Psychological assistance to children with cerebral palsy. Guidelines for working with children with cerebral palsy

Introduction……………………………………………………….3

1. Characteristics of the phenomenon of cerebral palsy………………………..4

2. Working with children with cerebral palsy………………………………….7

Conclusion………………………………………………..12

Literature………………………………………………...13

INTRODUCTION

Every family wants to have a healthy child. Perhaps there are no parents who would not want their children to be strong, smart and beautiful, so that in the future they would be able to take their rightful place in society.

But some children immediately after birth experience painful changes in muscle tone and a number of other symptoms, which then leave an indelible imprint on the entire life of the child, and subsequently the adult and the life of his parents.
The well-known Austrian physician and psychologist Sigismund Freud at the end of the nineties of the century before last united these phenomena under the name of cerebral palsy. The causes of this disease can also be an infection, antibodies, an incorrect Rh factor, hypoxia in newborns, or birth trauma.

Most children with cerebral palsy have speech disorders that greatly hinder their contact with parents and peers.

Severe movement disorders and speech disorders in children with cerebral palsy make it difficult for these children to communicate with others, negatively affect their entire development, contribute to the formation of negative character traits, the appearance of behavioral disorders, and the formation of an acute sense of inferiority.

But these children are full-fledged members of society and it is necessary to provide all conditions for the full-fledged personal development of children with disabilities.

aim This work is to study the features of working with children with cerebral palsy.

A great contribution to the study of this issue was made by: Badalyan L.O., Lebedev V.N., Kirichenko E.S. , Zeigarnik B.V., Petrova V.G.

1. CHARACTERISTICS OF THE PHENOMENON OF ICP.

As mentioned earlier, in the late nineties of the nineteenth century, the Austrian physician and psychologist Sigismund Freud singled out a group of diseases called "cerebral palsy". Although, in fact, we are not talking about paralysis, as such, but about impaired coordination of movements associated with damage to certain brain structures that occurs in the pre- and postnatal period of a child’s development and as a result of birth trauma. Often such lesions occur even in the embryo. Their culprits are infection, antibodies, wrong Rh factor or neonatal hypoxia.

Neurologists distinguish three main forms of cerebral palsy: spastic, which is characterized by a constant increased tone of individual muscle groups - most often flexors; hyperkinetic, or athetoid, when the tone in the flexors and extensors is constantly changing, which causes sharp involuntary movements of the trunk and limbs that prevent the child from walking and maintaining balance, and asthenic-astatic. With this form of the disease, the tone of all muscle groups is reduced, which also makes it difficult to maintain balance and move normally. There are cases when the asthenic-astatic form becomes athetoid.

Most children with cerebral palsy have speech disorders that greatly hinder their contact with parents and peers. Severe, so-called generalized, forms of cerebral palsy, when the arms and legs, speech, and sometimes the child's hearing are affected, lead him to a deep disability. Cerebral palsy is a non-progressive disease, but it can cause complications in the form of contractures and various deformities. In fact, cerebral palsy is not even a disease, but a condition in which the normal development of a child is extremely difficult.

Forms of cerebral palsy.

The hemillegic form is the most common type of cerebral palsy. It depends on the predominant damage to one hemisphere of the brain. Already from the first days of a child's life, it can be noted that one of his arms and legs do not take part in the constant movement of the limbs. Such children begin to sit up late and especially late and with difficulty to stand and walk. In the paretic limbs, violent movements of an athetotic nature are often noted. There are epileptic seizures of the general or Jacksonian type.

The diplegic form of cerebral palsy, which is called Little's disease, is expressed in spastic paralysis or spastic paresis of both legs. The child lags behind in physical development and if he starts to stand and walk, then with a big delay. As a result of an increase in muscle tone, a sharp tension in the adductor muscles of the thigh and contracture of the calf muscles, the gait of such patients is very peculiar, which sometimes makes it possible to make a diagnosis without a detailed study. Patients do not rely on the sole, but on the fingers, the knees touch each other and rub against each other when walking, the gait is spastic-paretic, and it seems that the patient is constantly striving forward and down. This defect in the legs may be accompanied by athetosis in the muscles of the face and in the distal parts of the arms. Various synkinesis can also be observed, which, combined with hyperkinesis, make it very difficult to perform voluntary movements. Intellectually, these patients can be quite safe.

The hyperkinetic form is characterized by the presence of violent movements such as athetosis, myoylonia, which are combined with a significant violation of muscle tone and psyche. Speech disorders are often noted.

Thus, motor disorders in children with cerebral palsy adversely affect the entire course of its mental development.

Psychophysical development of children with CP.

A feature of mental development in children with cerebral palsy is not only its slow pace, but also its uneven nature, disproportion in the formation of individual, mainly higher cortical functions, accelerated development of some, lack of formation, lagging behind others.

Violations of spatial gnosis are manifested in the slow formation of concepts that determine the position of objects and parts of one's own body in space, the inability to recognize and reproduce geometric figures, to put together a whole from parts. While writing, errors in the graphic representation of letters, numbers, their specularity, asymmetry are revealed.

In close connection with violations of visual-spatial synthesis is the weakness of counting functions. These disorders are manifested in slow assimilation of the number and its bit structure, slow automation of mechanical counting, misrecognition or confusion of arithmetic signs and numbers when writing and reading.

Disorders of attention and memory are manifested in increased distractibility, inability to concentrate for a long time, narrowness of its volume, predominance of verbal memory over visual and tactile. At the same time, in individual conditions and in a learning experiment, children reveal a sufficient "zone" of their further intellectual development, show a kind of perseverance, perseverance, pedantry, which allows them to compensate to a certain extent for disturbed activity and more successfully assimilate new material.

Manifestations of mental infantilism, characteristic of almost all children suffering from cerebral palsy, are expressed in the presence of features of childishness, spontaneity, predominance of activity motivated by pleasure, a tendency to fantasize and daydreaming, which are unusual for this age. But in contrast to the classical manifestations of “harmonic infantilism”, children with cerebral palsy show insufficient activity, mobility, and brightness of emotionality. The fearfulness and increased inhibition in unfamiliar conditions, which are characteristic of children with cerebral palsy, are fixed for a long time, which significantly affects the learning process.

In children, there is also often a delay in the formation of individual mental functions. The severity of motor impairment in a child does not correlate with the severity of deviations in his mental development.

Specially conducted studies have shown that cerebral palsy is a disease that has a non-progressive type of course.

2. WORK WITH CHILDREN WITH ICP

One of the most important aspects of working with children with cerebral palsy is the creation of conditions for the full-fledged personal development of children with limited mobility in the course of implementing measures for psychological and pedagogical rehabilitation and social adaptation with their subsequent integration into modern society. Systematic monitoring of the development of students in the course of the educational process, dynamic, comprehensive, comprehensive and holistic study of the child is considered as the basis for the socio-psychological support of the educational process of children with cerebral palsy. Taking into account the results of the psychological and pedagogical study of the child, the educational route is adjusted, individual training programs are developed, and their implementation is analyzed. The model of socio-psychological support for children with cerebral palsy has its own specifics, which is determined by the psychological characteristics of children, the deformation of their personal development, and sometimes disharmonious relationships with parents.

Approximately half of children with cerebral palsy are mentally retarded. However, one should not rush to conclusions. Children with cerebral palsy move clumsily, either too slowly or too fast. Their faces are distorted due to weakness of the facial muscles or difficulty in swallowing, grimaces appear on them. Therefore, a child with normal mental development may appear mentally retarded.

Annotation: The article reveals questions about correctional and speech therapy work with children with cerebral palsy.

In children, the formation of all motor functions is delayed and impaired. Motor disorders that limit subject-practical activity and impede the development of independent movement, self-service skills make a sick child from the first years of life almost completely dependent on the adults around him. This contributes to the formation of his passivity, lack of initiative, disrupts the development of his motivational and volitional sphere. Thus, movement disorders affect the entire course of the mental development of the child. In speech therapy work with children with cerebral palsy during the period of speech development, psychotherapy occupies an important place, the main goal of which is to eliminate painful mental manifestations and develop an adequate attitude towards oneself, one's own defect and the environment.

