Intellectual impairment: causes, identification, classificationmaterial on the topic

Good afternoon Today we will study psychiatry again. On our agenda is the intellect (mind), and several major disorders that are associated with it. The terms that I will use in this article went “to the people” a long time ago and, as a rule, are pronounced with a completely different meaning. Therefore, we will try to analyze intellectual impairments, and before that, of course, we will find out what intelligence is.

So, intelligence is the general capacity for cognition and problem solving, which combines all cognitive abilities such as thinking, memory, imagination, will, perception and sensation.

Causes of mental retardation

• hereditary factors, including pathology of the generative cells of the parents (this group of oligophrenia includes Down's disease, true microcephaly, enzymopathic forms);
• intrauterine damage to the embryo and fetus (hormonal disorders, rubella and other viral infections, congenital syphilis, toxoplasmosis);
• harmful factors of the perinatal period and the first 3 years of life (asphyxia of the fetus and newborn, birth trauma, immunological incompatibility of the blood of mother and fetus - conflict over the Rh factor, head injuries in early childhood, childhood infections, congenital hydrocephalus).

Lightweight

With a mild form of mental retardation in children, the IQ level ranges from 50 to 69 points. Children with mild mental retardation are practically no different in appearance from their healthy peers. Problems, as a rule, begin at school age: children find it difficult to perceive and remember information from the teacher, they find it difficult to concentrate on completing a task, and they are constantly distracted. Even memorizing a four-line poem can be very difficult for a student. – Children with mild mental retardation often develop some strange behavior. They can be closed, unsociable, difficult to make contact and panicky afraid of everything new, in particular new acquaintances. But it happens that such a child, on the contrary, is hyperactive, he fools around too much, does some strange things, thus trying to express himself and attract attention. In any case, a problem of social adaptation may arise, says the oligophrenopedagogist. A child with mild mental retardation is able to experience the whole gamut of emotions, but complex, mixed emotions are more difficult for him to express. Also, such children can be too naive and suggestible, so they can fall under bad influence. As a rule, children with mild mental retardation can study in a correctional school using a special lightweight program. With regular sessions with a speech pathologist and psychotherapists, they achieve good results in their learning. In the future, they can receive a secondary specialized education and find a decent working profession, have a family and children.

Moderate

With a moderate (average) form of mental retardation in children, the IQ level varies from 35 to 49 points. Children with moderate mental retardation differ in appearance from healthy children: their faces are practically devoid of facial expressions, their eyes blink very rarely. Children with moderate mental retardation often have protruding ears and attached lobes, a defective bite, rough facial features, micro- or hydrocephalus, and widely spaced eyes. The gait of such children is slow and stiff, and fine motor skills are very poorly developed. Possible speech defects: stuttering, lisp. Children with a moderate form of mental retardation have serious problems with the perception and expression of information and their own emotions (they experience fear, joy, affection, and can distinguish praise from blame). Memory is very limited and selective. It is possible to teach self-care skills to children with moderate mental retardation, but serious problems arise with schooling. Even reading and basic arithmetic can become an impossible task. The total vocabulary does not exceed 200 - 300 words. Of course, there is no longer any question of receiving any kind of education, but in the future, people with a moderate form of mental retardation can perform some simple work that does not require decision-making. They can live at home, in a family, under the supervision of loved ones. As they grow older, they are assigned to special schools or social institutions, where they can live and do some simple work. If problems with neurology and psyche develop, hospitalization in a psychiatric clinic may be required. – A child suffering from a moderate form of mental retardation needs to be dealt with comprehensively. A neurologist and psychiatrist will prescribe drug therapy that improves brain processes, psychostimulants, and anticonvulsants. Classes with a speech therapist-defectologist are also necessary; training is possible only at home, the oligophrenopedagogist clarifies.

Heavy

A severe form of mental retardation in children is characterized by serious organic damage to the brain and an intelligence not exceeding 34 points. With this form of mental retardation, speech and thinking are almost completely absent - patients communicate only with the help of mooing and inarticulate sounds. Most often, children with idiocy cannot walk independently and have multiple internal defects. Children with severe mental retardation are practically unable to experience conscious emotions, but during uncontrollable outbursts of anger they can be aggressive and dangerous to others. They often harm themselves - they scratch their faces, pull out their hair, and in a calm state they are lethargic and inactive. As a rule, idiocy is detected at an early age - the child begins to hold his head up, roll over and sit very late. A child with idiocy has a characteristic facial expression with a grimace of anger or, on the contrary, aloof. The tongue may be very large and protrude from the mouth. A child with a severe degree of mental retardation is completely unteachable, is not capable of even basic self-care skills, does not control the processes of urination and defecation, does not distinguish edible from inedible, cold from hot, is not able to feel satiety, and openly engages in masturbation. Unfortunately, children with idiocy cannot live and be raised in an ordinary family, and they are sent to specialized boarding schools, where, with proper care and medication correction, they are quite capable of living up to 40 years.

