When a child develops a nervous system. Consequences and treatment of neurophysiological immaturity of the cerebral cortex in a newborn child

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On the one hand, a newborn is very defenseless, and on the other hand, nature has endowed him with all the necessary functions for survival and development. From birth, a child has many unconditioned reflexes that help him navigate how to start eating, how to roll over, turn your head so as not to suffocate.

All this happens due to the fact that the neuropsychic development of children begins during pregnancy. After birth, this process continues, and the functions of the nervous system become more complex. The baby learns something new in the first month of life. After this, the nervous system improves and brain . This process lasts for many years. It is very important for parents to track the stages of the baby’s development, the development of his reflexes, movements, psyche, and emotions.

Development of the nervous system and brain

The formation of a child's brain in the womb begins quite late. All the main organs are already formed, and the brain is just beginning to develop. First the cortex, then the medulla... Only in the third trimester of pregnancy does the brain acquire so-called convolutions, grooves. But it is still not fully developed. The baby has already been born, and this process continues. The brain will be fully formed only by 6-7 years.

The nervous system develops earlier. By the time of birth, the main part of the central nervous system must be prepared and
function. Without this, the baby will not survive, or his life will be limited in possibilities. It is very important for pregnant women to remember this. By taking antibiotics, strong drugs or alcohol, a pregnant woman primarily harms the nervous system of the unborn child. This is one of the most important systems, and it is very vulnerable.

The growth rate of nerve cells, axons and neurons accelerates by 3 months. After this, the first unconditioned reflexes should disappear, and the child’s nervous activity will become more complicated. He develops new, conditioned reflexes. All this should be monitored by your pediatrician, because at this stage (2-3 months) the first deviations in the development of the nervous system and mental activity of the baby will be noticeable.

Child's psyche

From the first days of life, she has a simple structure. If the child is happy, if he is comfortable, then he is completely relaxed. If an irritant appears, then, according to the baby, a “black streak” begins. An adult differentiates his reactions: for example, you have a stomach ache - you know that this is a temporary condition that can be treated, a pill or just warm tea will help you. A simple stomach ache won't make you completely miserable. For the baby, unfortunately, this is not the case - he takes everything completely seriously. His
the psyche reacts globally, all parts of the brain are involved.

The psyche develops quickly: by the age of 3 months he recognizes his relatives and reacts with a smile to his mother’s face. The range of his emotions changes greatly. By the age of 1, he can react quite vividly to various events. By the age of 3, his reactions are quite conscious, and a logic of action appears. At the age of 5 years, primary myelination ends nerve fibers- many rules, conventions, and ways to solve problems at his level become clear to the child.

The gradual development of the psyche prepares the child to become an independent adult, to take care of himself. The psyche and nervous system are connected and exist in a single mechanism. Here:

Every year the development of mental capabilities becomes more complicated. That is why the age of 6-7 years is optimal for sending your child to school. Mentally he is ready to be on his own for at least half a day, follow rules and regulations, concentrate on tasks and communicate with other people.

Child development chart

It is very important to ensure that development proceeds in stages. Of course, we are all different. These differences are laid down in childhood: everything depends on our family, relationships, number of relatives, quality of life, predispositions and heredity. There is a generally accepted schedule for the development of children - both neuropsychic and physical.. Based on it, doctors draw a conclusion about how correctly the process of improvement, growth, and development is proceeding. There are some assumptions - 1-3 months usually does not matter.

When
the difference between real indicators and the graph is large, a diagnosis of “developmental delay” is made. Latency is a lag that can be caught up. There is no need to be scared and label your child as incapable of something. Often in 2-3 years the situation is correctable. Of course, there are more serious problems, at the level of structural damage to the brain or central nervous system - this is a matter for doctors.

There is a rule: the younger the child, the faster the development of his neuropsychic activity. This is because the body needs to quickly prepare for independent life. The older the child, the slower these processes go. So, at 4-5 years old, it is easier to start learning a foreign language than at 35. Many adults know this for themselves.

Stages of neuropsychic development

Here we can distinguish 5 periods from birth to 16 years. After this, the psyche becomes akin to an adult. Of course, at 16 it is still necessary to indicate young man way, but now he
can already make informed choices. It is believed that now his psyche will develop more slowly, but these changes are more qualitative than before.

Everything that comes after is the result collaboration parents, teachers, friends and the person’s environment. This is how our psyche is formed. What kind of personality your child will have depends on you, and not only in terms of heredity. Everything that young children see and hear is stored in their brain, which at this moment is actively growing, functioning like a large sponge. Knowledge of the stages of formation of neuropsychic reactions will help parents pay attention to important issues in the lives of their children. The stages can be divided as follows:

• Infancy (0-12 months)

Now connections are being formed with loved ones. Your relatives
The child greets you with a smile, but is afraid of newcomers in the house. During this period, physical development comes to the fore: the child grows and learns to eat solid food. His psyche is still tuned to emotions: joy and sadness. The first emotional reactions are positive - the baby smiles, laughs. Now his first contact with the world is taking place: he sees, hears, touches objects, tastes. Its knowledge base is updated every day - this forces the brain to work hard on new information.

• Childhood (1-3 years)

Time to develop many situational skills. For a child, some actions become familiar: opening and closing boxes, playing with his toys, using a spoon, a toothbrush.
The brain is now developed enough to begin stimulating speech. It serves as a link between inner world and external. The richer and more emotional she is, the better her psyche is developed.

By 1 year or a little later, fine motor skills should already be present in the child’s games and movements. This is very important and means that nerve endings formed correctly. For example, children can easily use only 2 fingers to take a small object and get it out, but previously all 5 were needed. Communication with other children and adults becomes more difficult, because communication is now important for the baby. This suggests that his brain can already build friendships.

• Preschool age (3-7 years)

Time for active development logical thinking. The child can invent games, entertainment, stories. He shares these ideas with his parents. Your task is to participate in the development of his imagination. In the period of 5-7 years, children can already act according to the situation; they have accumulated experience and knowledge that allow them to make choices.. At this age, ethical norms and concepts of “good” and “bad” are formed, which means that mental activity has become more complex. Now a little person even has an internal struggle between what he wants and what needs to be done.

• School period (7-12)

This is a difficult period for many, but very important. Grades are given in a group of students. Children study evaluate your role in society: how successful they are in their studies, how many friends they have, whether they can be common favorites or vice versa. Now they are studying in parallel: gaining new knowledge about the world and relationships various kinds. Friendship , first childhood love, sympathy, resentment. The role of communication becomes first plan: it is necessary to share your thoughts and experiences with someone who understands him - with the same children.

Games and entertainment are becoming more and more diverse. At the age of 11-12, it is important for girls how they look, what clothes they wear. In this regard, boys look at the world more simply, although they have different values: games, technique, strength, speed. They have already fully adapted to school life - it has become familiar and understandable. Very soon you will have to make a choice: where to go next? Usually at the age of 12-15, the child already imagines who he would like to become in the future.

• Puberty (12-16)

Now adulthood begins. The teenager already feels completely ready to conquer the world. During puberty, the psyche is not very stable - the whole point is that hormones are activated. In one year, you can change several images, become completely disappointed in the company and find a new one. By the age of 17-18, this period will end. In the meantime, everything is important - emotions, like adults. The outlook on life, on yourself, your body, your role changes. Parents must be patient with their teenager. Remember yourself at 16 years old - what were you like?

4 ages of “crisis” for children

The entire stage from infancy to puberty goes through several crisis ages for the child. Parents need to adhere to a schedule of visits to the pediatrician, therapist and neurologist. At different stages of brain and nervous system development, disruptions can occur. Even if development went according to schedule until the age of 3, no one is immune from the fact that problems may begin at the age of 4-5. For example, during the period of adaptation to
kindergarten, and then to school. At this moment, his worldview may suffer, which means mental problems arise.

During times of crisis, our brains operate differently than usual. Many parents claim that they simply no longer recognize their child. During these periods you need to show maximum patience, because it is not easy for both of you. There is a restructuring of the psyche, and this is always accompanied by unusual, non-standard behavior. In total, there are 4 crisis ages:

• One year

This is still a baby, but already independent. Can walk, pick up toys, and play by himself. He pulls out the spoon - he wants to show that he can eat himself. At this time, children want to separate from their mother. They cannot speak yet, so any misunderstanding of the child’s initiative makes him aggressive and nervous.

• Three years

First
rebellion against parents. The baby can already show his character traits: obstinacy, disagreement, denial of routine. You shouldn’t scold him - it’s better to direct your energy in a positive direction: educational games, clubs, kindergarten . During this same period, children are very active, they need to run and play outdoor games.. If they are deprived of this, then they eat poorly and fall asleep through crying and scandals.

• Seven years

The child learns to be in a new environment. He has a public “I” - his new face. What is he like at school? Cheerful, positive and active, or vice versa – gloomy. Children change their behavior a lot - sometimes it seems unnatural or imitation to someone. Game and movie characters become influencers. This manifests itself very clearly in boys, but for girls it usually passes peacefully. Girls are becoming more interested in appearance and relationships. Even at such a young age, she can already dream about princes, love and wedding dresses.

• Puberty crisis

Here The main thing to remember is that a child is a full-fledged person. He becomes uncontrollable, and parents and teachers are no longer authorities for him. His nature wakes up, but now all feelings are aggravated due to hormonal changes. Unfortunately, this crisis may drag on, which means no one can tell you when it will end. Strong feelings can lead to a nervous breakdown. IN puberty it is very dangerous.

What parents should pay attention to

Crises, studies, friends - these are signs normal development psyche. It becomes more and more difficult, sometimes even faster than necessary. Then the child does not understand himself. Unfortunately, things don't always go smoothly. It is worth knowing about risk groups for children of any age.

At-risk groups

These include two groups: congenital risks and environmental risks.

Inherent risks:

Environmental risks:

• dysfunctional family;
• large families where children receive little attention;
• mental trauma (violence, abuse);
• social limitations (does not go to school, does not hang out with children).

Most of these children have a delay in neuropsychic development, and some have severe deviations. For such a child there is no opportunity to go to school with the rest - he needs home education or a correction class. Much depends on how and when he was treated. The sooner this was done, the better.

Parents need to remember that their child is a separate person. He cannot become a copy of you or your parents - his life is just beginning, and it is his own life. It is important to ensure that the baby’s development takes place in a comfortable and safe conditions. Then he will be able to learn new things, find out, and rejoice without harm to his psyche. The task of parents is to help, love and protect children from all dangers. Now you are laying the foundation from which the construction of their life, the formation of their own “I”, and attitude towards themselves will begin. The entire future life of your child depends on this foundation.

The nervous system of a child, especially one under 5 years of age, is still too weak. Therefore, you should not be surprised if the baby begins to be capricious for no apparent reason, flinch at the appearance of any source of noise, and his chin shakes. Moreover, it turns out to be very difficult to calm him down. What could cause such a reaction? How to treat and strengthen a child’s nervous system?

Children and adults have completely different features of the nervous and cardiovascular systems. The regulation of nerve pathways up to 3-5 years of age is still immature, weak and imperfect, but is an anatomical and physiological feature of his body, which explains why they quickly get bored with even their favorite activity, a game, and it is extremely difficult for them to sit in one place during the same monotonous classes. This is how the neuropsychic development of children differs.

From about 6 months, the child already becomes an individual; before that, children mostly still identify themselves with their mother. When communicating with the baby and raising him, parents are obliged to take into account the characteristics and type of nervous system of the little person and, of course, the anatomical and physiological characteristics of their child.

Sanguine children are always on the move, they are full of strength and energy, cheerful and easily switch from whatever activity they were currently doing to another. Phlegmatic people are distinguished by their efficiency and calmness, but they are too slow. Cholerics are energetic, but they find it difficult to control themselves. They are also not easy to calm down. Melancholic children are shy and modest, offended by even the slightest criticism from outside.

A child's nervous system always begins its development long before birth. At the 5th month of intrauterine life, it is strengthened due to the enveloping of the nerve fiber with myelin (another name is myelination).

Myelination of nerve fibers of different parts of the brain occurs in different periods in a natural order and serves as an indicator of the beginning of the functioning of the nerve fiber. At the time of birth, the myelination of fibers is not yet complete, because not all sections of the brain can still fully function. Gradually, the development process occurs in absolutely every department, thanks to which connections are established between different centers. The formation and regulation of children's intelligence occurs in a similar way. The baby begins to recognize the faces and objects around him and understands their purpose, although the immaturity of the system is still clearly visible. Myelination of the fibers of the hemispheric system is considered complete at the 8th month of intrauterine development of the fetus, after which it occurs in individual fibers for many years.

Therefore, not only the myelination of nerve fibers, but also the regulation and process of development of the mental state and the anatomical and physiological characteristics of the child and his nervous system take place in the course of his life.

Diseases

Doctors say that it is impossible to name a single childhood disease with the absence of physiological characteristics and changes in the functioning of the heart or central nervous system. This statement especially applies to children under 5 years of age, and the younger the child, the more peculiar the manifestation of reactions from the blood vessels and the central nervous system.

Such reactions include respiratory and circulatory disorders, amyia of the facial muscles, pruritus, shaking chin, others physiological symptoms indicating damage to the brain tissue. Diseases of the central nervous system are very different, and each has its own characteristics. To treat her immaturity, respectively, they also need to be different. And remember: you should never self-medicate!

