According to inexorable statistics, the percentage of children diagnosed with mental retardation increases by about 2 times every year in the world. What it is, not everyone knows. Meanwhile, the abbreviation ZPRR stands for simply - a delay in psychoverbal development. In addition to this deviation, children have two others, designated SRR (speech developmental delay) and ZPR (mental retardation). All three in most cases are interconnected and interdependent. Not every mom and dad attach serious importance to the fact that their child barely pronounces individual words when his peers are already speaking in sentences with might and main. Many parents are sure that the time will come and their baby will “talk”. Knowing all the nuances of ZPRR, what it is, what causes it, how to overcome it, and why to do it, will help to avoid mistakes and correct the situation in time. After all, verbal communication among people, and especially among our smallest citizens, is directly related to adaptation in society, self-realization, achieving certain successes, and in general - with a full life.
Norms of psychoverbal development
To help answer the questions "ZPRR - what is it? And when is it, and when is everything in order?", Let's give a scale of normal development of a child up to 7 years. It should be noted that psychoverbal development is a whole complex of skills and abilities. In addition to the simple reproduction of sounds, this includes the correct pronunciation of words and their logical use, linking individual words into sentences, the use of verbs in time without errors, as well as pronouns (I, he, me, you, and so on), the ability to clearly and reasonably express their thoughts and desires. A child should be diagnosed with RDD at about 5 years of age. The table below will help parents figure out what and at what age their baby should be able to.
| Age | Skills |
| 0-1 (months) |
Emotional response of the baby to the appeal to him (for affectionate - a smile or any manifestation of joy, for a sharp and strict crying, sobbing, facial expressions of resentment or frustration). |
| 1-3 (months) | Cooing, babbling, and towards the end of 3 months - the pronunciation of individual, the simplest sounds. |
| 3-6 (months) | In babbling, at first involuntary, and after a deliberate combination of sounds into sound combinations, the baby should be interested in what he does, listen to the new sounds he creates, and closer to 6 months more clearly pronounce individuallight syllables (ba, ma, pa, etc.). |
| 6-9 (months) | Sufficiently clear pronunciation of simple letter combinations and syllables, and closer to 9 months, babies should begin to repeat syllables and simple words after adults (give, na). Also, children should already understand the meanings of some words and expressions, for example, “this is mom”, “where is dad?”, “meow” makes a kitty, “woof” makes a dog” and so on. |
| 1 (year) |
Meaningful pronunciation of simple words. Someone may have only 2-3 of them, someone has 10-12, but they should already appear in the children's vocabulary. |
| 1-1, 5 (years) | The child is happy to make contact, plays enthusiastically, learns something new every day. Being engaged in active children's activities, the baby quickly develops his vocabulary, which over the next 6 months should reach about 100 words. The child can already formulate the simplest sentences, such as “kisa meow-meow”, “mother give”. He still pronounces many words distortedly, does not pronounce all sounds, where they do not understand him, he adds facial expressions and gestures to speech, he can come up with new words that do not exist in nature, but by the way and what he is trying to say, it is clearly visible that his development is going well. |
| 1, 5-3 (years) |
The child's speech becomes more distinct. Some children at 3 years old can correctly pronounce almost all sounds, but more often there are still problems with “r”, “l”, “z”, “s”, “h”, “u” and “sh”. Vocabulary in 3 years should grow to about3000 words and already include “where”, “because”, “when”, moreover, they need to be used meaningfully. |
| 3-5 (years) | Children correctly pronounce all or the vast majority of sounds, are good at combining words into meaningful sentences and making short stories out of them, describing a picture, answering questions not only unambiguously “yes” or “no”, but also more spatially, telling something that happened to them during the day. |
| 5-6 (years) | Most children pronounce sounds without distortion, can communicate and clearly express their desires. |
| 6-7 (years) | Speech is correct and meaningful. The child should not have difficulty retelling what he saw, describing the picture. Many children at this age can read, count, and solve simple logic puzzles. |
Deviations from these norms may be a reason for parents to seek medical advice.
When to sound the alarm
The values of the above table are not absolute, there is no strict framework in this matter. Each person, and the baby too, is a person, a whole separate “universe”, which has its own individual characteristics. Therefore, all the above data can be adjusted in the plus or minus range, but by the age of 7, development should be normal. However, a significant lag behind the norms often means not the individuality of the child, but the presence of a ZPRR.
