Psychomotor, speech and mental development in children with infantile cerebral paralysis

Abstract

Purpose of the study . Optimization of the diagnostic algorithm of neuropsychic development in the context of primary pediatric and specialized neurological care on the basis of analysis of the formation of psychomotor, speech and mental abilities in children with infantile cerebral paralysis, formed on the background of hypoxic-ischemic and hypoxic-hemorrhagic perinatal CNS damage. Materials and methods . The article presents an assessment of psychomotor, speech and mental development of 81 children with infantile cerebral paralysis (ICP): 50 patients with hypoxic-ischemic central nervous system damage and 31 patients — with hypoxic-hemorrhagic central nervous system damage. Results . PSlowing of psychomotor development (SPD) was diagnosed in 98.8% of cases. The greatest percentage of children with SPD was noted in children under 1 year of age — 40%. The majority of children with SPD are noted under age 2. The amount of children with the delay in speech development (DSD) was 93.8%. DSD was absent in 5 (6.2%) patients. In children under 1.5 years of age, DSD was noted in 34.2% of all cases, while in the group with hypoxic-ischemic damage (HID) of the central nervous system — 47.9% and only 10.7% — in children with hypoxic-hemorrhagic damage (HHD) of the central nervous system(p < 0.01). At the age of 1.6 up to 2 years, the proportion of children with DSD from the group with HID of the central nervous system was 35.4%, and in the group with HHD of the central nervous system — 82.1% (p < 0.01). Mental retardation (MR) was noted in 28.4% of children. The severe and deep forms of MR were 2 times higher in groups with HHD of the central nervous system (22.2 and 11.1%, respectively). Other mental disorders, caused by brain dysfunction, were diagnosed in 50.6% of patients. The absence of MR and other mental disorders was noted in 21% of cases. Conclusion . Presumably, the cause of high detectability of SPD in children under 2 years of age is late evaluation of the child’s speech abilities by parents . The presence of MR in 1/3 of all children under study, and the presence of other mental disorders in 50.6% of patients, indicates a significant proportion of developmentally delayed children with infantile cerebral paralysis (ICP).