• Poliomyelitis is caused by a filter virus that enters the body orally. Sources of infection include wastewater and food products, including milk. Antibiotics cannot be used to treat polio; they have no effect on it. This disease characteristic elevated temperature body, various presence of signs of intoxication and various vegetative disorders - itching, dermographism of the skin and increased sweating. First of all, this virus negatively affects blood circulation and breathing.
• Meningococcal meningitis, caused by meningococcus, usually occurs in children under 1 to 2 years of age. The virus is unstable and therefore usually external environment under influence various factors dies pretty quickly. The pathogen enters the body through the nasopharynx and spreads extremely quickly to the entire body. With the onset of the disease, a sharp jump in temperature occurs, hemorrhagic rashes appear, itchy skin that cannot be soothed.
• Purulent secondary meningitis - occurs most often in children under 5 years of age. This disease develops rapidly after purulent otitis media, with a sharp rise in the patient’s body temperature, anxiety in children, headache, and possible itching. It is dangerous due to the possibility of the virus penetrating the membranes of the brain.
• Acute serous lymphocytic meningitis is characterized by the immediate development of its symptoms. Body temperature literally rises in minutes to 39-40 degrees. The patient feels a severe headache, which cannot be calmed even with pills, vomiting and a short-term loss of consciousness of the child occur. But the disease does not affect the internal organs.
• Acute encephalitis - appears in a child if a corresponding infection develops. The virus has a negative effect on the walls of blood vessels, causing disturbances in the functioning of the heart and other physiological disorders. The disease is quite severe. At the same time, the patient’s body temperature rises, loss of consciousness occurs, vomiting, skin itching, as well as convulsions, delirium and other mental symptoms appear.

Any suspicion of any of the diseases described above is a reason to urgently call a doctor, after reassuring the child.

Damage to the system before and after birth

In addition to viral diseases, the diagnosis of “damage to the central nervous system in newborns” is relatively often made. It can be detected at any time: both during intrauterine development of the fetus and at the time of birth. Its main causes are considered to be birth trauma, hypoxia, intrauterine infections, developmental defects, chromosomal pathologies and heredity. The first assessment of the maturity of the system, mental state and anatomical and physiological characteristics is made immediately after the birth of the baby.

Such a child is easily excitable, often cries for no reason when he is nervous, his chin shakes, sometimes he suffers from itchy skin, there is squint, head tilt, muscle tone and other physiological symptoms of a mental disorder. During tantrums, it is almost impossible to calm a child down.

We strengthen the nerves

There is a whole range of strengthening methods. It is a long but quite effective process aimed at calming the baby and at overall improving his emotional, mental and nervous state. And above all, try to surround your child with calm and balanced people who are ready to instantly come to his aid.

We evoke positive emotions

The first place to start is to learn to control and regulate children's emotions and their anatomical, physiological and nervous state. There are a number of exercises that develop a child's muscles and calm him down. For example, a baby helps riding a ball. It is advisable that both parents be with the baby while performing the exercises. It is the joint actions of parents that give their child confidence in his abilities, which in the future will only have a positive impact on determining his place in society.

Relaxing massage

The next point in the complex is a massage using various oils that prevent itching of the skin. A massage session can only be performed by a highly qualified specialist who is well acquainted with the ways of influencing the anatomical and psychological state and physiological processes in the human body. Quiet and calm music, especially the works of Mozart, has a beneficial effect on the child's psyche. The duration of one such massage session should be about 30 minutes. Depending on the mental state, nervous and vascular system, the child is prescribed from 10 to 15 massage sessions in different cases. The assessment of his mental state is made by the doctor individually.

Proper nutrition

Proper nutrition for children, especially under 5 years of age, is one of the main ways to strengthen the child’s nervous and vascular systems. It is important to exclude from the baby’s diet sweet and carbonated drinks, flavors and dyes, and semi-finished products, whose quality often leaves much to be desired. But be sure to eat eggs, fatty fish, butter, oatmeal, beans, berries, dairy and sour-milk products, lean beef.

Taking vitamins and minerals

The strengthening of the nervous, vascular and other systems and the normal anatomical, physiological and mental state of the body are greatly facilitated by taking vitamins. Vitaminization is especially relevant during the cold season, when the physiological strength of the body is at its limit. The lack of vitamins in the body deteriorates memory, mood, and general condition of the body. This is why regulating the amount of vitamins and minerals in the body is so important.

For example, calcium deficiency negatively affects the general condition. The child has hyperreactivity, it is possible nervous tics, convulsions, pruritus.

Physical activity

Regulation of the cardiovascular and nervous systems, myelination of nerve fibers are associated with physical exercise. They tone the body and help improve mood, general and anatomical and physiological development of the brain, which significantly reduces the risk of developing various ailments nervous and cardiovascular systems. Swimming and yoga are best for older children.

Daily regime

Since childhood, we have been told about the importance of following a daily routine - and not in vain. Routine is extremely important for children. Make sure your child gets adequate sleep, which has a significant impact on the nervous and cardiovascular systems. You need to go to bed and wake up at the same time every day. Also, daily walks in the fresh air contribute to saturating the body with oxygen, necessary for anatomical and physiological development.

Every parent should realize that the child’s neuropsychic development largely depends on him.

Pregnancy is a physiological process in which a new organism develops in the uterus, resulting from fertilization. Pregnancy lasts on average 40 weeks (10 obstetric months).

In the intrauterine development of a child, two periods are distinguished:

1. Embryonic(up to 8 weeks of pregnancy inclusive). At this time, the embryo is called an embryo and acquires characteristic human features;
2. Fetal(from 9 weeks until birth). At this time, the embryo is called a fetus.

The growth of a child, the formation of its organs and systems occurs naturally during various periods of intrauterine development, which is subject to the genetic code embedded in the germ cells and fixed in the process of human evolution.

Embryo development in the first obstetric month (1-4 weeks)

First week (days 1-7)

Pregnancy begins from the moment fertilization- fusion of a mature male cell (sperm) and a female egg. This process usually occurs in the ampullary section of the fallopian tube. After a few hours, the fertilized egg begins to divide exponentially and descends through the fallopian tube into the uterine cavity (this journey takes up to five days).

As a result of division it turns out multicellular organism , which is similar to a blackberry (in Latin “morus”), which is why the embryo at this stage is called Morula. Approximately on the 7th day, the morula penetrates the uterine wall (implantation). Villi outer cells The embryo is connected to the blood vessels of the uterus, and subsequently the placenta is formed from them. Other outer morula cells give rise to the development of the umbilical cord and membranes. Over time, various tissues and organs of the fetus will develop from the internal cells.

Information At the time of implantation, a woman may have slight bleeding from the genital tract. Such discharge is physiological and does not require treatment.

Second week (8-14 days)

The outer morula cells grow tightly into the lining of the uterus. In the embryo the formation of the umbilical cord, placenta, and neural tube from which the fetal nervous system subsequently develops.

Third week (15-21 days)

The third week of pregnancy is a difficult and important period.. At that time important organs and systems begin to form fetus: the rudiments of the respiratory, digestive, circulatory, nervous and excretory systems appear. At the site where the fetal head will soon appear, a wide plate is formed, which will give rise to the brain. On day 21, the baby's heart begins to beat.

Fourth week (22-28 days)

this week laying of fetal organs continues. The rudiments of the intestines, liver, kidneys and lungs are already present. The heart begins to work more intensely and pumps more and more blood through the circulatory system.

From the beginning of the fourth week in the embryo body folds appear, and appears vertebral primordium(chord).

Completed by day 25 neural tube formation.

By the end of the week (approximately 27-28 days) are being formed muscular system, spine, which divides the embryo into two symmetrical halves, both upper and lower limbs.

During this period it begins formation of pits on the head, which will later become the eyes of the fetus.

Development of the embryo in the second obstetric month (5-8 weeks)

Fifth week (29-35 days)

During this period the embryo weighs about 0.4 grams, length 1.5-2.5 mm.

Formation begins the following bodies and systems:

1. Digestive system: liver and pancreas;
2. Respiratory system: larynx, trachea, lungs;
3. Circulatory system;
4. Reproductive system: precursors of germ cells are formed;
5. Sense organs: the formation of the eyes and inner ear continues;
6. Nervous system: the formation of parts of the brain begins.

At that time a faint umbilical cord appears. The formation of limbs continues, the first rudiments of nails appear.

On the face formed upper lip and nasal cavities.

Sixth week (36-42 days)

Length embryo during this period is about 4-5 mm.

Starts in the sixth week formation of the placenta. At this stage, it is just beginning to function; blood circulation between it and the embryo has not yet been formed.

Ongoing formation of the brain and its parts. At the sixth week, when performing an encephalogram, it is already possible to record signals from the fetal brain.

Begins formation of facial muscles. The fetal eyes are already more pronounced and uncovered by eyelids that are just beginning to form.

During this period they begin upper limbs change: they lengthen and the rudiments of hands and fingers appear. The lower limbs still remain in their infancy.

Changes are happening important organs :

1. Heart. The division into chambers is completed: ventricles and atria;
2. Urinary system. Primary kidneys have formed, the development of the ureters begins;
3. Digestive system. The formation of sections of the gastrointestinal tract begins: the stomach, small and large intestines. The liver and pancreas had practically completed their development by this period;

Seventh week (43-49 days)

The seventh week is significant in that it is finally The formation of the umbilical cord is completed and uteroplacental circulation is established. Now the breathing and nutrition of the fetus will be carried out due to blood circulation through the vessels of the umbilical cord and placenta.

The embryo is still bent in an arched manner; there is a small tail on the pelvic part of the body. The size of the head is at least half of the embryo. The length from the crown to the sacrum increases by the end of the week up to 13-15 mm.

Ongoing upper limb development. The fingers are visible quite clearly, but their separation from each other has not yet occurred. The child begins to perform spontaneous movements with his hands in response to stimuli.

Fine eyes are formed, already covered with eyelids, which protect them from drying out. The child can open his mouth.

The formation of the nasal fold and nose occurs, two paired elevations are formed on the sides of the head, from which they will begin to develop ears.

Intensive continues development of the brain and its parts.

Eighth week (50-56 days)

The body of the embryo begins to straighten, length from the crown to the coccyx is 15 mm at the beginning of the week and 20-21 mm on day 56.

Ongoing formation of important organs and systems: digestive system, heart, lungs, brain, urinary system, reproductive system (boys develop testicles). The hearing organs are developing.

By the end of the eighth week the child's face becomes familiar to the person: the eyes are well defined, covered with eyelids, the nose, the ears, the formation of the lips is ending.

Intensive growth of the head, upper and lower horses is noted characteristics, ossification develops long bones arms and legs and skull. The fingers are clearly visible; there is no skin membrane between them.

Additionally The eighth week ends embryonic period development and fetal stage begins. From this time on, the embryo is called a fetus.

Fetal development in the third obstetric month (9-12 weeks)

Ninth week (57-63 days)

At the beginning of the ninth week coccygeal-parietal size fetus is about 22 mm, by the end of the week - 31 mm.

Happening improvement of blood vessels of the placenta, which improves uteroplacental blood flow.

The development of the musculoskeletal system continues. The process of ossification begins, the joints of the toes and hands are formed. The fetus begins to make active movements and can clench its fingers. The head is lowered, the chin is pressed tightly to the chest.

Changes occur in the cardiovascular system. The heart beats up to 150 times per minute and pumps blood through its blood vessels. The composition of blood is still very different from the blood of an adult: it consists only of red blood cells.

Ongoing further growth and development of the brain, cerebellar structures are formed.

The organs of the endocrine system are intensively developing, in particular, the adrenal glands, which produce important hormones.

Improves cartilage tissue: auricles, cartilages of the larynx, vocal cords are being formed.

Tenth week (64-70 days)

By the end of the tenth week fruit length from coccyx to crown is 35-40 mm.

Buttocks begin to develop, the previously existing tail disappears. The fetus is in the uterus in a fairly free position in a semi-bent state.

Nervous system development continues. Now the fetus performs not only chaotic movements, but also reflex ones in response to a stimulus. When accidentally touching the walls of the uterus, the child makes movements in response: turns his head, bends or straightens his arms and legs, and pushes to the side. The size of the fetus is still very small, and the woman cannot yet feel these movements.

The sucking reflex is formed, the child begins reflex movements with his lips.

The development of the diaphragm is completed, which will take an active part in breathing.

Eleventh week (71-77 days)

By the end of this week coccygeal-parietal size the fetus increases to 4-5 cm.

The body of the fetus remains disproportionate: small body, large head, long arms and short legs, bent at all joints and pressed to the stomach.

The placenta has already reached sufficient development and copes with its functions: ensures the supply of oxygen and nutrients to the fetus and removes carbon dioxide and products of exchange.

Further formation of the fetal eye occurs: At this time, the iris develops, which will later determine the color of the eyes. The eyes are well developed, half-closed or wide open.

Twelfth week (78-84 days)

Coccygeal-parietal size fetus is 50-60 mm.

Goes clearly development of the genital organs according to the female or male type.

Happening further improvement of the digestive system. The intestines are elongated and arranged in loops, like those of an adult. Its periodic contractions begin - peristalsis. The fetus begins to make swallowing movements, swallowing amniotic fluid.

The development and improvement of the fetal nervous system continues. The brain is small in size, but exactly replicates all the structures of the adult brain. Well developed cerebral hemispheres and other departments. Reflex movements are improved: the fetus can clench and unclench its fingers into a fist, grabs the thumb and actively sucks it.

