ZPRR - what is it? Treatment of children with a diagnosis of "ZPRR"
It would seem that in the age of modern technology, our children are smarter and more developed than we are. But unfortunately, every year an increasing number of parents turn to doctors about the lag of their children in emotional and mental development from their peers. According to statistics, 20% of children are diagnosed with late psychoverbal development (ZPRR). What is it, is it possible to defeat this diagnosis, we will understand further.
ZPR and ZRR - what is the difference
Quite a few parents do not pay special attention to the fact that their child speaks only in words when their peers speak in whole sentences. They believe that everything has its time and their baby will soon speak.
In medical circles, there are two diagnoses that most often go hand in hand and are highly interrelated - this is a delay in speech development (SUR) and mental retardation (SUR). If symptoms of both are observed, then RRR is diagnosed.What is this diagnosis, and how to cope with it, consider next.
If there is only delayed speech development, then the kid can fulfill all the requests of the parents, understand what he is being told, but he simply does not hurry to speak and speaks little and reluctantly. Emotional and mental development while it remains normal.
Delayed psychoverbal development implies not only problems with speech, but also mental retardation.
Up to 4 years of age, the diagnosis of ZPRR is made quite rarely, but in children older than 5 years, the majority is diagnosed not only with lag in speech, but also in mental terms. This is due to the fact that at this age the child is actively exploring the world, communicating with parents and peers, and if it suffers, it leads to inhibition of mental development.
That is why, if the pediatrician diagnoses the child ZRR to the child, then the parents should not expect that everything normalizes by itself, because the difficulty in communicating with others with speech will certainly lead to a violation of the formation of the emotional-volitional sphere.
Some parents resort to the help of defectologists, but with such a diagnosis, medical assistance is also necessary, because the lost time is fraught with serious developmental disorders.Treatment of ZPRR in children should begin as early as possible.
Individual features of development or lag?
In order not to be mistaken with the diagnosis, it is necessary to know where the individual feature of development takes place, and where it is already a question of lagging. Each baby develops at his own pace, so developmental standards are quite flexible. For example, the pronunciation of 10 words is considered the norm for one-year-olds, but this does not mean that if your child speaks only 7, then he should already have delayed speech development. It is even affected by gender: it is not a secret to anyone that boys always lag a little behind girls in their development.
This is easily explained if you look at the physiology. Speech can be adequately formed by the coordinated work of both hemispheres, which are interconnected by a bundle of nerve fibers - the corpus callosum. In boys, this bundle is much thinner, so the connection between the hemispheres develops more slowly, which leads to a later development of speech. Boys just harder to translate their thoughts into words, but this does not mean that they do not understand.
If there are no pathologies in the development of brain structures or mental abnormalities, then over time, everything will return to normal, and the future man will speak no worse than girls.But mommies of boys should not let the situation take their course, especially if there is a strong lag, because the percentage of GPRR is quite large among boys.
Many mothers are interested in, when is the RRR what time do children start talking? Only one thing can be said, if up to 2.5 years, “baby” speech, incomplete pronunciation of words is considered the norm, then after this age the child should put words into simple sentences. If there are no such attempts, then it is worth sounding the alarm and contacting specialists. For parents, it is not at all clear if a diagnosis of ZPRR is made, what to do, but, above all, do not panic. Therapy, started on time, gives good results.
Signs of delayed psychoverbal development
If ZPRR (what we have, we already found out) is provoked by hereditary deviations, then it will begin to manifest itself quite early. For parents, you can name the following signs by which you can recognize a deviation from the norm:
- A 4-month-old baby does not emotionally react to the approach of native people, does not smile.
- If in 8-9 months there is practically no babbling, and at the age of one year the child makes little sounds, quiet and silent.
- At 1.5 years old, the baby cannot fulfill the simple request of parents, for example, “come here”, “sit down”. Does not understand simple words.
- There are difficulties with chewing at 1.5 years, such children can choke even a small piece of fruit or cookies.
- If, at 2 years of age, a child uses only a few familiar words in speech, the vocabulary is not replenished with new ones.
- At 2.5 years old, it is difficult for a child to name parts of the body and show them, does not fulfill the requests of parents, uses less than 20 words in speech, is not able to make a phrase of even two words.
- Incomprehensible speech at 3 years, inability to express suggestions, lack of understanding of simple stories about past and future events.
- At the age of three or too fast speech, as if rumbles, or too slow, with stretching words.
- The speech is based at three years on the heard phrases from cartoons and books, but it cannot build its own proposals - this is a clear sign of the RRT that this is, the expert will explain.
- If there is a mirror speech, when at 3 years old the child repeats what he hears from adults, then an urgent need to hurry to the doctor, it is better to see a psychiatrist.
Parents should remember that the treatment of ZPRR is more successful, the earlier it is started.
In children with disabilities in mental and speech development, in addition to the listed symptoms, the following symptoms may occur:
- Increased salivation.
- Open mouth.
- Reduced attention.
- There may be an aggressive reaction.
- Baby quickly tired during class.
- Memory is bad.
- Imagination is not developed at all, it is difficult for a child to invent something himself.
