There are different opinions about a child with mental retardation in kindergarten. For parents, the question arises whether to send him to a correctional or regular children's educational institution. It is believed that mental retardation is a mild deviation, since the symptoms for many are quite mild if it is not accompanied by secondary diagnoses. The greatest difficulty for such children is only social adaptation in a team with other children. As a rule, their mental development is within normal limits, and the curriculum is more or less assimilated. They may have problems with self-care and neatness skills, but they gradually learn them by watching others. My opinion is that it is better to send children with minor mental retardation to a regular kindergarten, where there is an example of normative behavior.
When it comes to a child with mental retardation with additional diagnoses (ADHD, speech pathologies, cerebral palsy and other motor disorders, secondary decline in intelligence, etc.), I advise you to think about a correctional kindergarten. There are many reasons for this: firstly, the accompanying deviations greatly leave an imprint on different areas of the child’s development, and not just at the time of adaptation and integration into the team; secondly, such institutions employ specialists, create a favorable learning and development environment, and create individual educational routes for each student. In fact, it is easier for a complex child with mental retardation to adapt and at least partially overcome his illnesses before school in a simplified environment where he will not feel like a “black sheep.”
My daughter Anya is a child with mental retardation and related diagnoses, i.e. our version is just less favorable according to forecasts. She has been officially diagnosed with ADHD, ODD (now already grade 3), motor impairments, which are expressed in underdevelopment of fine motor skills, poor coordination, ataxia (at the moment already in a residual form), and peculiarities of the emotional-volitional sphere. Simply put, it will not cope with an ordinary kindergarten, where another 25-30 children with normal development run around, and the teachers do not have experience working with individuals. I chose a correctional kindergarten. We ended up in a group for children with disabilities (disabilities), where there are children with mental disorders, speech disorders, hyperactivity and attention deficit, cerebral palsy, mental retardation, etc. Why was I not afraid of such a “company” and chose a kindergarten for children with mental retardation, and not a regular or logo group?
A child with mental retardation in kindergarten in a regular group
Initially, we were given a place in an ordinary garden right in the yard, near our house. I was happy and consoled myself with the thought that Anya would definitely get used to the group and would soon catch up with the ordinary kids in speech, behavior, and even in her self-care skills. How disappointed I was when I came to the manager and visited the group to which we received a ticket...
There are 35 children on the list; 20-22 children regularly attend preschool educational institutions. Considering that Anya has ADHD and it is difficult to capture her attention even with individual interaction, I immediately realized that in these conditions she would “stick” to her own little world somewhere in the corner or, on the contrary, she would start jumping around without stopping amid the general noise , without delving into the essence of what is happening. What child will come home in the evening?
The manager honestly said that the staff does not know how to work with such children. They cannot create an individual program for her, and, alas, she is not yet suitable for a general program for her age category. Such a break with other children will negatively affect her mental state. In addition, children will quickly understand her otherness and may offend her. She does not know how to stand up for herself, because although aggression is characteristic of her, she directs it into space or at herself, and not at a living person. Most likely, Anya would have become an outcast, whose ineptitude everyone made fun of every day.
Regarding the training program, there are also nuances here. Previously, a child with developmental delays could be placed in a younger age group. Now this is prohibited, and from time to time commissions from the Education Committee carry out inspections. This option was immediately ruled out. At the time of admission to the kindergarten, Anya was 5 years old. The program for her peers assumed a completely different level of development and pace of activity in the classroom. She would not have been able to withstand such a rhythm, although she already knew how to read and count. But at that time, completely undeveloped fine motor skills would not have allowed her to take many lessons in modeling, drawing, origami, etc. And attention, which is defective in all respects, would knock her out of the general regime. Let’s not forget that ZPRok’s behavior is infantile, and the perception of the surrounding reality is too one-sided and flat. She would simply get lost.
Speech problems also left their mark. At 5, children speak with all their might in complex sentences, but Anya had difficulty forming a simple statement, since OSD is a multifaceted disorder of speech development. An ordinary speech therapist in an ordinary kindergarten does not know how to work with complex pathologies. She needed a speech pathologist-defectologist who corrects the phonetic, phonemic, lexical and grammatical aspects of speech as a whole. I think I was not mistaken in assuming that Anya would only be nervous, aggressive and withdrawn into her own emotions if she found herself in such conditions for the whole day.