Symptoms confirming pathology:
- at 3-4 months, the baby does not react in any way to the parents' appeal to him, remains indifferent to the toys offered to him, does not respond with a smile to the manifestation of love, tenderness and care for him;
- by 9 months there is no babbling, the baby does not pronounce individual syllables (some children, when they need something, can explain their desire with gestures, grunt at the same time or repeat any one sound that is most acceptable to them);
- by the 1st year, the child is quiet, silent, constantly serious, smiles little, makes difficult contact;
- by the age of 2, the vocabulary of a person suffering from mental retardation includes 10 words or so, the child does not repeat new words after adults, does not understand well what others want from him, cannot and does not try to make sentences even from two words, like "mom give";
- by 2.5 years old, the baby gets confused in the names of objects, cannot quickly and correctly answer questions about body parts (“where is the nose?”, “Where are the ears?”), often does not want to do what is from him demand, as if not paying attention to the simplest requests at all;
- ZPRR at the age of 3 or a little later is manifested by the child’s inability to make sentences on his own, misunderstanding of the meaning of the fairy tales read to him, some kids start talking either very quickly, “swallowing” the endings of words, or too slowly, or remain silent, answer the questions posed gestures, facial expressions, or do not react at all, or selectively repeat words after an adult, do not know how to use a potty.
In addition to shortcomings in speech development, ZPRR can manifest itself in the following:
- open mouth almost constantly;
- excessive salivation;
- aggressiveness;
- carelessness;
- fatigue;
- weak memory;
- delay in physical development;
- lack of imagination;
- isolation.
Reasons contributing to developmental disabilities
There are parents who doubt: ZPRR - what is it? Disease or not? However, scientists have figured this out for a long time. The results of numerous studies have shown that delays in psychoverbal development are caused by disorders in the brain and central nervous system. They can be caused by various factors, some of which affect the baby even before birth, and some occur in the first months of life. These include:
- during pregnancy, infectious and other diseases suffered by the expectant mother;
- childbirth with complications (protracted, rapid, premature, late);
- injuries at birth (cervical vertebrae, skull, CNS);
- severe infectious diseases in the first months of life;
- hypoxia in the womb;
- twisting the umbilical cord around the neck during childbirth;
- some methods of upbringing (too annoying guardianship, suppression of any initiative and independence shown by the child, cruel treatment of him, indifference of parents to their children, situations when they are left to themselves almost all day, starting from infancy, and careparents consists only in feeding and changing diapers);
- Psychic trauma to babies in early life.
Diseases causing STDs
ZPRR in a child will almost certainly occur as a concomitant, and in some cases as one of the main symptoms in the following diseases:
- genetic, disrupting the structure of brain cells;
- epilepsy;
- cerebral ischemia;
- CNS anomalies;
- mental illness;
- CP;
- hydrocephalus;
- intracranial pressure;
- brain tumor;
- leukodystrophy;
- injury of the nerve of the cervical vertebrae;
- problems with cerebral vessels;
- impaired CSF dynamics.
In addition, autism is often a companion of ZPRR, most doctors recognize it as a disease of the nervous system, in which changes in brain regions are observed. These pathologies are associated with mutations in genes and changes in their interaction.
ZPRR and ACH
First, let's explain what AF is. In this case, this abbreviation means "autistic traits." The number of autistic people in our society is growing every year. According to sociological and medical studies, there are about 3-5 such people for every 1000 people, and there are much more those who have certain autistic traits. Autistic adults lead a secluded life, in most cases they are lonely, often experiencing difficulties in the social aspect. You can notice both ZPRR and AF in a child from infancy, but often their firstmanifestations do not cause anxiety in parents, because the developmental lag is attributed to age, and AF to the character traits of the baby. Sometimes it happens that some children with AF, against the general background of some lagging behind their peers, have unusual talents that they do not possess, for example, a unique memorization of difficult words, numbers with a large number of digits, and so on. In addition, many autistic children surprise and touch their parents with their love for a certain, memorized ritual, for example, before eating, it is mandatory to wash hands with a daily repetition of all actions to the smallest detail, and the slightest deviations from the established ritual are often perceived with hostility. In addition to preparing for meals, such children often observe the ritual of preparing for sleep. Toddlers with AS do not throw toys, but fold them in the way they choose, remaining not childishly serious, perform a series of sequential actions with changing clothes, and so on. Many parents are not only not alarmed by such uncharacteristic behavior of their children, they even like it. ZPRR with autistic features becomes quite pronounced by about 3 years. If no action is taken during this period, the matured child will experience great difficulties at school, may withdraw into himself, withdraw from society, or begin to show aggression towards those who are not like him, who do not understand him or ridicule him in some way.
SDDD with Autistic Traits: Symptoms
Suspect that a newborn baby has autistic traits that can cause a further lag indevelopment, it is possible by the following symptoms:
- strong crying and unreasonably violent reaction to seemingly minor discomfort and irritants (moved the lamp, turned on the TV, etc.);
- weak or completely absent reaction to strong stimuli (for example, an injection);
- weak motor revival (legs, arms, smile);
- the manifestation of activity and interest, aimed only at the toy, while indifference to the care and communication of people with him.
The older these children become, the brighter they show ZPRD with autistic features. Symptoms of this disease at the age of 1-1.5 years:
- no babbling;
- rarely and reluctantly respond to being called by their name;
- avoid making eye contact with other people, which is especially noticeable when the baby is learning to walk;
- express desire with gestures, and often do it with the hand of the one who is next to them;
- do not show a pen, where, for example, mom, do not wave goodbye;
- do not say any syllables;
- sleep hard and sleep poorly.