In fetal blood Not only red blood cells are already present, but the production of white blood cells - leukocytes - also begins.

At this time the child single respiratory movements begin to be recorded. Before birth, the fetus cannot breathe, its lungs do not function, but it makes rhythmic movements of the chest, imitating breathing.

By the end of the week the fetus eyebrows and eyelashes appear, the neck is clearly visible.

Fetal development in the fourth obstetric month (13-16 weeks)

Week 13 (85-91 days)

Coccygeal-parietal size by the end of the week is 70-75 mm. The proportions of the body begin to change: the upper and lower limbs and torso lengthen, the size of the head is no longer so large in relation to the body.

Improvement of the digestive and nervous systems continues. Germs of milk teeth begin to appear under the upper and lower jaws.

The face is fully formed, the auricles, nose and eyes are clearly visible (completely closed for centuries).

Week 14 (92-98 days)

Coccygeal-parietal size by the end of the fourteenth week increases up to 8-9 cm. Body proportions continue to change to more familiar ones. The face has a well-defined forehead, nose, cheeks and chin. The first hair appears on the head (very thin and colorless). The surface of the body is covered with vellus hairs, which retain skin lubrication and thereby perform protective functions.

The musculoskeletal system of the fetus is improved. Bones become stronger. Intensifying physical activity: the fetus can turn over, bend, and make swimming movements.

Development of the kidneys, bladder and ureters is complete. The kidneys begin to secrete urine, which mixes with the amniotic fluid.

: pancreatic cells begin to work, producing insulin, and pituitary cells.

Changes in the genital organs appear. In boys, the prostate gland forms; in girls, the ovaries migrate into the pelvic cavity. At the fourteenth week, with a good sensitive ultrasound machine, it is already possible to determine the sex of the child.

Fifteenth week (99-105 days)

Coccygeal-parietal size of the fetus is about 10 cm, fruit weight – 70-75 grams. The head still remains quite large, but the growth of the arms, legs and torso begins to outstrip it.

Improving circulatory system . In the fourth month, a child’s blood type and Rh factor can already be determined. Blood vessels (veins, arteries, capillaries) grow in length and their walls become stronger.

The production of original feces (meconium) begins. This is due to the ingestion of amniotic fluid, which enters the stomach, then into the intestines and fills it.

Fully formed fingers and toes, they have an individual pattern.

Sixteenth week (106-112 days)

The weight of the fetus increases to 100 grams, the coccygeal-parietal size - up to 12 cm.

By the end of the sixteenth week, the fetus is already fully formed., he has all the organs and systems. The kidneys are actively working, a small amount of urine is released into the amniotic fluid every hour.

The skin of the fetus is very thin, subcutaneous fatty tissue is practically absent, so blood vessels are visible through the skin. The skin appears bright red, covered with vellus hairs and grease. Eyebrows and eyelashes are well defined. Nails are formed, but they only cover the edge of the nail phalanx.

Facial muscles are formed, and the fetus begins to “grimace”: frowning of the eyebrows and a semblance of a smile are observed.

Fetal development in the fifth obstetric month (17-20 weeks)

Seventeenth week (days 113-119)

The weight of the fetus is 120-150 grams, the coccygeal-parietal size is 14-15 cm.

The skin remains very thin, but subcutaneous fatty tissue begins to develop under it. The development of baby teeth continues, which are covered with dentin. The embryos of permanent teeth begin to form under them.

There is a reaction to sound stimuli. From this week we can say for sure that the child began to hear. When strong sharp sounds appear, the fetus begins to actively move.

Fetal position changes. The head is raised and is in an almost vertical position. The arms are bent at the elbow joints, the fingers are clenched into a fist almost all the time. Periodically, the child begins to suck his thumb.

The heartbeat becomes clear. From now on, the doctor can listen to him using a stethoscope.

Eighteenth week (120-126 days)

The weight of the child is about 200 grams, length - up to 20 cm.

The formation of sleep and wakefulness begins. Most of the time the fetus sleeps, movements stop during this time.

At this time, the woman may already begin to feel the baby moving, especially with repeated pregnancies. The first movements are felt as gentle jolts. A woman may feel more active movements when she is nervous or stressed, which is reflected in her emotional state child. At this stage, the norm is about ten episodes of fetal movement per day.

Nineteenth week (127-133 days)

The child’s weight increases to 250-300 grams, body length – to 22-23 cm. The proportions of the body change: the head lags behind the body in growth, the arms and legs begin to lengthen.

Movements become more frequent and noticeable. They can be felt not only by the woman herself, but also by other people by placing their hand on their stomach. Primigravidas at this time can only begin to feel movements.

The endocrine system is improved: the pancreas, pituitary gland, adrenal glands, gonads, thyroid and parathyroid glands are actively functioning.

Blood composition has changed: In addition to erythrocytes and leukocytes, the blood contains monocytes and lymphocytes. The spleen begins to take part in hematopoiesis.

Twentieth week (134-140 days)

Body length increases to 23-25 ​​cm, weight – up to 340 grams.

The fetal skin is still thin, covered with protective lubricant and vellus hairs, which can persist until childbirth. Subcutaneous fatty tissue develops intensively.

Well formed eyes, at twenty weeks the blink reflex begins to appear.

Improved movement coordination: The child confidently brings his finger to his mouth and begins to suck it. Facial expressions are pronounced: the fetus may close its eyes, smile, or frown.

This week all women are already feeling movements., regardless of the number of pregnancies. Movement activity varies throughout the day. When stimuli appear (loud sounds, stuffy rooms), the child begins to move very violently and actively.

Fetal development in the sixth obstetric month (21-24 weeks)

Twenty-first week (days 141-147)

Body weight grows to 380 grams, fetal length – up to 27 cm.

The layer of subcutaneous tissue increases. The skin of the fetus is wrinkled, with many folds.

Fetal movements become more active and tangible. The fetus moves freely in the uterine cavity: it lies head down or buttocks, across the uterus. Can pull on the umbilical cord, push off the walls of the uterus with hands and feet.

Changes in sleep and wake patterns. Now the fetus spends less time sleeping (16-20 hours).

Twenty-second week (148-154 days)

At week 22, the size of the fetus increases to 28 cm, weight - up to 450-500 grams. The size of the head becomes proportional to the trunk and limbs. The legs are almost all the time in a bent state.

Fully formed fetal spine: it has all the vertebrae, ligaments and joints. The process of strengthening bones continues.

Improves the fetal nervous system: The brain already contains all the nerve cells (neurons) and has a mass of about 100 grams. The child begins to take an interest in his body: he feels his face, arms, legs, tilts his head, brings his fingers to his mouth.

Heart size increases significantly, the functionality of the cardiovascular system is improved.

Twenty-third week (155-161 days)

The length of the fetal body is 28-30 cm, weight is about 500 grams. Pigment begins to be synthesized in the skin, resulting in the skin becoming bright red. The subcutaneous fatty tissue is still quite thin, as a result the child looks very thin and wrinkled. The lubricant covers the entire skin and is more abundant in the folds of the body (elbow, axillary, inguinal, etc. folds).

Development of internal genital organs continues: in boys - the scrotum, in girls - the ovaries.

Frequency increases breathing movements up to 50-60 times per minute.

The swallowing reflex is still well developed: the child constantly swallows amniotic fluid with particles of protective skin lubricant. The liquid part of the amniotic fluid is absorbed into the blood, leaving a thick green-black substance (meconium) in the intestines. Normally, the bowel should not have a bowel movement until the baby is born. Sometimes swallowing water causes hiccups in the fetus; a woman can feel it in the form of rhythmic movements for several minutes.

Twenty-fourth week (162-168 days)

By the end of this week, the weight of the fetus increases to 600 grams, body length to 30-32 cm.

The movements are getting stronger and clearer. The fetus takes up almost all the space in the uterus, but can still change position and turn over. Muscles grow rapidly.

By the end of the sixth month, the child has well-developed sense organs. Vision begins to function. If a bright light hits a woman’s belly, the fetus begins to turn away and closes her eyelids tightly. Hearing is well developed. The fetus determines pleasant and unpleasant sounds for itself and reacts to them differently. When hearing pleasant sounds, the child behaves calmly, his movements become calm and measured. When unpleasant sounds occur, it begins to freeze or, conversely, moves very actively.

An emotional connection is established between mother and child. If a woman experiences negative emotions(fear, anxiety, melancholy), the child begins to experience similar feelings.

Fetal development in the seventh obstetric month (25-28 weeks)

Twenty-fifth week (169-175 days)

The length of the fetus is 30-34 cm, body weight increases to 650-700 grams. The skin becomes elastic, the number and severity of folds decreases due to the accumulation of subcutaneous fatty tissue. Skin stays thin big amount capillaries, giving it a red color.

The face has a familiar appearance to a person: eyes, eyelids, eyebrows, eyelashes, cheeks, ears are well defined. The cartilage of the ears remains thin and soft, their bends and curls are not fully formed.

Intensively developing Bone marrow , which takes on the main role in hematopoiesis. The strengthening of the fetal bones continues.

Important processes occur in lung maturation: small elements of lung tissue (alveoli) are formed. Before the baby is born, they are without air and resemble deflated balloons, which straighten out only after the first cry of the newborn. From week 25, the alveoli begin to produce a special substance (surfactant) necessary to maintain their shape.

Twenty-sixth week (176-182 days)

The length of the fruit is about 35 cm, the weight increases to 750-760 grams. The growth of muscle tissue and subcutaneous fat continues. Bones are strengthened and permanent teeth continue to develop.

The formation of the genital organs continues. In boys, the testicles begin to descend into the scrotum (the process lasts 3-4 weeks). In girls, the formation of the external genitalia and vagina is completed.

Improved sense organs. The child develops a sense of smell (smell).

Twenty-seventh week (183-189 days)

Weight increases to 850 grams, body length - up to 37 cm.

The organs of the endocrine system are actively functioning, in particular the pancreas, pituitary gland and thyroid gland.

The fetus is quite active, makes freely various movements inside the uterus.

From the twenty-seventh week in the child individual metabolism begins to form.

Twenty-eighth week (190-196 days)

The child’s weight increases to 950 grams, body length – 38 cm.

By this age the fetus becomes practically viable. In the absence of organ pathology, a child with good care and treatment can survive.

Subcutaneous fat continues to accumulate. The skin is still red, vellus hair They begin to gradually fall out, remaining only on the back and shoulders. Eyebrows, eyelashes, and hair on the head become darker. The child begins to open his eyes frequently. The cartilage of the nose and ears remains soft. The nails do not yet reach the edge of the nail phalanx.

This week starts more one of the cerebral hemispheres is actively functioning. If it becomes active right hemisphere, then the child becomes left-handed, if left-handed, then right-handedness develops.

Fetal development in the eighth month (29-32 weeks)

Twenty-ninth week (197-203 days)

The weight of the fetus is about 1200 grams, the height increases to 39 cm.

The baby has already grown enough and takes up almost all the space in the uterus. Movements become less chaotic. The movements manifest themselves in the form of periodic kicks with the legs and arms. The fetus begins to take a definite position in the uterus: head or buttocks down.

All organ systems continue to improve. The kidneys already secrete up to 500 ml of urine per day. The load on the cardiovascular system increases. The blood circulation of the fetus is still significantly different from the blood circulation of the newborn.

Thirtieth week (204-210 days)

Body weight increases to 1300-1350 grams, height remains approximately the same - about 38-39 cm.

Subcutaneous fat tissue constantly accumulates, skin folds straighten out. The child adapts to the lack of space and takes a certain position: curls up, arms and legs crossed. The skin still has a bright color, the amount of grease and vellus hair decreases.

Alveolar development and surfactant production continues. The lungs prepare for the birth of the baby and the start of breathing.

Brain development continues brain, the number of convolutions and the area of ​​the cortex increases.

Thirty-first week (211-217 days)

The child's weight is about 1500-1700 grams, height increases to 40 cm.

Your child's sleep and wake patterns change. Sleep still takes a long time, during which time there is no motor activity of the fetus. While awake, the child actively moves and pushes.

Fully formed eyes. During sleep, the child closes his eyes, while awake, the eyes are open, and the child blinks periodically. The color of the iris is the same for all children (blue), then after birth it begins to change. The fetus reacts to bright light by constricting or dilating the pupil.

Brain size increases. Now its volume is about 25% of the volume of the adult brain.

Thirty-second week (218-224 days)

The child's height is about 42 cm, weight - 1700-1800 grams.

Accumulation of subcutaneous fat continues, due to which the skin becomes lighter, there are practically no folds left on it.

Internal organs are improved: organs of the endocrine system intensively secrete hormones, surfactant accumulates in the lungs.

The fetus produces a special hormone, which promotes the formation of estrogen in the mother’s body, as a result, the mammary glands begin to prepare for milk production.

Fetal development in the ninth month (33-36 weeks)

Thirty-third week (225-231 days)

The weight of the fetus increases to 1900-2000 grams, the height is about 43-44 cm.

Skin becomes increasingly lighter and smoother, the layer of fatty tissue increases. The vellus hair is increasingly wiped off, and the layer of protective lubricant, on the contrary, increases. Nails grow to the edge of the nail phalanx.

The baby becomes increasingly cramped in the uterine cavity, so his movements become more rare, but strong. The position of the fetus is fixed (head or buttocks down), the likelihood that the child will turn over after this period is extremely small.

