Home Coated tongue Medical and social rehabilitation of disabled children. Fundamentals of medical rehabilitation of a child Treatment and rehabilitation of disabled children

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Medical and social rehabilitation of disabled children. Fundamentals of medical rehabilitation of a child Treatment and rehabilitation of disabled children

Some babies are born with disabilities, while others pathological changes appear with age. In both cases, medical rehabilitation of children is necessary. This is a fight for the future healthy development of the child. The main difference from simple treatment is the normalization of life activities, taking into account the age of the baby.

The main goal of rehabilitation is to return to the patient lost opportunities, skills, health, adaptation to society, and everyday life.

Medical rehabilitation of children is a set of measures to maximize the restoration of a child’s health physically and mentally.

According to WHO, 650 million people, a third of whom are children, have serious illnesses that require rehabilitation. Every year their number increases.

Sometimes medical rehabilitation of children with disabilities, disabled people, is urgently needed from the first days of life. Special centers and services help with this.

Rehabilitation includes all types and methods of services provided for different age categories. This is a complete complex that socializes children with special needs.

In addition to health, there is a full or partial restoration of ability to work.

Acquired abnormalities usually appear after suffering a serious illness or trauma, both physical and psychological.

There are the following main types of rehabilitation:

Medical. To restore lost functions. A step-by-step treatment is carried out until complete or partial recovery. The body's capabilities are activated. They conduct psychotherapy so that the baby learns to calmly accept his illness and fight it on his own ( physical exercise, positive attitude, training).
Social. Social and everyday adaptation. Helps create a daily routine, taking into account the characteristics of the child and his age. The necessary care for children with special needs is considered. This type helps the child to perceive himself and his family in a positive way, and to be aware of the surrounding society. Social assistance rehabilitation is great: adaptation, obtaining special funds, housework, financial assistance, education in special institutions.
Labor (professional) activity (for children – training). There is high-quality preparation for learning, perception, and memorization. curricula. Funds are allocated for study, career guidance or retraining.

Note! Society plays important role in the healthy development of the younger generation.

Essence, features of rehabilitation

The main essence is the maximum restoration of health physically and mentally. Rehabilitation centers and healthcare organizations carry out rehabilitation. It is also worth doing at home on your own.

The first place where recovery begins is the maternity hospital. Next comes the clinic, various consultations, and inpatient treatment. When the baby grows up, it is possible further treatment in special sanatoriums, camps, boarding schools, schools, kindergartens, dispensaries.

To improve the child’s condition and develop his capabilities, certain programs are used, which are prescribed directly by the doctor. It could be:

physiotherapy;
drug treatment.

Taking into account the abilities of the child’s body, rehabilitation has certain features:

an individual plan is drawn up (taking into account existing changes, disorders, characteristics of the patient), according to which all prescribed rehabilitation complexes are carried out;
the highest effectiveness is manifested if treatment is started in the first stages of the disease or deviation;
an integrated approach is applied;
all instructions are carried out daily, without skipping;
rehabilitation has a goal full recovery or adaptation to existing circumstances.

At chronic forms diseases (poliomyelitis, defects, asthma) the essence of rehabilitation for a child is to support the body, compensate for lost functions for the diseased organ.

Children are registered and undergo regular examinations. For example, medical rehabilitation of children with cerebral palsy can take a long time, with periodic exacerbations. The main thing is not to give up, but to continue treatment.

Rehabilitation means

It is necessary to take a serious approach to organizing and choosing a method for the rehabilitation of a child with some disabilities. After all, a correctly selected treatment regimen gives a greater chance of recovery. It is necessary to strictly adhere to the medical rehabilitation of children according to a special program.

