Method for treating children for psychical development disorders
SUBSTANCE: method involves carrying out transcranial micro polarizations once a week during 4-6 weeks in 15-20 min long sessions with 80-200 mcA large current over 2 electrodes. Anode is applied to the boundary of posterior region of superior temporal convolution and inferior parietal zone of the left hemisphere. The electrode is applied in later sessions to the boundary of inferior frontal region and anterior regions of superior temporal convolution and to projection of motor area of the left hemisphere cortex. The cathode is applied to the inferior regions of the left occipital area. Logopedic lessons are combined with psychological training during and between the transcranial micro polarization sessions. The treatment course is repeated when needed not more than 2-3 times a year.
EFFECT: enhanced effectiveness of treatment.
The invention relates to medicine, more specifically to the Psychoneurology, and may find application in the treatment of children with abnormalities of mental development.
Mental development, as manifestations of mental dysontogenesis, currently classified in the following main options anomalies (Lebedinsky CENTURIES mental development in children. M: Academy, 2003):
- hypoplasia and delayed development caused by a delay in development;
- damaged development deficit and development, caused by a breakdown in the development;
- distorted development and disharmoniously development caused by asynchrony development.
A typical model of mental underdevelopment is mental retardation, mental retardation. The cause of his many authors consider the influence of genetic factors. Clinical-psychological structure of the defect when the mental retardation caused by irreversible phenomena underdevelopment of the brain as a whole with primary immaturity of the cerebral cortex, primarily in frontal and parietal areas. Formulated two main clinical-psychological law of mental retardation: the totality of underdevelopment of all psychological functions and hierarchy of underdevelopment in the form of smaller manifestations of deficiency of gnosis, praxis, language, emotions and memory compared to the underdevelopment Maslen who I am. Low intellectual abilities of these children source impede the assimilation of new information, create a situation of isolation from their peers, the loss from the sphere of proper communication that promotes cultural and social deprivation.
When mental retardation (mental retardation) we are talking about slowing the rate of development. This is manifested by the failure of the common stock of knowledge, the immaturity of thinking, fast intellectual precisement and low intellectual focus, the prevalence of gaming interests. In the framework of the origin of the delayed mental development identified constitutional factor, somatogennye, psychogenic and cerebral organic. For patterns WIA characteristic is not the totality (as in mental retardation), and mosaic violations, particularly with regard to higher cortical functions. So, some of them can be rude damaged, other functionally unstable due to neurodynamic disorders, third - immature. The phenomenon of immaturity of the most typical regulatory systems, with a longer period of development. In some cases, the immaturity of the regulatory system defines specific dilation of emotional development (long-term preservation of affective responses, characteristic of the infantile psyche), in other - casts the regulation of intellectual activity (focus, programming, control).
A characteristic model of the damaged mental development is organic dementia due to infection, intoxication, injuries, and other Distinctive feature of her from mental retardation is the dynamics of development: for example, in organic dementia often there are indications initially correct and timely development of the child transferred to brain damage due to the above reasons. When dementia is much rudeness brain damage, razlozhennosti activity, gross non-critical and large weight loss of the individual functions. Features of mental development in terms of social adaptation are severely limited.
The deficient mental development due to a primary failure of individual systems: vision, hearing, speech, locomotor and other Primary defect, on the one hand, contributes to complex hierarchical number of secondary violations, determining violations of child development in General. On the other hand, heterochronia development, a healthy baby is the impetus for the formation of new functional systems, in a child with an anomaly of development contributes to a mismatch in the development of individual systems, which, in turn, inhibit the overall development. However, with the rennosti other analyzers and intellectual capability can be achieved with a high level of compensation. When cerebral lesions depending on its intensity abnormality, caused by the defect of this analyzer, combined with a strong General development disorder: either functional-type a kind of mental retardation or coarser organic by type of mental retardation.
The distorted mental development in the form of the syndrome of early infantile autism differs from the above-described abnormalities of the greatest complexity and disharmony as clinical, and psychological patterns of violations. Analogy between them can be traced in the etiology, including genetic and due to exogenous reasons. Autism manifests itself in the absence or significant reduction of contacts with others, “care of itself”, the violation of the emotional sphere due to the lack of emotional resonance to external events, on the one hand, in combination with hyperesthesia to normal sensory stimuli, the fears and the associated emotional discomfort on the other side. Significantly impaired communicative function of speech. Even when potentially saved intelligence autism are outside of the real situation and the requirements are often given the reaction of negativity, with frequent rejection of already existing skills. Associated with autism underdevelopment of social contact is in a dramatically distorts the entire course of mental development of the child.
Demonstration model disharmonious development are psychopath and pathological personality development, based on dysontogenesis emotional-volitional sphere. Even the initially intact intellect does not regulate the emotional sphere, and is often from him in a greater dependence than observed in normal. Disharmony personality underlies the frequent persistent violations of adaptation to the social environment, and the inclination to decompensation when changing the usual conditions.
In accordance with modern views of the same mental disturbance can coexist different ways dysontogenesis. The number of children with disorders of mental development is steadily growing from year to year, which requires the use of a graded approach to the identification and analysis of the leading, primary mental development of children, selection of appropriate methods of rehabilitation.
This invention relates to methods for correction of disorders of mental development of children, namely gross mental retardation, mental retardation, early childhood autism. Currently widely used methods for correction of these violations is a combination of drug therapy with psychotherapy, teaching, speech therapy methods, as well as transcranial ICRI is polarized (TCMP) (Ilyukhin, VA and other “Method of treating tempo delay of mental development in children” - Patent of RF №2180245, 2002, MCI A 61 N 1/20).
This method is closest to the proposed and taken as a prototype. The method consists in the fact that children with tempo delay of mental development after the course of pharmacotherapy (antioxidant, antihypoxic agents, trace elements, enzymes and amino acids) in addition carry out TCMP, placing the anode on the border of the left signalone and anterior vernaison gyrus within 3-6 sessions, the cathode on the lower parts of the occipital region of the left hemisphere, and then the anode is placed on the projection of the motor cortex of the same hemisphere. The effect is achieved within a few weeks and is manifested in a significant increase in the level of speech development of children, which leads to the enhancement of their learning during the psychological and speech training during and after the course, with the possibility of subsequent development of age-related loads.
However, in more severe forms of mental development (coarse delay speech development, mental retardation, early infantile autism) using TCMP on these areas of the cortex showed lower their effectiveness in relation to the understanding of speech, the establishment of verbal the aqueous contact, necessary for the conduct of remedial and developmental classes, which makes the treatment more severe mental development in children is not effective enough.
The technical result of the present invention is to empower correctional treatment of mental development in children due to the expansion of the area affected by the TCMP.
This result is achieved by the fact that in the known method, including neurological and speech therapy examination, drug therapy, speech therapy classes and transcranial micropolarization who spend not more than 1 time per week for 4-6 weeks sessions for 15-20 min in 2 of the electrode, placing the anode on the border signalone region and anterior vernaison gyrus and on the projection of motor areas of the cortex of the left hemisphere, the cathode is on the lower parts of the left occipital region, continuing speech therapy classes during the entire course of treatment, according to the invention transcranial micropolarization spend amperage from 80 to 200 μa, during 1-3 sessions anode placed on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, speech therapy classes combined with psychological during and between sessions, and these repeat treatments if necessary, not more than 2-3 times per year.
Working the camping for many years, evaluation and treatment of children with disorders of mental development, we used in correctional treatment opportunities TCMP, Logotherapy for the development of fine motor and articulatory skills, conducting articulation exercises in children with speech delay.
Based on our experience, when working with children with coarser mental disorders in the first stage, we tried that we developed earlier modes TCMP with the scheme of the provisions of the anode on the border signalone and anterior vernaison gyrus of the left hemisphere. However, we are faced with the fact that this effect, which gave a quick positive effect of a systemic nature in children with speech delay, had no significant influence on the communicative functions of children with coarse delay or lag in mental and speech development in children with the syndrome of early infantile autism, which created significant difficulties in the implementation of the psycho-speech therapy practice in connection with the difficulties of establishing contact with the child.
In this regard, we decided to expand the scope of the TCMP. Saving the location of the cathode on the lower sections of the occipital region of the left hemisphere, we tried to move the anode within the left temporal lobe, negatemoney, sidelobes areas. The best effect was obtained when the position it on the border of the posterior vernaison of ilini and negatemoney region of the cortex of the left hemisphere. It manifested itself in the rapid emergence of the ability to understanding of speech - first, more simple, then more complex forms, and consequently the understanding of the instructions-tasks during the sessions with the psychologist and speech therapist, which led to a pronounced increase productivity correctional practice, aimed at the development of mental functions.