"Features of speech therapy work in children with cerebral palsy"

Cerebral palsy is a disease of the central nervous system with a leading lesion of the motor areas and motor pathways of the brain.

Signs of cerebral palsy in a child are detected from birth, therefore, already in the first weeks of life, the entire course of the mental development of the baby is disrupted, in particular, the process of forming his speech is slowed down and distorted. As a rule, in the future there is a severe speech disorder - dysarthria.

Despite the fact that violations of pre-speech development can be detected in the first months of life, speech therapy work sometimes begins only after reaching the age of three and is aimed at correcting an already established persistent speech disorder.

In addition, the slow and distorted speech development of children with cerebral palsy leads to a violation of the cognitive and emotional-volitional sphere of the child.

In this regard, the primary task of early correctional and developmental work with children with cerebral palsy, aimed at preventing secondary deviations in the development of the child, arises.

Tasks:

Studying and overcoming not only speech, but also other developmental disorders. The system of speech therapy work with children with cerebral palsy includes:

• development and correction of auditory perception,
• development and correction of visual perception,
• development and correction of speech-auditory and speech-motor analyzers.

Speech therapy work is built taking into account the age of the child, the severity of damage to the articulatory apparatus, the degree of delay in pre-speech and speech development, the age and intellectual characteristics of the child, the general somatic and neurological condition.

The effectiveness of working with children of a very early age largely depends on how the speech therapist will be able to properly organize not only special individual lessons, but also the upbringing and development of pre-speech and speech activity at all regime moments.

Early speech therapy work should be an integral part of the overall comprehensive work with children with cerebral palsy.

Goals:

correctional and pedagogical work in the pre-speech period with cerebral palsy is the consistent development of the functions of the pre-speech period, ensuring the timely formation of the speech and personality of the child.

The main directions of correctional and pedagogical work:

Normalization of the state and functioning of the organs of articulation through differentiated and acupressure massage, articulatory gymnastics;

Development of visual and auditory perception;

Development of emotional reactions;

Development of hand movements and actions with objects;

Formation of preparatory stages in the development of speech understanding.

There are IV levels of pre-speech development in cerebral palsy: the absence of voice activity, the presence of undifferentiated voice activity, cooing, babbling.

The main task of correctional and pedagogical work with children who are at the I pre-speech level of development- stimulation of vocal reactions. Work is carried out in the following areas:

exhalation vocalization;

Development of a "revitalization complex" with the inclusion of a voice component in it;

Development of visual fixation and tracking;

Development of auditory concentration;

Formation of hand-eye coordination.

In order to normalize muscle tone and motor skills of the articulatory apparatus, a massage is performed. To increase the volume of inhaled and exhaled air, followed by exhalation vocalization, breathing exercises are used for 1-1.5 minutes 2-3 times daily.

In order to form a “revitalization complex” and include a voice component in it, the adult leans towards the child, talks to him affectionately, melodiously, strokes him, and shows bright toys.

The appearance of a smile indicates the emergence of a child's need to communicate with an adult. Stimulation of vocal reactions begins with the vocalization of the child's exhalation.

Against the background of emotionally positive communication between a child and an adult, the vibration of his chest and larynx is carried out in order to evoke vocal reactions.

The ability to vocalize exhalation is reinforced by repeated repetition of this exercise throughout the day. For the development of visual fixation and tracking, the child is presented with optical objects that are adequate from the point of view of his perceptual capabilities. For the formation of auditory perception, a time is chosen when the child is in an emotionally negative state. The speech therapist leans towards the child, gently talking to him, trying to calm him down and attract his attention.

Work on the development of hand-eye coordination begins with the normalization of the position of the hand and fingers.

Working with children in at the II pre-speech level of development, is the stimulation of cooing. The main directions of correctional and pedagogical work:

Normalization of muscle tone and motility of the articulatory apparatus;

Increase in volume and exhalation followed by vocalization, stimulation of humming;

Development of gaze fixation stability, tracking smoothness;

Formation of the ability to localize sounds in space and perceive the differently intoned voice of an adult;

Development of the grasping function of the hands.

Classes last 10-15 minutes and are individual. In order to normalize muscle tone and motor skills of the articulatory apparatus, speech therapy massage is performed. Breathing exercises in the form of passive breathing exercises are aimed at increasing the volume and strength of exhalation with its subsequent vocalization in order to train the depth and rhythm of breathing.

The development of visual perception is aimed at increasing the mobility of the eyeballs, the smoothness of tracking a moving object, the stability of fixing the gaze when the position of the head and body changes, and the formation of smooth tracking with the eyes while the head position remains unchanged. These exercises are carried out using bright voiced toys.

Further development of auditory attention goes towards the formation of the ability to localize sounds in space and to perceive differences in the intonations of an adult's voice. To this end, they cause concentration on sounds that are adequate for this child(loud, quiet, high, low). Sound irritants are toys of different sound quality.

Preparation for the formation of an understanding of addressed speech begins with the development of perception of various intonations of the voice. The child, first of all, learns those intonations that are more often used by adults. It is necessary to ensure that the child not only perceives the intonations of the voice, but also adequately responds to them.

For the development of the grasping function of the hands, it is necessary to draw the child's attention to their own hands, to develop kinesthetic sensations in the hands.

The main task of working with children who are at the III pre-speech level of development- Stimulation of intoned vocal communication and babble. Work is carried out in the following areas:

Normalization of muscle tone and motility of the articulatory apparatus;

Development of the rhythm of breathing and movements of the child;

Stimulation of babbling;

Formation of a positive emotional attitude to classes;

Development of visual differentiations;

Stimulation of kinesthetic sensations and the development of finger touch based on them;

Development of an acoustic installation for sounds and voice;

Development of auditory differentiations;

Formation of preparatory stages of speech understanding.

Speech therapy massage is aimed at normalizing the muscle tone of the tongue and lips, attenuating hyperkinesis, and at developing afferentation of the oral muscles. Passive gymnastics contributes to an increase in the activity of the lips and tongue; the development of the mobility of the lips and tongue is also carried out through active gymnastics.

An important factor for the development of voluntary vocalization is the correctly set voluntary breathing of the child. For this purpose, more complex breathing exercises are carried out compared to the exercises of the previous levels, which are aimed at establishing the rhythm of movements and breathing.

In order to stimulate babble, they try to cause a "complex of revival." The child has a smile, he begins to fix his attention on the articulation of the speech therapist, who leans low towards him, talks to him, utters melodious sounds.

Stimulation of emotional reactions involves the formation in children of a positive emotional attitude to classes and the activation of vocal babble activity.

The decisive role is played by the emotional state of the child during classes: only a positive emotional background contributes to the actualization of cooing, babbling, etc.

The main goal of the development of visual perception is the development of visual differentiations. During the lesson, the child’s attention is attracted not only to toys, but also to the environment: the child must learn to recognize others, to be alert at the sight of the mother’s changed face.

The absence of kinesthetic sensations and the lack of formation of touch under visual control due to motor pathology prevent the child from developing the simplest manipulation of objects, and therefore it is necessary to pay attention to this side of hand-eye coordination. Work continues on developing the sensitivity of the fingertips.

The development of auditory perception is aimed at the formation of an acoustic attitude to a person's voice and sounds and auditory differentiation. To develop an acoustic attitude to sounds and voice, the child is offered various sound stimuli (sounds are different in height and sound strength).

To form auditory differentiations, the tone of the conversation is changed from affectionate to strict and vice versa, while trying to evoke adequate reactions in the child. Any intonationally colored sound of a child serves as a means of expressing his state, desire, attitude to the environment, feelings, which, in combination with expressive facial expressions, gestures, expressive eye movements, serves as a means of speechless contact with people around him and contributes to the formation of preparatory stages in the development of speech understanding.