There are basic rehabilitation provisions recognized here and abroad:

the place where rehabilitation is carried out must use all types of treatment and have connections with similar institutions;
recovery begins from the early stages of the disease using an integrated approach;
treatment is carried out without interruption, until the most positive result;
All treatment stages carried out comprehensively;
individual programs are prescribed for each patient (it is necessary to take into account all the characteristics of each organism);
The goal is, if possible, to restore health, to form a positive attitude towards future life, to teach how to cope with basic everyday tasks, to instill a desire to fight for one’s health, and to reveal a desire to study.

Not always after a visit treatment centers children quickly return to their former conditions. They need time. To avoid a relapse or another illness, you need to carefully consider the baby’s adaptation.

You should reorganize your daily routine with the activities prescribed by your doctor. Use massage, exercise therapy, adhere to the prescribed diet, physiotherapy, work on the child’s psyche (the main thing is not to injure it).

Stages of medical rehabilitation of a child

There are state programs for the rehabilitation of children with certain diseases; medical rehabilitation of disabled children has been developed, which consists of the following stages:

Clinical. Occurs in a hospital. The work is aimed at the affected body systems that need to be cured or improved. It also prepares the child for further work on his or her deviations. To help the child as much as possible, at this stage all methods are included: medications, massage, diet (during the acute phase of the disease - fasting, during recovery - high-calorie, with vitamins, easy to digest), exercise therapy, physiotherapy. The results of achievements are recorded after various analyzes (biochemistry, indicators of functional capabilities, ECG).
Sanatorium. An important period when the affected systems return to normal. Here, more attention is paid not only to the physical state, but also to the mental one (the character of the child is taken into account). They carry out measures to harden the body in order to quickly increase immunity and normalize basic health indicators. If this stage is performed correctly, the body begins to grow and develop normally. It is important to maintain positive emotions in the baby, good sleep, quality food, excellent health. The stage is completed when the pathologies disappear.
Adaptive. Here, almost all indicators of the body’s condition are already normalized, and the baby returns to normal life. Procedures also continue to be selected individually, and they are constantly performed. It is carried out both at home and in centers designated for this purpose. At the end of this period, the child’s health should be restored or improved as much as possible.

When carrying out rehabilitation measures, they must be entered into the patient’s personal record.

Important personal qualities, positive life position. Teach your child the basic rules that must be observed in society.

Every person is full-fledged, regardless of his physical capabilities. In the future, active group games in the fresh air will help maintain health and establish social connections.

Important! The main thing is to make the child not lose heart, to believe in himself and his capabilities, and to help him gain confidence. If necessary, contact a speech therapist or another pedagogical method.

Unfortunately, some consequences of diseases leave their mark on the entire future life of the baby. And in order to make his existence more fulfilling, rehabilitation is necessary. It will help restore lost functions or compensate for lost capabilities. Thus, the child will feel comfortable leading a normal lifestyle.

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State budgetary professional

educational institution

« Solikamsky socially-Pedagogical College named afterA.P.Ramensky"

Essay

on the topic of: "Psychosocialrehabilitation of disabled people"

Performed:

student of group F-47

specialties General Medicine

Boyko Ekaterina Andreevna

Checked:

Shiverskaya N. A.

Solikamsk 2016

1. Psychosocial rehabilitation: essence, principles, directions

2. Psychological characteristics of persons with disabilities

3. Psychosocial work with people with disabilities

Conclusion

Literature

1. Psychosocial rehabilitation:essence, principles, directions

Psychosocial rehabilitation (from the Latin re - again, habilis - convenient, adapted) is a system of medical, psychological, pedagogical, social events, aimed at restoring, correcting or compensating for disorders of mental functions, conditions, personal and social-labor status of sick and disabled people, as well as persons who have suffered from illness, received mental trauma as a result of a sharp change in social relations, living conditions, etc. At the heart of Psycho social rehabilitation lies the idea of illness as a destructive process in the human body, characterized not only by the patient’s poor physical well-being, but also by changes in his personality and shifts in the emotional sphere.