Syndromes combined with different degrees of MR

Down syndrome is the most common genetic cause of intellectual disability. It is caused by a chromosomal abnormality - if normally there are 46 of them, then in this case there is an unpaired 47th chromosome. People with this syndrome can be identified by an abnormally short skull, flat face, short arms and legs, short stature, and small mouth. They process the information received poorly and remember it, they lack the concept of time and space, and their speech is poor. Moreover, such individuals adapt well to society.

Martin-Bell syndrome (fragile X chromosome). The second most common genetic cause of mental retardation. It is recognized by the following external features: increased mobility of joints, an elongated face, an enlarged chin, a high forehead, large, protruding ears. They start talking late, but poorly, or don’t speak at all. Very shy, hyperactive, inattentive, constantly moving their arms and biting them. Men have more cognitive impairment in this category than women.

Williams syndrome (“elf face”). It occurs as a result of hereditary chromosomal rearrangement, the loss of genes in one of them. The patients have a very interesting appearance: the face is narrow and long, blue eyes, flat nose, large lips. Usually suffer from cardiovascular diseases. Rich vocabulary, good memory, excellent musical abilities, and social interaction skills. But there are problems with psychomotor skills.

Angelman syndrome (happy doll or Parsley). Caused by a change in chromosome 15. Very light eyes with characteristic spots on the iris and hair, the head is small, the chin is pushed forward, the mouth is large, the teeth are sparse and long. Severe delay in psychomotor development, significant impairment of speech and movement (poor balance, walks on stiff legs). He often smiles and even laughs for no reason.

Prader-Willi syndrome . It is characterized by the absence of a paternal copy of chromosome 15 and a number of other disorders. He is short in stature, has small arms and legs, suffers from compulsive overeating, and, as a result, obesity. Problems with short-term memory, speech, information processing.

Lejeune's syndrome (cry of the cat or 5p syndrome). A very rare and serious disease caused by the absence of the short arm of chromosome 5. The head is small, the face is round, the lower jaw is underdeveloped and the bridge of the nose is wide, so the eyes are located far from each other. The feet are turned out, the hands are small. The larynx is underdeveloped, there are vision problems, in particular, strabismus. She often cries and makes a sound similar to a kitten meowing. Motor development is delayed, and the ability to pay attention is limited.

In addition to the syndromes mentioned, intellectual disability can coexist with cerebral palsy, deafness and blindness, autistic disorders, epilepsy and other somatic and mental illnesses.

How to identify mental retardation disorders: signs and symptoms of delayed psycho-speech development

ZPRD, if it is caused by congenital factors, can begin to manifest itself at a fairly early age of the child.

Signs of delayed psycho-speech development:

• 4 months : the child does not respond to the words and gestures of the parents, does not smile (these are also symptoms of autism);
• 8–9 months : absence of babbling (repetition of identical syllables);
• 1 year : the child is very quiet, makes almost no sounds;
• 1.5 years : does not speak simple words (“mom”, “give”) and does not perceive them, does not understand when addressed by name or with a request; may also not be able to chew;
• 2 years : knows and uses a very limited set of words, does not repeat new words after others;
• 2.5 years : uses no more than 20 words, cannot form a phrase out of two or three words, does not understand the names of body parts and objects;
• 3 years : cannot form a sentence on his own, does not understand simple stories from adults. Speaks too quickly, “swallowing” endings, or too slowly, drawing out words. In response to an adult’s address to him, he can repeat what was said verbatim.

A child with PVD at any age may experience increased salivation and an always slightly open mouth. Such children are characterized by hyperactivity, increased aggressiveness, inattention, fatigue, and poor memory. The child thinks very slowly, has an undeveloped imagination and a narrow range of emotional manifestations, experiences great difficulties in communicating with peers, and therefore avoids them. Physically, such children are also poorly developed and may even have cerebral palsy.

Symptoms of ZPRD also manifest themselves in organic changes. When examined using electroencephalography (EEG) or the evoked potentials (EP) method, disturbances are detected in the left hemisphere (it is responsible for speech development).

In general, the longer a child experiences difficulties with speech, the more his mental and mental development is delayed. After all, the older children are, the more information they receive from what they are told in dialogues with others. This is another reason to start treatment for PVD as early as possible.

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How is the cause of RRR determined?

In order to cure a disease, you need to know exactly why it appeared. The cause of a delay in speech development in a child can be determined by conducting a comprehensive examination of him with doctors of traditional medicine; naturopaths do not need all examinations, but it will not hurt to undergo them.

Pass special testing to determine whether the child’s skills correspond to his age.

Bayley Scale Early Language Development Scale

Denver test Have your hearing checked by an audiologist Determine facial motor dysfunction - difficulty swallowing Compare the processes of understanding speech and producing it Analyze the ways adults interact with a child Determine how well the brain works using MRI, EEG and other methods See a child psychologist and psychiatrist and also visit a speech therapist and neurologist

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How to treat ZRR?

Early diagnosis of such problems allows you to prescribe appropriate treatment in time and, in some cases, successfully get rid of them.