The main task of correctional and pedagogical work with children who are IV level of pre-speech development, is the development of communication with an adult through the intonational sounds of babble and babble words. Areas of work:

Normalization of muscle tone and motility of the articulatory apparatus;

Increasing the strength and duration of exhalation;

Stimulation of physiological echolalia and babbling words;

Development of the manipulative function of the hands and differentiated movements of the fingers;

Formation of understanding of speech instructions in a specific situation.

Speech therapy massage is performed to normalize muscle tone and motor skills of the articulatory apparatus. Breathing exercises aimed at increasing the strength and duration of exhalation. Along with passive exercises, active breathing exercises are carried out with the inclusion of an element of imitation. At the same time, the required position of the lips is passively held. Drawing the child's attention to the sound of his own voice, encouraging his activity, they try to cause the repetition of sounds, i.e. autoecholalia, which contributes to the development of speech-motor and speech-auditory analyzers, babble activity.

The development of the simplest manipulation with objects is hindered not only by the child's lack of kinesthetic sensations, but also by the lack of formation of touch under visual control due to motor pathology.

Much attention should be paid to the development of this side of hand-eye coordination. Work continues on developing the sensitivity of the fingertips.

Children who are at the IV level of the pre-speech level of development understand the speech addressed to them, therefore, special attention is paid to attracting the child himself to the task.

Speech therapy work during the period of speech development begins with learning to manipulate objects (toys), which stimulates the lexical side of speech. Before starting classes, children are given massage, articulation and breathing exercises, they activate attention, perception and pronunciation of available sounds, their combinations, simple words.

When performing various tasks, an adult first shows the child what to do. This contributes to the accumulation of speech impressions and the development of the ability to imitate the speech of others.

A child with cerebral palsy is encouraged to speak in ways that are interesting and easy for him.

Speech therapy classes begin with the creation of a certain sound base, for which they use massage, articulatory gymnastics. Further, the child's communication is stimulated with the help of sound reactions available to him, amorphous root words, sentence words. After that - classes on the development of onomatopoeia.

To stimulate speech development, classes on the formation of speech hearing, pitch, phonemic, auditory attention, perception of the pace and rhythm of speech are important.

To develop pitch hearing, children are taught to differentiate adult voice variations in pitch in accordance with emotional coloring speech. This is achieved with the help of expressive reading of fairy tales by roles, recognition of the voices of children and adults, etc.

Special games are aimed at developing auditory attention: “Whose voice?”, “Guess what sounds”, etc. The child should focus his eyes on the sounding toys.

AT before school age stimulation of speech development is aimed at expanding the vocabulary and developing the grammatical structure of speech. Every day, children should be introduced to new objects, their verbal designations.

Classes for the development of speech are phased in nature. They are based on learning how to write various kinds sentences with a gradual complication of their syntactic structure.

It is recommended to conduct special games-classes, during which the child names objects, actions, images in pictures. You should make the most of the visibility and rely on the joint subject-practical and gaming activities of the speech therapist and the child.

Special training of children in the methods of sensory examination of objects is necessary with the obligatory connection of a motor-kinesthetic analyzer (feeling objects with a paretic hand and recognizing them). At the same time, words are introduced that indicate the quality of the subject (adjectives). For their development, a comparison of objects with opposite properties is used. The child is offered objects in which the distinguishable qualities are presented most clearly.

In older preschool age, they develop the ability to more accurately select words that characterize the features and properties of objects. To consolidate and activate the dictionary, they use a description of objects, guessing riddles, didactic games and daily interactions with the child.

A special direction of work on the word, as a unit of the language, ensures the development of the qualitative side of the vocabulary. The child acquires an understanding of the ambiguity of a word, synonyms and antonyms, the ability to correctly use words in context. This work, begun at preschool age, is most intense at school.

At school age, practical familiarization of children with the most simple ways the formation of the main lexical and grammatical categories of words, which helps to overcome persistent language difficulties. It is necessary to constantly develop the motivation of speech utterance through the cultivation of the desire for communication. Already at the initial stages of education, to stimulate the development of coherent speech, children are given primary information about the language, because. conscious comprehension accelerates the development of relevant skills and abilities.

As already noted, dysarthria is most often observed in cerebral palsy, in the majority - its pseudobulbar form.

Speech therapy classes for dysarthria are built taking into account the pathogenetic commonality of the structure of motor and speech defects. So, with pseudobulbar dysarthria in conditions of increased muscle tone in the speech muscles, classes begin with relaxation of the muscles of the articulatory apparatus, for which they use techniques aimed at relaxing the muscles of the neck, labial muscles, muscles of the tongue, relaxing facial massage.

Further work includes articulation, breathing exercises, voice development, articulatory praxis, work on sound pronunciation.

A variety of exercises when working on sound pronunciation with children with cerebral palsy depends on the form of dysarthria:

With pseudobulbar dysarthria, the focus is on relaxing the general and facial muscles, overcoming hypersalivation, synkinesis;

With cerebellar dysarthria, a strengthening massage of the articulatory muscles is combined with exercises to develop coordination of breathing, phonation and articulation. They train the ability to reproduce and maintain articulation patterns, the accuracy of articulation movements;

With extrapyramidal dysarthria, the child is taught to monitor the position of the mouth, tongue, general facial expressions, inhibit hyperkinesis, arbitrarily close and open the eyes without accompanying movements and general tension, reproduce, hold and feel various articulation modes and smoothly move from one to another;

In cortical afferent apraxic dysarthria, the focus is on the development of kinesthetic sensations, oral and manual praxis;

With cortical efferent dysarthria, articulatory gymnastics is aimed at developing fine differentiated movements, especially moving the tip of the tongue up. The child's attention is focused on the feeling of the position of the tongue, then they are taught to lower the tongue to the bottom of the mouth. The main thing is the stimulation of anterior lingual sounds.

Corrective speech therapy work with alalia in cerebral palsy syndrome includes four stages:

- I stage- preparatory. They activate the mental processes that form the basis of speech activity, there is a consistent development of memory, attention, thinking, the need for speech communication, and they also form skills aimed at perception, comprehension, and understanding of speech messages.

- Stage II- the formation of speech skills in a situation of dialogic communication. Much attention is paid to the formation of speech in the process of subject-effective and play communication between a child and an adult. Semantic, lexical, syntactic, morphological, phonemic and phonetic speech operations are consistently developed.

- stage III- teaching the child to build sentences various types, then to a simple statement.

- Stage IV- development of coherent speech skills, the ability to plan a speech message, the selection of the necessary words and control over one's own statement.

With sensory alalia, they develop an understanding of addressed speech, communication skills and abilities. On the preparatory stage carry out work on the formation of visual, tactile perception, voluntary attention, memory, thinking.

Particular attention is paid to the development of auditory gnosis. With the help of sounding toys, stimulation of the perception of non-speech sounds is carried out. At the same time, the psychological prerequisites for speech perception are formed: speech-auditory attention, speech understanding in a particular situation.

At the second stage, the main attention is paid to the skills of understanding speech outside the specific situation. To do this, they train auditory memory, the ability to recognize words by their sound form, the ability to correlate words with objects and actions.

At the third stage, communicative skills are formed through the development of phonemic analysis and synthesis, phonemic and phonetic operations, semantic and lexico-grammatical aspects of speech.

Conclusions:

In children with cerebral palsy, various speech disorders are noted, on average, their frequency is 70-80%.

Features of the structure of speech disorders and the degree of their severity depends primarily on the location and severity of brain damage.

Violation of speech ontogenesis in children with cerebral palsy is also associated with the insufficiency of subject-practical activity of children and the limitation of their social contacts.

