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

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).

1. Gubina-Vakulik G.I., Omelchenko O.A., Kikhtenko E.V. et al. Pathologic features of the development of the macroglia of the brain of the fetus and newborn with the damaging effects of chronic intrauterine hypoxia in the perinatal period (experimental study). UNIVERSUM: medicine and pharmacology. 2017;4(38):50. (in Russian).

2. Dochkina E.S., Ustinova A.V., Taranushenko T.E. Analysis of perinatal period and damage of CNS in children with CP. Siberian Medical Review. 2018;(5):41–47 (in Russian).

3. Semina V.I., StepanovaYu.A. Perinatal hypoxia: pathogenetic aspects and approaches to diagnosis (literature review). Part 1. Medical imaging. 2015;2:95–105. (in Russian).

4. Graf A.V., Goncharenko E.N., Sokolova N.A. Antenatal hypoxia: participation in the development of CNS pathologies in ontogenesis. Neurochemistry. 2008;25(1):11–16. (in Russian).

5. Subbotin A.V., Kovalenko A.V., Karkashina O.V. Psychomotor development of children with hydrocephalic syndrome of hypoxic-ischemic genesis in the first year of life. Mother and child in the Kuzbass. 2009;1(36):31–35. (in Russian).

6. Zhestkova E.A. Accounting for psychomotor development in the physical education of infants. Bulletin of the South Ural State University. Series: education. Pedagogical sciences. 2013;5(1):151–154. (in Russian).

7. Lukashevich I.P., Partsalis E.M., Shklovsky V.M. Perinatal risk factors for the formation of speech pathology in children. Russian Bulletin of Perinatology and Pediatrics. 2008;53(4):19–22. (in Russian).

8. Bobylova M.Yu., Braudo T.E., Kazakova M.V. et al. Delayed speech development in children: an introduction to terminology. Russian Journal of Pediatric Neurology. 2017;12(1):56–62. (in Russian).

9. Petrukhin A.S. Pediatric neurology. textbook in 2t.: for students of educational institutions of higher education in the specialty 060103.65 «Pediatrics» in the discipline «Nervous diseases». 2012;2:555. (in Russian).

10. Khyshiktueva T.P., Usacheva E.L., Lebedeva Yu.V. et al. Mental retardation in children (literature review). Doctor. ru. 2014;6–2 (94):22–26. (in Russian).

11. Nemkova S.A., Maslova O.I., Karkashadze G.A. and others. Cognitive impairment in children with cerebral palsy (structure, diagnosis, treatment). Pediatric Pharmacology. 2012;9(3):77–84. (in Russian).

12. Medvedeva E.V. Features of the manifestations and causes of anxiety in children with cerebral palsy. Bulletin of the Adyghe State University. Series 3: pedagogy and psychology. 2009;4:239–243. (in Russian).