- Low emotional involvement.
- It is difficult to communicate with peers.
- Physical development can also lag behind, often these babies have a diagnosis of cerebral palsy.
Late psychoverbal development is manifested by various organic changes. If an electroencephalogram is performed on such a baby, then violations can be detected in the left hemisphere, which is responsible for the formation of speech. The longer you don’t pay attention to ZPRR, parents' reviews confirm this, the more the problems in mental and mental development are aggravated.
Causes of developmental delay
In order for ZPRR treatment to be more successful, it is very important to identify the reasons that provoked such deviations. The delay of speech or mental development, as a rule, occurs against the background of pathologies in the development of the brain and the entire nervous system. The provoking factors include:
- Infectious diseases during pregnancy.
- The effects of toxic and toxic substances on the fetus during its carrying.
- Hypoxia of the fetus.
- Severe pregnancy and labor, entanglement with umbilical cord, birth injuries.
- Severe injuries in infancy.
- Postponed in early childhood serious infectious diseases.
- Chromosomal diseases affecting brain structures.
- Child abuse.
- Education in conditions of excessive care.
- Education in the antisocial family.
- Abandoned children.
- Serious mental injury in childhood.
You can also list some diseases that can provoke ZPRR, that this is probably already clear to everyone.
- Congenital pathologies of the central nervous system and metabolic disorders in it.
- Epilepsy and other mental pathologies.
- Ischemia of the brain.
- High intracranial pressure.
- Cerebral palsy.
- Neoplasms in the brain.
- Pathological changes in the vessels of the brain.
- Violation of liquor dynamics.
Given the huge list of provoking factors and diseases, it is important to note that the treatment of ZPRR, the reviews confirm this, only then it will be effective when the causes of such deviations are eliminated.
It is important to keep in mind that the presence in the family of people suffering from such deviations increases the likelihood of the development of ZPRR in a baby.
Autistic trait ZPRR
Disorders in the nervous system, pathology in the development of the brain, the impact of infectious agents can lead not only to the development of a lag in speech and psyche, but also to the formation of signs of autism. You can recognize it already in infancy for some symptoms:
- The child often cries a lot, reacts violently to wet diapers, a loud sound.
- The baby does not respond to strong stimuli, for example, to injections.
- No active motor revitalization.
- Absolute indifference to the treatment of relatives, their care.
- No babbling.
The older the baby becomes, the brighter the features of autism appear.
ZPRR with autistic features symptoms in later age has the following:
- The child does not communicate emotionally with others, he does not even smile at his parents.
- Such babies try not to look into the eyes.
- Small vocabulary.
- Often shows aggression, especially if dissatisfied with something. He can direct her towards himself, that is, bite himself, beat him.
- Makes stereotypical movements: walks in a circle, swings, constantly turns the same object in his hands, does not like changes and reacts negatively to them.
- No skills in self-play with toys, can be strongly attached to one of them.
- Can not play with other children.
- Avoids any communication.
- Such children have difficulty falling asleep and sleep poorly.
- Practically do not turn to their parents or other children with requests.
- Incorrectly use pronouns, for example, to the question “what is your name?” The child answers “your name is Masha”.
ZPRR with autistic features in a child is also manifested by a lack of understanding of the speech addressed to him. If the listed symptoms are present, then you should not delay with the appeal to experts. It is necessary to treat ZPRR and autism at the same time at several experts.
Diagnostics to identify the causes of speech and mental retardation
To start an effective therapy, it is important to identify the causes, and for this it is necessary to conduct a detailed diagnosis, which includes:
- Examination by an audiologist, especially if there is a suspicion of delayed speech.
- To assess the developmental correspondence of a certain age, various tests, the scale of early speech development and the Bailey scale for infants are used.
- A conversation is held with the parents, during which the specialist will find out how the child communicates with the parents, how he expresses his demands and wishes, and informs about his needs. This is very important, because if there are simply problems with hearing, the child can express his needs.
- The doctor checks the presence of apraxia of the muscles of the face, which can lead to difficulties with swallowing and movement of the tongue. The specialist compares how the child understands speech and reproduces it.
- Be sure to find out the features of the environment in which the baby grows and develops.
The neurologist, speech therapist, psychiatrist, may be required to clarify the causes of developmental delays; the help of a psychologist may be required. Parents should also understand that, in almost 100% of cases, ZPRR therapy is impossible without prescription of drugs.
From what age to start treatment
All experts will say unanimously that the sooner the better. A neurologist is most likely to prescribe medication from the age of one, especially in cases where there are pathologies that can lead to a delay in speech and mental development.
The defectologist will recommend starting classes at 2 years of age. Specially developed techniques help develop the attention, memory, fine motor skills and thinking of a child.
The speech therapist begins work with the child, as a rule, from 4-5 years. He teaches how to make sentences, pronounce sounds.
Speech and Mental Delay Therapy
Any expert will say that the treatment of ZPRR should be comprehensive, and it should begin as soon as possible. If the gap with the norm is small, then in almost 100% of cases it is possible to achieve excellent results. The child gets every chance to study in a regular secondary school and communicate normally with his peers.