Consecutive sessions TCMP with the imposition of the anode on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere within 1-3 sessions and then the following sessions in the area of the motor cortex accelerated the development of various parties verbal functions and related psychomotor functions.
The current strength was determined by us experimentally and ranged from 80 to 200 µa. The number of sessions and the interval between them was determined according to observations, the results of the neurological, psychological and speech therapy examination.
Conducting psychological and speech training during and between sessions TCMP was objectivesyou accelerated formation of social adaptation and development of mental processes in children with disorders of mental development.
The method consists in the following. The child with impaired mental development based on neurological, psychological and speech therapy examination by tanglefoot the severity of the lag from age norms and depending on this, assign TCMP amperage 80-200 µa in the form of sessions for 15-20 min, not more than 1 time a week, through 2 electrodes: anode within 1-3 sessions impose on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, the cathode is on the lower parts of the occipital region of the left hemisphere, then the anode move to the border of the left signalone and anterior vernaison gyrus or motor cortical area. Such courses if necessary, repeat 2-3 times per year. TCMP is performed using a serial medical device FLOW-1 (included in the State register of medical equipment) in the constant current mode. Use two standard metal disk electrode with a diameter of 27 mm, which are mounted on the skin of the head through 6-8 layers of moist flannel lining. The electrodes are fixed on the head with a rubber helmet on the coordinates of the scheme Kronlein used to Refine the projections of the intracerebral reference points on the head surface. During and between sessions TCMP throughout the course of ongoing sessions with a speech therapist and a psychologist and speech pathologist.
The essence of the method is illustrated by the following examples.
EXAMPLE 1. Dasha M, 4 years, 9 months. Was admitted for examination and treatment 11.12.2002, complaining of delays in speech development, low effectiveness of speech therapy sessions.
History: a child of 4 pregnancies, FR is cawsey amid threats of termination. Childbirth account 2, the urgent, the first cry of a newborn baby after stimulation. Birth weight 3250 g, attached to the chest on the 2nd day, was sluggish, sucked poorly, poorly gaining weight. Home was discharged on the 8th day. Psychomotor development up to 1 year: holds head with 1, 5 months, sitting with 6-7 months worth of 5-6 months, goes to 1 year. In I/s went in 11.5 months, has adapted quickly. Speech and communication development: start cooing with 2-3 months. 1 year suffered whooping cough, then began to speak less. In 2.8, addressed to the neurologist. Surveyed about the touch Allie. A course of treatment with Cerebrolysin, Cavinton.
According to the examination by a neurologist: girl contact available. It is prattling, there are simple words. Facing it is not always understood. There hypersalivation. FMN: easy smoothness of the right nasolabial fold. Trunk boars reflex (+). Language tense, sedentary. The amount of movement in the left limb is restricted more in his hand, hypotrophy of the left upper and lower extremities. Muscle tone was increased in the left limbs along the pyramidal type. Tendon and periosteal reflexes above on the left. M Babinski (+) with 2 sides. The abdominal reflexes are symmetric. The sensitivity of the saved. Coordinatorsee samples: there are intentsionnogo tremor on the left. Posture sluggish. Gait unsteady.
According to a speech therapist: child contact superheros. Not always understands facing it, there is no attention to the speech of the speaker. Sometimes, hearing a familiar concept, attempts to perform an action or to repeat the word. The request to show the subject, the toy does not. Poor vocabulary (set prattling words, one word refers to several concepts. Grammatically, the phrase is not decorated. Significantly impaired lexical and grammatical components of language, conceptual dictionary. There are fears, sleeps poorly at night. In d/with almost no talking. 's action primitive. Conclusion: the General underdevelopment of speech (NRO) I level of speech development delay in speech and mental development.
According to the psychologist, the contact with the girl gradual. On examination there is no speech, only suukompleks. The behavior surveys adequate verbal instructions understands and fulfills part and only clearly-effective nature. Leading hand right. The pace of work is slow, the efficiency is low. The leading type of motivation games, the interest of the proposed jobs are. Colour perception: not correlates with the sample, does not show the word, geometric shapes does not name, “mailbox” plays randomly, using the power of the sample, the pyramid collects without regard to size, doll collecting is not able. Graphic work is not formed. Attention is quite stable n and work with the bulk material, there are difficulties switching, concentration. Memory visual involuntary - 0 images from 10 proposed, arbitrary - 0, of hearing - waiver of the sample “10 words”. Thinking operations analysis-synthesis is not formed. Generalizations not emit 4th unnecessary. Split image does not collect even from 2 parts. Classification 2 signs no. Causation (consecutive images) does not set. No imitation activities. Emotional and personality traits: the girl is friendly, responsive to affection and praise. Conclusion: mental retardation (mental retardation), the edge with mental retardation.
According to electroencephalography (EEG) is slow cortical rhythm, with a tendency to the “acceleration” of EEG rhythms during functional loading. Signs of irritation at rest and during exercise is highlighted in the right parieto-temporal region of cerebral cortex. Manifestations of dysfunction of stem nonspecific structures at rest and during light loads is not revealed.
According to rheoencephalography (REG) showed signs of moderate deficit of pulse blood, more distinct in the carotid pool. There are moderate amiodaronesee symptoms with increased tonus of vessels of small caliber, compensatory phase difficulty of venous outflow. Marked the height vertebral effect on vertebral artery during rotation of the head.
Based on the results of clinical neurological and additional methods of examination was diagnosed with organic brain damage perinatal Genesis, left gamecentral, delayed psychomotor development, General underdevelopment of speech (NRO) I-II level of speech development, dysarthria erased form. Recommended course TCMP.
Course TCMP conducted between 11.12.2002, 26.02.2002,
First TCMP held 11.12.2002, a current of 150 μa for 20 minutes, the anode is on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, the cathode is on the lower sections of the left occipital region. During the session TCMP when correctional-developing lesson, psychologist and speech pathologist noted: child contact, the efficiency is extremely low. The behavior close to the field: for a short time attracted attention with bright toys and items to which interest very quickly lost). Observed chaotic, aimless manipulation of objects. Perceptual tests on the ratio of objects by color, shape not fulfilled, laid out randomly, the verbal description is missing. Could be folded only simple pictures of 2 parts.
The same evening after the session TCMP mom said that the house she was very active, energetic. In the week following the d/s is also noted that girl became active, asks a lot of questions, new words appeared, She began to run jobs on the exercise.
The following TCMP spent 3 weeks 5.02.2003, (later appointed in connection with the transferred ARD) current of 120 μa for 20 minutes, the location of the anode and cathode is the same as in the first TCMP. When correctional-developing lesson during the session showed positive results: increased overall speech activity, improved quality statements appeared 2-3-complex words; appeared simple phrase speech, increased active dictionary. The girl began to give monosyllabic answers to questions, perform tasks on visual correlation (folding puzzles). The girl rarely looks into his eyes, are stereotypie in speech, boilerplate statements.
Next TCMP held 12.02.2003, a current of 120 μa for 20 minutes, the anode is moved to the border signalone and anterior vernaison region of the left hemisphere, the location of the cathode is the same as in the previous TCMP. On correctional-developing lesson during the session, the girl on the contact went immediately became more relaxed, emotionally positive, often smiling. During the lesson the girl is quite active, interested in various forms of activity. Attention became more stable. All actions arecaused (but quietly, in a whisper, answers questions. Understands simple phrases, instructions, job executes on clearly-effective level. Differentiates and compares the shapes by color, shape, size, colour backgrounds, boards with inserts etc). The job executes on a bright, three-dimensional didactic material, experiencing difficulties with tasks ink character..
During subsequent TCMP conducted 12.02.2003, and 19.02.2003, the above schemes, remedial and developmental classes marked with the child throughout the active, purposeful. Manifested stable cognitive interest. After each job asked “and?”. In the exercise, there is a constant narration (voice), often not connected with execution of the job (“mom, buy”, “dad goes” and so on). - delayed echolalia. When tasks graphic activities identified impairment of fine motor skills (slow, inaccurate, discoordinated manual motor).
Course TCMP held from 5 sessions.
In General, after a course TCMP positive developments especially in relation to General and speech activity. The girl became more attentive, increased time to focus on the activity performed, improved health and productivity activities. Appeared resistant poznavatelnaya to ambient, various forms of activity in correctional practice. The girl takes the help of a training nature. Improved the quality of the speech sound, syllable clearance of words. Increased vocabulary (nouns, verbs, adjectives). Significant improvements were observed in sensory-perceptual sphere. It is necessary to continue work on the development of memory, thought and speech, gross and fine motor skills.
Recommended next repetition rate TCMP in 4-6 months.