The functioning of internal organs is becoming more and more improved: the mass of the heart increases, the formation of the alveoli is almost complete, the tone of the blood vessels increases, the brain is fully formed.

Thirty-fourth week (232-238 days)

The child's weight ranges from 2000 to 2500 grams, height is about 44-45 cm.

The baby now occupies a stable position in the uterus. The bones of the skull are soft and mobile thanks to the fontanelles, which can close only a few months after birth.

Head hair grows rapidly and take on a certain color. However, hair color may change after childbirth.

Intensive strengthening of bones is noted, in connection with this, the fetus begins to take calcium from the mother’s body (the woman may notice the appearance of cramps at this time).

The child constantly swallows amniotic fluid, thereby stimulating the gastrointestinal tract and the functioning of the kidneys, which produce at least 600 ml of clear urine per day.

Thirty-fifth week (239-245 days)

Every day the child gains 25-35 grams. Weight during this period can vary greatly and by the end of the week it is 2200-2700 grams. Height increases to 46 cm.

All internal organs of the child continue to improve, preparing the body for the upcoming extrauterine existence.

Fatty tissue is intensively deposited, the child becomes more well-fed. The amount of vellus hair is greatly reduced. The nails have already reached the tips of the nail phalanges.

A sufficient amount of meconium has already accumulated in the fetal intestines, which normally should go away 6-7 hours after birth.

Thirty-sixth week (246-252 days)

The weight of a child varies greatly and can range from 2000 to 3000 grams, height - within 46-48 cm

The fetus already has well-developed subcutaneous fatty tissue, skin color becomes lighter, wrinkles and folds disappear completely.

The baby occupies a certain position in the uterus: more often he lies upside down (less often, with his legs or buttocks, in some cases, transversely), his head is bent, his chin is pressed to his chest, his arms and legs are pressed to his body.

Skull bones, unlike other bones, remain soft, with cracks (fontanelles), which will allow the baby's head to be more pliable when passing through the birth canal.

All organs and systems are fully developed for the existence of a child outside the womb.

Fetal development in the tenth obstetric month

Thirty-seventh week (254-259 days)

The child's height increases to 48-49 cm, weight can fluctuate significantly. The skin has become lighter and thicker, the fat layer increases every day by 14-15 grams per day.

Nasal cartilage and ears become denser and more elastic.

Fully formed and mature lungs, the alveoli contain the necessary amount of surfactant for the newborn to breathe.

Completion of the digestive system: Contractions occur in the stomach and intestines to push food through (peristalsis).

Thirty-eighth week (260-266 days)

The weight and height of the child varies greatly.

The fetus is fully mature and ready to be born. Outwardly, the child looks like a full-term newborn. The skin is light, the fatty tissue is sufficiently developed, and vellus hair is practically absent.

Thirty-ninth week (267-273 days)

Usually two weeks before delivery fetus starts to drop clinging to the bones of the pelvis. The child has already reached full maturity. The placenta begins to gradually grow old and deteriorate in it. metabolic processes.

The mass of the fetus increases significantly (30-35 grams per day). The proportions of the body change completely: the chest and shoulder girdle are well developed, the belly is round, and the limbs are long.

Well developed sense organs: the child catches all sounds, sees bright colors, can focus vision, taste buds are developed.

Fortieth week (274-280 days)

All indicators of fetal development correspond to new to the awaited one. The baby is completely ready for birth. The weight can vary significantly: from 250 to 4000 and above grams.

The uterus begins to periodically contract(), which is manifested aching pain lower abdomen. The cervix opens slightly, and the fetal head is pressed closer to the pelvic cavity.

The skull bones are still soft and pliable, which allows the baby’s head to change shape and pass the birth canal more easily.

Fetal development by week of pregnancy - Video

CHAPTER 10. DEVELOPMENT OF THE NERVOUS SYSTEM IN NEWBORN AND YOUNG CHILDREN. RESEARCH METHOD. SYNDROMES OF DEFEAT

CHAPTER 10. DEVELOPMENT OF THE NERVOUS SYSTEM IN NEWBORN AND YOUNG CHILDREN. RESEARCH METHOD. SYNDROMES OF DEFEAT

In a newborn baby reflex acts are carried out at the level of the stem and subcortical parts of the brain. By the time the child is born, the limbic system, the precentral region, especially field 4, which provides early phases motor reactions, occipital lobe and field 17. The temporal lobe (especially the temporo-parieto-occipital region), as well as the inferior parietal and frontal regions, are less mature. However, field 41 of the temporal lobe (projection field of the auditory analyzer) at the time of birth is more differentiated than field 22 (projection-associative).

10.1. Development of motor functions

Motor development in the first year of life is a clinical reflection of the most complex and currently insufficiently studied processes. These include:

The action of genetic factors is the composition of expressed genes that regulate the development, maturation and functioning of the nervous system, changing in a spatiotemporal manner; neurochemical composition of the central nervous system, including the formation and maturation of mediator systems (the first mediators are found in the spinal cord from 10 weeks of gestation);

myelination process;

Macro- and microstructural formation of the motor analyzer (including muscles) in early ontogenesis.

First spontaneous movements embryos appear at the 5-6th week of intrauterine development. During this period, motor activity is carried out without the participation of the cerebral cortex; segmentation occurs spinal cord and differentiation of the musculoskeletal system. The formation of muscle tissue begins from the 4-6th week, when active proliferation occurs in the places where muscles are formed with the appearance of primary muscle fibers. The developing muscle fiber is already capable of spontaneous rhythmic activity. At the same time, the formation of neuromuscular

synapses under the influence of neuron induction (i.e., axons of developing spinal cord motor neurons grow into the muscles). In this case, each axon branches repeatedly, forming synaptic contacts with dozens of muscle fibers. Activation of muscle receptors influences the establishment of intracerebral connections in the embryo, which provides tonic stimulation of brain structures.

In the human fetus, reflexes develop from local to generalized and then to specialized reflex acts. First reflex movements appear at 7.5 weeks of gestation - trigeminal reflexes that arise from tactile stimulation of the facial area; at 8.5 weeks, lateral flexion of the neck is first noted. At the 10th week, a reflex movement of the lips is observed (the sucking reflex is formed). Subsequently, as the reflexogenic zones in the area of ​​the lips and oral mucosa mature, complex components are added in the form of opening and closing the mouth, swallowing, stretching and compressing the lips (22 weeks), and sucking movements (24 weeks).

tendon reflexes appear at the 18-23rd week of intrauterine life, at the same age the grasping reaction is formed, by the 25th week all unconditioned reflexes evoked from the upper extremities are clear. From 10.5-11 weeks are detected reflexes from the lower extremities, primarily plantar, and a reaction such as the Babinski reflex (12.5 weeks). First irregular breathing movements chest (Cheyne-Stokes type), which appear at 18.5-23 weeks, pass into spontaneous breathing by the 25th week.

In postnatal life, improvement of the motor analyzer occurs at the micro level. After birth, thickening of the cerebral cortex in areas 6, 6a and the formation of neuronal groups continue. The first networks formed from 3-4 neurons appear at 3-4 months; after 4 years, the thickness of the cortex and the size of neurons (except for Betz cells, which grow until puberty) stabilize. The number of fibers and their thickness increase significantly. The differentiation of muscle fibers is associated with the development of spinal cord motor neurons. Only after the appearance of heterogeneity in the population of motor neurons in the anterior horns of the spinal cord does the division of muscles into motor units occur. Subsequently, at the age of 1 to 2 years, not individual muscle fibers develop, but “superstructures” - motor units consisting of muscles and nerve fibers, and changes in muscles are primarily associated with the development of the corresponding motor neurons.

After the birth of a child, as the controlling parts of the central nervous system mature, its pathways also develop, in particular, myelination of peripheral nerves occurs. At the age of 1 to 3 months, the development of the frontal and temporal regions of the brain occurs especially intensively. The cerebellar cortex is still poorly developed, but the subcortical ganglia are clearly differentiated. Up to the midbrain region, myelination of fibers is well expressed; in the cerebral hemispheres, only sensory fibers are completely myelinated. From 6 to 9 months, long associative fibers are most intensively myelinated, and the spinal cord is completely myelinated. By the age of 1 year, myelination processes cover the long and short associative pathways of the temporal and frontal lobes and the spinal cord along its entire length.

There are two periods of intense myelination: the first of them lasts from 9-10 months of intrauterine life to 3 months of postnatal life, then from 3 to 8 months the rate of myelination slows down, and from 8 months the second period of active myelination begins, which lasts until the child learns to walk (t .e. on average up to 1 g 2 months). With age, both the number of myelinated fibers and their content in individual peripheral nerve bundles change. These processes, most intense in the first 2 years of life, are mostly completed by 5 years.

An increase in the speed of impulse transmission along the nerves precedes the emergence of new motor skills. Thus, in the ulnar nerve, the peak increase in impulse conduction velocity (ICV) occurs in the 2nd month of life, when the child can clasp his hands for a short time while lying on his back, and in the 3-4th month, when hypertonicity in the hands is replaced by hypotension, the range of active movements increases (holds objects in the hand, brings them to the mouth, clings to clothes, plays with toys). In the tibial nerve, the largest increase in SPI appears first at 3 months and precedes the disappearance of physiological hypertension in lower limbs, which coincides with the disappearance of automatic gait and positive ground reaction. For ulnar nerve the next increase in SPI is observed at 7 months with the appearance of the reaction of preparing to jump and the extinction of the grasping reflex; in addition, opposition of the thumb arises, active force appears in the hands: the child shakes the bed and breaks toys. For the femoral nerve, the next increase in conduction velocity corresponds to 10 months, for the ulnar nerve - 12 months.

At this age, free standing and walking appear, hands are freed up: the child waves them, throws toys, and claps his hands. Thus, there is a correlation between an increase in SPI in peripheral nerve fibers and the development of a child’s motor skills.

10.1.1. Newborn reflexes

Newborn reflexes - this is an involuntary muscle reaction to a sensitive stimulus, they are also called: primitive, unconditioned, innate reflexes.

Unconditioned reflexes, according to the level at which they are closed, can be:

1) segmental stem (Babkina, sucking, proboscis, searching);

2) segmental spinal (grasping, crawling, support and automatic gait, Galant, Perez, Moro, etc.);

3) posotonic suprasegmental - levels of the trunk and spinal cord (asymmetric and symmetric cervical tonic reflexes, labyrinthine tonic reflex);

4) posotonic suprasegmental - the level of the midbrain (righting reflexes from head to neck, from torso to head, from head to torso, start reflex, balance reaction).

The presence and severity of the reflex is an important indicator of psychomotor development. Many newborn reflexes disappear as the child develops, but some of them can be detected in adulthood, but they have no topical significance.

The absence of reflexes or pathological reflexes in a child, a delay in the reduction of reflexes characteristic of an earlier age, or their appearance in an older child or adult indicate CNS damage.

Unconditioned reflexes are examined in the position on the back, stomach, vertically; in this case it is possible to identify:

Presence or absence, suppression or strengthening of the reflex;

Time of appearance from the moment of irritation (latency period of the reflex);

Expressiveness of the reflex;

The speed of its decline.

Unconditioned reflexes are influenced by factors such as the type of higher nervous activity, the time of day, and the general condition of the child.

The most constant unconditioned reflexes In the supine position:

search reflex- the child lies on his back, when stroking the corner of his mouth, he lowers himself, and his head turns in the direction of irritation; options: opening the mouth, lowering the lower jaw; the reflex is especially well expressed before feeding;

defensive reaction- painful stimulation of the same area causes the head to turn in the opposite direction;

proboscis reflex- the child lies on his back, a light, quick blow to the lips causes contraction of the orbicularis oris muscle, while the lips are extended “proboscis”;

sucking reflex- active sucking of a pacifier placed in the mouth;

palm-oral reflex (Babkina)- pressing on the thenar area of ​​the palm causes the mouth to open, the head to tilt, and the shoulders and forearms to flex;

grasping reflex occurs when a finger is placed in the child’s open palm, while his hand covers the finger. An attempt to free the finger leads to increased gripping and suspension. In newborns, the grasp reflex is so strong that they can be lifted off the changing table if both hands are used. The inferior grasp reflex (Werkom) can be induced by pressing on the balls of the toes at the base of the foot;

Robinson reflex- when trying to free the finger, suspension occurs; this is a logical continuation of the grasping reflex;

inferior grasp reflex- plantar flexion of the fingers in response to touching the base of the II-III toes;

Babinski reflex- with line irritation of the sole of the foot, fan-shaped divergence and extension of the toes occur;

Moro reflex: Phase I - raising the arms, sometimes so pronounced that it occurs with a rotation around the axis; Phase II - return to the starting position after a few seconds. This reflex is observed when the child is suddenly shaken, loud sound; the spontaneous Moro reflex is often the cause of a child falling from the changing table;

protective reflex- when the sole is pricked, the leg flexes three times;

cross extensor reflex- an injection of the sole, fixed in an extended position of the leg, causes straightening and slight adduction of the other leg;

start reflex(extension of arms and legs in response to a loud sound).

Upright (normally, when a child is suspended vertically by the armpits, flexion occurs in all joints of the legs):

support reflex- in the presence of solid support under the feet, the torso straightens and the foot rests on the full foot;

automatic gait occurs if the child is slightly tilted forward;

rotational reflex- when rotating in a vertical suspension by the armpits, the head turns in the direction of rotation; if the head is fixed by the doctor, then only the eyes turn; after the appearance of fixation (by the end of the neonatal period), eye rotation is accompanied by nystagmus - assessment of the vestibular response.