Traditional medicine and doctors suggest combining the following methods:

• Taking medications prescribed by a neurologist or psychiatrist. They are designed to nourish the neurons of the brain - Cortexin, Lecithin, Neuromultivit, etc.
• Modern hardware procedures , such as: reflexology and magnetic therapy They can activate the brain and improve speech, but have many contraindications
• Classes with a speech pathologist and speech therapist according to individually designed programs, which include various game exercises
• One of the types of speech therapy massage , selected for each specific child
• dolphin or hippotherapy as additional treatment methods.

We suggest you replace drug treatment with a unique recovery program - effective and safe. After all, only living products can effectively enter a cell and work there.

FDD, like any other delays in the development of a child, has dangerous social consequences

lagging behind peers problems with studying further acquisition of a profession

Therefore, the main task of parents of such special children is to notice the problem in time and competently get rid of it.

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ZPRD with elements of autism

As a result of malfunctions of the central nervous system or the impact of severe infections on the child’s body, not only speech and mental development delays can form: in some cases, the disease is accompanied by signs of autism.

Autistic traits in a child’s behavior:

• Does not enter into emotional contact with people, does not smile, does not reach out to parents.
• Prone to frequent attacks of aggression, when he is dissatisfied with something, he can direct this aggression towards himself (biting himself, hitting himself).
• Stereotypical behavior: may sway for a long time in one place or walk in a circle, twirl one object in his hand, tends to place objects in a row, reacts negatively to any changes.
• Does not know how to play with toys, uses them in his own way, may be committed to only one toy or part of it.
• Avoids society, does not know how to interact with peers.

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Delayed motor development - MSD

This type of deviation appears already in the first year of a child’s life. And it is noticeable quite clearly. While other children begin to hold their head up, sit, stand, and walk, a baby with mental retardation does not do all this. The causes of MR are delayed motor development.

If a little person’s motor system is developing well, he does everything listed on time or even earlier than normal. What is the cause of problems with motor functions?

There are several of them:

• Hereditary factors
• Parents' health status
• Perinatal problems - injuries, stress, illness, bad habits, poor nutrition and difficult working conditions for the expectant mother
• Birth abnormalities - premature birth, rapid, protracted, postmaturity, prematurity, birth injuries

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Features of children with mental retardation

Disturbances in the intellectual sphere of children who have developmental delays are relatively mild, but all intellectual processes are affected: perception, attention, memory, thinking, speech.

The perception of a child with mental retardation is fragmented, slow and inaccurate. Some analyzers operate at the same level as in normally developing children, but a child with mental retardation will have difficulty forming a holistic image. Visual perception is better developed than auditory perception. This feature is important to take into account when teaching such children: they definitely need visual aids to better assimilate the material. In children with mental retardation, such properties of perception as objectivity and structure are impaired (recognizing objects from an unusual angle causes them certain difficulties), including the integrity of perception. Children with mental retardation have difficulty identifying individual elements of an object, which they perceive as a single whole, find it difficult to complete a complete object based on part of it, and find it difficult to guess what is in front of them if only part of the object is shown.

As for attention, in children with mental retardation it is unstable, short-term, and superficial. The child is distracted by any extraneous stimuli, it is difficult for him to concentrate on any one activity, so situations related to concentration cause great difficulties. In addition, their selectivity and distribution of attention are impaired. They cannot assess which stimulus is significant in order to concentrate on it and which is not. Even a small stimulus can distract them from completing the main task.

Memory in children with mental retardation is characterized by fragmented memorization of material, poor selectivity, and a predominance of visual-figurative memory over verbal memory. They remember visual stimuli better and faster than auditory ones. Their involuntary memory is more preserved. In addition, children with mental retardation have a low level of self-control in the process of memorization and reproduction, the inability to independently organize their work to memorize the necessary educational material, insufficient cognitive activity and focus when memorizing, and the inability to use memorization techniques.

As for thinking, in children with mental retardation, visual-effective thinking is more intact, while figurative thinking is more impaired due to the fact that they are characterized by inaccurate perception. As for abstract-logical thinking, its development and functioning is impossible without the help of an adult. Children with mental retardation have difficulty with analysis and synthesis, comparison, and generalization, so they cannot cope with tasks related to the ordering of events, build an inference, they cannot make a generalization and formulate conclusions based on it.

Speech in children with mental retardation also has its own specifics. They have a distortion of the articulation of many sounds, a violation of auditory differentiation. Their vocabulary is limited. Such children have a violation of control over the grammatical form of speech; it is much more difficult for them to construct coherent, literate statements. Therefore, their speech may seem quite illiterate and too simple.