According to the follow-up monitoring: the girl was transferred to the d/s from a group of mentally retarded in the group of children with mental retardation.
EXAMPLE 2. Dmitry Y., 7 years. He entered the examination and treatment of 25.12.2003, with complaints of gross developmental delay, lack of speech. History: the child from first pregnancy going on in the background threat of termination. Delivery is urgent, the cry of a newborn at once, Apgar 8/9, birth weight 3160 g, attached to the breast within 1 day, the character of sucking without violations issued on the 5th day. Psychomotor development: holds head with 1 month, sits with 8 months worth 10 months, goes to 1 year. Start cooing to 3 months, the emergence of babbling to 1 year. 1 year 3 months moved mononucleosis with fever, and then came a series of strong cries. Up to 2 years to doctors did not address. On ultrasound atrophic changes in the right hemisphere is more pronounced than is evom. With 3 years was observed by a psychiatrist, diagnosed with organic brain syndrome of autism. In outpatient map also includes the following entries specialists: dementia, expressed imbecile, petit-mat, motor alalia. The last course of therapy included nootropil, Cerebrolysin, pantogram.
According to the examination by a neurologist: contact not available. Facing it does not understand. The behavior close to the field. Pronounce some sounds, screams (lows). No speech. Motor disinhibited. The language in the mouth in the midline. Nasolabial fold on the left is slightly smoothed. Reflexes of oral automatism (+ -). On the skin of the cheeks vascular net. Range of motion in joints full. Appearances no. Muscle tone - the tendency to hypotension. Tendon and periosteal reflexes high, symmetrical. The abdominal reflexes are symmetric. M Babinski (+ -). Fine motor skills are severely disrupted. Coordinatorsee samples (takes things up) performs satisfactorily. Walks independently, unstable posture sluggish.
According to EEG are diffuse changes in the average degree, mainly residual organic nature. Pathological forms of activity not identified. Delayed formation of the main rhythm of the brain. During the two years of observations in the dynamics of EEG without positive changes.
According to REG are the reasonable price is e amiodaronesee symptoms with increased tonus of vessels of small caliber. Compensated phase difficulty of venous outflow. Signs of the original pulse deficit of blood in VB with a tendency to increase in vertebral impact on the rotation of the head.
According to a speech therapist: the boy in the contact is not involved. At home eating, dressing, obovata. According to parents, turned it understands. Responds well to intonation. Very mobile, examining with interest the bathroom. No speech. The approval gives a smile, displeasure cry. According to parents, there are several prattling words. Conclusion: anarthria.
According to psychologist: contact comes gradually. The look in his eyes sliding. The behavior of the examination was inadequate, close to the field. Leading hand right. The pace of work is fast (liners). The leading type of motivation games. Visual perception is not formed: does not perform simple tests on color, shape, size. Fine motor skills are extremely awkward. Attention depleted, the difficulties in attracting, concentration, and switching. Job analysis-synthesis does not collect split images of 2 parts. Generalization and 4th extra - does not emit. Thinking clearly-effective in its formative stages (uses the power of the sample). Conclusion: mental retardation.
On the basis of clinical neurological and additional methods surveys the Denmark diagnosed with organic brain damage mixed Genesis (neuroinfection). Delays in mental and motor development. Anarthria. After a course of pharmacotherapy (diacarb with asparkam, neuroactive, Magne-6) assigned to the course TCMP.
Course TCMP conducted between 25.12.2002, 5.02.2003,
First TCMP held 25.12.2002, a current of 120 μa for 20 min, the anode is on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, the cathode is on the lower sections of the left occipital region. During the remedial and developmental classes in session TCMP noted: the child is not active, is not workable impulsive. The behavior of the field. Focus on 2-3 seconds only on the brightest objects and toys. The proposed task is not practically performed. During the handling items, toys there is no visual control (opinion aside - looking at the wall). Emotionally excitable, observed flattening of emotional reactions, only the relationship with her father are adequate emotional manifestations (affectionate, seeks support, obey it). The child of a marked stereotyped vocalizations in the form of grunts, screams.
After TCMP during the week close note that the boy became more active, “clever”, I began to look homemade photo album, a better understanding of how adults puts “Russian dolls”, cuts with scissors. The mood has become is more smooth. The boy tries to draw, collect pictures of animals in the “layout”, is mother's hand to work with clay, scissors and glue. Before the table was set, now tries to hunting, but if not, throws a lesson.
Second TCMP held 8.01.2003, according to the same scheme as the first TCMP current of 180 μa. During the sessions with the psychologist and speech pathologist in the course of the sessions TCMP noted: behavior persists, impulsive, chaotic, but the beginnings of interest in the proposed tasks. The child began to run jobs on the visual-active level (“Board SEGUIN”, “mailbox” “Split images of the 2-piece” and so on). Manipulation performs, touching objects, but began to appear and visual control. Took active assistance of the father, the psychologist. There is a positive emotional reaction to the compliment. Hand movements become more coordinated.
In the week following parents for the first time were able to identify the boy short sessions with a speech pathologist (previously they were denied even in specialized institutions).
The following TCMP held 15.01.2003, current 190 µa for 20 minutes, the anode is moved to the border signalone and anterior vernaison region of the left hemisphere, the cathode is on the lower sections of the left occipital region. In the process of correctional busy with the I with the psychologist during TCMP noted that the efficiency is low, attention is extremely depleted, after 10 minutes came fatigue (started to manipulate objects by touch, without visual control, sight translated on the wall). The child was better able to perform familiar tasks. Independently folded “Board SEGUIN”, volume split images, other tasks will be performed with the help of a psychologist. In General, in the exercise were observed polar emotional reactions (happy tears). Limitation of actions and prohibitions child showed aggression to the psychologist (tried to pinch). The child has decreased involuntary vocalizations, more clearly began to pronounce vowels, appeared slovosochetaniya (like “ha-ha”).
Next TCMP held 22.01.2003, according to the same scheme as the previous ones. During the remedial and developmental classes in session TCMP marked: low efficiency, attention is extremely depleted (time optimal operation within 10 minutes - then resolutely refused to perform the task). Familiar tasks and similar executes successfully, but the didactic exercises that used to have the greatest difficulty refuses to comply. New items of interest feels, sees. Focus on the objects increased from 2-3 seconds to 5-6 seconds. The job executes on clearly-effective level. If the problem was to “ask for help”: the contributions of the AET in the hand of a psychologist liner, to help you find the right puzzle.
The last TCMP course conducted 29.01.2003, and 5.02.2003, on the same pattern as the previous ones. During practice during the sessions TCMP psychologist notes: square, circle Jura already invested himself, other geometric shapes invested with the help of a psychologist. Long researched on the touch part of the figures. Was clearly expressed interest in colored hedgehogs. Attention was quite stable within 5 seconds. Cube Séguin piled with the help of a psychologist, but he began to twist the details. Working within 10 minutes.
Just spent 6 sessions TCMP.
Immediately after the course TCMP therapist notes: the boy began to look into the eyes, to pay attention to the pictures. Performs requests to “raise up”, “sing” (began to buzz). Monitors the movements of the lips, trying to repeat the clapping. Have an interest in letters. There are also positive developments in stability and focus to bright objects. There is the memory of past job, boy longer began to manipulate objects, to feel.
It is recommended to repeat the course TCMP in 4-6 months.
According to the follow-up monitoring: after 3 months after 1 year TCMP grandmother said that the boy is engaged with the language already not 1, but two times per week individually for 1.5 hours. Became more calm, sensible, understand more, goes well in public transport: erectal to rush to each bus, know your route.
EXAMPLE 3. Lisa K. was Admitted for examination and treatment at the age of 6 years and 10 months. complaining coarse lag in mental retardation, absence of speech.
History: the child from 3rd pregnancy occurring without features. Birth second term, with stimulation, gluteal previa fetal asphyxia at birth, Apgar 6/8. Chest is applied on the 2nd day, not sucked, was discharged from the hospital on day 7. Psychomotor development: head keeps 3 months, sitting with 2 years worth of 3 years, going from 4 years old to support. D/s visits with 4 years. Phrasal speech is absent. Was observed by a neurologist with 8 months with a diagnosis of antenatal CNS damage with delayed psychomotor development and lesions of the cranial nerves, the suspected microcephaly. Concomitant diagnosis: infantile eczema, myopic astigmatism. In the neurological status was marked change in muscle tone by mixed type: with Hyper Flexural and hypotonia extremities, bilateral lesion VI pair FMN, peripheral paresis VII couples, paresis IX pairs. Received dehydration, neurohormonal therapy, was also neurorehabilitation. 4, diagnosed with organic lesion of the Central nervous system, microcephaly, coarse delay of mental development, mental retardation, scoliosis.