In the prone position:

protective reflex- when placing the child on his stomach, the head turns to the side;

crawling reflex (Bauer)- lightly pushing the hand towards the feet causes repulsion from it and movements reminiscent of crawling;

talent reflex- when the skin of the back near the spine is irritated, the body bends in an arc open towards the irritant; the head turns in the same direction;

Perez reflex- when running a finger along the spinous processes of the spine from the tailbone to the neck, a painful reaction and a cry occur.

Reflexes that persist in adults:

Corneal reflex (squinting of the eye in response to touch or sudden bright light);

Sneezing reflex (sneezing when the nasal mucosa is irritated);

Gag reflex (vomiting when the back of the throat or root of the tongue is irritated);

Yawning reflex (yawning when there is a lack of oxygen);

Cough reflex.

Assessment of a child's motor development of any age is carried out at the moment of maximum comfort (warmth, satiety, peace). It should be taken into account that the child’s development occurs craniocaudally. This means that the upper parts of the body develop before the lower parts (e.g.

manipulations precede the ability to sit, which, in turn, precedes the appearance of walking). Muscle tone also decreases in the same direction - from physiological hypertonicity to hypotension by 5 months of life.

Components of motor function assessment are:

muscle tone and postural reflexes(proprioceptive reflexes of the muscular-articular apparatus). There is a close connection between muscle tone and postural reflexes: muscle tone affects posture in sleep and in a state of quiet wakefulness, and posture, in turn, affects tone. Tone options: normal, high, low, dystonic;

tendon reflexes. Options: absence or decrease, increase, asymmetry, clonus;

volume of passive and active movements;

unconditioned reflexes;

pathological movements: tremor, hyperkinesis, convulsions.

In this case, it is necessary to pay attention to the general condition of the child (somatic and social), the characteristics of his emotional background, the function of analyzers (especially visual and auditory) and the ability to communicate.

10.1.2. Development of motor skills in the first year of life

Newborn. Muscle tone. Normally, tone predominates in the flexors (flexor hypertension), and the tone in the arms is higher than in the legs. As a result of this, a “fetal position” occurs: the arms are bent at all joints, brought to the body, pressed to the chest, the hands are clenched into fists, the thumbs are clamped with the rest; the legs are bent at all joints, slightly abducted at the hips, dorsiflexed in the feet, and the spine is curved. Muscle tone is increased symmetrically. To determine the degree of flexor hypertension, the following tests are available:

traction test- the child lies on his back, the researcher takes him by the wrists and pulls him towards himself, trying to sit him up. In this case, the arms are slightly extended at the elbow joints, then the extension stops, and the child is pulled up to the arms. If the flexor tone is excessively strengthened, there is no extension phase, and the body immediately moves behind the hands; if there is insufficiency, the volume of extension increases or there is no stretching of the hands;

With normal muscle tone in a horizontal hanging position by the armpits, face down, the head is positioned in line with the body. In this case, the arms are bent and the legs are extended. When decreasing muscle tone The head and legs hang passively; when raised, there is a pronounced flexion of the arms and, to a lesser extent, the legs. When extensor tone predominates, the head is thrown back;

labyrinthine tonic reflex (LTR) occurs when the position of the head in space changes as a result of irritation of the labyrinths. At the same time, the tone in the extensors in the supine position and in the flexors in the prone position increases;

symmetrical cervical tonic reflex (SCTR)- in the position on the back with a passive tilt of the head, the tone of the flexors in the arms and extensors in the legs increases, with the extension of the head - the opposite reaction;

asymmetric cervical tonic reflex (ASTR), Magnus-Klein reflex occurs when the head of a child lying on his back is turned to the side. At the same time, in the hand, to which the child's face is turned, the extensor tone increases, as a result of which it unbends and is retracted from the body, the hand opens. At the same time, the opposite arm is bent and her hand is clenched into a fist (swordsman's pose). When you turn your head, your position changes accordingly.

Volume of passive and active movements

Flexor hypertension surmountable, but limits the range of passive movements in the joints. It is impossible to completely unbend the child's arms in the elbow joints, raise the arms above the horizontal level, spread the hips without causing pain.

Spontaneous (active) movements: periodic bending and extension of the legs, crossing, pushing away from the support in a position on the stomach and back. Movements in the hands are performed in the elbow and wrist joints (hands clenched into fists move at chest level). The movements are accompanied by an athetoid component (a consequence of the immaturity of the striatum).

Tendon reflexes: in a newborn it is possible to evoke only knee reflexes, which are usually elevated.

Unconditioned reflexes: All reflexes of newborns are evoked, they are moderately expressed, and slowly deplete.

Posotonic reactions: the newborn lies on his stomach, his head is turned to the side (protective reflex), his limbs are bent in

all joints and brought to the body (tonic labyrinth reflex). Direction of development: exercises for holding the head upright, resting on the hands.

Walking Ability: a newborn and a child 1-2 months of age have a primitive reaction of support and automatic gait, which fades by 2-4 months of life.

Grasping and manipulation: In a newborn and a 1-month-old child, the hands are clenched into a fist, he cannot open the hand on his own, and a grasping reflex is triggered.

Social contacts: A newborn's first impressions of the world around him are based on skin sensations: warm, cold, soft, hard. The child calms down when he is picked up and fed.

Child aged 1-3 months. When assessing motor function, in addition to those listed earlier (muscle tone, postural reflexes, range of spontaneous movements, tendon reflexes, unconditioned reflexes), the initial elements of voluntary movements and coordination begin to be taken into account.

Skills:

Development of analyzer functions: fixation, tracking (visual), localization of sound in space (auditory);

Integration of analyzers: finger sucking (sucking reflex + influence of the kinesthetic analyzer), examining one’s own hand (visual-kinesthetic analyzer);

The appearance of more expressive facial expressions, a smile, and a complex of animation.

Muscle tone. Flexor hypertension gradually decreases. At the same time, the influence of postural reflexes increases - ASTR and LTR are more pronounced. The meaning of postural reflexes is to create a static posture, while the muscles are “trained” to actively (rather than reflexively) maintain this posture (for example, the upper and lower Landau reflex). As the muscles are trained, the reflex gradually fades away, as the processes of central (voluntary) regulation of posture are activated. By the end of the period, the flexion posture becomes less pronounced. When testing traction, the extension angle increases. By the end of 3 months, postural reflexes weaken and are replaced by straightening reflexes of the torso:

labyrinthine righting reflex to the head- in the tummy position, the baby’s head is located in the middle

line, a tonic contraction of the neck muscles occurs, the head rises and is held. Initially, this reflex ends with the head falling and turning it to the side (the influence protective reflex). Gradually, the head can remain in a raised position longer and longer, while the legs are tense at first, but over time they begin to actively move; the arms are increasingly extended at the elbow joints. A labyrinthine one is formed righting reflex in an upright position (holding your head upright);

righting reflex from trunk to head- when the feet touch the support, the body straightens and the head rises;

cervical erection reaction - with passive or active rotation of the head, the torso turns.

Unconditioned reflexes still well expressed; The exception is the support and automatic gait reflexes, which gradually begin to fade. At 1.5-2 months, the child is in an upright position, placed on a hard surface, resting on the outer edges of the feet, and does not make stepping movements when bending forward.

By the end of 3 months, all reflexes weaken, which is expressed in their inconstancy, prolongation of the latent period, rapid exhaustion, and fragmentation. The Robinson reflex disappears. Moro reflexes, sucking and withdrawal are still well evoked.

Combined reflex reactions appear - a sucking reflex at the sight of a breast (kinesthetic food reaction).

The range of movements increases. The athetoid component disappears, the number of active movements increases. Arises revitalization complex. The first ones become possible purposeful movements: straightening the arms upward, raising the hands to the face, sucking fingers, rubbing the eyes and nose. At the 3rd month, the child begins to look at his hands, reach out with his hands to an object - visual blink reflex. Due to the weakening of the synergy of the flexors, flexion in the elbow joints occurs without bending the fingers, and the ability to hold an inserted object in the hand.

Tendon reflexes: in addition to the knee, the Achilles and bicipital are caused. Abdominal reflexes appear.

Posotonic reactions: During the 1st month, the child raises his head for a short time, then “drops” it. Arms bent under the chest (labyrinthine righting reflex to the head, tonic contraction of the neck muscles ends with the head falling and turning it to the side -

element of the protective reflex). Direction of development: exercise to increase the time of holding the head, extension of the arms at the elbow joint, opening of the hand. At 2 months, the child can hold his head at an angle of 45 for some time? to the surface, while the head still sways uncertainly. The angle of extension in the elbow joints increases. At 3 months, the child confidently holds his head while lying on his stomach. Support on the forearms. The pelvis is lowered.

Walking Ability: a 3-5 month old child holds his head well in an upright position, but if you try to stand him up, he tucks his legs in and hangs in the arms of an adult (physiological astasia-abasia).

Grasping and manipulation: at the 2nd month the hands are slightly open. At the 3rd month, you can put a small light rattle in the child’s hand; he grabs it and holds it in his hand, but he himself is not yet able to open his hand and release the toy. Therefore, after playing for some time and listening with interest to the sounds of the rattle that are heard when it is shaken, the child begins to cry: he gets tired of holding the object in his hand, but cannot voluntarily release it.

Social contacts: at the 2nd month a smile appears, which the child addresses to all living beings (as opposed to non-living ones).

Child aged 3-6 months. At this stage, the assessment of motor functions consists of the previously listed components (muscle tone, range of motion, tendon reflexes, unconditioned reflexes, voluntary movements, their coordination) and newly emerged general motor skills, in particular manipulations (hand movements).

Skills:

Increased period of wakefulness;

Interest in toys, looking at, grasping, bringing to the mouth;

Development of facial expressions;

The appearance of humming;

Communication with an adult: the indicative reaction turns into a revival complex or a fear reaction, a reaction to the departure of an adult;

Further integration (sensorimotor behavior);

Auditory vocal reactions;

Auditory-motor reactions (turning the head towards the call);

Visual-tactile-kinesthetic (looking at one’s own hands is replaced by looking at toys and objects);

Visual-tactile-motor (grasping objects);

Visual-motor coordination - the ability to control with one's gaze the movements of a hand reaching for a nearby object (feeling one's hands, rubbing, joining hands, touching one's head, holding a breast or bottle while sucking);

The reaction of active touch is feeling an object with the feet and grasping it with their help, stretching the arms in the direction of the object, palpating; this reaction disappears when the object capture function appears;

Skin concentration reaction;

Visual localization of an object in space based on the visual-tactile reflex;

Increasing visual acuity; the child can distinguish small objects on a plain background (for example, buttons on clothes of the same color).

Muscle tone. There is a synchronization of the tone of the flexors and extensors. Now the posture is determined by a group of reflexes that straighten the torso and voluntary motor activity. In a dream, the brush is open; ASTR, SSHTR, LTR faded away. The tone is symmetrical. Physiological hypertension is replaced by normotonia.

There is further formation rectifying reflexes of the body. In the position on the stomach, stable holding of the raised head, support on a slightly extended arm, and later support on an outstretched arm are noted. The upper Landau reflex appears in the prone position (“swimmer’s pose,” i.e., raising the head, shoulders and torso in a prone position with straightened arms). Head control in a vertical position is stable and sufficient in a supine position. There is a straightening reflex from the body to the body, i.e. the ability to rotate the shoulder girdle relative to the pelvic.

tendon reflexes everyone is called.

Developing motor skills the following.

Attempts to pull the body to the outstretched arms.

Ability to sit with support.

The appearance of a “bridge” is an arching of the spine with support on the buttocks (feet) and head when tracking an object. Subsequently, this movement is transformed into an element of turning onto the stomach - a “block” turn.

Turn from back to stomach; at the same time, the child can rest his hands, raising his shoulders and head and looking around in search of objects.

Objects are grasped with the palm (squeezing the object in the palm using the flexor muscles of the hand). There is no opposable thumb yet.

Grasping an object is accompanied by many unnecessary movements (both arms, mouth, legs move at the same time), and there is still no clear coordination.

Gradually the number of unnecessary movements decreases. Grasping an attractive object with both hands appears.

The number of movements in the hands increases: lifting up, to the sides, clutching together, feeling, putting in the mouth.

Movements in large joints, fine motor skills are not developed.

Ability to sit independently (without support) for a few seconds/minutes.

Unconditioned reflexes fade away, with the exception of the sucking and withdrawal reflex. Elements of the Moro reflex are preserved. The appearance of the parachute reflex (in the position of hanging horizontally by the armpits, face down, as if falling, the arms are extended and the fingers are spread apart - as if in an attempt to protect yourself from falling).

Posotonic reactions: at 4 months the baby’s head is stably raised; support on an extended arm. In the future, this pose becomes more complicated: the head and shoulder girdle are raised, arms are straightened and extended forward, legs are straight (swimmer’s pose, superior Landau reflex). Raising your legs (inferior Landau reflex), The baby can rock and turn around on his stomach. At the 5th month, the ability to turn from the position described above onto the back appears. At first, turning from the stomach to the back occurs accidentally when throwing the arm far forward and disturbing the balance on the stomach. Direction of development: exercises for purposeful turns. At the 6th month, the head and shoulder girdle are raised above the horizontal surface at an angle of 80-90?, the arms are straightened at the elbow joints, the support is on fully open hands. This position is already so stable that the child can follow the object of interest by turning his head, and also transfer his body weight to one hand, and with the other hand try to reach the object and grab it.