Return to health, from the point of view of this approach, involves eliminating the consequences of worries, unwanted attitudes, self-doubt, anxiety about the possibility of deterioration and relapse of the disease, etc. Special attention in psychosocial rehabilitation, work is aimed at compensating for lost professional and socially adaptive qualities. The implementation of psychosocial rehabilitation requires the creation of psychosocial conditions that contribute to maintaining the positive effect of treatment (for example, organizing leisure time, communication, medical examination). The development of the theory and practice of psychological rehabilitation is directly related to the solution of problems of psychoprophylaxis and clinical psychology.

Psychosocial rehabilitation is a system of measures for the fullest possible restoration of a psychosocial state, taking into account psychosocial problems (deviations) that have arisen in a person due to certain factors. Contributes to the creation of the necessary functioning of the basic psychosocial phenomena characteristic of this person, his mood for self-government and self-realization.

Psychosocial rehabilitation is a system of psychological, pedagogical and professional measures aimed at restoring a person’s lost social status (for example, social behavior, communication, interaction), taking into account his potential. In the process of psychosocial rehabilitation, a set of measures is carried out to restore the lost social experience of self-service, behavior, communication, interaction, and professional activity of a person. Psychosocial rehabilitation allows a person to return to active social life at work, in society and in the family, to ensure the most complete self-realization.

2. PsychologicalpeculiaritiespersonsWithdisabilitieshealth

One of the main objectives of rehabilitation is psychological correction and psychosocial assistance in difficult life situations that arise in a person due to disability. Knowledge psychological characteristics the personality of an individual with physical and mental defects will help his successful rehabilitation and adaptation to society.

Mental disorders can be primary—directly caused by illness, birth defect, or brain injury. But secondary psychologically caused disorders of mental activity also arise.

A disabling disease, injury or defect, regardless of what its nature is, what organ or functional system is affected, puts a person in psychologically special living conditions, or, in other words, creates a special objective socio-psychological situation. If this happens to an adult, then by this time he already has characteristics formed in previous periods of life. mental organization: a certain level of cognitive capabilities, the motivational structure of the individual, the current level of assessment of one’s capabilities and expectations.

The emerging social situation associated with the onset of disability sharply reduces the ability to satisfy urgent needs, the possibility of social, professional and personal self-realization of the individual. As a result, a state of frustration arises, i.e. a reactive state in response to the inability to satisfy needs. Obviously, a person who has become disabled faces a difficult task - how to continue to live in conditions of illness or defect.

Gradually, a qualitative and quantitative restructuring of a person’s “internal position” occurs, the content and dynamics of which reflect the main semantic changes in the structure of the personality. Acting as an active subject of activity, a person, despite a disability, continues to remain one.

This finds expression, first of all, in the fact that in the new life situation- in conditions of disability - a person forms his own attitude towards new circumstances of life and towards himself in these circumstances. In 1880, the famous Russian psychiatrist V.Kh. Kandinsky pointed out that “a painful state is the same life, but only under changed conditions.” Illness and subsequent disability are only a biological prerequisite for personality change.

The experience of illness and disability, leaving a special imprint on the entire personality of the patient as a whole, also leads to a gradual change in the emotional-volitional sphere, thought processes, to a serious revaluation of life attitudes, social values and becomes a source for the formation of maladaptive behavior. Maladjustment of behavior is determined by physical criteria (forced isolation), physiological indicators (various somatic disorders associated with existing damage and trauma), social attitudes in the form of certain prejudices (“I’m not like everyone else”) and psychological characteristics (depression, apathy, aggression , resentment, disappointment and guilt).

The forced social isolation of a disabled person from society becomes the source of the formation of the so-called social autism, which manifests itself in the form of a stereotypical lifestyle and corresponding psychological disorders and personal changes. At the same time, disability and its experience in itself prevent the establishment of normal relationships with others, affect performance, general worldview, and thereby deepen the social isolation of the disabled person. A kind of vicious circle arises - social and psychological factors are aggravated by negative influence on each other.