According to the electromagnetic scanning of the brain in may 2003 the. identified organic decrease of brain tissue, residual ventriculodilatation, neuronal atrophy, periventricular degeneration, atrophy of the white matter, more pronounced in the right hemisphere due to perinatal encephalopathy mixed Genesis.
According to the examination by a neurologist: microcephaly. FMN: diplopia, reaction to light alive, bilateral lesion VI pair FMN, left-peripheral paresis VII pair. Muscle tone - dystonia with hypertonicity of the proximal muscles (torsion dystonia), there's contracture. Scoliosis of the cervical-thoracic spine. The reflexes of the limbs high above in the legs, right more than left. Sensitivity is normal. In the Romberg unstable, misses when planosol sample. Gait, spastic-atoxicity.
According to EEG from 18.03.2003, are expressed diffuse changes in the bioelectrical activity in the form of low-level electrogenesis (amplitude not more than 5 µv), disritmia. Under functional loads increased level of activity in motor areas of the cortex. Paroxysmal activity was not detected. EEG from 12.11.2003, after a course of pharmacotherapy with positive dynamics in the form of increase electrogenesis in General with the “acceleration” of cortical rhythms, including the main range (alpha) rhythm. They is no place instability of the functional state of the cerebral cortex with a tendency to periodic reduction. Against the background of increasing levels of bioelectric activity in fronto-parietal departments of both hemispheres periodically EPI-equivalents.
According to REG from 18.03.2003, are moderate amiodaronesee symptoms with increased tonus of vessels of small caliber, soft expressed venous Disgaea, more distinct in VB. Signs of moderate source of pulse deficit of blood in VB, moderate vertebral effect on vertebral artery during rotation of the head, mainly on the right. In dynamics from 12.11.2003, the marked increase in intensity of the pulse of blood, more distinct in VB, in combination with a decrease in tonus of vessels of small caliber to normal values.
According to a speech therapist: (19.06.2003,): affectionate girl, quickly came into tactile contact. If the show sounds stares at your mouth, like to feel the vibration of the throat in the pronunciation of sounds. Accompanied by a familiar game sound. Get the syllables “bi-bi”sound,“”, “u”. Trying to repeat the movement, the sounds that her show. The movement of the tongue and lips sluggish, a lot of involuntary movements. The language in tone. Lips sedentary, no dense bows lips. There is salivation. The hand of the weak, poorly captures in a fist, but the toy holds. Understands specific instructions. There are basic hygiene skills. Attempt is carried out to eat. Quickly grasps stereotyped movements. Conclusion: mental retardation in phase of imbecility. Dysarthria.
According to psychologist: contact with the child situational, short-term. Girl friendly. Behavior survey close to the field. Activities: inadequate manipulation of objects. The pictures look focuses during intense stimulation of attention, verbal instruction does not execute. The help of an adult does not accept, for the actions of her hand - the hand tries to resist. Positive and negative emotions expressed similar: quickened breathing. From toys attention was attracted only by the figure of a man, the other is not considered in hands did not take. Pointing gesture no research activity was shown to pieces of furniture, delayed only by the heater. No question, only suukompleks. Strong salivation. Conclusion: mental retardation in phase of imbecility.
Based on the results of clinical neurological and additional methods of examination diagnosis: consequences of perinatal CNS damage with coarse delay of mental development, lesions of the cranial nerves, spastic diplegia, torsion dystonia. Chronic vertebral-basilar insufficiency in the background craniovertebral Pato is Ogii. Mental retardation in phase of imbecility. Assigned course TCMP.
The first course TCMP conducted in the period from 12.11.2003, 3.12.2003,
First TCMP first course of treatment performed 12.11.2003, a current of 120 μa for 20 min, the anode is on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, the cathode is on the lower sections of the left occipital region of the cortex. Before the session and during the session the girl was capricious, escaped from my mother from the hands. Immediately after the session, where Lisa had to forcibly hold, the girl was aggressive, whining.
The evening of the same day the first development session with a psychologist. Lisa has been active, motor explored space, the proposed didactic toys. Focusing on the picture over a long time - up to 30 sec. The girl behaves kindly, smiling, allows you to manipulate your hand. Of particular interest was hanging bell: long time listened to the sound and came back a few times to him for lessons. Active class - 30 minutes Then tired, became a “kiss” to the floor and the table. Left with a smile.
At home in the next week, she began to watch TV, more closely watching what is happening on the screen. Learned to take a bite from solid pieces of food (she used to eat mostly is the natural enemy of liquid food). Improved speech understanding. Better shows what he wants. By the end of the week sharply deteriorated mood for no apparent reason, then passed. While riding in vehicles Lisa became more worried about what is happening around them.
The following TCMP held 19.11.2003, 26.11.2003, according to the same scheme that the first session, a current of 100 and 80 μa, respectively. For the second session with a psychologist at the meeting, the girl smiles, tries to cuddle. In the room looked around and went straight to the bell (remember where hanging). Throughout the lessons, tapping his head toys, hits his forehead on the wall or Desk. To distract managed, but barely. Calmed down, hand over hand sand. Jobs by mom did also reluctant, but less aggressive. The hand was not allowed, not allowed to invest in the palm of toys. With interest only shook toys and listened to the sounds.
In the next week, normalization of sleep. The girl became more calm, more listens, responds to new commands, normalized emotional state. There is no aggression, goes better transport, better react to strangers. The house was in the evening “too long”, long could not fall asleep. Began to play ball, add more small details, play more complex games. Becoming more intelligent, more persistent in their desires, prowl is no impatience, if it something you need.
The last TCMP held 3.12.2003, a current of 80 μa for 20 min, the anode is on the left border signalone and anterior vernaison gyrus, the position of the cathode is constant. After the session has calmed down faster than usual.
By the end of the course TCMP on lesson psychologist with pleasure rang rattle, put a few balls in a jar with a hole for a long time and several times looked at the picture of the dolls, was on and off the light. Autostimulation was attended by all the class.
In General, the effect of 1 year in relation to mental processes manifested in the fact that Lisa became more active, friendly and helpful help, autoaggression quite easily extinguished by a change of activity.
The first course TCMP held from 4 sessions. Recommended course TCMP be repeated after 4-6 months.
According to the follow-up monitoring: during the past 4 months after the first course TCMP home with Lisa became much easier to communicate at the household level. It performs a simple request, can show a gesture that wants to eat (which pulls in the kitchen), wants scolded (covers ears). She can resign from the school that shows the development of personality and communication skills. After an absence of mothers at work for 3 weeks (Lisa was in another house) Lisa showed resentment: it wasn't the mother was accustomed. If this is m itself with great joy, returning home, rushed to his toys, crib, played all evening and even at night, waking up, again played that indicates the development of long-term memory. During the day the house Lisa is always occupied by their “works”, more active movement, prone to more long-term focus.
According to a speech therapist (before the second course TCMP): appeared emotional coloring of conduct: there is a clear expression of frustration, joy, fear. The girl understands situational speech, the mandates of the mother. All items trying to take in her mouth, to lick, to taste. Play prefers lying down. For children watching, but the contact is not. New sound combinations in speech not, but significantly expanded conceptual dictionary. Appeared gesture: leads by the hand to the door, into the kitchen. During class trying to avoid repetitions.
According to psychologist (before the second course TCMP): learned the Cabinet, he began to take a familiar toy, go to familiar places (bell box with toys). However, situational interest, the behavior at the beginning of the survey close to the field. When the perseverance of the adult follows the refusal to perform the task, but at the same time to leave the office girl doesn't want to.
The second course TCMP 4 sessions conducted between 7.04.2004, 28.04.2004, similar to the first course scheme. During the session remains negative behavior of the child, but devack who calms down quickly after the inspection is completed (when the mother stops her to keep). Sitting quietly during the sessions TCMP until enough milk in the horn.
In the course of remedial and developmental classes for the second year noted: there are more sounds in speech, Lisa better understand more complex addressed to her speech became more “flexible”.
Lisa it is quieter rides on public transport, even though she can walk still does not like. With interest continuing to watch the children, but not perfect. Began to distinguish mother from among the other ones: running with joy to meet, laughing. Trying to repeat its motion while washing dishes and Laundry. Faster to adapt to new circumstances, may, at the request mom to go to my room and play a little one (previously not allowed to move away from a single step).