With regard to written speech, children with mental retardation often experience such phenomena as dysgraphia and dyslexia. In psychoneurology, dyslexia is understood as a violation of the reading process, and dysgraphia is a violation of the writing process. Children with dyslexia make mistakes when reading: they miss sounds, add unnecessary ones, and distort the sound of words. Reading speed with dyslexia is low, children change places of letters, and sometimes miss the initial syllables of words. With dysgraphia, children have difficulty mastering writing: everything they write contains a fairly large number of grammatical errors. When writing, they do not use capital letters, punctuation marks, confuse letters with similar spellings, combined and separate spelling of prepositions and prefixes. Their handwriting, as a rule, is ugly, sloppy and incomprehensible. In middle and high school, schoolchildren try to use short phrases with a limited set of words when writing, but this does not save them from making quite serious mistakes. Such children write and read much more slowly than their peers.

The formation of the personal sphere in children with mental retardation also has a number of features. It is characterized by excessive emotional mobility, frequent mood swings, and suggestibility. They are characterized by lack of initiative and lack of will; they rarely become the life of the party, leading in any activity, but follow the lead of their peers. In addition, they may experience affective reactions, increased aggressiveness, and increased anxiety. This can lead to serious conflicts with other people.

But more often, children with mental retardation are withdrawn and uncommunicative. Unable to adapt socially, they prefer to play alone and avoid contact with peers. Their gaming activities are stereotypical and monotonous, the plot of the game is one-dimensional, very simple. They play as if according to a template, their imagination is quite stingy.

Features of the motor skills of children with mental retardation include awkwardness, clumsiness, and lack of coordination. They are often susceptible to such phenomena as hyperkinesis (pathological sudden involuntary movements in one or an entire group of muscles following an erroneous command from the brain) and tics (this is a rapid involuntary stereotypic muscle contraction).

Psychology of intelligence.

Intelligence (intellectus - understanding, understanding, comprehension) is a relatively stable structure of an individual’s mental abilities, a person’s thinking abilities. According to Wexler, intelligence is the global ability to act intelligently, think rationally, and cope well with life’s circumstances—to successfully measure one’s strengths with the world around us. There are no operational definitions of intelligence today. On this occasion, it is wittily said: “Every smart person knows what intelligence is. This is something that others don’t have.” Currently, most psychologists understand intelligence as an individual's ability to adapt to the environment. There are various theories of intelligence, the role of heredity and environment in its development, and methods for measuring it. Measuring IQ according to Western standards, based on determining the speed of solving various problems, is currently losing credibility, since in different cultures and social groups the problems whose solution ensures successful adaptation are not the same. Dividing people into “average”, “retarded” and “super gifted” based on test results says little about the social value of these people. Theremin revealed a striking fact: not one of those with an increased IQ became Mozart, Einstein, or Picasso, or left a noticeable mark on the history of their country. It also turned out that social success depends not only on mental abilities. An equally important role is played by the family environment with its emotional and socio-economic characteristics, as well as personal qualities.

Intelligence research has shifted in recent decades to the study of creative or creative thinking. Guilford in 1959 synthesized the results of all these studies and created an expanded concept of intelligence. He identified two types of thinking: convergent, necessary to find the only accurate solution, and divergent, thanks to which “original solutions” arise. A person with normal intelligence usually also has normal creative abilities. But starting from an IQ of 120%, the paths of mental and creative abilities diverge. Creativity, as Ferguson notes, is not created, but released. This is largely facilitated by the characteristics of a creative personality, who is alien to conformism, is not dogmatic, is interested in different things and tries to combine data from different areas. The head of a creative person is full of wonderful ideas. These are people who retain the childlike ability to wonder, dream, accept and integrate different aspects of their behavior (Goedefroy, 1993). They offer tests to identify and measure creative potential. The results of their application are encouraging, however, the only reliable method for determining intellectual abilities and creative capabilities remains the practice of life.

Intellectual impairment. Dementia is characterized by persistent or progressive weakening of all aspects of cognitive activity - memory, thinking, cognitive needs, higher emotions, critical and predictive functions, perception or, in other words, intelligence in general. There are congenital (oligophrenia) and acquired forms of dementia (dementia). Oligophrenia (according to the criteria adopted in domestic psychiatry) is a hereditary form of mental retardation, as well as acquired during the first three years of life. In this case, there is a persistent delay in the development of intelligence and, to varying degrees, other mental functions. Dementia characterizes the disintegration of a previously well-developed intellect, its decline under the influence of various harmful and debilitating processes.

Congenital dementia, depending on the level of intelligence development, is divided into idiocy, imbecility and debility.

Idiocy is the most profound degree of mental retardation. Accounts for 5% of all cases of oligophrenia. The intellectual quotient for idiocy does not exceed 20% of the level of normal mental development inherent in the biological age of the subjects. There are three degrees of idiocy. With deep idiocy, there is no recognition, cognitive needs (orienting reflex), speech and its understanding, basic orientation in the situation and the purpose of objects, any differentiated emotions and expressive actions, reactions to facial expressions, gestures and intentions of others. Various types of sensitivity are reduced, including pain, motor development is sharply delayed (vertical standing, walking), stereotypical swaying of the head and the whole body is often observed. Neatness skills are not developed. With moderate and mild idiocy, patients are able to understand the meaning of individual simple words, gestures of others, know how to laugh and cry, recognize some objects and familiar surroundings. They know and have several dozen words in their active dictionary. To some extent, they are teachable - they can, for example, learn to eat on their own. They react to the appearance of new people and objects, to pain, to the emotions of others.