Disabled people with childhood They find themselves infantilely attached to their parents and unable to tear themselves away from parental care. Sometimes there is a transformation of relationships with the closest people, usually the mother and sometimes the father. Such relationships are characterized by tension and internal conflict. This tension and inconsistency may not only not have an open external manifestation, but also not recognized by the disabled person himself. Apparently, among disabled people with the most severe forms of illness and in need of daily care, their dependence on loved ones is so great that it cannot but burden them.

When establishing new connections and relationships, disabled people turn out to be socially immature, acutely aware of their inferiority and rejection by the social environment. The establishment of social contacts is hampered by qualities such as shyness, vulnerability, touchiness, hypersensitivity to critical remarks, and egocentrism. Having reached psychosexual maturity, disabled people remain passive and selfish when establishing intimate relationships with the opposite sex, and constantly experience dissatisfaction in the sexual sphere and the need for love.

For most people with disabilities, their social circle is narrowed. Often, disabled people, deprived of the opportunity to engage in any productive and creative activities, devote all their time and energy to communicating by phone or the Internet, but their circle of contacts is limited to persons with similar forms of disability.

When assessing social qualities that are important in life, people with disabilities give preference to passive, subordinate characteristics, such as tolerance, honesty, and benevolence. Dominant social qualities (courage, the ability to defend one’s views, intransigence to shortcomings) are at the end of the value hierarchy.

The same can be said about business qualities: performance qualities (accuracy, diligence, conscientiousness) are more valuable for disabled people. For people without disabilities, dominant personality traits, both social and business, are preferred.

Some disabled people have managed to find certain positive aspects in their illness. They believe that the disease has made them more sensitive, responsive, and kind. In a number of cases, it was a disabling illness that forced people to mobilize all their strength and achieve such success in some areas of life (work, art, social life), which, in their own opinion, they could not count on if they were healthy.

3. PsychosocialJobWithdisabled people

For a long time, there was a stereotype in our society: a disabled person is an inferior person. It is only recently that the problem of disability has begun to be treated as a problem for the whole society.

In accordance with the Law “On the Basic Principles of Social Protection of Disabled Persons in the USSR”: A disabled person is a person who has a dysfunction of the body caused by diseases, consequences of injuries or defects, leading to a limitation of life activity and necessitating his social protection.

The focus is on the relationship between man and his environment (including society). Limited opportunities are understood as a consequence of the fact that social conditions narrow the opportunities for self-realization of people with disabilities (public morality, psychological climate, social organization, infrastructure, etc.), i.e. disabled people are seen as an oppressed group rather than as an abnormal one. And the essence of the disability problem is the inequality of opportunities with the proclaimed equality of rights.

The content of psychosocial work is the psychosocial rehabilitation of people with disabilities and helping them to understand their inalienable rights. Promoting the process of adaptation, rehabilitation, integration of disabled children into the system of social relations: on equal terms to receive education, vocational training, a workplace, access to facilities for creative activities, expanding the child’s sphere of communication, leisure, etc.; protection of the rights and interests of disabled children and their families; formation in society among the adult population of a civilized view of the attitude towards such children and their families.

One of the priorities social policy is the social protection of disabled people, the most important area of which is rehabilitation. Rehabilitation is an integral component of social technologization.

Methods of socio-psychological rehabilitation include psychological counseling, psychotherapy, sociotherapy, i.e. the whole range of activities that have a positive impact on the sick or disabled person and create a psychologically favorable microsocial environment around him.

With all methods, socio-psychological rehabilitation, first of all, appeals to the personality of the individual, actively trying to achieve harmony with himself and society, increase competence in analyzing the situation, instill confidence in his strengths and capabilities, and restore social ties disrupted by the disease. The success of rehabilitation is largely determined by such psychological factors as the level of maturity of the individual, attitudes and structure of value orientations, the internal picture of the disease, stereotypes of psychological defense, adequate perception of society, harmonious relationships with others. The attitude of a sick or disabled person to the rehabilitation process, to returning to labor activity, his assessment of his condition and prospects form a subjective assessment of the quality of life and subsequently determine social activity.