According to the results of the sessions with the psychologist noted: the girl began to focus on images up to 30 minutes Prefers balls cubes when inserted into the corresponding hole (make a choice). For the first time began to perform actions with both hands simultaneously: holding the bottle and put it sticks. With pleasure, “lit” ball (held in one hand and extinguished the light (hardly switched to another job). Significantly fewer manifestations of autoaggression. Drawing refused. The Charter was hiding under the table, but to leave the office of the psychologist is not wanted. In General there is a positive shift in the development of cognitive activity, large and fine motor skills, as well as identity.
Recommended course TCMP be repeated after 4-6 months.
EXAMPLE 4. Tina Was 5 years and 11 months. He entered the examination and treatment of complaints on violations speech development, inappropriate behavior, difficulties contact.
History: pregnancy proceeded against the background of anemia, with the threat of termination. Was missing the first cry of a newborn baby. During the first year of life suffered 5 purulent otitis with punctures. 1 year 3 months development for age, sleep was restless, interrupted, the girl did not like when she was placed in my arms, eyes. Cooing and babbling by age, repeated prattling words, but with age, the number decreased. It was further observed the loss of primary language skills. In 2 years by a psychiatrist on a residence diagnosed with autism. On pharmacotherapy - without significant positive changes.
According to the examination by a neurologist: contact the girl enters with difficulty. Is distinct combined spinal deformity, obesity 1 tbsp. hydrocephalic Head shape, m Graefe (+), absent-eye, left - light converging strobism, tendon reflexes reduced quickly fade.
According to EEG is immature age structure of biorhythms (low electrogenesis, dysrhythmia, no regional differences). According to REG marked the but symmetric and sufficient pulse volume.
According to a speech therapist: a girl can say a lot of words, repeating them echolalia, speech does not use, know the alphabet, can read words that are familiar with direct counting to 20 (dealing with baby Mama). Loves to twist the rope. Books are not listening, no eye contact, protest expresses a cry. Conclusion: early infantile autism.
According to psychologist: first contact with the child through the mother, by the end of the test was to run a separate voice instructions psychologist. The pace of work is fast, impulsive. The low efficiency, increased exhaustion attention. Job on the study of visual perception performs a simple form, with a more complex works by touch. The girl has good hearing mechanical memory - remembers the names of the pictures, commercials. Job operations analysis-synthesis performs half and only the subject image with geometric refuses. Tasks for the classification of objects performs only one sign - on color or shape. Conclusion: early infantile autism.
On the basis of clinical neurological and additional methods of examination diagnosed coarse delay mental and speech development on residual organic background, the vertebro-basilar insufficiency, hypertension-hydrocephalic syndrome, early dedciated. The recommended course of pharmacotherapy diakarbom with asparkam, daily by, glycine and phenibut, then the course TCMP.
The first course TCMP conducted between 27.06.2002, 18.07.2002,
First TCMP held 27.06.2002, a current of 120 μa for 20 min, the anode is on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, the cathode is on the lower sections of the occipital area in the same hemisphere. 2 days after the 1st session, the child became more calm, “peaceful” (words of my mother).
The following TCMP conducted according to the same scheme as the first TCMP, a current of 80 μa. On the last TCMP first cycle, the anode is moved to the left border signalone region and anterior vernaison gyrus, the remaining parameters are the same. On remedial and developmental classes Tina to sit can not.
The first course TCMP consisted of 4 sessions.
After the first course TCMP therapist notes: the girl understands turned it situational, can display the toy in the picture. Sometimes it may answer your question. Itself calls their actions - “I will not leave, goodbye, and others”. He became more sociable, sometimes looks into his eyes. There was an inverse count to 10. Counting operations there. Tina learns some written words. Paint does not like, bad writing, but at the household level motor skills developed eno is but. Well remembers highway routes, worried, when changing the usual way. Not afraid of cars: if you do not hold by the hand, and may break on the roadway. In General, over the past period of time marked a significant improvement in understanding of speech.
It is recommended to repeat the course TCMP in 4-6 months.
According to the follow-up monitoring (within the next six months): the child began to attend 2-3 hours a day ski kindergarten. In kindergarten behavior “field”: excited in the new team, runs, if forced to do something is hiding in the corner, where her not to get it. At home Tina was more than adequate, but any compulsion begins to “whoop it up”: escapes from the hands, and runs away. In public places trying to use these techniques to manipulate their parents to get what you want. For reviews of relatives, Tina began to talk more, has increased the need for communication, but mainly with adults and not with children. For granting disability was hospitalized at the Republican psychiatric hospital, where he received psychotropic drugs. The girl's mother observed a gradual loss of positive changes in the mental development of the child, which were evident after TCMP. Slow recovery of the positive effect TCMP start gradually razvivatsea early discharge of the child at the parents ' initiative to cancel the specified pharmacotherapy.
On the second course TCMP girl came six months later at the age of 6 years and 5 months. During examination, the psychologist noted a more peaceful and adequate behavior, increasing the ease of making contact; most jobs psychologist Tina performs with pleasure. In test jobs uses not only strength, but also a visual mapping, fitting. Deftly works with the “pyramid” and inserts. Calls during work pictures, colors, giving yourself instructions. Marked increase efficiency, sustainability focus.
The second course TCMP conducted between 4.11.2002, 25.11.2002.
First TCMP second course held 4.11.2002, a current of 150 μa for 20 min, the anode is on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, the cathode on the lower sections of the occipital region of the left hemisphere.
The following TCMP second course held 11.11.2002, a current of 150 μa for 20 min, the anode is moved to the border signalone gyrus of the left hemisphere and anterior vernaison gyrus, the position of the cathode is constant. The last TCMP second course conducted with an interval of 1 week between sessions under the scheme first TCMP for 15-20 minutes to Do during the TCMP can't.
The second course TCMP conducted 4 sessions.
Recommended next course TCMP in 4-6 months.
Third hens the TCMP conducted between 11.06.2003, on 7.07.2003, at the age of 7.
According to a speech therapist: (before beginning the third year) Tina observed the presence of phrase speech, save echolalia. Have an interest in toys-dolls, man. Tina collects photos of famous artists are known by name. Remember what was presented in the previous test, tries to repeat. Letters are not interested in, although individual words when writing know. For reviews of the mother, can count the number of items (during the examination, it refused to do). According to mothers, compared with last year, Tina “Golden child”. Notes that on the phone Tina can carry on a conversation in the dialogue form.
According to psychologist: Tina looks into his eyes for a longer time can give without shouting favourite toy, quietly refers to the instructions in the job. Behavior is generally quite adequate, is governed by the mother. In tasks of visual perception purposefully performs the full scope of tests, knows all geometric shapes, visually correlates all subject liners. To work with split images refused. Looking at what he is doing. More deftly works with pencil: you may copy the elementary images of the sun, the flower, the grass. Attention is more stable, it is easier to attract. Easily copes with the tasks with clearly-action is authorized material: quickly find pairs of pictures on the box of 8 pieces. In the process, with the encouragement from my mother can name all the items, to answer the question.
First TCMP third course conducted 11.06.2003, a current of 150 μa for 20 min, the anode is on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, the cathode is in the lower divisions of the left occipital region of the cortex. It is possible to conduct remedial and developmental classes with a psychologist and speech pathologist in the course of the session TCMP. During the session noted: efficiency and productivity below the average, the pace of work is slow, not interested in the job. Contact immediately went in. Job perceptual processes performed easily (concepts of color, shape, size formed). Attention is quite stable. Turned it understands, but not arecaused, nothing calls. However, when he wanted a toy, he asked: “Soldiers! The elephant!...”. After 15 min tired, refused to do.
The following TCMP held 18.06.2003, according to the scheme first TCMP current of 120 μa. During sessions with a psychologist in the course of the session TCMP noted: efficiency and productivity remain below average, the pace of work is slow, interest in the practice shows. Nonverbal job difficulties do not cause. Using help put right the shapes by color and shape, correlating visually. Surely raskladyvaem the Lotto, but its still not arecaused, items not called. Began to look in the eye and smile, but questions not answers. In the end, tired and refused to work with the words: “do Not want! Get out!”.
In the next week, the mother noted that Tina began to guess the actions of loved ones, indicating their words (“read?”). During the course TCMP mother notes that Tina has become more difficult to deceive; the road became less apparent tendency to stereotypes and it became possible to change the itinerary. Girl sleeps better. May, on its own initiative to show affection. From the Playground now “not to steal”, tries in communication elementary phrase “give...”, “go”, “good-bye”. Tina started to walk around puddles (previously passed right over them, regardless of the shoes and the depth of a puddle, shouts mom), stopped at home to break the flowers. Became aware of footwear for the weather and dress accordingly. More adequately responds to the prohibitions. Growing vocabulary.