In children with cerebral palsy, there is a certain relationship between motor and speech disorders. This is manifested in the commonality of disorders of the skeletal and speech muscles. Speech disorders in children with cerebral palsy include:

1. phonetic-phonemic, which manifest themselves in various forms of dysarthria;
2. specific features of the assimilation of the lexical system of the language, due to the specifics of the disease itself. When forming the lexical system of the language in children with cerebral palsy, it is necessary to widely mediate all classes with practical tasks based on game techniques that activate the cognitive activity of the child. At the same time, children are specially taught methods of sensory examination of objects;
3. violations of the grammatical structure of speech, which are inextricably linked with lexical and phonetic-phonemic disorders, their formation is carried out as a single inseparable process;
4. violations of the formation of coherent speech and understanding of the speech message, which have some specifics in different forms cerebral palsy. These disorders can be both of a specifically linguistic nature and of a non-specific nature due to the general mental characteristics of children with cerebral palsy;
5. all forms of dysgraphia and dyslexia. In the genesis of these disorders, a large role belongs to the immaturity of the visual-motor and optical-spatial systems. Their formation, as well as the development of articulatory and acoustic skills, is important in the prevention and correction of dyslexia and dysgraphia in children with cerebral palsy.

An important problem in the study of speech disorders in cerebral palsy is the development of a neurolinguistic approach to their analysis, taking into account the forms of cerebral palsy, as well as improving the ways and methods of speech therapy, taking into account the main mechanisms of speech disorders in this disease.

No less important is the further development of ways and methods of early speech therapy, starting from the pre-preschool and preschool period.

Melnik G.V.
teacher speech therapist,
Chelyabinsk

Cerebral palsy () is a disease of the nervous system, in which the coordination of speech and movement is disturbed, there is a delay in intellectual development, a disorder of the muscular and motor systems. These disorders are secondary and appear against the background of brain anomalies. The defeat of the musculoskeletal system occurs in the womb, during childbirth or in the early postpartum period.

Infantile paralysis usually appears at an early age. brain changes that can occur in adults different reasons have other consequences.

The main causes of cerebral palsy in children

There are many factors and causes that predispose children to cerebral palsy.

The main reasons are:

• Genetic factors, heredity. Deviations in the genetic apparatus of parents contribute to the occurrence of cerebral palsy in children.
• Oxygen starvation and circulatory disorders. They can occur during pregnancy and childbirth, with concomitant hemorrhage and vascular disorders.
• infectious cause. After birth, a child can suffer meningitis, encephalitis, arachnoiditis due to these diseases, cerebral palsy may occur. In this case, the disease proceeds quite hard. This is evidenced by the poor results of tests in which the causative agents of the disease are detected.
• Toxic and poisonous drugs acting on the fetus. This is due to the use of strong drugs during pregnancy, work in adverse conditions, where the pregnant woman comes into contact with various chemical and other harmful substances.
• physical factors. Irradiation and radiation that affect the body of the expectant mother subsequently adversely affect the mental and embryonic development of the child.
• mechanical factor. Damage to the child's brain during childbirth or some time after them. By negligence, a pregnant woman can be injured before childbirth, which can also cause pathological changes in the child.

The appearance of this pathology in children is due to many factors. In this regard, there are 3 groups of cerebral palsy.

1 group. True, not acquired cerebral palsy. The disease is inherited and is primary, the child is born with a pathology. At the same time, there are genetic changes in the brain and developmental disorders. The size and volume of the brain is small, the cerebral cortex is underdeveloped, the study reveals pathological abnormalities in anatomical and functional terms. The child's brain is paralyzed and does not perform all the basic functions.

2 group. False, acquired cerebral palsy. The occurrence of acquired cerebral palsy is facilitated by a traumatic situation and hemorrhages in the child's brain during childbirth. This leads to the death of some parts of the brain. Also, acquired cerebral palsy can be caused by exposure to toxic substances, after severe infectious diseases, etc. As a result of all these signs, a severe picture of cerebral palsy is formed. Despite the fact that the brain and nervous system are affected, the child can move independently and is capable of self-care.

3rd group. False, acquired cerebral palsy. This group has a different name - false or secondary cerebral palsy syndrome. Unlike other types, this type is quite common.

Before birth, the child is formed, he is full-fledged in terms of biological and intellectual functions. The resulting injuries during childbirth contribute to the disruption of some parts of the brain, which then lead to the paralysis of its individual functions. Children with false cerebral palsy syndrome in appearance are no different from others. They retain intelligence, which distinguishes them from other types of the syndrome. For such children, there is every chance for further recovery.

Symptoms and signs of cerebral palsy

The main symptoms that indicate brain damage can be detected some time after birth, they can gradually manifest themselves in infancy and older age.

The main signs of cerebral palsy include:

• Rigidity
• Tremor of the limbs
• Athetosis
• spasticity
• Ataxia (impaired coordination)
• Inability to maintain balance
• Stepping on the toe while walking
• Hearing and vision impairment
• Anxiety and poor sleep
• Tremors and convulsions
• Epilepsy
• Violation of the development of speech
• Delayed emotional and mental development
• Urinary system disorders

Signs of cerebral palsy can be noticeable to parents and others, and some of them can only be noticed by a specialist. Depending on where the pathological foci are located in the brain, the child has various signs and symptoms of cerebral palsy.

Both in infancy and in the senior age, according to the table of skills, it is possible to determine the existing signs of cerebral palsy. Only a qualified specialist can establish an accurate diagnosis.

Forms of cerebral palsy

Depending on the degree and localization of anomalies, several forms of cerebral palsy are distinguished. According to the type of movement disorder, the following forms are distinguished:

• spastic
• Dyskinetic
• Ataxic
• mixed

In the spastic form, the shoulder and hand on one side of the body are affected. There may be a violation of vision, attention, speech and mental development. Children suffering from this pathology begin to walk late and move mainly on their heels, since the tendons of the heels are stiff.

Spastic diplegia is characterized by damage to the muscles of the lower extremities of both legs. At an early age, contractures are formed, leading to anatomical pathology of the spine and joints.

The dyskinetic form occurs in children who have had a hemolytic disease. This form is characterized by involuntary muscle movements that occur in different parts of the body. They are called dyskinesias. The movements of the child are slow, viscous, they may be accompanied by convulsions with muscle contraction. At the same time, the usual posture of individual parts of the body of the body is disturbed in children. No changes are observed in the mental and intellectual development of children. They can be fully trained in educational institutions, they are inclined to a normal life in a children's team.

The manifestation of the ataxic form of cerebral palsy is characterized by a decrease in muscle tone and the presence of strong convulsive reflexes in the tendon. Children with the ataxic form have speech impairment. This is caused by paralysis of the vocal cords, muscles of the larynx, etc. Such children are mentally retarded, they are difficult to learn.

Depending on the damage to a separate motor system of the brain (cerebellar, pyramidal, extrapyramidal), a specific form of the disease is isolated. With a combination of several forms and variants of diseases with damage to the parts of the brain, a mixed form of cerebral palsy occurs.

Diagnosis and treatment of cerebral palsy

Often, some symptoms in newborns are transient, and the final diagnosis can be made only a couple of years after birth.

1. cerebral palsy is possible by monitoring the presence of any deviations in the child's intellectual and physical development, these tests and magnetic resonance imaging.
2. To identify cerebral palsy syndrome, a number of activities are carried out:
3. Analysis of all available information about the child's illnesses
4. Physical examination (hearing, vision, posture, etc.)
5. Identification of the latent form of the disease
6. To exclude any other diseases, additional brain studies are prescribed: ultrasound, tomography, questioning.

Conducting all diagnostic measures to identify the form of the disease allows you to make a correct and final diagnosis.

Treatment of cerebral palsy is based on training, which can reduce the severity of defects. Basically it is psychophysical stress. Various therapies are used to improve muscle function. A speech therapist works with a sick child to develop speech. In order to maintain balance and walking, various orthopedic devices and special fixators are used.

In addition, the treatment of infantile paralysis includes massage courses and physiotherapy exercises. Doctors recommend taking drugs to improve microcirculation and nutrition of the nervous tissue.