Symptoms from age 3:
- children rarely approach other children on their own;
- avoid communication, preferring to play alone;
- do not react to the emotions of those around him;
- do not understand what it means to "take turns with other children (for example, in kindergarten)", they are poorly oriented in the social environment that is developing around them.
ZPRR with autistic features in this age range maymanifest themselves with the following deviations:
- small vocabulary;
- replacing verbal requests with gestures;
- weak ability to combine those words that are already familiar;
- rare appeals to adults or other children with requests;
- inability or unwillingness to tell parents, for example, what was interesting today in kindergarten and the like;
- incorrect use of pronouns (to the question "what's your name?" the child answers "your name is Sasha");
- inability to play those games that require fantasy, imagination;
- fatal attachment to only one thing (toy, book, fairy tale, TV show);
- auto-aggression (self-harm).
Older children diagnosed with mental retardation and AS develop difficulties with their studies, inattention to school and other tasks that are not interesting, aggression (because the child is already beginning to be punished for poor grades in some way).
Diagnosis
The final diagnosis of ZPRR is made on the basis of a comprehensive examination of the child. First of all, the attending physician must:
- clarify the data (take an anamnesis) about how the pregnancy, childbirth proceeded, what were the features of the first months of the child's life (infection, injuries, etc.);
- analyze the child's behavior based on personal communication with him, test him for attentiveness, the ability to think logically, memorize, understand the questions asked, and so on (child 5 years oldZPRR shows not only speech therapy problems, but also the inability to think logically, solve the simplest tasks corresponding to his age, navigate in the concepts of “faster-longer”, “more-less” and the like, logically explain the compared values, colors, characteristics of objects familiar to him);
- conduct clinical examinations (examination by a neurologist, speech therapist, neuropsychologist);
- in some cases, the doctor may refer the child for tests (chromosome tests, metabolic and genetic tests, and others);
- sometimes conduct differential computer diagnostics.
With an accurate diagnosis of ZPRR, disability is given, as a rule, for 1-2 years. It is established on the basis of the conclusion of the ITU (medical and social expertise). For longer than 2 years, disability is not given for the reason that the concept of "delay" means a temporary phenomenon and implies the achievement of the norm sooner or later. Therefore, after the expiration of the disability period, children must again go through the commission and take a new ITU conclusion.
Basic treatments
All doctors agree: the earlier the treatment of ZPRR is started, the better the prognosis will be.
Treatment methods for each baby may be different. This directly depends on the reasons that caused the developmental delay. In all cases, an integrated approach is required, because only speech therapy classes or pills cannot achieve 100% success. Current treatments include:
1. Reflexology with microcurrents. At the same time, minimal electrical impulses are applied to bioactive pointsand areas of the brain where violations were found, as well as those that are responsible for speech development, after which the work of the central nervous system is restored. The greatest effect of the method was observed in patients with hydrocephalus. The method is applied until children reach the age of 6 months.
2. Medical therapy.
3. Speech therapy classes, correction of diction and pronunciation.
4. Stimulation Therapy.
5. Working with a psychologist, psychotherapist.
In especially severe cases, the treatment of ZPRR includes the use of autoneurite therapy (introduction of nootropics into the brain) and microsurgery (in this case, additional vessels are added to the areas of the brain responsible for speech).
Treatment in Israel, Germany, China gives excellent results.
Additional methods
Surprisingly good results are obtained by the treatment of ZPRR in children with non-traditional methods. These include:
- osteopathy (manual impact on special points of the body. In this case, a balance is achieved in the work of the nervous system, psyche, metabolism);
- therapeutic riding (hippotherapy);
- swimming with dolphins (dolphin therapy);
- exposure of a non-child to music, smells (aromatherapy);
- multiple activities for logical thinking and motor skills (puzzles, Lego), active games.
Parents should work a lot and regularly with children who have a lag in psychoverbal development, using any available games, inventing fun, interesting and understandable tasks for the child.
Opinions of parents anddoctors
Native children who have been diagnosed with STDs leave different reviews about treatment, the activities of doctors and getting a disability, depending on the result. Regarding disability: many mothers and fathers are against the fact that it is given to a child under 3 years old, and they believe that some lag in speech development is completely overcome, so there is no need to put a stigma on the child. Also, many parents are against sending their child to specialized preschool children's institutions, perhaps rightly believing that developmental delays will disappear faster in a regular kindergarten. The only thing that every parent agrees with is that you need to do a lot of work with lagging children, be sure to contact a speech therapist, if possible, use non-traditional treatment, which helps very well, especially in cases where, in addition to ZPRR, there is also ACh.
A lot of grateful reviews about the treatment of children in the Clinic of Restorative Neurology (Moscow), whose doctors truly work wonders and help to almost completely get rid of STDs, autism and other abnormalities.
Doctors regarding children with STDs believe that developmental delays that are not caused by serious diseases (cerebral palsy, Down syndrome, and others) can be completely reduced to zero if treatment is started on time.