Ability to sit - keeping the body in a static state is a dynamic function and requires the work of many muscles and clear coordination. This position allows you to free up your hands for fine motor actions. To learn to sit, you need to master three fundamental functions: holding your head upright in any position of the body, bending your hips and actively rotating your torso. At 4-5 months, when pulling the arms, the child seems to “sit down”: bends his head, arms and legs. At 6 months, the child can be seated, and for some time he will hold his head and torso upright.

Walking Ability: at 5-6 months, the ability to stand with the support of an adult, leaning on a full foot, gradually appears. At the same time, the legs are straightened. Quite often, in an upright position, the hip joints remain slightly bent, as a result of which the child does not stand on his full foot, but on his toes. This isolated phenomenon is not a manifestation of spastic hypertonicity, but a normal stage of gait formation. The “jumping phase” appears. The child begins to jump, being placed on his feet: the adult holds the child under the arms, he squats and pushes off, straightening his hips, knees and ankle joints. This causes a lot of positive emotions and is usually accompanied by loud laughter.

Grasping and manipulation: at the 4th month, the range of movements in the hand increases significantly: the child brings his hands to his face, examines them, brings them up and puts them in his mouth, rubs hand against hand, touches one hand with the other. He may accidentally grab a toy lying within his reach and also bring it to his face or mouth. Thus, he explores the toy - with his eyes, hands and mouth. At 5 months, the child can voluntarily pick up an object lying in his field of vision. At the same time, he extends both hands and touches it.

Social contacts: from 3 months the child begins to laugh in response to communication with him, a complex of revival and cries of joy appear (before this time, a cry occurs only with unpleasant sensations).

Child aged 6-9 months. In that age period The following functions are noted:

Development of integrative and sensory-situational connections;

Active cognitive activity based on visual-motor behavior;

Chain motor combination reflex - listening, observing one’s own manipulations;

Development of emotions;

Games;

Variety of facial movements. Muscle tone - fine. Tendon reflexes are evoked by all. Motor skills:

Development of voluntary purposeful movements;

Development of the straightening reflex of the torso;

Turns from stomach to back and from back to stomach;

One arm support;

Synchronization of the work of antagonist muscles;

Stable independent sitting for a long time;

Chain symmetrical reflex in the prone position (the basis of crawling);

Crawling backwards, in a circle, using pull-ups on your hands (legs are not involved in crawling);

Crawling on all fours with the body raised above the support;

Attempts to take a vertical position - when pulling the arms from a position lying on the back, one immediately stands on straightened legs;

Attempts to stand up while holding onto support with your hands;

Start walking along support (furniture);

Attempts to sit up independently from a vertical position;

Attempts to walk while holding the hand of an adult;

Plays with toys; the second and third fingers are involved in manipulations. Coordination: coordinated clear movements of the hands; at

manipulations in a sitting position, there are a lot of unnecessary movements, instability (i.e. voluntary actions with objects in a sitting position are a stress test, as a result of which the pose is not maintained and the child falls).

Unconditioned reflexes have faded away, except for sucking.

Posotonic reactions: at 7 months the child is able to turn from his back to his stomach; For the first time, based on the righting reflex of the torso, the ability to sit down independently is realized. At the 8th month, turns improve and the phase of crawling on all fours develops. At the 9th month, the ability to purposefully crawl with support on the hands appears; leaning on the forearms, the child pulls up the entire torso.

Sitting Ability: at the 7th month, the child lying on his back takes a “sitting” position, bending his legs at the hip and knee joints. In this position, the baby can play with his feet and pull them into his mouth. At 8 months, a seated child can sit independently for a few seconds, and then “fall over” to one side, leaning on the surface with one hand to protect himself from falling. At the 9th month, the child sits for a longer time on his own with a “round back” (lumbar lordosis has not yet been formed), and when tired, he leans back.

Walking Ability: at the 7-8th month, a reaction of support on the hands appears if the child is sharply tilted forward. At the 9th month, a child placed on the surface and supported by the arms stands independently for several minutes.

Grasping and manipulation: At 6-8 months, the accuracy of grasping an object improves. The child takes it with the entire surface of his palm. Can transfer an object from one hand to another. At the 9th month, he voluntarily releases the toy from his hands, it falls, and the child carefully follows the trajectory of its fall. He likes it when an adult picks up a toy and gives it to a child. He releases the toy again and laughs. Such an activity, according to an adult, is a stupid and meaningless game, in fact it is a complex training of hand-eye coordination and a difficult social act- playing with an adult.

Child aged 9-12 months. In this age period the following are noted:

Development and complexity of emotions; the revitalization complex fades away;

Various facial expressions;

Sensory speech, understanding simple commands;

The appearance of simple words;

Story games.

Muscle tone, tendon reflexes remain unchanged in comparison with the previous stage and throughout the rest of life.

Unconditioned reflexes everything has faded away, the sucking reflex is fading away.

Motor skills:

Improvement of complex chain reflexes of verticalization and voluntary movements;

Ability to stand on support; attempts to stand without support, on your own;

The appearance of several independent steps, further development of walking;

Repeated actions with objects (“memorization” of motor patterns), which can be considered as the first step towards the formation of complex automated movements;

Purposeful actions with objects (putting in, putting on).

Development of gait in children it is very variable and individual. Manifestations of character and personality are clearly demonstrated in attempts to stand, walk and play with toys. In most children, by the beginning of walking, the Babinski reflex and the lower grasping reflex disappear.

Coordination: immaturity of coordination when taking an upright position, leading to falls.

Improvement fine motor skills: grasping small objects with two fingers; Opposition of the thumb and little finger appears.

In the 1st year of a child's life, the main directions of motor development are distinguished: postural reactions, elementary movements, crawling on all fours, the ability to stand, walk, sit, grasping abilities, perception, social behavior, making sounds, understanding speech. Thus, several stages are distinguished in development.

Posotonic reactions: at the 10th month, in the position on the stomach with the head raised and supported on the arms, the child can simultaneously raise the pelvis. Thus, he rests only on his palms and feet and swings back and forth. At 11 months he begins to crawl using his hands and feet. Next, the child learns to crawl in a coordinated manner, i.e. alternately extending the right hand - the left leg and the left hand - the right leg. At the 12th month, crawling on all fours becomes more rhythmic, smooth, and fast. From this moment on, the child begins to actively master and explore his home. Crawling on all fours is a primitive form of movement, atypical for adults, but at this stage the muscles are prepared for the next stages of motor development: muscle strength increases, coordination and balance are trained.

The ability to sit develops individually from 6 to 10 months. This coincides with the development of a position on all fours (support on the palms and feet), from which the child easily sits down, turning the pelvis relative to the body (rectifying reflex from the pelvic girdle to the body). The child sits independently, stably with a straight back and legs straightened at the knee joints. In this position, the child can play for a long time without losing balance. In the future, sitting

becomes so stable that the child can perform extremely complex actions while sitting, requiring excellent coordination: for example, holding a spoon and eating with it, holding a cup with both hands and drinking from it, playing with small objects, etc.

Walking Ability: at 10 months, the child crawls to the furniture and, holding on to it, stands up independently. At 11 months, the child can walk along furniture, holding on to it. At 12 months, it becomes possible to walk while holding one hand, and finally take a few independent steps. Subsequently, the coordination and strength of the muscles involved in walking develop, and the walking itself becomes more and more improved, becoming faster and more purposeful.

Grasping and manipulation: at 10 months, a “pincer-like grip” with an opposable thumb appears. The child can grasp small objects by extending his thumb and forefinger and holding the object with them, like tweezers. At the 11th month, a “pincer grip” appears: the thumb and index finger form a “claw” when gripping. The difference between a pincer grip and a pincer grip is that in the former the fingers are straight, while in the latter the fingers are bent. At 12 months, the child can accurately place an object in a large dish or in the hand of an adult.

Social contacts: by the 6th month, the child distinguishes “friends” from “strangers”. At 8 months, the child begins to be afraid of strangers. He no longer allows everyone to pick him up, touch him, and turns away from strangers. At 9 months, the child begins to play hide and seek - “peek-a-boo”.

10.2. Examination of a child from the neonatal period to six months

When examining a newborn baby, its gestational age should be taken into account, because even slight immaturity or prematurity of less than 37 weeks can significantly affect the nature of spontaneous movements (movements are slow, generalized, with tremor).

Muscle tone is altered, and the degree of hypotonia is directly proportional to the degree of maturity, usually in the direction of its decrease. A full-term baby has a pronounced flexor posture (reminiscent of an embryonic one), while a premature baby has an extension posture. A full-term baby and a child with stage I prematurity, when pulling the arms, holds his head for a few seconds; children with prematurity

This problem is of a deeper degree and children with damaged central nervous system cannot hold their head. It is important to determine the severity of physiological reflexes in the neonatal period, especially grasping, hanging, as well as reflexes that ensure sucking and swallowing. When studying the function of the cranial nerves, it is necessary to pay attention to the size of the pupils and their reaction to light, the symmetry of the face, and the position of the head. Most healthy newborns fix their gaze on the 2-3rd day after birth and try to follow an object. Symptoms such as Graefe's sign and nystagmus in the extreme leads are physiological and are caused by the immaturity of the posterior longitudinal fasciculus.

Severe swelling of a child can cause depression of all neurological functions, but if it does not decrease and is combined with an enlarged liver, a congenital form of hepatocerebral dystrophy (hepatolenticular degeneration) or a lysosomal disease should be suspected.

Specific (pathognomonic) neurological symptoms characteristic of dysfunction of a particular area of ​​the central nervous system are absent until 6 months of age. The main neurological symptoms are usually disturbances of muscle tone with or without motor deficits; communication disorders, which are determined by the ability to fix the gaze, follow objects, highlight acquaintances with a glance, etc., and reactions to various stimuli: the more clearly a child’s visual control is expressed, the more perfect his nervous system. Great importance given by the presence of paroxysmal epileptic phenomena or their absence.

An accurate description of all paroxysmal phenomena is more difficult the younger the child is. Convulsions that occur in this age period are often polymorphic.

The combination of altered muscle tone with movement disorders (hemiplegia, paraplegia, tetraplegia) indicates severe focal lesion brain substances. In approximately 30% of cases of central hypotension, no cause can be found.

History and somatic symptoms are of particular importance in newborns and children under 4 months of age due to the paucity of neurological examination data. For example, respiratory disorders at this age can often be a consequence of damage to the central nervous system and occur when

congenital forms of myatonia and spinal amyotrophy. Apnea and respiratory rhythm disturbances can be caused by abnormalities of the brain stem or cerebellum, Pierre Robin's anomaly, as well as metabolic disorders.

10.3. Examination of a child aged 6 months to 1 year

In children from 6 months to 1 year, both acute neurological disorders with a catastrophic course and slowly progressive ones often occur, so the doctor must immediately outline the range of diseases that can lead to these conditions.

The appearance of febrile and unprovoked seizures such as infantile spasms is characteristic. Movement disorders are manifested by a change in muscle tone and its asymmetry. In this age period, congenital diseases such as spinal amyotrophy and myopathy clearly manifest themselves. The doctor must remember that the asymmetry of muscle tone in a child of this age may be due to the position of the head in relation to the body. The lag in psychomotor development may be the result of metabolic and degenerative diseases. Disturbances in the emotional sphere - poor facial expressions, lack of a smile and loud laughter, as well as disorders of pre-speech development (babbling formation) are caused by hearing impairment, brain underdevelopment, autism, degenerative diseases of the nervous system, and when combined with skin manifestations - tuberous sclerosis, for which motor stereotypes and convulsions are also characteristic.

10.4. Examination of a child after the 1st year of life

Progressive maturation of the central nervous system causes the appearance of specific neurological symptoms indicating focal damage, and dysfunction of a particular area of ​​the central or peripheral nervous system can be determined.

The most common reasons for visiting a doctor are a delay in the formation of gait, its disturbance (ataxia, spastic paraplegia, hemiplegia, diffuse hypotonia), gait regression, and hyperkinesis.

The combination of neurological symptoms with extraneural (somatic), their slow progression, the development of dysmorphia of the skull and face, mental retardation and disturbance of emotions should prompt the doctor to think about the presence of metabolic diseases - mucopolysaccharidosis and mucolipidosis.

The second most common reason for treatment is mental retardation. Severe retardation is observed in 4 children out of 1000, and in 10-15% this delay is the cause of learning difficulties. It is important to diagnose syndromic forms in which oligophrenia is only a symptom of general underdevelopment of the brain against the background of dysmorphia and multiple developmental anomalies. Intellectual impairment can be caused by microcephaly; progressive hydrocephalus can also cause developmental delay.

Cognitive impairment in combination with chronic and progressive neurological symptoms in the form of ataxia, spasticity or hypotonia with high reflexes should lead the doctor to think about the onset of mitochondrial disease, subacute panencephalitis, HIV encephalitis (in combination with polyneuropathy), Creutzfeldt-Jakob disease. Disorders of emotions and behavior combined with cognitive deficits suggest the presence of Rett syndrome, Santavuori disease.