The following TCMP held 25.06.2003, a current of 120 μa for 20 min, the anode is in the projection of the motor cortex of the left hemisphere, the cathode - consistently. On the session with a psychologist during the session was excited, shouted, jumped up. Efficiency and productivity is low. Job performed only with three-dimensional shapes. From the rest refused. However, used it to ask the (“help!”), to refuse (“take!), to take machine!”). From the rest of the didactic material refused.
Next TCMP held 7.07.2003, with the same modes of current when moving the anode on the border of the left signalone region and anterior vernaison gyrus, the cathode - consistently. To deal with the psychologist could not.
The third course TCMP consisted of 4 sessions. Recommended refresher course TCMP in 4-6 months.
EXAMPLE 5. Ruslan, was admitted for treatment at the age of 3, 3 months. with complaints about the difficulties of communication, the delay in the formation of self-help skills, inadequate behavior.
History: he was born at term by caesarean section (breech presentation of the fetus), weight 3400 g, Apgar scale 7/8. Psychomotor development: sitting with 8 months worth of 10 months. goes with the 12 months. Cooing appeared in 2 months, babble by 8 months, reacted to his name with 1 year, first words - with 2 years of phrase speech - with 3 years. Differed that did not respond to adults, not dedicated mother, asked on hand, resisted the weasel. In kindergarten went 2 year 10 months with hunting, but children are not played. In action with toys prevail stereotypie (rolls all the time machine).
According to the examination by a neurologist: hydrocephalic skull shape expressed by the expansion of the subcutaneous vascular network in fronto-temporal areas. Voltage zadnesheynyh muscles. Eyes wide, symmetrical. GLA is nye apples movable in all directions, the tongue in the midline. Muscle tone was increased in the distal lower extremities, more to the right. Reflex von lively, Clonaid foot to the right. Coordinatory disorders no. Motility imperfect, is afraid of heights, has a hard time walking up stairs. Contact with the child superficial, fleeting, 's cognitive interest is significantly reduced, the game is manipulative, attention to the subject concentrates briefly, the whole of the parts does not fold, the pyramid does not collect. Simple instruction to perform can only wish. Voice activity during a game is low, the speech production Malorossiya, but there is intonation-the melodic contour of the phrase.
The age structure of the EEG in the stage of formation of regional differences, the level of electrogenesis reduced (the amplitude of the EEG to 10-30 MCI). According to REG, the intensity of the pulse of the blood in the carotid pool and VBB symmetric and sufficient, the curve type REG hypertensive. When rotation of the head a decrease in the amplitude of pulse blood 25-30% of the original.
According to a speech therapist: speech obscure, the boy repeats what he hears, mainly in the form of echolalia, there is a narration of his actions, but impersonal. On the matter of other people react selectively, often “does not hear”your name responds poorly, don't deal with about IBAMA, if you need something (if he wants the toilet starts to whine). Even when she was little, she did not cry, did not attract attention to themselves. Sleeps in a separate room, with himself playing. Conclusion: exit early infantile autism.
According to psychologist: contact difficult, the child behaves indifferently, voice instructions performs partially, requires stimulation, additional attracting attention, not always react to loud noises (knocking on the table). Memory (according to mom) good: remembers and tells his desire large excerpts of poems, during the examination finishes her line poems. Tests on the development of thinking: “big-small” no-shows, the color is not correlated with the sample and the word, split images of the 2-piece does not collect, “mailbox”, subject liners - performs with the help of an adult, without interest, started the game through to the end, the task to find “the same” does not. The eye looks rarely, ignores bodily touching, toys uses inadequate. Conclusion: WIA, autistic symptomatology.
Based on the results of clinical neurological and additional methods of examination diagnosed with organic brain damage, delayed speech development, the syndrome of early infantile autism, hypertension-hydrocephalic the th syndrome. Recommended course diakarba, pantogama, aktovegin, then the rate of the TCMP.
Course TCMP conducted between 29.04.2002, 20.05.2002,
First TCMP held 29.04.2002, a current of 100 μa for 20 min, the anode is on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, the cathode is on the lower sections of the left occipital region of the cortex. Development activity during the session TCMP could not take place.
In the week following the close noted that Ruslan has become more clear to read poems as a whole has become more active, including the movements began to play on the Playground, where there is a tendency communication, contact. Became more affectionate.
The following 3 TCMP was conducted on a weekly basis according to the following scheme: anode on the border signalone region and anterior vernaison gyrus, the position of the cathode is constant, the current from 80 to 100 µa for 20 minutes Close said further positive changes in behavior: the boy became obedient, including a shop, where the grandmother has previously refused to go because of “disgraceful behavior”. The boy began to respond to treatment adults at home verses from children's books. Became more concerned about their toys, have become more active in the group practice of mathematics. However, the requests does not apply, to questions of adults not responding. Just spent 4 session the TCMP.
It is recommended to repeat the course TCMP in 4-6 months.
According to the follow-up monitoring: 2 weeks after completion of the course, according to my mother, “has become a completely different person”, he has a more “human” face it understands almost in full, with nuances. If necessary, we may say, first addressed using lines of poetry, then began to use the impersonal form (“let's drink”). I have no fear and to avoid children, trying to get in contact with them - looks in the face, but the words can't find. Became more willing to eat, asks supplements, although I ate so far as planted at the table. Become more agile: the climb everywhere (previously bypassed Playground party), began to run, to perform more complex coordinated movements (walking along the train of logs). While in individual sessions with the speech therapist is not working, hides his face, but in a group sometimes answers questions.
EXAMPLE 6. Paul S. was admitted for examination and treatment at the age of 5.5 years, with complaints about the difficulties of establishing contact, inappropriate behavior.
History: the child was born at 36-37 week of the term by caesarean section (planned due to swelling of the mothers, pregnancy proceeded with the threat of termination), the weight of 3500 g, Apgar 7/7. Indubious in connection with intrauterine pneumonia. Psychomotor development: sitting with 6-7 m is s, goes to 11 months, first walked on all fours. From an early age had little contact with children, fond of solitude. At the age of 3 years old my parents took with me to Turkey was very excited, afraid to let go of them wanted to go home. Likes to visit unfamiliar places, prefers the house. Loves to be near her mother, play with toys, watch books. Often makes all the “spite”. If you do not want to do not make. In kindergartens is not charged, with no talking, often sitting in the corner.
According to the examination by a neurologist: contact the boy comes to work. Eye contact is unavailable. For questions not answered. In the speech elements echolalia. Trying to escape into the corridor. Does not give the doctor to himself to touch, tries to escape and from his mother. FMN: pupils equal, reaction to light, lively, movement of the eyeballs in full. Muscle tone was normal. Reflexes live, symmetric. Coordination within the norm. Posture sluggish. Gait is not changed. Focal neurological symptoms are not detected.
EEG with positive dynamics as compared with EEG from 23.01.03, in the form of increase in the amplitude of action potentials, the design of regional differences in primary (alpha) rhythm frequency of 8 Hz. There was a further increase of the amplitude of the EEG during sensory loads, after hyperventilation - slow cortical rhythm. According to REG - sufficient blood flow increases as PE is the fusion in both basins), the compression ratio in VB when you tilt the head back up to 35%. The people's Assembly within the age limit.
According to a speech therapist: child considers a new person, but not directly, but as if from the outside. Proposed job executes, but only what is good, says formulaic phrases and only at the request of the mother and stimulating. In the classroom in the garden can all quickly be done, if anything to promise. A feeling that is not listening to the questions, but if mom calls, gives the answer without repeating the question. Love numbers can be called within 100. Verses tells echolalia. Selectively refers to the food, the smells indifferent. Color distinguishes but does not name. Conclusion: the syndrome of autism (moderate).
According to psychologist: contact becomes situational, through the mother. Instructions performs partially, after multiple repetition and attract attention. Interest in toys and tasks of the election (only with clearly-effective material). Color relates, but is not reflected and not calls. Form relates through trial, but not calls. Size “large” and “small finds, called fickle. Motor awkward. Samples on memorizing is not carried out, because the job went echolalia. But the routes remembers well, does not like to change them, verses remembers involuntarily, from mid-cannot tell. Radresni the picture collects with the help of a psychologist. Intelligence clearly-effective. Physical contact: allow, when busy, eyes looking short - promote. Dialog no speech. Often pronounces advertising stamps. With affectionate mother. The game is manipulative in nature. Conclusion: autism.
Based on the results of clinical neurological and additional methods of examination diagnosed with autism. Recommended course TCMP.