One of the successful methods in the treatment of cerebral palsy is dolphin therapy.

Dolphins make contact with sick children. In turn, touching dolphins in children activates reflex zones that are responsible for the nervous system. The effect of hydromassage is created by the dolphin's fin, while the water trains the muscles and reduces the load on the joints.

For prophylactic purposes, Diazepam, Baclofen, Dantrolene, etc. are prescribed to relax muscles and contractures. A beneficial effect is the introduction of Botox into the affected muscle. Anticonvulsants are used for seizures. Passivity of movements in the joint, i.e. contracture is treated surgically. The procedure to separate the tendon is called a tenotomy.

If you start a course of treatment and rehabilitation measures for children with cerebral palsy, you can avoid major developmental deviations.

Correctional work with children with cerebral palsy

The main directions and tasks of correctional and pedagogical work with children at preschool age:

• Formation and correction of temporal and spatial relationships
• The development of emotional, gaming, speech and other activities with others
• Development of motor coordination and functional abilities of the hands
• Development of the speed of perception of objects and phenomena
• Normalization of muscle tone and motility of the articulatory apparatus
• Development of voice, prosodic and speech breathing
• Pronunciation correction
• Education for self-care and personal hygiene

For children with movement disorders, various light physical activities or therapeutic exercises are shown, aimed at reducing spasticity and hyperkinesis, stimulating the function of paretic muscles, increasing the mobility of the spine and joints. In addition, exercises and loads allow you to create a positive and emotional mood.

Exercises in the pool with balls and fitball gymnastics contribute to muscle relaxation, as well as increase their contractility, improve blood circulation and lymph flow. The bulge of the ball is used to correct spinal deformity.

In corrective gymnastics, exercises with objects are often used. They develop strength, agility and coordination of movements. Some types of such exercises: climb over a small fence while not releasing the stick from your hands, quickly passing the ball behind your back, etc.

Corrective work helps to reduce small reflexes and increase the range of motion.

Basic exercises for working with children of the DPC:

• Stretching and strengthening exercises and
• Exercises for the development of muscle sensitivity
• Training exercises for relaxation, relieving spasms, tension and cramps
• Training exercises for learning normal walking
• Training exercises for the senses
• Vertical climb exercises
• In physical activity classes, a special place is given to corrective and breathing exercises.

Complex sensitive stimuli have an effective effect on motor abilities. Among them are:

1. Visual. Almost all exercises are performed in front of a mirror. Tactile. Stroking various parts of the body, leaning on a surface that is covered with fabrics of various materials, walking on sand, etc.
2. proprioceptive. Resistance exercises, their alternation with open and closed eyes, etc.
3. All exercises are useful to perform to the music.
4. In the classroom exercise take into account not only the age of the child and his qualitative pathological changes in the body, but mainly his psychological characteristics and the level of motor development.

Children with such a serious disease as cerebral palsy receive medical, psychological, pedagogical, speech therapy and social assistance in a timely manner. Proper training in movements, the use of therapeutic exercises, hydrotherapy, massage and orthopedic products have a huge impact on the development of the child's body. can be aimed at relaxing and strengthening the tongue and lips, neck muscles, facial and labial muscles. To do this, carry out vibration and acupressure of the facial muscles.

At the same time, the effectiveness of physiotherapeutic and speech therapy effects can increase with the simultaneous use of drug treatment.

In the attached video you can see an example of therapeutic exercises for children with cerebral palsy.

Correctional and medical-psychological work should be complex. To do this, you should be guided by the actions of specialists in various fields and follow the appropriate recommendations. The sooner work begins with a person suffering from cerebral palsy, the better for him.

It is important to constantly monitor the child's condition with continued psychoverbal and physical development.

Communal

government agency

"Secondary school named after R. Marsekov"

public institution

"Department of education of the Ulansky district"

Educational psychologist secondary school: Ashkanova I.A.

Explanatory note

Features of the development of children with cerebral palsy (CP)

Cerebral palsy (ICP) is a disease of the central nervous system with a leading lesion of the motor areas and motor pathways of the brain.

Motor disorders in this disease are the leading defect and represent a kind of anomaly of motor development, which, without appropriate correction and compensation, has an adverse effect on the entire course of the formation of the neuropsychic functions of the child.

Damage to the motor sphere in cerebral palsy can be expressed to varying degrees: motor disorders can be so severe that they completely deprive children of the opportunity to move freely; with sufficient range of motion; with a mild violation of muscle tone, dyspraxia is noted, children have difficulty mastering self-service skills.

A weak sense of one's movements and difficulty in actions with objects are the reasons for the insufficiency of active touch, recognition by touch (stereognosis). This, in turn, further complicates the development of purposeful practical actions and is reflected in the mental development of children.

Motor disorders that limit subject-practical activity and impede the development of independent movement, self-service skills, often make a sick child completely dependent on the immediate environment.

Features of the development of the child's brain, its plasticity and ability to compensate for impaired functions determine the importance of early correctional and developmental work in cerebral palsy.

The formation of motor functions, including subtle movements of the hands, occurs in the process of the interaction of the child with the surrounding objective world.

Manipulative actions with objects are mastered by the child through learning in the process of his communication with adults. Thus, the child develops objective thinking (I.M. Sechenov), thinking in action (I.P. Pavlov). In addition, the child's motor activity, his object-manipulative activity, which contributes to the development of fine movements of the hands and fingers, has a stimulating effect on the child's speech function, on the development of his sensory and motor aspects of speech (M.M. Koltsova).

The aim of this program is - consistent development and correction of hand movements, the formation of fine motor skills, which ensures the timely development of speech, the personality of the child, and adaptation in society.

The main principles of building correctional and developmental work:

Correctional and developmental work is based on a thorough study of impaired and preserved functions. A differentiated approach during classes provides for taking into account the capabilities of the child and building a system of exercises that are in the zone of his proximal development.

The use of kinesthetic stimulation in the development and correction of hand movements.

Creative use of such basic didactic principles as an individual approach, systematic and consistent presentation of the material, activity and visibility. These teaching principles are interrelated and interdependent, but should be used with the specific needs of children with LC in mind.

Organization of classes within the framework of leading activities.

The main requirement for teachers is the observance of the protective regime.

Under the influence of psychophysical exercises in the muscles, tendons, joints, nerve impulses arise that go to the central nervous system and stimulate the development of the motor areas of the brain. In the process of working with the body, the postures and position of the limbs are normalized, muscle tone is reduced, violent movements are reduced or overcome. The child begins to correctly feel the position of various parts of the body and his movements, which is a powerful incentive for the development and improvement of motor functions and skills.

Diagnosis: cerebral palsy, atonic-astatic form of moderate severity. hyperkinetic syndrome. Pseudobulbar dysarthria, OHP level 3 ZPR of complex genesis, equinus foot, childhood invalid.

Calendar-thematic lesson plan

(first year of correction and development)

№ lesson

the date

holding

Finger drawing.

The game "Guess by touch".

Lacing circles.

The game "Guess by touch".

Self-massage. Finger games.

Stencil drawing.

The game "What is in the bag?".

Self-massage. Finger games.

Tying ribbons into a knot.

The game "What is in the bag?".

Self-massage. Finger games.

Drawing on a ruler of straight lines.

The game "Bodily figures".

Self-massage. Finger games.

Leaf application.

The game "Guess by touch".

Self-massage. Finger games.

Blotography.

The game "Guess by touch".

Self-massage. Finger games.

Application "Apple" (colored paper).

The game "Bodily figures".

Self-massage. Finger games.

Exercises "Threading".

Game "What has changed?"

Self-massage. Finger games.

Making crafts from threads "Balls".

Game "What has changed?"

Self-massage. Finger games.

Making crafts from threads "Rug".

Find the item game.

Self-massage. Finger games.

Seed mosaic.

The game "Guess by touch".

Self-massage. Finger games.

Mosaic from cotton balls.

Find the item game.

Self-massage. Finger games.

Mosaic from paper balls.