Methods of behavioral therapy, which are used in psychosocial work, rely on a person’s ability to purposefully and meaningfully change behavior. In the process of trainings focused on solving specific behavioral problems, a person learns to cope with life’s difficulties and increases his ability to self-control and take active action.

Psychosocial methods accumulate elements of psychocorrection, psychotherapy and social work. Psychosocial assistance is one of the most important components of the rehabilitation of persons with health problems and disabilities, since, along with solving many therapeutic problems, it necessarily helps to improve the social behavior of the individual.

The main directions of psychosocial work are:

· personality sociotherapy (individual and group forms);

· psychocorrectional work with the person being rehabilitated and his immediate environment (family, neighbors, colleagues at work, study or leisure), including family therapy, involvement of disabled people in group forms of activity, including self-help groups, psychosocial clubs;

· information and educational work with people with disabilities and society.

Sociotherapy- these are measures of social therapeutic influence that stimulate the social activity of the individual and contribute to his socialization. The methodological basis of sociotherapy consists of certain psychotherapeutic methods focused on the acquisition and development of social skills, increasing competence in situation analysis, as well as microenvironment therapy, employment therapy, organizing active leisure, occupational therapy and other rehabilitation methods that improve the social behavior of an individual.

Psychocorrection is aimed at correcting deficiencies in mental development or behavior in cases of individual dissatisfaction with himself and his own life.

The following specific features characteristic of the psychocorrection process are identified:

· targeting people who have difficulties, problems in everyday life and want to change their lives or are facing

· the goal is to increase the ability for self-realization;

· focus on healthy aspects of the personality, regardless of

· degree of impairment (can be used in both mentally healthy and sick people while maintaining criticism of one’s own personality and behavior);

· focus on changing behavior, interpersonal

· relationships (family, collective) and development of the client’s personality.

Psychocorrectional social work is carried out in individual and group forms. Psychosocial work in the form of an individual form is called individual work with the case: the social worker acts as the main and only instrument of influence on the patient. In this case, the social worker’s contact can be with one patient or a group of people (for example, members of the patient’s family). Social work with a group in such cases is understood as special shape individual work.

The main stages of individual work include opening a case, contact, diagnosis (identifying the client's needs), setting goals, planning work (with assessment of barriers), implementing the intervention, monitoring and control, evaluating the intervention, closing the case.

The most common method of individual psychosocial work is counseling, in which the main means of influence is targeted conversation. Its task is to help patients and their families cope with intrapsychic, interpersonal, socioeconomic difficulties, achieve adaptation to certain situation or public environment, increase the efficiency of managing your own life. Counseling is a series of sessions aimed at solving a problem.

Psychosocial group work focuses on techniques and methods of group work adopted in psychotherapy and the practice of psychologists and aimed at working with people with various socio-psychological pathologies. In this case, unlike social work with an individual or a group of people, where there are no strictly structured relationships between its individual members, the psychotherapeutic group has a certain therapeutic potential and is an active assistant to the social worker in the psychocorrectional process.

The specificity of group therapy lies in the targeted use of group dynamics, that is, the entire set of relationships and interactions that arise between group members in the process of work.

The choice of method and techniques of group work depends on the purpose of the therapeutic intervention, problems, age, personality characteristics and number of patients, as well as on the specialist’s tactics.

There are the following types of psychocorrection groups:

1. Groups of socio-psychological training, which

2. their intended purpose is:

· social skills training groups;

· communication skills development groups;

· assertive behavior training groups;

· groups of interpersonal relationships (family problems, industrial conflicts).