Course TCMP conducted between 8.11.2003, 4.02.2004,
First TCMP held 8.11.2003, a current of 100 μa for 20 min, the anode is on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, the cathode is on the lower sections of the left occipital region of the cortex. During the sessions with the psychologist and speech pathologist in the course of the session noted: efficiency and productivity is low, the average pace of work, the boy is excited. The contact is gradually, his eyes trying not to look, all the time something sings, mumbles. Shape of objects differentiates within normal limits. Refused to job to arrange the items by color. The pyramid is assembled correctly. Items not called, often uses templates (“We'll go with the clown walk”). Split image gathers with the help of a psychologist, but uses it poorly, often begins to decline.
After the first session in the next week, mom notes: boy n the REC himself approached and began to play with her friend, girl, noticed that she had dirty hands and told him to wash. The house became calmer, can answer “popad”.
The following TCMP held 15.10.2003, according to the same scheme current of 130 mA. During the remedial and developmental classes compared with the first noted: there are no signs of excitation, no bounce from exercise. Fairly stable cognitive interest. But the contact is only through the mother, the action does not arecaused. For questions not answered, the subject does not name. But if mom says to do and you will leave immediately performs tasks without errors: lists the colors, names of animals and how they “speak”, which indicates a fairly well developed conceptual dictionary.
The following TCMP held 29.10.2003, (later than planned due to acute respiratory infection) current of 120 μa for 20 min, the anode - on projection of the motor cortex of the left hemisphere, the position of the cathode is constant. During the sessions with the psychologist and speech pathologist in the course of the session TCMP efficiency and productivity below average interest in the activities average, mainly to jobs on bulk material associated with the manipulation of objects, in the middle of the class, tired, tried to stand up. Assistance in performing tasks takes. Started speaking more in the context of the game situation, but mostly templates. Began to name objects, sometimes to answer questions. For the first time went on tactile shall ontact with the psychologist.
In the next week, the mother says, he better understands the speech of adults and responsible. Usually he doesn't eat in the garden - only at home, cooked a certain way familiar food. Now for the first time to eat bread with butter. Was in a group be engaged with the logopedist, including paired with a girl. Was to remove the hand from your mouth, as it meets the mother, to repeat after her treatment, “mother, give me...”, etc. Began to learn to tell the poems can do at home with their mother for up to 20 minutes
Next TCMP held 5.12.2003, according to the same scheme current of 150 µa. During the examination before the session says a lot, to contact both visual and tactile. During the sessions with the psychologist noted: Pasha asked questions, he talked a lot, but in my eyes tried not to look. There were no failures of the jobs done by yourself, the part - with the help of a psychologist. He began to answer questions, to name objects. Gone stereotypie in speech, spoken phrase corresponds to the situation classes. At the end of the lesson tired. Worked primarily with non-verbal material.
The last TCMP this course were held later (because of SARS) 21.01.2004, and 4.02.2004, according to the scheme first TCMP current of 150 and 120 μa, respectively.
Course TCMP held from 6 sessions.
At the end of the course, according to a speech therapist, a marked increase of interest in toys, reducing the number of repetitions breci. Letters knows, but in syllables does not drain. Comment on its actions, sometimes in a whisper. With pleasure comes in contact with an adult, trying to communicate, albeit in primitive form, may repeat questions.
Over the next month after completion of the course TCMP on sessions with a psychologist active, contact, situational, often in Association recalls advertising stamps, gradually less and less. Instructions not listening, begins to act, but during the lesson, you can correct attention. Less afraid of wet sand can stain and wash toys. Tires quickly on the verbal material, but you stimulate job performs. When changing classes at a table on a visit to the sensory room, the boy becomes more contact, disappear advertising stamps, you receive the converted speech (“Natalya Fyodorovna, give...”).
In General, the exchange rate effect TCMP for mental sphere showed a significant increase efficiency - up to 40 minutes at a change of activity, but all the time at the table (the boy runs away, not shaken). Appeared dialog speech: answers questions in a whisper. Virtually no echolalia (1-3 for all the lesson), stereotyped actions and utterances. Appeared ordinal score to 7, the conversion to 4-5. Know the outlines of the letters in the points. But the number and the number is not correlated, the fingers not the renders (even 1). Basic concepts formed, but unstable. Unable without help to choose pictures of animals, vegetables, etc. does Not use General words. 3-4 extra can select from different objects within the same type are not focused. Your choice cannot explain. Seasons calls mechanically, not focusing on the signs. When stimulating the attention can pick up 1-2 images correctly. Sequential images are not puts even from 2-X. But when stimulating the selection can be done right. Determines the action in the pictures, but the story behind it, even a simple, no. Much better zastrahoval, connects the dots, cut along the contour. Easier develops new space: looks in crowded areas without fear. Thus, while maintaining the child's developmental level below normal after TCMP has made progress in developing communication skills, motor skills, health, a less significant in relation to mental processes.
It is recommended to repeat the course TCMP in 4-6 months.
The method developed in joint research staff of the laboratory of physiological States of the brain and body of the Institute of human brain RAS, the city center on treatment of children with congenital disorders of the maxillofacial region, St. Petersburg, center of psycho-medical-social support Kalininskoj the district of St. Petersburg, the Department of surdopedagogic WPC them. Alexander Herzen. To date, the proposed method with a positive result were treated with 54 children with diagnoses of organic brain damage from perinatal and mixed Genesis: a) delayed psychomotor development and General underdevelopment of speech 1-2 level of speech development; (b) delays in mental and motor development; (C) the syndrome of early infantile autism.
The positive effect of a course of treatment using TCMP found reflection: a) to increase the adequacy of children's behavior in public places and the home; b) in the form of opportunities for correctional practice at home (in those cases when the children could not be placed in a specialized institution - 28% of children); C) the possibility of placing children in specialized institutions, as well as moving children in d/s from a group of mentally retarded in the group of children with mental retardation (46% of children); d) training opportunities basic program in specialized classes of speech, the correctional-developmental, individual - 20% of children.
The proposed method is compared with the prototype has a number of advantages in achieving a higher effectiveness of the treatment process due to the expansion of the area affected by the TCMP by including the value in therapy TCMP on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, along with TCMP on the border of the left signalone and anterior vernaison gyrus, motor cortex of the same hemisphere. This manifests itself in the form of improved understanding of speech and a corresponding improvement of the communicative functions that, in turn, leads to further expansion of the sphere of positive changes in the mental development of the child due to the greater effectiveness of remedial and developmental classes due to mutual understanding between the training and the trainees, with the subsequent expansion of social contacts, improve social adaptation at the source expressed manifestations of dysontogenesis in the form of anomalies mental development of various origins.
A method of treatment of disorders of mental development in children, including neurological and speech therapy examination, drug therapy, speech therapy classes and transcranial micropolarization who spend not more than 1 time per week for 4-6 weeks sessions for 15-20 min in 2 of the electrode, placing the anode on the border signalone region and anterior vernaison gyrus and on the projection of motor areas of the cortex of the left hemisphere, the cathode is on the lower parts of the left occipital region, continuing speech therapy classes during the entire course of treatment, characterized in that transcranial micropolarization p is avodat amperage from 80 to 200 µa, in 1-3 sessions anode placed on the border of the posterior vernaison gyrus and negatemoney region of the left hemisphere, and speech therapy classes combined with psychological during and between sessions, and the courses of treatment repeat 2-3 times per year.
FIELD: medicine, narcology.
SUBSTANCE: one should pre-detect the frequency of magnetic field ranged 1.0-15.0 Hz at which one should observe the shift of bioelectric activity waves towards deceleration, the decrease of motor thresholds, amplitude, the decrease of rhythmic disorders, and the increase of dopamine level in blood and/or liquor. Stimulation should be performed with magnetic field of certain frequency at induction being 0.5-1.2 Tl in projection of cerebral hemispheres. Simultaneously, one should carry out visual stimulation at frequency of stimuli presentation of 3-25/sec. Moreover, valuable visual stimuli should be presented at 0.1-20 msec, and invaluable ones at 35-350 msec. Seances take place every day for 30-60 min, therapeutic course consists of 10-20 seances. The method applies magnetic field at optimal induction for every patient in combination with psychotherapeutic impact.
EFFECT: higher efficiency of therapy.
FIELD: medicine, psychotherapy.
SUBSTANCE: one should generate light and sound signals, synchronize them and apply them to affect both visual and auditory analyzers, then patient should be isolated from environmental impacts and with light and sound signals it is necessary to imitate patient's movements and feelings due to reproducing dynamic stereoscopic pictures modeling any preset moving environment around the patient and stereo-sounds. As the source of light and sound signals and, also, for isolating against external impacts one should apply a computer and a helmet or spectacles of virtual reality with mini-displays to be put on patient's head. The method enables to widen the number of ways to introduce patients into trance state.
EFFECT: higher efficiency.
