Neuropsychological analysis of the features of mental development in school age children with mild perinatal hypoxic damage of the nervous system in their anamnesis
Background. Perinatal pathology of the nervous system (PPNS) of hypoxic genesis is one of the most significant causes of deviations in mental development. It is necessary to investigate the impact of mild PPNS for the child’s mental ontogenesis, because coarser perinatal lesions, as a rule, lead to significant violations of development and should be analyzed separately. From our point of view, the qualitative neuropsychological syndromic analysis adopted in Russian child neuropsychology is the most productive way to study this problem.
Objective. The purpose of this study was to conduct neuropsychological analysis of the features of mental development of school-age children with mild hypoxic PPNS in their anamnesis.
Design. Our research involved 62 children 10-12.5 years old, who were studying in comprehensive schools in Moscow. The main group was comprised of 42 neurologically healthy children who had hypoxic-ischemic encephalopathy of mild severity in their anamnesis. The control group was comprised of 20 neurologically healthy children without indication of pathology of pregnancy and labor in their anamnesis.
Methods. We used neuropsychological Luria tests that have been adapted for children, conducted an interview of parents and teachers about the peculiarities of children’s behavior, and analyzed electroencephalogram reports.
Results. Every child with PPNS exhibited similar features, such as neurodynamic disorders and a lack of voluntary control. We called this symptom complex “subcorticalfrontal” neuropsychological syndrome. In addition, each child in the main group had a failure of at least one neuropsychological factor. The following functions showed insufficiency most often: voluntary attention, speech development, verbal-auditory memory, kinetic and kinesthetic praxis, visual-spatial gnosis, and phonemic hearing. Left hemisphere functions and interhemispheric interaction suffered to a greater degree. The children with PPNS were divided into two subgroups, depending on the severity of the insufficiency of executive functions (EF). Children with severe insufficiency of EF more frequently demonstrated violation of development of verbal-logical thinking, difficulties in social adaptation, emotional disorders, and deviant behavior.
Conclusion. The mental development of school-age children with mild PPNS in their anamnesis differs from the development of their peers. We can talk about the longterm consequences of mild hypoxic perinatal damage of the nervous system.
Abbreviation: PPNS — perinatal pathology of the nervous system; CNS — central nervous system; EEG — electroencephalogram; EF — executive functions.
Authors: Sultanova, Alfiya
Keywords: perinatal hypoxic damage of the nervous system; child neuropsychology; cultural-historical concept; neuropsychological analysis; school-age children.