2. Meeting (or self-help) groups;

3. Groups in which work is aimed at changing value orientations;

4. Other types of groups: groups of joint activities, music therapy, bibliotherapy, art therapy, dance psychotherapy, creative expression therapy, etc.

Psychocorrectional groups, just like others, can be centered primarily on the leader (skills training groups) or on the group members (meeting group).

In a group, a person feels accepted and accepted, trusted and trusted, cared for and helped. In such an environment of mutual understanding and interaction, the process of resolving interpersonal conflicts that arise outside the group is facilitated. A person tries and masters new behavioral skills, he has the opportunity to experiment with different styles of interpersonal relationships. A psychocorrectional group can facilitate the process of self-research and self-knowledge, and check, through group opinion, the level of self-esteem and the reality of one’s own aspirations.

INinformation and educational work with disabled people, two blocks can be distinguished:

1. carrying out educational programs related to health issues;

2. provision of information on legal issues, on the availability of a network of rehabilitation institutions, on public associations of people with disabilities and the list of services they provide, on the holding of cultural and sports events for people with disabilities, etc.

Educational programs, or, as they are also called, “health schools,” include lectures and auxiliary information materials (brochures, booklets) that highlight the clinical features of a particular disease, a list of measures necessary to maintain good health and prevent exacerbations, modern advances in treatment and rehabilitation. Particular attention is paid to issues dietary nutrition, especially in diseases in which diet becomes a vital condition for maintaining health (for example, diabetes, cardiovascular diseases). Training provided proper breathing, psychophysical self-regulation.

Information and education, which extend to all areas of life, are of no small importance for people with disabilities. First of all, a person who has received the status of a disabled person needs information about his rights and benefits, about the authorities and institutions where he can receive help, and about the types of support existing in communities.

With the development of computerization, the role of the Internet in the dissemination of information of this kind is increasingly increasing. The task of creating websites and databases containing any information of interest to people with disabilities is being updated. Information services should be tailored to individual needs and any social situations- up to the possibility of satisfying the interests of a hobby, finding friends or a group for a joint hike.

The isolation of people with disabilities in specialized institutions or in their own families, practiced for many decades, has led to the fact that society has seemingly forgotten about their existence; it is not ready to meet them either psychologically or in terms of providing them with full access to all material and spiritual benefits . Persons with physical disabilities or psychical deviations are subject to stigmatization.

Stigma is the exclusion from society of certain groups of people on the basis of their difference from the majority of society. Literally, this term means a mark, a brand that was placed on the body of slaves or criminals in Ancient Greece. The level of prevalence and forms of stigmatization vary depending on the degree of civilization of society and its culture, and the prevailing ideas at each historical moment. Social consciousness tends to be reflected in individual consciousness, so it is not surprising that both disabled people themselves and their family members are prone to self-stigmatization, which entails self-isolation and limitation of social activity.

One of the conditions for the successful implementation of policies for the integration of persons with disabilities into society is the implementation of programs aimed at increasing society’s tolerance towards this category of persons. To solve the problem of destigmatization by professionals and disabled people themselves, different ways can be used.

Properly constructed information and educational programs, publication of popular scientific books, magazines, information brochures, which should help raise the level of public awareness about social, medical, economic and psychological problems disabled people. Programs are needed to promote community involvement in solving these problems.

psychosocial rehabilitation disabled person

Conclusion

The main goal of psychosocial rehabilitation of people with disabilities today is to launch cultural changes and create an emotional climate that can improve the current state of affairs, generate solidarity and support, and create new relationships between people.

Catalysts for programs for the psychosocial rehabilitation of people with disabilities can be public organizations of people with disabilities and their relatives, and the assistants of these organizations can be political and public figures in the field of art, literature, music, sports, journalists, clergy, scientists, teachers, business and financial leaders.

To attract public attention to pressing issues related to disability, it is necessary to widely use the possibilities of the media, holding press conferences, appearances on radio and television, appeals to the population during church services, organizing open lessons in secondary and higher educational institutions, charitable bazaars and exhibitions, participation of disabled people in special sessions of parliament.