Shop game.

Self-massage. Finger games.

Design from ready-made forms.

Shop game.

Self-massage. Finger games.

Braiding.

Game "Remember and find".

Self-massage. Finger games.

Twisted threads.

Game "Remember and find".

Self-massage. Finger games.

Plasticine drawing.

The game "Remember a couple."

Self-massage. Finger games.

Plasticine drawing.

The game "Remember a couple."

Self-massage. Finger games.

Salty dough. Modeling.

Game "Patch up the rug."

Self-massage. finger games.

Salty dough. Modeling.

Game "Patch up the rug."

Self-massage. Finger games.

Salty dough. Modeling.

Self-massage. Finger games.

Origami from circles.

The game "Collect the beads into garlands."

Self-massage. Finger games.

Origami.

Columbus egg game.

Self-massage. Finger games.

Origami.

Columbus egg game.

Self-massage. Finger games.

New Year cards.

The game "Name the same."

Self-massage. Finger games.

New Year cards.

The game "Name the same."

Self-massage. Finger games.

New Year's toys "chain".

Experiment game.

Self-massage. Finger games.

New Year's toys "Flashlight".

Experiment game.

Self-massage. Finger games.

New Year's toy "Herringbone".

Exercise "Choose quickly."

Self-massage. Finger games.

3 1

Modeling from matches.

Exercise "Choose quickly."

Self-massage. Finger games.

Modeling from matches.

Exercise "Find the extra letter."

Self-massage. Finger games.

Break application.

Exercise "What is common and how are they different?".

Self-massage. finger games

Break application.

Self-massage. Finger games.

Thread graphics.

Self-massage. finger games

Break application.

Exercise "The Fourth Extra".

Self-massage. Finger games.

Exercises "Make sentences."

Self-massage. Finger games.

Postcards in the technique of "isolate".

Self-massage. Finger games.

Exercise "Orientation in space".

Self-massage. Finger games.

A toy with moving parts (tying).

Exercise "Fly".

Self-massage. Finger games.

Symmetrical cut.

Exercise "Fly".

Self-massage. Finger games.

Symmetrical cut.

Self-massage. Finger games.

Crafts from cones.

Exercise "Attentive drawing".

Self-massage. Finger games.

Crafts from cones.

Exercise "Cryphers".

Self-massage. Finger games.

Exercise "Cryphers".

Self-massage. Finger games.

Paper craft "Book with butterflies".

Caring exercise.

Self-massage. Finger games.

Caring exercise.

Self-massage. Finger games.

Production of cardboard tubes.

Exercise "Shop".

Self-massage. Finger games.

Crafts from newspapers.

Exercise "What has changed?".

Self-massage. Finger games.

Crafts from newspapers.

Exercise "Spread the letters."

Self-massage. Finger games.

Modeling from buttons.

Exercise "Spread the letters."

Self-massage. Finger games.

Modeling from buttons.

Ball exercise.

Self-massage. Finger games.

Fabric applique.

Ball exercise.

Self-massage. Finger games.

Fabric applique.

Ball exercise.

Self-massage. Finger games.

Fringe incision.

Exercise "Choose a word."

Self-massage. Finger games.

Fringe incision.

Exercise "Choose a word."

Self-massage. Finger games.

Drawing according to the scheme.

Exercise "Four Elements".

Self-massage. Finger games.

Drawing according to the scheme.

Exercise "Four Elements".

Self-massage. Finger games.

Drawing according to the scheme.

Self-massage. Finger games.

Exercise "Look around."

Self-massage. Finger games.

Collage of various materials.

Exercise "Look around."

Self-massage. Finger games.

Crafts from plasticine.

Self-massage. Finger games.

Crafts from plasticine.

Exercise "Be attentive to the words."

Self-massage. Finger games.

Painting patterns.

Exercise "Guess"

Self-massage. Finger games.

Painting patterns.

Exercise "Guess"

Self-massage. Finger games.

Painting patterns.

Exercise "Say one word"

Self-massage. Finger games.

Exercise "Remember a couple."

Self-massage. Finger games.

Sculpting using natural material.

Exercise "Remember a couple."

Self-massage. Finger games.

Calendar-thematic planning of correctional and developmental classes (art techniques) the second year of correction and development

Technology

materials

Samples

the date of the

Drawing according to schemes and stencils

Watercolor, pencils, album, felt-tip pens, blueprints.

Salt dough molding.

Salty dough

Application No. 1

paper plastic

col. paper, cardboard, scissors, glue.

Application №2

Spiral technique

Patterns for weaving, threads, scissors.

Application №3

Fabric applications

Templates, pieces of fabric, scissors, glue, cardboard

Application No. 4

Ribbon weaving

Satin ribbons

Application No. 5

Weaving on the frame

Frame, thread, scissors, needle.

Application No. 6.

Nylon dolls

Nylon tights, scissors, halafiber, threads, needle, eyes, pieces of fabric.

Application No. 7

1. In the classroom, it is necessary to observe the motor mode:

fixation in a special chair that holds the vertical position of the child sitting or standing;

the use of weights for children with sweeping hyperkinesis (violent movements) that complicate the capture of an object (pen, book, etc.) or other educational activities (for example, reading, because hyperkinesis interferes with fixing the gaze and tracing the line);

obligatory break in the lesson for a physical education minute.

2. It is advisable to include an exercise in spatial and temporal orientation in each lesson (for example, put a pen to the right of the notebook; find today's date on the calendar, etc.).

3. For children with increased salivation, controlling help from the teacher with a reminder to swallow saliva is required to form a stable habit in the child - control of salivation.

4. It is necessary to pay attention to the state of the emotional-volitional sphere of the child and take it into account during classes (children with cerebral palsy are characterized by increased anxiety, vulnerability, resentment; for example, hyperkinesis and spasticity can be aggravated by a loud voice, a sharp sound, and even if it is difficult to perform task or attempt to complete it).

5. For children with severe hand motility disorders (almost always associated with severe speech impairment), an individual selection of tasks in a test form is necessary, allowing the child not to give a detailed speech response.

6. The class requires a special speech mode: clear, intelligible speech without a sharp rise in voice, the required number of repetitions, emphasized articulation.

7. It is necessary to adapt the volume and nature of the educational material to the cognitive abilities of students, for which it is necessary to significantly detail the system for studying one or another section of the program: the educational material should be presented in large portions, it should be complicated gradually, it is necessary to find ways to facilitate difficult tasks.

8. For the successful assimilation of educational material, pedagogical correctional work is necessary to normalize their activities, which should be carried out in the classroom in any subject.

9. A special place should be occupied by manual labor lessons, drawing, since, in them, activity according to a visual-subject model occupies a significant place, which allows the formation of generalized methods of mental work.

10. It is necessary to teach children to check the quality of their work, both in the course of its implementation and in the final result; at the same time it is necessary to develop the need for self-control, conscious attitude to the work being done.

11. In cases where, due to his mental state, the student is unable to work in this lesson, the material should be explained in individual-group lessons.

12. To prevent rapid fatigue or relieve it, it is advisable to switch children from one type of activity to another, to diversify the types of activities.

13. Interest in classes and a good emotional state of students should be supported by the use of colorful didactic material, the introduction of game moments.

14. Of exceptional importance are the soft, friendly tone of the teacher, attention to the child, and encouragement of his slightest successes.

15. Each parent should be given recommendations on upbringing, education, correction of developmental deficiencies, taking into account the age, individual and psychophysical capabilities of their children.

The development of fine motor skills of the hands

The personal immaturity of a child suffering from cerebral palsy is manifested in the weakness of volitional attitudes, emotional immaturity. Persistent failure in trying to reproduce the desired movement or action can lead to abandonment of classes. Therefore, any activity should be offered in game form, which will arouse his interest and, due to positive emotional stimulation, will help to increase mental tone, and, consequently, improve performance.