Imbecility is an average degree of mental underdevelopment. It accounts for 20% of cases of oligophrenia. The intellectual quotient in patients with imbecility ranges from 20 to 50% of the average age norm; an understanding of simple connections between objects in primary, everyday situations is available. Speech appears belatedly, by the age of three or five, and the active vocabulary numbers in the hundreds. Simple self-service skills and simple work skills are developed. Mechanical counting is available in the range of 10-20; arithmetic operations are not learned. Reading is also not available. Cognitive needs are not developed, although there are reactions of curiosity. Imbeciles freely use personal pronouns and recognize their image in the mirror or in a photograph. Emotional reactions and means of their expression are more differentiated, attachments and aversions are revealed. In motor terms, patients are clumsy, awkward, and their speech is tongue-tied. Game activities are monotonous. Imbecility is divided into deep, moderate and mild severity.

Moronism is a mild degree of mental retardation. It occurs most often—75% of cases of oligophrenia. The intellectual quotient for debility varies from 50% to 70% relative to the norm. In connection with the issues of training, labor and military examination that arise in relation to morons, mild, moderate and severe moronity are distinguished. Debility is characterized by an inability to master complex mental operations, such as generalization and abstraction, a lack of creativity, and independence. Thinking occurs at the visual-figurative and figurative level. The vocabulary may be decent, but the concepts are distinguished by unclear boundaries and vague content. General and abstract concepts are not assimilated. Emotional reactions lack subtlety. Motor development may be satisfactory, but cortical motor skills are not sufficiently developed. For example, good handwriting is not developed. Mechanical counting is possible, but arithmetic operations are only possible with simple numbers; they are performed with difficulty in the mind, and then, rather, from memory. Mechanical memory can be good, and sometimes, although rarely, phenomenal. Voluntary memory and active attention remain in their infancy. Curiosity and inquisitiveness are not characteristic of morons. There is no thirst for knowledge, thinking occurs according to a template, without invention or imagination. Increased suggestibility. Self-esteem is often inflated and based on external data. Simple types of physical labor, mastering some manual professions, satisfactory social adaptation, and starting a family are available. Speech defects in the form of a lisp, sigmatism, rhotacism and lambdacism (the sounds “s”, “r”, “l” are not pronounced) are not uncommon. The grammatical structures of speech are simplified, patients can be talkative, but do not master the culture of speech and its communicative aspects (ability to listen, interest, etc.). Borderline mental retardation should be distinguished from oligophrenia. The fundamental difference is that with oligophrenia, inferences, processes of generalization and abstraction, as well as cognitive needs are primarily affected. With borderline mental retardation, the predominant impairment concerns the so-called prerequisites of intelligence (attention, memory, activity, perception, etc.), while the processes of generalization and abstraction, the ability to grasp logical relationships remain at a satisfactory level, children are teachable, intellectual limitations, in principle, can be overcome with age or through appropriate training.

Dementia syndromes.

Dementia (weakness of mind) is a decrease in intelligence caused by a brain disease. It manifests itself as a violation of a number of higher cortical functions, including attention, memory, thinking, orientation, understanding, counting, judgment, speech, and learning ability. There is a weakening of cognitive functions, emotional control, and social adaptation. Consciousness is not changed, however, there is no awareness of the disease (anosognosia) if the dementia is total.

Dementia does not include temporary (transient) changes in intelligence that resemble dementia, such as those associated with depression. The main ones in dementia are disturbances in memory processes (fixation, retention, reproduction) and thinking (interpretation of incoming information, reasoning ability, slowing down of thinking processes). The diagnosis of dementia can be considered reliable if the above-mentioned disorders exist (progress) for at least six months.

There are partial and total dementia.

Partial (partial, lacunar, dysmnestic) dementia is manifested by uneven loss of intellectual functions with a predominance of dysmnestic disorders. The core of personality, self-awareness, and style of behavior are not noticeably affected; the stock of skills and knowledge is maintained at a level that ensures orientation in what is happening and self-service. Limitations primarily relate to new experience, planning, imagination, originality and creativity, predictive function, criticism disorder is mildly expressed or absent. Patients understand the fact of intellectual decline, react adequately to it, and strive to compensate for their failure.

Total (global) dementia is characterized by more or less uniform damage to all aspects of cognitive activity, a deep decline in personality, loss of spontaneity, and loss of criticism of one’s condition. As lacunar dementia progresses, it can become global. The division of dementia into partial and total is dictated by practical considerations and is conditional. The following types of dementia are distinguished.