I know stories where children came to a regular kindergarten, and a few months later there was a nervous breakdown due to the impossibility of full inclusion in the children's society. When moving to a correctional kindergarten, the child’s condition improved.
There is another significant disadvantage for a child with mental retardation in a regular kindergarten - the attitude of other parents. If your baby is very different from the norm, shows negative aspects of behavior, often fights, sets a bad example, parents will show dissatisfaction with you, write complaints to the head and even demand that you be transferred to another kindergarten. I think neither you nor the child need such hassle. Moral pressure from the majority still undermines your confidence, regardless of the fact that today the program of any preschool educational institution is aimed at tolerant and currently popular inclusion.
Keep in mind that many educators will not even be able to feed a special child normally if he has not yet developed self-care skills and does not speak. They are afraid of such children, their reactions, needs, because they are not trained to communicate with them. One of your children will distract her from a crowd of 20-30 people, respectively, except for internal irritation, your baby will not receive anything, at least this is the relationship of 80-90% of ordinary educators and nannies. We can demand, swear, prove, but the fact remains a fact - the child is uncomfortable where he is not understood and shunned, or, even worse, humiliated and ignored.
General information
Mental retardation in children can be caused by a large number of reasons (including pronounced congenital syndromes), and the symptoms of mental retardation manifest themselves not only in a decrease in cognitive abilities, but also in other physical and mental abnormalities.
Mental retardation is characterized by a violation of the intellectual and emotional-volitional spheres. This condition is accompanied by learning difficulties. We are talking primarily about the psychological and pedagogical category, but it can also be based on organic disorders.
Mental changes in mentally retarded children are stable and do not progress, so psychosomatic complications are unlikely. The diagnosis is made for preschool children at the age of 4-5 years or during schooling. The main difficulty for such patients is the lack of opportunity to fully adapt to society.
ZPR group in kindergarten, should I send my child there?
I have already said that we attend approximately the same group - we have a “hodgepodge”. To be honest, at first I was afraid that Anya would adopt many negative behavioral reactions from other individuals, which would only worsen the situation and cause a setback in development. I was wrong. Yes, she copies some manners, but, you see, don’t children in an ordinary preschool learn to spit, swear, push and pull each other’s braids? We don’t have children with autism, where behavioral problems are more acute (these children are placed in a separate group), so the most that my daughter learned from the other “laggards” was to spit, sometimes push and stomp her feet.
I see many more advantages from attending a correctional kindergarten for two years and can describe them in detail.
Causes of mental retardation
Mental retardation in preschool children is a consequence of many different factors that ultimately lead to a defect in the neurobiological and functional development of the brain. Biological and social factors should be highlighted.
The most common causes of mental retardation in children
are:
· Embryonic development disorders: rubella, treponema, toxoplasma, cytomegalovirus, listeria, herpes infection, HIV. No less dangerous are placental dysfunction, alcohol, drug use, and smoking. Phenol poisoning, pesticides, lead and increased levels of radiation leave their mark.
· Perinatal problems: prematurity, hypoxia, intracranial hemorrhage, metabolic disorders in newborns, meningitis, severe brain injury, encephalitis.
· Severe somatic diseases of the child: rickets, neuroinfections, influenza. Epilepsy can also be a cause.
In some cases, the cause of mental retardation is heredity. This disease is diagnosed in some families from generation to generation. Congenital mental retardation is almost inevitable in many genetic diseases, for example: Patau, Edwards, Cornelia de Lange, Down syndrome.
Delayed development of a child of a secondary nature develops against the background of visual or hearing impairment. The cause may be a speech defect, as well as a severe deficit in communication and sensory information.
Mental retardation or dementia can be caused by abnormal brain development:
· insufficient brain size (microcephaly);
· complete or partial absence of the cerebral hemispheres (hydranencephaly);
· underdevelopment of the brain (lissencephaly);
Cerebellar hypoplasia (pontocerebellar hypoplasia).
Often the pathogenesis of mental development disorders lies in metabolic disorders or enzyme production (phenylketonuria). Postpartum mental retardation in children can also be caused by the destruction of red blood cells - hemolytic disease of the newborn. It occurs as a result of Rh conflict during pregnancy and leads to serious dysfunction of the cortex and subcortical neural nodes of the brain.