Massage is one of the types of passive gymnastics. Under its influence, impulses arise in the receptors of the skin and muscles, which, reaching the cerebral cortex, have a tonic effect on the central nervous system, as a result of which its regulatory role in relation to all systems and organs increases.

stringing rings on a braid;

work with manuals for fastening zippers, buttons, buttons, hooks, locks of various sizes;

coin sorting;

sorting cereals;

work with matches;

work with paper;

modeling (clay, plasticine, dough);

lacing on special frames, boots;

tying knots on a thick rope, on a cord, thread;

winding a thin wire in a colored winding on a coil, on your own finger (a ring or a spiral is obtained);

tightening screws, nuts;

games with a constructor, cubes;

drawing in the air;

drawing with various materials (pencil, pen, chalk, paints, charcoal, etc.);

needlework.

You can start classes with self-massage:

An exercise in which the children themselves will knead their hands. "Hands are frozen";

Exercise “We put on gloves” - we pull a glove on each finger;

We grind each finger from the base to the nail;

An exercise in which children are invited to draw with each finger in the air;

Bend each finger in turn;

Straighten each finger in turn;

Children pull their thumb up, and all the rest are clenched into a fist - a “flag”;

In this exercise, one hand should be bent into a fist, and with the other hand, cover this fist horizontally - “table”;

Also, bend one hand into a fist, and lean the other hand horizontally with the palm - “chair”;

Invite the children to press their palm firmly against the table or against the other palm, and take each finger in turn - “fingers stuck”;

In this exercise, you need to connect the thumb, index, middle and ring fingers, and pull the little finger up - “dog”;

First, cross your fingers, then raise your hands up, and spread your fingers - you get "sun rays";

Alternately perform the exercises - clench your hand into a fist, then place your palm edge on the table, then press your palm to the table. You can gradually speed up the pace of execution - "fist, rib, palm."

“Fingers say hello” - first you need to fix the names of each finger with the children. Then, with the tip of your thumb, alternately touch each tip of the remaining fingers (hereinafter, first perform the exercise with your dominant hand, then with your second hand, and then with both hands, from the thumb to the little finger, and vice versa);

The fingers of one hand simultaneously "hello" with the fingers of the second hand;

Exercise "Wasp" - straighten your index finger and rotate it;

"Goat" - straightening the index finger and little finger;

Form two circles by connecting the tips of the thumb and forefinger;

"Bunny" or "Ears" - clench your fingers into a fist and straighten only the index and middle fingers;

"Trees" - all fingers are widely spaced.

Circle any figure or object along the contour;

Draw any object point by point;

Draw strokes in different directions using stencils;

Draw a pencil along a narrow path and do not lead to the side;

“Double drawings” is a very interesting type of exercise in which children draw different ones with both hands, it can be various geometric shapes, or an artistic drawing (it is suggested to draw either two identical objects at the same time, or one drawing with both hands, as if complementing it).

To develop and improve coordination of hand movements, it is recommended to perform exercises:

The exercise is performed under the count, while gradually accelerating the pace, and strictly following the verbal instructions:

Make a fist with your left hand, open your right hand, and vice versa;

We put the right palm on the edge, the left - we bend into a fist;

Tasks for the development of tactile sensations

Game "Guess by touch"

Prepare planar geometric shapes cut out of wood, plastic, cardboard. Invite your child to play this game: “Let's feel this figure together. This is how we run our finger along the edge of the square. This is a corner, it is sharp, turn, now we are moving your finger down, again a corner.

Ask each time the child what this figure is. When he has practiced on each shape (circle, square, triangle, rectangle, oval), invite the mind to do the same, but with closed eyes.

After that, invite the child with his eyes closed to find all the circles, all the squares, etc. (the selection of figures is made from a set of figures of different shapes).

The game "What is in the bag?"

Put various toys and small items (buttons, balls, cones, dolls, animals, acorns, etc.) in a bag.

Invite the child to play: “Look what I got out of the bag. Now you get something." When the child gets out and names all the objects, fold everything back and offer to do the same, but with closed eyes, to the touch, and name each object. And then let the child take the item out of the bag at the request of the adult (by touch).

Games and exercises for the development of tactile-kinesthetic sensitivity.

The game "Bodily figures"

On the palm or on the back of the child, the adult draws geometric figures, the child guesses what the adult has drawn, then the adult and the child change places.

Tasks for correction and development of attention

Game "What has changed?"

The child should carefully look at the drawing (2 subjects) and answer the question, what has changed?

Quest "Find the item"

Among 8 drawings, he must find the same object as the standard.

Memory Games

Game "Shop"

You can send the child to the "shop" and ask him to remember all the items that need to be bought. They start with 1-2 items, gradually increasing their number to 5-7. in this game, it is useful to change roles: both an adult and a child can take turns being a son (or daughter), and a mother (or father), and a seller who first listens to the buyer's order, and then goes to pick up the goods. Stores can be different: Bakery, Milk, Toys, etc.

Game "Remember and find"

The game requires tables with the image of objects, geometric shapes. Show the child for 5-10 s. a card with the image of objects and offer to remember them, in order to then find them among others at the bottom of the table. The same goes for geometric shapes.

Game "Remember a couple"

Forms with figures for memorization and reproduction are required.

Explain to the child how he will remember the figures. He looks at the 1st form and tries to remember the proposed pairs of images (figure and sign). Then the form is removed and he is offered the 2nd form - for reproduction, on which he must draw in the empty cells in front of each figure the pair corresponding to it.

Games for the development of imaginative thinking, the formation of mental operations

Task "Patch the rug"

From the four options, choose the right patch for each rug.

The game "Collect beads into garlands"

Offer to connect the beads into garlands, paying attention to the alternation in the color of the beads, after the adult reads the poem:

Santa Claus walked through the forest past maples and birches,

Passed the glades, past the stumps, walked through the forest for eight days,

He walked along the forest - he dressed the Christmas trees in beads.

This night under New Year he will take them down to the guys.

Columbus egg game

Instructions: "Let's try to repair a broken testicle. You have fragments from the “magic egg” and a drawing according to which you can correctly and accurately fold the egg.”

Relaxation exercises

Etude "From seed to flower"

An adult "gardener" invites the child to turn into a small wrinkled seed (shrink into a ball on the floor, remove his head and cover it with his hands). The gardener treats the seeds very carefully, waters them (strokes the head and body), takes care of them. With a warm spring sun, the seed begins to slowly grow (rise). His leaves open (hands hang from his head and stretch upward), a stalk grows (the body stretches), branches with buds appear (hands to the sides, fingers clenched). A joyful moment comes, and the buds burst (the fists open sharply), the sprout turns into a beautiful strong flower.

Breathing exercise "Singer"

Deep breath. At the same time, hands slowly rise through the sides up. Holding the breath while inhaling.

Exhale with an open strong sound A-A-A. hands down slowly.

Inhale. Hands rise to shoulder level through the sides. Retention of breath.

Slow deep breath. At the same time, raise your hands to chest level. Retention of breath.

Slow exhalation with a strong the sound of woo. At the same time, the hands go down, the head on the chest.

Exercise "Fly"

Imagine that you are lying on the beach, the sun warms you, you do not want to move. Suddenly a fly flew in and sat on the forehead. To drive away the fly, move your eyebrows. A fly is spinning near the eyes - blink them, flies from cheek to cheek - inflate each cheek in turn, sits on your chin - move your jaw.

Exercise "Snowman"

Imagine that we were outside in winter, snow fell and fell on us, and soon we turned into snowmen. (Children spread their tense arms to the sides, puff out their cheeks, make a sad face and stand motionless.) So our snowman stood all winter, but then spring came, the sun warmed up, and the snow began to melt. (Children gradually relax, lower their hands, “go limp, expose their faces to the sun” and squat).

Exercise "Sunshine"

We played and played and got a little tired. They sat down to rest and fell asleep. But here's a ray of sunshine:

touched the eyes - open your eyes;

touched the forehead - move your eyebrows;

touched your nose - wrinkle your nose;

touched your lips - move your lips;

touched the chin - move your jaw;

touched the shoulders - raise and lower the shoulders;

touched hands - shake hands;

touched your legs - lie on your back and kick your legs.