Neurosensory disorders (visual, oculomotor, auditory) are very widely represented in childhood. There are many reasons for their appearance. They can be congenital, acquired, chronic or developing, isolated or combined with other neurological symptoms. They can be caused by embryofetal damage to the brain, an abnormal development of the eye or ear, or the consequences of meningitis, encephalitis, tumors, metabolic or degenerative diseases.

Oculomotor disorders in some cases are a consequence of damage to the oculomotor nerves, including congenital Graefe-Moebius anomaly.

From 2 yearsThe incidence of febrile seizures sharply increases, which should completely disappear by 5 years. After 5 years, epileptic encephalopathy debuts - Lennox-Gastaut syndrome and most childhood idiopathic forms of epilepsy. The acute occurrence of neurological disorders with impaired consciousness, pyramidal and extrapyramidal neurological symptoms, debuting against the background of febrility, especially with concomitant purulent diseases in the facial area (sinusitis), should raise suspicion of bacterial meningitis, brain abscess. These conditions require urgent diagnosis and specific treatment.

IN younger age Malignant tumors also develop, most often of the brain stem, cerebellum and its vermis, the symptoms of which can develop acutely, subacutely, often after children stay in southern latitudes, and manifest not only as headaches, but also dizziness, ataxia due to occlusion of the cerebrospinal fluid ducts.

Blood diseases are not uncommon, in particular lymphomas, which begin with acute neurological symptoms in the form of opsomyoclonus and transverse myelitis.

In children after 5 years The most common reason for visiting a doctor is headache. If it is particularly persistent and chronic, accompanied by dizziness, neurological symptoms, especially cerebellar disorders (static and locomotor ataxia, intention tremor), it is necessary first to exclude a brain tumor, mainly a tumor of the posterior cranial fossa. These complaints and the listed symptoms are an indication for CT and MRI studies of the brain.

Slowly progressive development of spastic paraplegia, sensory disorders in the presence of asymmetry and body dysmorphia may raise suspicion of syringomyelia, and acute development symptoms - for hemorrhagic myelopathy. Acutely developed peripheral paralysis with radicular pain, sensory disturbances and pelvic disorders are characteristic of polyradiculoneuritis.

Delays in psychomotor development, especially in combination with the collapse of intellectual functions and progressive neurological symptoms, occur against the background of metabolic and neurodegenerative diseases at any age and have different rates of development, but in this age period it is very important to know that impairment of intellectual functions and motor skills and speech may be a consequence of epileptiform encephalopathy.

Progressive neuromuscular diseases debut at different times with gait disturbances, muscle atrophy and changes in the shape of the feet and legs.

In older children, more often in girls, episodic attacks of dizziness, ataxia with sudden blurred vision and the appearance of attacks may appear, which at first

difficult to distinguish from epileptic ones. These symptoms are accompanied by changes in the child’s affective sphere, and observations of family members and assessment of their psychological profile make it possible to reject the organic nature of the disease, although in isolated cases additional research methods are required.

They often make their debut during this period various shapes epilepsy, infections and autoimmune diseases of the nervous system, less often - neurometabolic. Circulatory disorders may also occur.

10.5. Formation of pathological postural activity and movement disorders in early organic brain damage

Impaired motor development of a child is one of the most common consequences of damage to the nervous system in the ante- and perinatal period. Delayed reduction of unconditioned reflexes leads to the formation of pathological postures and attitudes, inhibits and distorts further motor development.

As a result, all this is expressed in a violation of motor function - the appearance of a complex of symptoms, which by the 1st year is clearly formed into the syndrome of cerebral palsy. Components of the clinical picture:

Damage to motor control systems;

Delayed reduction of primitive postural reflexes;

Delayed general development, including mental development;

Impaired motor development, sharply enhanced tonic labyrinthine reflexes, leading to the appearance of reflex-blocking positions in which the “embryonic” posture is preserved, delayed development of extensor movements, chain symmetrical and alignment reflexes of the body;

Recently, more and more often (according to some data - from 70% to 90%), newborn children are diagnosed with perinatal encephalopathy (PEP), which is very frightening for parents.

IN Lately More and more often (according to some data - from 70% to 90%), newborn children are diagnosed with perinatal encephalopathy (PEP), which is very frightening for parents. Let's try to talk a little more about what PEP is, how it manifests itself, how to deal with it in order to avoid various unpleasant consequences, and how to prevent the baby from developing the disease.

Clinically, PEP is manifested by the following five syndromes:

• increased neuro-reflex excitability;
• convulsive;
• hypertensive-hydrocephalic;
• oppression;
• comatose.

One child may have either an isolated syndrome or a combination of several (we will talk about the manifestations of each syndrome below).

During the course of the disease, the following periods are distinguished:

• acute (from birth to 1 month);
• early recovery (from 1st to 4th month);
• late recovery (from 4 months to 1 year);
• residual consequences or outcome (after 1 year).

It should be noted that the earlier treatment is started, the smaller the changes that occur in the brain, the more favorable the outcome and the less severe the consequences. If treatment begins only in the residual period, then the effect of treatment is minimal.

Now let's talk a little about the reasons that can lead to development.

About the reasons for the development of PEP

There is no doubt that only a healthy woman can give birth to a healthy child. Many diseases of the expectant mother (chronic diseases of the stomach, kidneys, diabetes mellitus, thyroid diseases, malformations of the cardiovascular system), infections suffered during pregnancy can lead to oxygen starvation of the fetus, and the most sensitive organ suffering from a lack of oxygen is the brain, since all metabolic processes occurring in it require the obligatory presence of oxygen.

The course of pregnancy plays a major role in the development of the fetus, and complications such as:

• maternal anemia
• hypertension,
• threatened miscarriage,
• premature placental abruption,
• placenta previa,
• preeclampsia,
• premature or delayed birth,
• toxicosis of both the first and second half of pregnancy,
• long water-free period,
• multiple births,
• entry of meconium (feces of newborns) into the amniotic fluid long before birth, maternal age (under 18 and over 35 years),
• fetoplacental insufficiency (change in blood flow between mother and fetus and, as a result, oxygen starvation),
• changes in the structure of the placenta (for example, calcification - excessive deposition of calcium salts, leading to disruption of the trophic ("nutritional") function of the placenta, since the so-called "overripe" placenta during a post-term pregnancy is unable to ensure adequate blood flow between the mother and the fetus, therefore, it is disrupted main function- providing the unborn child with nutrients and oxygen).

Childbirth- the most physiological process and, at the same time, the biggest risk factor in the development of PEP. Any deviations in childbirth can cause brain damage (premature and late, and, conversely, weakness labor activity; the birth of two or more children; “caesarean section” - here the brain suffers during the period of anesthesia; wrapping the baby's umbilical cord around the neck). Therefore, the health and fate of her child will depend on how a woman prepares for childbirth mentally and physically.

The condition of a child at birth throughout the world is assessed using a single method, the so-called Apgar scale (after the author’s surname). Assess indicators such as breathing rate, heartbeat, reflexes, color skin and the cry of a child. Each indicator can have from 0 to 2 points; the condition is assessed in the first and fifth minutes of life. You can judge his condition based on how many Apgar scores the baby received:

• 8-10 points - an almost healthy child;
• 4-7 points - (that is, oxygen starvation of the brain) of moderate severity, the child needs thorough examination and treatment from the first days of life;
• 1-4 points - asphyxia (complete oxygen starvation) - the child needs resuscitation measures, urgent intensive care(usually such children are transferred from the maternity hospital to specialized neonatal pathology departments and carefully carry out examination and treatment, make any forecasts).

Now let’s take a closer look at the clinical manifestations of various syndromes.

Clinical manifestations of syndromes

Syndrome of increased neuro-reflex excitability more common with mild brain damage (as a rule, at birth such children have 6-7 Apgar points) and manifests as restlessness shallow sleep; prolongation of periods of wakefulness, uncharacteristic for newborns; difficulty falling asleep; frequent “causeless” crying; tremor (twitching) of the chin and limbs; increased reflexes; shuddering; increase or decrease in muscle tone. The diagnosis is established during observation of the child, examination by a neonatologist or neurologist and is differentiated, as a rule, from convulsive syndrome using an electroencephalogram (EEG), in the latter case, areas increased activity and a decrease in the threshold of excitability.

Convulsive syndrome in the acute period, as a rule, it is combined with depression or coma syndrome, occurs as a result of hypoxic cerebral edema or intracranial hemorrhages. It manifests itself in the first days of life as tonic-clonic or tonic convulsions, characterized by short duration, sudden onset, lack of pattern of repetition and dependence on the state of sleep or wakefulness, feeding and other factors. Convulsions can be in the form of small-scale tremor, short-term cessation of breathing, automatic chewing movements, short-term cessation of breathing, tonic spasm of the eyeballs, imitation of the “setting sun” symptom.

Irina Bykova, irleon200 [email protected], pediatrician and part-time mother of two children.

Discussion

With me with the first child PEP and a bunch of other diagnoses, there was a difficult birth with stimulation for 3 days.... they were treated from 4 months, very intensively, everything was corrected... At 2 and 3 years old there were febrile seizures, at 3.5 they diagnosed ICP, then ADHD, problems with behavior (((we visited an osteopath, we are being treated by a neurologist, psychiatrist, psychologist... Platovalgus has also increased..
The daughter was born well, but received 7/8.. She slept constantly, from 2 weeks there were profuse cramps, leg tremors, her eyes bulged, but she was calm, at 2 months according to the NSG there was a slight accumulation of fluid and increased blood flow, they put PEDs, medications, massage did not they helped, there was a slight tone and her body was pulled to the right in an arc, at 5 months the NSG diagnosed foci of hemorrhages and intracranial hypertension...then we went to an osteopath.. After her, after 3 weeks the tone began to go away and my daughter began to straighten up (she had a dislocation first cervical vertebra and there were some other bones above the roof of the mouth, which caused problems with sucking, and I didn’t take the pacifier). There is no fluid on the NSG at 7 and 8 months! The hemorrhage lesions decreased by millimeter, one resolved. My advice... If you see that your child has any signs, even the slightest, go to an osteopath! Common problem(but not always) this is damage to the neck during childbirth and a consequence of impaired blood flow... and further along the chain! Do not spare money for your child and look for good specialist in the register of osteopaths! Now our daughter and I haven’t been diagnosed yet, but the neurologist told us to forget it! The child is developing perfectly! The osteopath also told me to leave my daughter alone, everything is fine with her now)) I regret that my son and I didn’t get into the hands of an osteopath until a year ago... he also had problems with his neck, but the manual ruled ((with pain, fears...how Now I already know... he just shouldn’t have been under such stress, he had to be gently influenced.

10/14/2016 23:33:18, Tatyana

the child is 6 months old, the pregnancy is full-term, the birth is uncomplicated, there are no problems from the point of view of pediatrics and neurology, but for several days now the tip of the tongue has begun to stick out. With what it can be connected?

05/08/2008 22:11:18, Ekaterina

what can we say about organic lesions of the central nervous system?

06/01/2007 15:32:24, lyubik 10/30/2002 21:45:46, Svetlana

Everything that is described here is terribly scary, especially when doctors make such a diagnosis for your child. For my son, an ultrasound showed the immaturity of the central nervous system (central nervous system), impaired cervical blood flow, and the so-called dropsy of the brain, which I learned about from the attending physician... We underwent a 2-week intensive course of treatment with a bunch of drugs, massage, injections , current. Now we are “recovering” in a rehabilitation center. The baby is developing, pah-pah, excellently, weighs 7700, height 67 cm and this is at 4 months...

10/30/2002 21:45:23, Svetlana

Tell me what we should do at 2.5 months with a natal ischemic-traumatic lesion at the cranio-vertebral level, blocking of the vertebrae. The doctor first recommended dibazol and verashpiron, and then an osteopath.
Thank you!

07/07/2001 01:01:37, Vadim

Ya rojala starshuy dochku v Israele, rodi bez patologii, po Apgar postavili 9, priehali v Rosiyu i nachalos" - rodovaya travma, gipertenziya, "kuda je vi smotreli, mamasha?" i t.p. Propisali goru lekarstv, grozilis" umstvennoy otstalostyu, ya s perepugu vse davala, o chem seychas jaleyu. Seychas dochke 5 let, vse u nee v poryadke, po moemu rossiyskie vrachi - paniku razvodyat.

05/17/2001 12:55:10, marina

I am very glad that I read your article, but now I am terribly worried. My baby is seven weeks old, and from the age of four she began to cry for no reason and has difficulty falling asleep, and we still don’t have any routine, we also have all the other signs, such as shuddering and rolling the whites of the eyes, etc. We were not given any assessment at birth (I did not give birth in Russia). Please tell me what to do now, how to be treated.
Thank you, Lyudmila.

04/08/2001 15:56:31, Lyudmila

My daughter was given a PEP at 1 month; she began treatment immediately: injections with medicine (cerebrum), massage;
Now everything is within normal limits,
everything needs to be treated for up to a year.

My girl was diagnosed with pep by our pediatrician - but there are no symptoms listed above (we sleep well, eat very cheerful child (born 8-9) - only the skin was marbled for the first month) - I read your article and became worried - maybe in vain - could doctor make a mistake?

06.04.2001 16:26:59

Thanks for the info. Only now I have concerns. My baby was given 7-8 Apgar scores. The card is marked as a threat of asphyxia. And he had (now it seems almost none) such symptoms as: restless sleep; prolongation of periods of wakefulness, difficulty falling asleep, startling. Is my mask really sick with this disease? But the doctors don't say anything. What to do now, how to recognize this disease and what measures to take. I'm at a loss now.