Nowadays, specialists know how to treat ZPRR, usually the following methods are used:
- Drug therapy.
- Classes with speech therapist.
- Work with a psychologist and psychotherapist.
- Stimulating therapy.
Using only one direction in therapy will not give the desired result, therefore, a competent specialist always draws up a therapeutic treatment plan that necessarily takes into account the characteristics of each baby, the severity of the pathology, and concomitant diseases.
Some parents act recklessly when they refuse to give the child prescribed medications, believing that they will not be of any use.But it has already been proven that only in combination, the methods of therapy will give a positive result in the treatment of ZPRR. By the way, disability in case of ZPRR, by the way, is not allowed, unless there are no concomitant serious pathologies, for example, cerebral palsy, hydrocephalus.
Drugs should be prescribed only by a neurologist who does this after a set of examinations and prescribes an individual regimen. Most often, doctors prescribe nootropic drugs that directly affect the central nervous system, improve memory and stimulate mental activity. Nootropics also do a good job of protecting the brain from hypoxia and exposure to toxic substances. These drugs affect the integrative and cognitive functions of the brain - memory, attention, thinking, speech, emotional-volitional functions, perception of information.
Currently, for children with a lag in mental and speech development they prescribe:
- Picamilon, Phenibut.
- Drugs that enhance cholinergic processes in the brain tissue: "Cerebrolysin", "Ceraxon", "Gliatilin".
- Neuropeptides: Actovegin, Cortexin.
- Cerebrovascular drugs: Vinpocetine, Tsinnarizin.
- Means to prevent hypoxia and antioxidants: "Mexidol", "Cytoflavin."
- General tonic drugs: Elkar, Lecithin.
- Vitamin preparations: Neuromultivitis, Magne B6».
It should be borne in mind that in case of increased excitability it is necessary to choose the means that do not have a stimulating effect, or combine the medication with the use of sedatives.
This method of treatment is based on the use of ultra-small electrical impulses on the neuro-reflex zones of the brain. This method allows you to restore the nervous system in those areas where there is a violation. With a lag in speech development, the impact is on the areas associated with speech.
According to experts, this method gives good results in the presence of hydrocephalus. It is allowed to use microcurrent reflexotherapy in babies from 6 months.
Work with a speech therapist and a pathologist
Classes with a defectologist must begin no earlier than 2 years of age. The specialist conducts classes that help develop the baby's memory, attention, thinking, fine motor skills.Speech therapists start their work from 4-5 years. Their task is to teach the kid to make suggestions, correct articulation. As an additional method of treatment can be called a speech therapy massage, which stimulates the facial and masticatory muscles of the face, the child becomes easier to pronounce sounds.
Parents are mistaken, believing that only working with a speech therapist and a pathologist can help to cope with all the problems in speech. Preliminary work with a child is very important and simply necessary. If there is a diagnosis of RRR, then it is too late to start therapy at 5 years of age.
Additional correction methods
In addition to drug treatment and classes with a speech therapist and a pathologist, there are additional methods of therapy that help to cope with the consequences of late development of speech and psyche:
- Classes with a psychologist. Such work is simply necessary if problems with speech and mentality are associated with psychological trauma, an unfavorable situation in the family.
- Alternative methods:
- Ippo and dolphin therapy.
- Music therapy.
- Developmental exercises, such as puzzle collection, outdoor games.
3. Osteopathy.The work of the chiropractor is aimed at balancing the work of the nervous system and psyche by acting on special points on the body.
It is very important that not only specialists deal with the child, but also the parents devote a lot of time to this. With a kid, you need to sculpt a lot of plasticine, make a simulator for fastening buttons, draw, especially with finger paints, string the beads on a string - all these simple exercises allow you to train fine motor skills of hands, and thus stimulate the development of speech centers in the brain.
Treatment of late speech and mental development abroad
It is very important for parents of such children to find a specialist who, after diagnosis, will select an effective therapy that includes various methods. It often happens that mothers cannot find such a doctor in our country to seek help from foreign specialists. Demand is the treatment of ZPRR in Israel. For many parents, of course, such therapy is not affordable, but those who can afford, do not miss such a chance.
Parents also apply to foreign specialists in cases where local doctors cannot help to cope with the consequences of RRD.The clinics abroad have the best specialists, are armed with the latest treatment methods, so even complex cases can be corrected.
As a rule, after such treatment, children are able to study in a regular school, no longer have difficulty in communication. Symptoms of ZPRR recede, reviews of parents confirm this.
We must pay tribute to the fact that now and in some Moscow clinics they are starting to use the newest methods of treatment for late psychoverbal development, therefore parents have hope that they will be able to help their children.
In conclusion, we can say that the diagnosis of ZPRR - this is not a sentence. Of course, parents will need a lot of effort, patience and full compliance with all the recommendations of the doctor. Corrective measures should not be stopped, no matter how much one wants to do this. The kid will often protest against the activities, be capricious, but you have to stand on your own and diversify the classes, then the result will be necessary. The main thing - love and patience.