The sunbeam played with you and disappeared.

Exercise "Snowflake"

Imagine that snowflakes are falling from the sky, and you catch them with your mouth. And now the snowflake:

lay down on the right cheek - inflate it;

lay down on the left cheek - inflate it;

lay down on your nose - wrinkle your nose;

lay on your forehead - move your eyebrows;

lay down on your eyelids - blink your eyes and open them.

The snowfall is over.

Physical education minutes

"Tell and Show"

Let's walk merrily together

And we bend our knees.

We will clench our fingers into a fist

And I'll take it back.

Hands to the sides, forward

And turn right.

Hands to the sides and down

And turn left.

“Two bears were sitting…”

Sitting two bears

On a thin bitch:

(squat)

One was reading a newspaper

(They stretch their arms forward, clench their fists, slightly turn their heads to the right and left).

The other kneaded flour.

(Press the fists against each other, make rotational movements)

One poo, two poo,

Both sank into agony.

(fall on the carpet)

finger games

"My family"

Here is grandfather

Here is grandma

Here is daddy

Here's mommy

Here is my baby

And here is my whole family.

Alternately bend down to the palm, starting with the big one, and with the words “Here is the whole family”, cover the entire fist with the other hand.

"Our Baby"

This finger is a grandfather

This finger is a grandmother,

This finger is daddy

This finger is mommy

This finger is our baby.

Bend your fingers into a fist, then unbend them one by one, starting with the thumb.

"Fingers"

The fingers went out for a walk.

One, two, three, four, five -

They hid in the house again.

Alternately unbend all fingers, starting with the little finger, then bend them in the same order.

"Fingers say hello"

I greet everywhere -

At home and on the street.

Even "hello!" I say

I'm the neighbor's chicken.

With the tip of the thumb of the right hand, alternately touch the tips of the index, middle, ring and little fingers. Do the same with your left hand.

"Met a hedgehog hedgehog"

Met a hedgehog hedgehog:

“Hello, brother! How is it going?"

At the same time, with the tips of the thumbs of the right and left hands, alternately touch the tips of the index, middle, ring fingers and little fingers.

"Hello!"

Hello golden sun!

Hello blue sky!

Hello, free breeze,

Hello little oak tree!

We live in the same region

I welcome you all!

With the fingers of the right hand, take turns “hello” with the fingers of the left hand, patting each other with the tips.

Finger game "Our walk"

One, two, three, four, five,

(the child bends his fingers one at a time, starting with the little finger)

We went out to the yard for a walk.

(the child "walks" on the table with the index and middle fingers, the rest of the fingers are tucked in)

They sculpted a snow woman,

(the child depicts modeling a snowball with both hands)

The birds were fed with crumbs,

(the child “crumbles bread” with all fingers)

We rode down the hill

(child drives index finger right hand on the palm of the left)

And they rolled in the snow.

(the child puts his hands on the table or knees on one side or the other)

Everyone came home in the snow

We ate soup and went to bed.

body games

Hand games

For example, a specialist holds out his hand to a child with the words: "Let's say hello." But the child's hand goes to the side or back. Therefore, we begin work with this movement. The instruction helps the child to focus on the movement and his sensations, and to realize them. “Your hand wants to play. Let's play with her. The hand went up, it is tense, hard, strong, so keep it there and intensify this movement. I will count to 3 (5). On the count of three (five), you will make a very big effort to keep her in this position and increase the movement. Now relax and let her rest. Now it is soft, relaxed, heavy.” The account is necessary when performing the exercise, as it marks the beginning and end of the process of tension, and the transition to the next stage - relaxation. The specialist touches the hand, but does not perform the exercise for the child. This gesture can mean "I'm with you" and helps the child to concentrate on the processes that occur in this hand. Hyperkinesis is an involuntary movement associated with an increase in muscle tone, that is, tension. Tension cannot continue all the time, and even with its intensification. Therefore, after the end of the exercise (at the expense of 3, 5), the hand relaxes. The child receives the first experience of voluntary tension and subsequent relaxation, which he is aware of. The exercise is repeated 2 more times. For better relaxation of the hand, gently shake it. To do this, gently hold the child's elbow with the left hand, and with the right, holding the fingers, lightly shake it. You need to raise your arm (leg) no more than 7-10 cm from the surface on which the child lies. But the most important thing at all stages of working with the body is the active participation of the child himself, his involvement in the process, his awareness of what is happening with his arm, leg, body, etc. This is very important. Next, we go clockwise. Let's move on to the left hand. What does this hand want? We start with the movement that the child suggests. We repeat all the procedures: an exercise for tension and shaking for the left hand.

The next exercise is aimed at strengthening the child's differentiation of feelings of tension and relaxation.

Breathing exercises

This stage of work is described in detail by us in the "Program" (See "Literature", 6). After working with the body using psychophysical exercises, you can move on to motor exercises. These can be yoga exercises and psychodynamic meditations (see ibid.). We give a few more exercises that we invented in the process of working with children with severe motor pathology.

Games with sticks and matches

Builders

The squirrels and bunnies decided to build houses for themselves. It is from these logs that you need to build (15 matches or counting sticks each). It is necessary to move the logs into place so that they do not slide on the ground.

Fulfilling the conditions of this game you need to transfer: -
a) using any fingers of both hands;
b) using the thumbs of the left hand;
c) only two fingers - thumb and little finger;
d) only index and middle fingers;
e) only the middle and ring fingers;
f) only the ring and little fingers;
g) with two little fingers of both hands lay out two straight lines of 4 sticks (matches) - a fence;
h) build a triangle (roofs of houses) with the ring and little fingers;
i) build a quadrangle (walls) with the middle and little fingers;
j) build a well with index and nameless ones.

This exercise can be given at home. Let the whole family play.

The second version of the game with matches

In front of each participant in the game, 5 matches are placed one after the other on the table. The player must raise the fingers of two hands: one match with two thumbs, the other with the index fingers, the 3rd, 4th, 5th - middle, ring and little fingers, not letting go of a single match. Raise consistently.

Game Building a house, Hammering nails

Hands clenched into fists, thumbs up - this is a hammer. Throughout the entire verse (or song), the hammer hammers in nails - we are building a house (movement from above with the thumb - first straight, then bent. It is more difficult to bent.)

Lacing

A large card is taken, on which holes are made along the edges, as well as in the center in a certain sequence. The edges of the holes are painted in different colors. With the help of a long thick thread, the child performs the following tasks:

a) draw a thread through all the holes along the edge of the card;

b) pull the thread into every second hole;

c) draw the thread only through the holes circled in red (alternating red and blue, etc.);

d) overcast over the edge;

e) in the center of the card make lacing, as in boots.

Methods of working with stencils and patterns

When working with a stencil with geometric shapes, the child puts it on an album sheet and traces familiar shapes with a simple pencil. Then the child removes the stencil from the sheet and divides each resulting geometric figure into parallel segments (strokes). Here, first of all, such strokes are worked out: parallel segments from top to bottom, from bottom to top, from left to right. The distance between the segments should be approximately the width of a lowercase letter. Initially, in order to make it clear the direction of the segment, the children shorten the arrow on one of them.

In subsequent lessons, children build various objects from geometric shapes, shade them and make semantic compositions. You can accompany these compositions with a story. For example, they built an electric locomotive or an airplane and went on a trip. You can use Picture Games. Letter elements can then be included in the hatching. Hatching during this period is done with a felt-tip pen. Children can also shade their own contour drawings on various topics: space, traffic rules, etc.

The above exercises contribute to the development of not only the muscles of the hand, their coordination, but also the eye, as well as the formation of inner speech, figurative and logical thinking.

OUR RESULTS

Ribbon weaving

prettification

Weaving rug

Weaving roses from ribbon