Among the social factors, one should highlight the influence of hypo- or hyperprotection, lack of opportunity to communicate with other people (for example, due to disability), authoritarian upbringing (unquestioning submission). Environmental factors, as a rule, cause mental retardation mainly in the presence of a primary organic basis for dysfunction.
Diagnostics
The differential diagnosis of mental retardation should be made by personnel trained in the use of standardized psychometric methods. In early childhood, the first signs of mental retardation rarely appear and can be clearly expressed only after 4-5 years.
Today, the diagnosis of mental retardation is carried out by collecting anamnesis (obstetric data on the course of pregnancy and information on diseases of relatives), a general psychological and psychometric assessment of the patient. This makes it possible to assess the somatic state, establish the presence of not only physical (visually defined) signs of mental retardation, determine the level of intellectual development and compliance with their standards, as well as observe mental behavior and reactions.
To accurately determine the specific form of ZPR, you may need:
· general, biochemical and serological blood test;
· blood for syphilis and other infections;
· Analysis of urine.
Genetic testing is performed to identify congenital causes of the disease.
Instrumental diagnosis of developmental delay includes:
· encephalogram;
· computed tomography;
MRI of the brain.
Differential diagnosis is necessary. Despite some characteristic physical defects, many neurological disorders (paresis, convulsions, trophic and reflex disorders, epileptiform convulsions) are observed in other neuropsychiatric pathologies.
Even when the fact of inhibition and inadequacy is obvious, a thorough professional assessment of the mental abilities of children is necessary in order to distinguish a mild form of mental retardation from emotional-behavioral (psychiatric) disorders.
Correction of mental retardation
Treatment begins with timely identification of the problem. Depending on the degree of mental dysfunction, the child will be asked to complete standard school work designed for children of a similar age. Correction of mental retardation is carried out through educational intervention optimized depending on the degree of mental retardation. Children must be integrated into social, educational and cultural life with the rest of the population.
If the cause of mental retardation is hypothyroidism, Rh conflict, phenylketonuria, etiological treatment of mental retardation with the help of hormonal drugs, blood transfusion to the child, or a special diet without protein is possible. In most cases, there is no etiological treatment.
Patients with intellectual disabilities are treated with symptomatic therapy. Drugs are prescribed to reduce the intensity of psychotic disorders: antipsychotics, as well as medications to stabilize mood (which helps to correct behavior).
Reduce anxiety levels, stop crises and improve sleep with the help of psychoactive substances with tranquilizers. The negative consequences of their use are expressed in muscle weakness, increased drowsiness, impaired coordination of movements and speech, and decreased visual acuity. Long-term use of these drugs can compromise attention and memory, even leading to the development of anterograde amnesia.
One of the main roles in the correction of intellectual disability is given to cognitive-behavioral therapy, i.e., medical correctional pedagogy. To raise children with mental retardation in specialized schools and boarding schools, specially developed methods of adapting children to society are used.
Rehabilitation of patients with mental retardation, especially with genetically determined forms of mental pathology, consists not so much of their treatment as of teaching programs and instilling basic household and, if possible, simple social skills. Experts say that mild mental retardation in children can be corrected, and despite the disability, such patients can perform simple work and take care of themselves.
Prognosis and prevention
According to statistics, a quarter of mental development defects are associated with chromosomal abnormalities, so prevention is only possible for non-congenital pathologies.
Basic preventive measures:
· during the planned period of preparation for pregnancy, it is necessary to undergo a full examination for the presence of infections, eliminate all foci of inflammation and cure existing chronic diseases;
· check the condition of the thyroid gland and hormone levels;
· some types of mental retardation can be prevented through genetic counseling of future parents to identify disorders that are potentially dangerous for the normal development of the embryo and fetus;
· During pregnancy, women should regularly visit their doctor, take the necessary tests and undergo an ultrasound scan on time.
An important preventive measure for delaying the pace of development is the early detection of certain metabolic processes leading to mental retardation. If congenital hypothyroidism affecting a newborn is detected during the first month of life, the development of dysfunction can be prevented. If the problem is not identified and treated before the age of three months, then 20% of children with thyroid hormone deficiency will be mentally disabled.