Epileptic dementia. (The more correct expression is “dementia due to epilepsy”). Along with a slowdown in mental processes (torpidity), a decrease in the level of mental activity and pathological thoroughness of thinking are detected. Thoughts are expressed with difficulty, confusedly, imprecisely, with stops and repetitions. In this regard, the thinking of patients with epilepsy is called labyrinthine. Memory weakens, primarily for events that have no personal significance. The vocabulary becomes impoverished, diminutive figures of speech are used - euphemisms, vague and unnecessary words and expressions. Speech in a drawl, in a sing-song manner, with an abundance of verbal cliches and interjections. The range of interests and motivations for activity is limited by concerns about one’s own well-being (“concentric dementia”). An exaggerated sharpening of characterological traits is observed. Thus, politeness turns into sweetness, unctuousness; courtesy - into helpfulness, servility; courtesy - into flattery; accuracy - into petty pedantry; sympathy - into servility; self-respect - into arrogance; frugality - into stinginess, etc. Patients can be touchy, vindictive, vindictive, and explosive. Sometimes hypocrisy, ostentatious piety, duplicity, and piety develop.

Senile (senile) dementia. At first, signs of spiritual impoverishment and callousness appear - inhospitability, coldness, rudeness, stinginess, etc. Patients are gloomy, distrustful, and suspicious. Biological drives are disinhibited, former interests and attachments fade away. Memory impairment reaches the level of progressive amnesia, and the ability to judge sharply decreases. Disorders of spatial orientation, speech, praxis, and loss of other higher cortical functions are added. Delusional ideas, hallucinations, depression, thoughts about death and dead people are observed. The process ends with mental insanity. There are different forms of senile dementia: simple, depressive, paranoid, with a state of confusion. The symptoms of presenile dementia are similar to those of senile dementia and characterize diffuse or focal brain atrophy (Alzheimer's disease, Pick's disease).

Paralytic dementia. It is observed in progressive paralysis. Characterized by severe disturbances of attention, memory, and thinking. Increased suggestibility. Behavior, at first frivolous, then becomes ridiculous. The background mood may be elevated, and euphoria is observed. Individual personality traits are erased, and mental disintegration may occur.

Traumatic dementia. The severity and clinical features of traumatic dementia reflect the depth and location of brain damage. Thus, predominant damage to the frontal-basal parts of the brain can be expressed by pseudoparalytic syndrome, a picture of moria. Damage to the frontal parts of the frontal lobes is manifested by apathy, aspontaneity, akinesia, and decreased thinking activity. When the temporal lobes are damaged, disturbances resembling epileptic degradation may occur; speech and verbal thinking disorders are typical. When the brain stem is damaged, inhibition of drives, affects, and torpidity are noted, but the opposite phenomena can also be observed: affective excitability, increased drives, and impulsivity. Damage to the interstitial brain is accompanied by loss of mental energy, a feeling of powerlessness, apathy, increased drowsiness, and sometimes euphoria, dysphoria, and gross manifestations of affects and drives. Endocrine and metabolic disorders may occur. A type of traumatic dementia is the so-called boxing dementia, which occurs in approximately 5% of people injured in the ring.

Vascular (post-stroke dementia Binswanger syndrome) dementia. Develops after a stroke or a series of micro-strokes. It is characterized by severe disturbances of memory, comprehension, speech (aphasia, logoclonia), phenomena of forced laughter, crying, psychotic episodes, and significant neurological disorders.

Vascular (dyscirculatory) encephalopathy often manifests itself as a picture of dysmnestic dementia. Mental disorders in hypertension can be expressed as pseudoparalytic syndrome. The severity of vascular disorders often varies.

Alcoholic dementia. Occurs as a consequence of alcoholic encephalopathy (Gaye-Wernicke's disease, Korsakoff's disease, Marchiafava-Bignami disease, etc.). More often it manifests itself in the form of amnestic (Korsakovsky) syndrome.

Dementia in Alzheimer's disease is characterized by progressive memory impairment, as well as local disorders of cortical functions, such as aphasia, agraphia, alexia and apraxia. Local disturbances may predominate in the early stages of the disease in cases of relatively early onset (before 65 years). Dementia in Pick's disease is characterized by slowly increasing character changes and social decline followed by a decline in intellectual functions. Memory loss, speech disorders, apathy or euphoria, and sometimes extrapyramidal phenomena are typical. Social maladaptation and behavioral deviations often precede the decline in memory and speech. In Creutzfeldt-Jakob disease, with its typical onset in the fifth decade of life, rapidly progressing dementia is combined with multiple neurological disorders (spastic paralysis of the limbs, rigidity, tremor, extrapyramidal signs, myoclonus). The course is subacute with death after one or two years. A three-phase ECG is typical. Dementia due to Huntington's disease (typically seen in the third decade of life) sometimes begins with anxiety, depression, paranoid behavior and personality changes. More often it debuts with choreiform hyperkinesis (especially in the face and upper shoulder girdle), which precede dementia. Dementia is characterized by a predominance of frontal lesions and relatively intact memory over a long period of time. The disease progresses slowly and leads to death after 10-15 years. No characteristic differences have been established for the structure of dementia in Parkinson's disease. It is stated against the background of verified Parkinson's disease, and can be combined with Alzheimer's disease and vascular dementia. Dementia in HIV is manifested by complaints of slowness and difficulty concentrating, difficulty reading, problem solving, and forgetfulness: Autism, apathy, and apathy increase. Possible affective disorders, psychotic phenomena, seizures, and neurological disorders - tremor, ataxia, muscle hypertension.