11 cl, 3 dwg, 3 ex
SUBSTANCE: method involves doing complex of physical training exercises on the background of medical rehabilitation treatment. First, dominant hemisphere is determined. Next, exercises are done expanding in turn over higher and higher levels of the nervous system beginning from homolateral movements of extremities. Then, heterolateral movements are done with extremities: first, without crossing median line of the body and then with shoulder girdle rotation to one side and pelvic girdle to the opposite side ending in movements crossing the median line. Then, the heterolateral movements are combined with eye movements and functional loads upon the hemispheres. Infinity sign drawing is carried out in the air with the right hand, left hand and with both hands, following the imaginary drawings with eyes and transferring center of gravity from one leg to the other one. Then, symmetrical figures are drawn simultaneously using both hands. Then, autotraining exercises are done consisting in creating and fixing in memory image of both working hemispheres.
EFFECT: enhanced effectiveness of influence exerted to both hemispheres in activating interhemispheric links and restoring injured cortical functions.
8 dwg, 2 tbl
FIELD: medicine, thoracic surgery, anesthesiology.
SUBSTANCE: as non-narcotic medicinal preparation one should apply heparin to be introduced intratracheally at the dosage of 300-500 IU/kg, moreover, heparin should be introduced during the first 30 min after the operation is over. The present innovation enables to create prolonged anesthetizing effect in combination with prophylaxis of postoperational thrombohemorrhagic complications due to heparin capacity to be kept in the body due to its accumulation by mast cells at blockade of their fermentative activity followed by its gradual release into the blood.
EFFECT: higher efficiency.
1 cl, 1 ex, 3 tbl
FIELD: medicinal cosmetology.
SUBSTANCE: at first, one should perform target psychological tuning up for the work with a certain patient. Then, at the fist stage it is necessary to remove articular blocks, relax muscular-ligamentous apparatus of body joints with light swingings of patient's head and limbs. Moreover, one should apply long smoothing movements for limbs. The first stage should be finished with respiratory exercises. Then comes relaxing massage of jugular area and hands, plastic impact upon facial fasciae and muscles, massage of biologically active points and linear facial massage. Then one should do the complex of strengthening exercises for the neck and face. At the same time, one should concentrate patient's attention upon coming feelings in jugular and facial areas. Complex of strengthening exercises for the face and the neck should be performed every day. The present innovation enables to maintain daily tonicity of facial myofascial layer well.
EFFECT: higher efficiency.
1 cl, 4 ex
FIELD: medicine, cardiology.
SUBSTANCE: the present innovation includes hypolipidemic diet. Additionally, in the state of meditation one should induce the feeling of thermal disposition in intestinal area due to autosuggestion spirally starting from dextral ileal area and performing about 3-5 circles clockwise, only by narrowing the radius of movement towards navel's area, then about 3-5 circles clockwise by widening the radius of movement against initial circumference. Then one should similarly work with feelings of colic pains and cold. Moreover, autosuggestive impact should be carried out twice daily for 30-40 d, and then - once daily every other day to maintain cholesterol level at normal value. The method enables to treat hypercholesterolemia in patients despite cholesterol level.
EFFECT: higher efficiency of therapy.
1 cl, 1 tbl
FIELD: medicine, anesthesiology, intensive therapy, surgery.
SUBSTANCE: the present innovation is suggested to correct anesthetic therapy in postoperational period. One should apply a modified visual-analog scale of pain on which patient should mark independently his (her) pain feelings by fixing them on vertical sections of the above-mentioned scale of pain every 2 h during the day, then doctor should plot an algogram of daily fluctuations of patient's pain feelings to analyze them for estimating the strength of pain feelings and adequacy of analgetic therapy conducted; and by taking into account the data obtained to conduct correction anesthetic program next day. The present innovation enables to adequately evaluate patient's pain feelings in postoperational period for subsequent performing adequate preventive analgetic therapy of pain syndrome, that, in its turn, enables to prevent pathological postoperational syndromocomplex.
EFFECT: higher efficiency of correction.
2 cl, 3 dwg, 1 ex
FIELD: medicine, human weight correction.
SUBSTANCE: while elaborating self-realization formula a dietologist should develop weight correction mode for a patient during certain period of time without health deterioration. A psychotherapist should detect several targets for weight correction followed by psychotherapeutic seance by applying neurolinguistic programming. For this purpose, a patient should provide picturesque and detailed description of desirable function. Moreover, a psychotherapist detects positive, emotional and autonomic manifestations to form conditionally reflector relationship due to tactile contact. Under supervision of a psychotherapist due to suggestion technique a patient should imagine "a part of personality" responsible for weight correction. Then his psychotherapist has communication with mentioned "part of personality", arouses patient's attention to desirable result and fixes elaborated conditioned reflex. Then a psychotherapist illustrates communication with physical feelings that correspond to either negative or positive answer and their appearance in "a part of personality". At establishing tactile contact a psychotherapist suggests to choose new ways of behavior directed onto weight correction, obtains agreement from "a part of personality" to take care of this very function, which a psychotherapist should monitor by physiological manifestations and fix with conditioned tactile contact. A patient suggests new ways of alimentary behavior, analyze them and choose not less than 3 really achievable ones and "a part of personality" is responsible for automatic implementation of these new ways of alimentary behavior in patient's next life and at achieving positive answer from "a part of personality" sйance of psychotherapy should be finished by returning a patients into awakening state. Moreover, one should prescribe a diet at decreased caloricity of 800-900 kcal during the 1st mo, then - 1200 kcal for another month with subsequent achieving its value to correspond to normal body requirements. Psychotherapy lasts for 3-4 seances in 3-5 d at repeated maintenance therapy in a month, 1 seance. The method enables to achieve stable weight decrease during preset period of time for prolonged terms.
EFFECT: higher efficiency of weight correction.
1 cl, 1 ex
SUBSTANCE: method involves carrying out physiological examination with electroencephalogram recorded. Cognitive evoked potential method is additionally applied as neuropsychological examination for detecting hard and latent organic brain lesions causing central nervous system pathological disorders. An additional psychophysiological examination is carried out with vision analyzer test, visuomotor response test being applied for obtaining estimations of selection, discrimination, noise immunity and muscle endurance index, movement coordination, response to moving object and integral estimation of attention and ability for perceiving significant information, motor analyzer rapid response production estimation, estimation of nature of cardiovascular system response to given psychoemotional loading estimation. The examination is sequentially carried out as primary control when hiring personnel, as intermediate control in following a training course and emergency training. Psychological testing is of multi-purpose nature. To achieve it, a set reliable tests and methods of prognostic and substantial validity are applied, including intellect and project-building tests and standardized self-reports. When making decisions concerning professional validity based on test and examination results, risk group is selected from operation personnel.
EFFECT: enhanced effectiveness of occupational skill assessment.
FIELD: medicine, in particular, narcology.
SUBSTANCE: method involves using computer as apparatus for displaying on monitor screen of brain colored images reflecting at least two states of brain: before coding by separating portions colored with yellow, green and blue colors and tints thereof reflecting increasing extent of brain affection, and after coding by separating big portion of bright-red color on the background of portions colored with yellow, green and blue colors and tints thereof, respectively; explaining to patient that portion of bright-red color is his dominant code resulted from treatment; before coding procedure, applying and fixing on patient's forehead electrodes simulating elimination of brain potentials; in the course of coding, exposing patient to light flashes with switched-off common illumination and to continuous acoustic signals generated by means of acoustic synthesizer; during coding procedure, exposing patient to light flashes issued from, for example, stroboscope, said light flashes being emitted at frequency of 1-3 Hz; providing immediate suggestion by means of microphone and telephone headsets electrically connected to microphone and secured on patient's head. Method allows preliminary treatment procedure to be avoided.
EFFECT: increased therapeutic effect.
4 cl, 3 dwg, 1 tbl
FIELD: medicine, psychiatry, psychotherapy.
SUBSTANCE: the present innovation deals with carrying out dietotherapy and psychotherapeutic impact in the course of group seances. Moreover, the main psychotherapeutic impact should be performed during two seances per 8 h each, each due to marathon technique under asthenization conditions, biorythmical misfunctioning and behavioral stereotypes. Motivation should be elaborated for patient's healthy nutrition along with self-confidence and belief into success. Program for losing body weight should be developed to visualize and concretize therapy. Diary for nutritive behavior should be written, psychological protection should be performed in case of affected dietary situation. After the main seances one should carry out psychotherapeutic impact during one seance of 3 h duration in 1 or 3 mo. During seances the results obtained should be fixed by discussing and excluding situations provoking obesity relapse. The method enables to prolong duration and stability of remission.
EFFECT: higher efficiency of therapy.