of psychological and pedagogical data on the level of development of a child’s motor skills, dynamic observation and a comprehensive clinical study makes it possible to most accurately and completely assess the general mental development of the child, the state of his psychomotor skills, give a forecast for further development and determine the most optimal ways of psychological development. pedagogical correction.