In addition to the above, transient dementia is observed: schizophrenic and psychogenic dementia.

With schizophrenic (apathetic-dissociative) dementia, there is no loss of memory, acquired knowledge and skills are retained, and the formal aspects of thinking may not be impaired. A characteristic feature of schizophrenic dementia is the dissociation between the inability to grasp the real meaning of specific events, everyday situations, role failure and satisfactory or good possibilities for abstract logical thinking - situational dementia. Sometimes significant experience and sufficient combinatorial abilities cannot be actualized in everyday practical activities due to autistic isolation from reality, spontaneity, and apathy.

Psychogenic dementia (pseudo-dementia). Hysterical reaction of a person to a traumatic situation in the form of imaginary dementia. It manifests itself as symptoms of past responses and past actions, especially evident in elementary situations. The behavior is so demonstrative and deliberate that this alone indicates the fact of a serious mental disorder.

There are depressive and agitated variants of pseudodementia. In the depressive variant, inhibition of motor and speech reactions and sometimes mutism are detected. Hysterical past responses, verbalization, poor memory of fresh impressions, and loss of interest in what is happening are observed. Patients are negativistic and often make passing actions (trying, for example, to light a match, rubbing it on the wrong side of the box, or striking the opposite end rather than the head). The agitated version of pseudodementia is expressed by patients’ agitation, euphoria, disinhibition, verbosity, and accelerated speech. Past responses and past actions occur not only in reactions, but also spontaneously. The phenomena of pseudodementia are reversible and disappear without a trace with the elimination or elimination of the traumatic situation. Memories! about the psychotic period are partially preserved.

Pseudo-dementia is described by Wernicke and is a form of hysterical psychosis. Its other forms are known, in particular, puerilism and Ganser syndromes.

Puerilism syndrome (puer - boy) is manifested by a transient regression of consciousness and behavior to the children's level of personality organization. At this time, the adult patient behaves and speaks like a child: crawls on all fours, plays with children’s toys, is capricious, throws hysterics, addresses others with the words “uncle”, “aunt”, asks not to punish him, not to beat him, not to put him in corner, demands to call “mom,” eats with his hands, babbles, reads syllables.

Ganser syndrome is characterized by the same set of hysterical manifestations (conversation that is not to the point, side actions, deliberateness, symptoms of regression, agitation or inhibition), but is distinguished by a greater severity of disturbances and, most importantly, confusion. Disorders of orientation in a situation, place, time are observed, and upon recovery from psychosis - the phenomenon of partial or complete amnesia. Hysterical psychoses of the type mentioned were previously described as “prison psychoses” in arrestees and prisoners, but they also occur in organic diseases of the brain and are more common in hospitals than in prisons. Their duration is several weeks and even months. For a long time they were confused with simulation. Unlike the latter, they are not associated with conscious mystification, but reflect the influence of unconscious attitudes of the individual or are caused by a reaction to organic damage to mental functions. There are other approaches to the taxonomy of dementia. Thus, V. M. Bleicher (1976) distinguishes its forms: simple, psychopathic, hallucinatory-paranoid, amnestic-paramnestic, paralytic and pseudoparalytic, asemic and terminal or marantic. The simple form is characterized by the predominance of deficit mnestic-intellectual disorders and the absence of productive symptoms. Psychopathic-like dementia is characterized by a painful sharpening of premorbid personality characteristics or the emergence of new ones that were not observed before the illness. Hallucinatory-paranoid dementia is characterized by a combination of mnestic-intellectual decline with hallucinations and delusions, the latter disappearing as the dementia deepens. Amnestic-paramnestic dementia is identical in symptoms to Korsakoff syndrome. Paralytic and pseudoparalytic dementia is determined by mental disorders characteristic of progressive paralysis, as well as the disorders mentioned earlier in the description of pseudoparalytic syndrome. Asemic dementia is typical of focal brain lesions, as well as Pick's diseases, Alzheimer's, and focal (Lissauer's) form of progressive paralysis. Dementia, most often of the global type, is combined with focal disorders of speech, gnosis and praxis. Marantic dementia is characterized by a complete collapse of mental activity, equifinality of the previously observed pictures of dementia.

What is the difference between mental retardation and mental retardation?

Mental retardation, or mental retardation, is associated with brain damage. The reasons for such a lesion can be very diverse, but they are always medical in nature. Social factors do not influence the development of mental retardation in any way, unlike mental retardation.

Children with mental retardation are able to keep no more than two or three objects in the focus of attention. Children with mental retardation are able to keep a larger number of objects in the focus of attention.

