Abstract:

Early development of mental capabilities and social involvement of children with diseases of the nervous system represent a serious medical and social challenge. However, the number of modern diagnostic methods to assess the mental development in infants with combined brain pathology and the scientifically based content of correctional assistance for this category of children within the first year of life is still narrow. We adapt a diagnostic procedure to determine the actual mental development in infants with combined brain pathology and to establish the priority areas for early pedagogical assistance.

Methods:
History analysis, Griffith's psychomotor development test, observation of behavior during wakefulness.
Study group: 115 infants with combined brain pathology of various etiology at the age of 3 to 6 months (mean age: 4 months 12 days).

Results:
Psychomotor development levels within the first months of life expectedly vary widely in infants with combined brain injuries. Exposure to high intensity stimuli recorded parameters corresponding to the standard at 1 month in 48.6 % of infants with single brain matter lesions of various etiology and delayed myelination in the meninges; single weak responses corresponding to the standard at 1 month were recorded in 39.2 % of the infants with multiple brain matter and structure lesions, in particular, in cystic transformation of fronto-parieto-temporal areas, with simultaneous effect of high intensity stimuli on several analyzers at the same time; and no single weak responses corresponding to the standard at 1 month were recorded in 12.2 % of the examined infants with atrophy of the cerebral hemispheres, ventriculomegalia, and localized epilepsy.
A degree of psychomotor development maturity is shown to be statistically significantly related to the severity and type of brain injury.
Differences in the psychomotor development of infants with combined brain injury determine the need for a differentiated approach in providing correctional and pedagogical assistance. For infants with the psychomotor development parameters corresponding to the standard at 1 month of life, early support should include special games and technical means, pedagogical methods and techniques in order to form the psychomotor development parameters corresponding to the age of 2 months. The content of early support of infants with only a single recorded psychomotor development parameters corresponding to the standard at 1 month of life should be focused on their activation and development. In the absence of the psychomotor development parameters to the standard at 1 month of life, early support should be provided only after the neurological state has been stabilized and a certain degree of psychophysical maturity has occurred in the form of single weak unconditioned reflex responses.

Conclusion:
The slow formation of the earliest age-related psychological achievements proves the need for special developmental stimuli when providing correctional and pedagogical assistance to be included in the treatment of infants with combined brain injury as soon as their psychophysical state has been stabilized. Early support will be efficient in training parents correctional and pedagogical technologies, which ensures the possibility to use them on a regular basis when raising an infant.

Keywords:

Early care organization for infants, combined brain pathology, mental capabilities.