Thank you. Very interesting article. I don’t know what my baby’s Apgar score was, but we were diagnosed with “posthypoxia” from birth and were registered with a neuropsychiatrist for up to a year. They drank some of the medicine. After a year, the doctor told me that there was no longer a threat of developing the consequences of hypoxia. So my question is: can this really go away “almost on its own” and now nothing threatens my son, or did I calm down too early? Thanks in advance for a possible answer.

04/05/2001 14:54:21, klodina

Comment on the article "Inorganic lesions of the central nervous system in young children (from 0 to 2 years) (beginning)"

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Today, diseases of the nervous system in children are among the most common. It is often necessary to identify certain abnormalities of the nervous system even among newborn children. First of all, this is due to pathology during pregnancy and childbirth: hypoxic, infectious processes suffered by the fetus in utero, feto-placental insufficiency (blood flow disturbances in the mother-child system), group and Rh blood conflicts, stress factors, harmful ...

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Health group 3. He is in a specialized children's home for children with organic damage to the central nervous system and mental disorders. Those. As far as I understand, he may have damage to the central nervous system?

Discussion

Contact on hepatitis now will not give a final answer whether there is a virus or not. (((He is still just a child. Here you are either ready for hepatitis to come out or not.
Ask if they tested you for PCR or just checked antibodies? PCR determines whether viral DNA is present in the blood. And antibodies generally show whether the child’s body is familiar with the virus. If the mother had the virus, then her antibodies to hepatitis are transferred to the child and remain until he is 18 months old. Therefore, the baby may not have the virus, but there are antibodies. But a positive response to PCR means there is definitely a virus.
Cerebral ischemia can also be written simply to be on the safe side, since pregnancy, for example, was unobserved. Or maybe it means something more serious.
In general, everything needs to be clarified in the DR.
I trusted the doctors in the DR. I believed everything they said. What I was most afraid of was brain damage. The result of sonography of the head can tell this. Listen to what the neurologist says about reflexes and reactions. What about vision and hearing?
Usually children at 2 months hold their head up. Look at the overall tone of the baby.
They will tell you everything about the mixtures when you pick them up. They will give you a piece of paper with the regime to support the first time and the menu.
It's better not to use perfume.
Smell the baby, hold it in your arms, listen to yourself. Take your time to make a decision. You can always do an independent medical examination.

A week ago, guardianship offered the child with contact, the previous adoptive parents refused, we did not find out the details. Because we ourselves are waiting for a PCR test of a child with a contact. If there is contact, then it is already positive. But it could be the mother's antibodies. The next analysis is done at 3 months, 6 months and 12 months. Hepatitis is removed at 1.5 years. But if it’s negative at 3 months, it doesn’t mean anything either. Although there is great hope that he is not infected. There were cases where 2 tests were negative. at 3 months and 6 months, and then positive, i.e. hepatitis. It seems that at this time it is “dormant” not in the blood, but in the tissues.
You definitely need to find out how the birth went, if in a hospital, then most likely only contact, but if at home, the likelihood of contracting hepatitis increases. Only after reaching 1.5 years can something be said unambiguously, and the diagnosis is removed, but the doctors themselves will tell you this on the spot. With such a diagnosis, the likelihood of the mother being a drug addict is very high. It’s up to you to decide.

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Psychological shock of parents after diagnosis of cerebral palsy little miracle natural And the most important task is to overcome it as soon as possible and begin comprehensive treatment of the child as early as possible. After all, the nervous system in the early infancy(up to 2-3 years) has unique plasticity and susceptibility. Healthy children go through a long journey in the first three years of life - they learn to walk and make many different movements, speak, understand, express their...

Very often I hear that they have confirmed or ruled out organic damage to the nervous system. I was never offered to do such a study on the child; they only did an MRI, and they were talking about organic brain damage.

But if the child does not have organic brain damage, if his nervous system is healthy, we can completely deny the presence of these children. These children sometimes show signs of damage to the central nervous system and poor performance at school.

Discussion

“Let us now consider cases where brain damage undoubtedly occurred. Let’s say the doctor reported that the child he examined had signs of hydrocephalus, i.e., dropsy of the brain. Does it follow from this that the child should be transferred to a auxiliary school as mentally retarded? No, this is not at all necessary. He may have signs of hydrocephalus in the absence of impairment of cognitive activity and mental abilities. Such children are often found in public schools.

It also happens that in the hospital where the child was hospitalized and treated, it was reliably established that he suffered meningoencephalitis, that is, inflammation of the brain and its membranes. Does this mean that such a child, who undoubtedly has brain damage, will necessarily be mentally retarded? No. Among those who suffered meningoencephalitis in childhood, a head injury, or who suffer from severe brain diseases throughout their lives, there are famous scientists and specialists with higher education. They may have some peculiarities, oddities of behavior and character, but their cognitive activity is not affected by the disease.

It is particularly difficult to assess the degree of mental underdevelopment of children in whom, due to relatively mild damage to the central nervous system, there is underdevelopment of one of the analyzers (motor or auditory) involved in the formation of speech. Poor and late development of speech is an essential circumstance on which the development of all cognitive activity of the child and, in particular, his success at school depends. These children sometimes show signs of central nervous system damage and poor school performance. And yet, if in the course of special experimental psychological studies it is found that the cognitive activity of such children is basically not disturbed, that they are quick-witted and easily trained, they should not be considered mentally retarded either. With appropriate speech therapy rehabilitation work, they will be able to continue their education in a mass or special speech school.

Therefore, the presence of only the second feature given in our definition is also not enough to establish mental retardation. Only a combination of two signs (impaired cognitive activity and organic brain damage that caused this violation) indicates that the child has mental retardation.

One more element of our definition of "mental retardation" should be noted. The definition refers to persistent impairment of cognitive activity. There may be cases when some kind of harmfulness, for example, a serious infectious disease, concussion, hunger, lead to some disturbances of nervous processes. As a result, children experience a temporary, transient impairment mental performance. These children may experience more or less prolonged mental retardation. However, they are not mentally retarded.
The defect in their cognitive activity is not permanent. Over time, they catch up with their peers. Distinguishing temporary, transient impairments of mental performance from persistent impairment of cognitive activity is quite difficult, but possible. For this purpose, experimental psychological techniques should be used.

In general, it is wrong to save specialists’ time when resolving issues on which the success of a child’s education and, to a certain extent, his entire fate depends.

Along with transient asthenic conditions Some children experience such persistent and long-term impairments in mental performance that they practically deprive them of the opportunity to study in a public school. In vain, some psychoneurologists try with the help of an inaccurate diagnosis - “delay mental development“- to keep them in public school. After three and sometimes six years of fruitless, painful repeating a year in a mainstream school, they are eventually transferred to auxiliary schools.

If a child suffers only from cerebrovascular disease and is given the opportunity to spend six months or a year in a sanatorium-forest school, live a year or two under conditions of a gentle regime and the necessary treatment, it is advisable to postpone his transfer to a auxiliary school in the hope of compensation for the condition.

To correctly judge the presence of all the mandatory signs characterizing mental retardation, a conclusion from at least two specialists is necessary: ​​a neuropsychiatrist, a special education teacher or a pathopsychologist. The first gives a conclusion about the state of the child’s central nervous system, the second gives a conclusion about the characteristics of cognitive activity. Thus, at present, the issue of a child’s mental retardation and the advisability of his education in a auxiliary school is being practically jointly resolved.”

Tell me, if the orphanage is specialized for children with organic damage to the central nervous system and mental disorders, are there only children with serious diagnoses? Conclusion of custody in hand.

Discussion

We have Sevastyan from such a DR. He is a foundling, apparently someone imagined something in the hospital, where he was immediately sent. Well, or I don't know.
The only diagnosis was speech delay, which was severe.

As far as I know, there are no non-specialized DRs... They are paid a premium for their “specialization”. So read the map. My daughter was in the DR with the same specialization, although her cardiology is semi-fake. It’s just that this is the only DR in that city)))

What diseases cause pain in the heart in children: Causes of pain in the heart in children: 1. Pain in the heart in children is most often functional in nature and, as a rule, may not be associated with the pathology of the heart itself. Cardialgia in children of early school age is usually a manifestation of the so-called growing pains, when the intensive growth of the heart muscle outstrips the growth of blood vessels supplying this organ. Such pains usually occur in asthenic, emotional, mobile children against the background of ...

When a child with such a diagnosis is started at the age of 2 years 4 months, then his nervous system is still plastic and the residual effects can be largely compensated. My child has an organic lesion of the central nervous system.

Discussion

Looks like we're doing an MRI tomorrow. And on Friday - a psychiatrist and a neurologist. In DD they gave me a lot of guilt - why do you need to do this, what kind of checks are these, etc., etc. I'm stupid - on my own. Thank you from the bottom of my heart girls. I myself did not expect such support and was very touched. I will write how and what as soon as something new.

I'm not a doctor. At all. Therefore, my reasoning is completely philistine. So: in my opinion, residual organic damage is a very general diagnosis. Manifestations should depend on the extent and location of the lesion. And they can range from “he doesn’t understand anything, he’s drooling” (sorry for the incorrectness) to “nothing is noticeable at all.” The first option clearly no longer threatens the girl. The child is adequate, obedient, reads poetry, plays role-playing games... So, I think, everything that could have happened has already manifested itself in this “bad student.” Is this critical for you? What if it is difficult to study? What if he doesn't go to university? If in fact as a last resort will he study in correction?
This is, in principle, a real prospect for many adopted children. It’s not a fact; a child taken at a younger age will not get the same problems at school.
In general, since my child is almost like this (he studies with difficulty, after 1st grade he couldn’t do anything), but he is wonderful and beloved, I feel bad for the girl. Somehow in the discussion they almost put an end to it. :(She’s a good girl. Although, of course, it’s up to you to decide.

Child from birth to one year Child from 1 to 3 Child from 7 to 10 Teenagers Adult children (children over 18) Child psychology. Breast-feeding Child from 3 to 7 Child from 10 to 13 Students Pediatric medicine Nannies, governesses.

Thank you, what is the central nervous system, I know that the child has some kind of perinotal problems with the central nervous system. there is OPCN (organic damage to the central nervous system) and there is PPCN (perinatal damage, i.e. intrauterine) these are the most common, not one in...

Discussion

Topic: QUESTION ABOUT cerebral palsy
Please answer and explain! The child has 1.1° cerebral palsy with spasmodic diplegia. At the next examination by a neurologist, the doctor who examined us told her students that we have clonus! What is this, she did not explain to me, she said that it was very bad .Please help, I’ll be really looking forward to your answer!!

01/29/2006 22:24:57, Anna.P

Hello Natasha and Margot! I am very happy with your success! I, too, Natasha, son Igor, we are 1.8, we have cerebral palsy spasmodic diplegia. We were born at 28 weeks of pregnancy, went through intensive care, mechanical ventilation, 2 months of hospital. We have been doing this since birth, massages, osteopaths, went to St. Petersburg to see Kapylov, in the end at 10 months we received our diagnosis:(! I read your topics with great interest and am very happy with the success of your baby, you are just great, Margot is an example for us! We only turned over at 1.2 months and began to crawl “on our feet”, trying to suck on our backs, we sit, stand and walk with support, but there is motivation and this is the main thing! I have a request to you, tell us about amino acids and in general share what medications you take, what kind of massage you do and where you are seen? Thanks in advance

organic damage to the central nervous system. Epilepsy can also be, but rather as a consequence, since the child apparently has a developmental delay, but the cause can also be different. maybe because no one is doing it, maybe because of op.

Discussion

Really try to get custody. This is possible without the biological mother’s refusal. Especially if it's a relative. But you will have to go through humiliation, that’s a fact. For them, the money issued by the state depends on the number of children. And the staff. They don’t want to lose their jobs, so they put a spoke in their wheels. But no one in the child care center will deal with the girl, and the symptoms will only get worse. She definitely needs medical treatment from vaccinations! And consultation with another (other) doctors. Neuropathologist, neurophysiologist. Competent treatment. Proper care and LOVE.

When a child is in pre-school age, no diagnosis can be made. I still have the boy in front of my eyes. I was about 10 years old at the time and spent several months in the hospital with pneumonia. In the next room was a little boy, a little over a year. They refused him. The head doctor took pity on him and left him in the ward for some time, because apparently the conditions in the place where he should have been taken were terrible, even compared to the hospital. He was born absolutely normal. But when he was discharged, he should have already been given some kind of diagnosis. He sat poorly and fell all the time. He just stood all day in his crib, holding on to the handrail, and caught every glance casually thrown at him by someone who passed by in the corridor. And so it was for several months while I was there. I still remember this look! I no longer remember what the adults told me - probably something that everything would be fine with him. But I probably remembered the look forever!
Please, do not leave anyone in the dd:.(Even if some change was found in the baby. Even if they suddenly tell you that this is not your niece at all. (I had this happen). Often people start lying so that what they think to do good, in fact it turns out to be terrible evil. Doctors, relatives... anyone can lie to you. Listen to your heart. It will tell you what to do with the baby, how to treat it.
Of course you take on so much. As far as I understand, you don’t have children of your own yet. But if you have this thought - to take the baby - then your heart needs it.
May God give you strength and health, you and your baby.