Their play activities also differ. Mentally retarded children experience stuckness at the stage of objective action. That is, the child learns to act with an object, to use it purposefully, but his imagination and transition to story-based games do not develop. In children with mental retardation, development stops at the stage of story-based games and does not move to the role-playing level without special training. That is, the child is already beginning to show imagination and come up with a story for his game, but his development does not allow him to move to a more complex and developed level of fantasy and interaction.

About counterfeit

If a trademark is placed on goods with the permission of the copyright holder or by the copyright holder himself, but they are imported into the Russian Federation without his consent, then these goods “may be withdrawn from circulation and destroyed in order to apply the consequences of violating the exclusive right to a trademark only if they are of inadequate quality and (or) to ensure safety , protection of human life and health, protection of nature and cultural values.”
Only a court can recognize a material medium as counterfeit

If necessary, the court orders an examination.
At the same time, the expert cannot be asked to evaluate a trademark, the exclusive right to which belongs to the copyright holder, and a designation expressed on a tangible medium for their confusing similarity . This issue is decided by the court from the point of view of an ordinary consumer who does not have special knowledge.

Danger of mental retardation

By and large, mental retardation does not pose a threat to the life and health of either the child himself (unless it is a consequence of a serious illness) or those around him. In this case, it is more correct to talk about the difficulties and inconveniences that may arise for children with mental retardation and their environment.

Children with mental retardation find it more difficult to adapt to society and have learning difficulties. If mental retardation is not corrected, this can lead to loss of educational motivation and social maladjustment. Every year it will be more and more difficult for the child to be with peers, he will remain in the same class for the second year, his behavior will continue to remain at a low level of development.

As for others, if a child with mental retardation ends up in a regular class of a general education school, and no corrective measures are applied to him, then this may interfere with the learning process of other children. Children with mental retardation are often distracted in class and can distract the teacher and other children. They may play during class or get up and walk around the room without the teacher's permission. All this complicates the educational process and can cause a negative attitude towards such a student both from teachers and from classmates.

That is why it is recommended to send the child either to special classes, or to carry out correctional measures before the start of education, so that the child himself can easily adapt to the school environment and does not complicate the learning process of other children.

Intelligence and thinking

The characteristic of intelligence is also given by its most important component - thinking. According to one of the classifications there are:

• Visual-effective thinking is the simplest. It is formed in the first years of life, when the child looks at adults and repeats their actions to get dressed, use a spoon to eat, etc. ;
• Concrete-figurative thinking . When a child tries to draw conclusions about things that he does not observe, but only imagines or remembers, he masters concrete figurative thinking;
• Abstract thinking . The highest level of development of thinking is abstract thinking, which is used for learning in high school. Abstract thinking requires the ability to work with concepts such as mathematical operations, physical laws and philosophical categories.

Treatment methods

After diagnosing the condition, depending on the indications, the specialist can prescribe drug therapy, but the most important thing is that he connects the child to a system of psychological and pedagogical assistance, which includes correctional classes, in most cases, with three specialists. This is a defectologist, speech therapist and psychologist. Very often one teacher has two specializations, for example, a speech therapist-defectologist. Help from these specialists can be obtained at correctional centers or within a preschool educational institution. In the latter case, the child, accompanied by his parents, must undergo a psychological, medical and pedagogical commission. Early identification and timely connection of a child to psychological and pedagogical correction directly affect the further prognosis and level of compensation for identified developmental disorders. The sooner it is identified and connected, the better the result!

About the domain name

As a general rule, a violation of the exclusive right to a trademark is the actual use of a domain name that is identical or confusingly similar to a trademark in relation to goods similar to those for which legal protection is granted to this trademark.
A violation of the exclusive right to a well-known trademark may be not only the use of a domain name, but also the very fact of registering a domain name that is identical to this well-known trademark or confusingly similar to it.

How to prevent mental development problems

Good and effective prevention of childhood mental retardation is based on the early and comprehensive development of children. In general, medical experts advise the child’s parents to adhere to the following simple rules in order to prevent mental retardation.

• It is necessary to create optimal conditions for a woman’s successful pregnancy and childbirth.
• In a family where a small child is growing up, a favorable and friendly environment must be created.
• If the baby develops any diseases, they must be treated in a timely manner.
• From the first days after birth, the baby’s condition must be carefully monitored.
• From an early age, you need to constantly work with your baby, developing abilities and skills.

In the prevention of mental retardation in children, contact between mother and baby on an emotional and physical level is of great importance. The child will feel calm when his mother hugs and kisses him. Thanks to attention and care, the baby better navigates his new surroundings and learns to adequately perceive the world around him.

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Components of Intelligence

The components of intelligence are divided into hereditary and acquired. The hereditary components of intelligence include ability, giftedness and determination. Acquired components of intelligence include upbringing, education and life experience. The ratio of innate and acquired components of intelligence is unique for each individual.

If I ever write about medical psychology, I will definitely define these concepts and talk a little about each. And for now we are moving on.