Public organizations of people with disabilities should take part in policy formation, planning the activities of medical and social rehabilitation services, and improving legislation regarding people with disabilities. Consumers know what they need to survive in modern society, and they are able to accurately identify their own needs in terms of meeting life needs, protecting health, and removing barriers.

Only a change in public attitude towards the problem of disability will guarantee the improvement of state policy in this area and, most importantly, its implementation.

Literature

1. Alexander F. Psychosomatic medicine. -- M., 2002.

2. Kvasenko A.V., Zubarev Yu.G. Psychology of the patient. -- L., 1980.

3. http://nashaucheba.ru

4. http://analiz4.by/

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2.2.3 SOCIAL REHABILITATION PROGRAM

Activities for the social rehabilitation of a disabled child are aimed at helping the child develop his social status, achieve financial independence in the future, social adaptation and integration into society.

The implementation of services for the social rehabilitation of disabled children is carried out gradually and continuously in institutions of the relevant profile. The content and duration of the rehabilitation process are determined by the child’s need for each specific service.

The need for social rehabilitation measures for disabled children is determined based on the results of social diagnostics of the child and his family.

The systemic classification of social rehabilitation services is presented in GOST R 54738-2011 “Rehabilitation of disabled people. Services for social rehabilitation of disabled people".

Activities for social rehabilitation in the IRP of a disabled child include:

Social and environmental rehabilitation;

Social and pedagogical rehabilitation;

Social and psychological rehabilitation;

Sociocultural rehabilitation;

Social and everyday adaptation.

Physical education and health activities and sports.

Social and environmental rehabilitation is aimed at integrating a disabled child into society by providing him with the necessary set of technical means of rehabilitation, teaching him how to use them, creating accessible environment in the immediate environment of a disabled child.

Measures for the social and environmental rehabilitation of a disabled child consist of restoring (forming) or compensating for the following elements of activity and participation: in ordinary social relationships (meetings with friends, relatives, talking on the phone, etc.), involvement in these relationships, role position in family, ability to manage money, visit stores, make purchases, service establishments, make other calculations, etc.), ability to use transport, transport communications, overcome obstacles - stairs, curbs, ability to use communications, information, newspapers, reading books, magazines, leisure activities, physical culture, sports, creativity, the opportunity to visit cultural institutions and use their services.

Social and environmental rehabilitation services are provided to disabled children in the following composition and forms:

Training a disabled person and his family members in the use of technical means of rehabilitation;

Information and consultation on vital issues social issues; on rehabilitation issues, legal assistance on issues of discrimination against children with disabilities in different areas life;

Social skills training for housekeeping;

Assistance in planning and creating a family, training in family and marital relationships;

Training in solving personal problems;

Social communication training, etc.

In our opinion, in the section “social and environmental rehabilitation” of the IPR of a disabled child, a conclusion can be drawn up on the possibility of self-care and leading an independent lifestyle for disabled children after they reach 18 years of age living in inpatient social service institutions.

Social and pedagogical rehabilitation- restoration (formation) of lost social and environmental status through teaching the child appropriate educational programs, knowledge, skills, behavioral stereotypes, value orientations, standards that ensure the full participation of disabled children in generally accepted forms of social interaction. Social and pedagogical rehabilitation includes:

Social and pedagogical diagnostics;

Social and pedagogical consultation;

Pedagogical correction;

Correctional training;

Pedagogical education;

Social and pedagogical patronage and support.

Socio-pedagogical counseling consists of assisting a disabled child in obtaining educational services in order to make an informed decision on the choice of level, place, form and conditions of training/education, activities that ensure the development of educational programs at the optimal level, on the selection and use of necessary teaching aids and technical teaching aids, educational equipment, taking into account the characteristics of the educational potential of a disabled person and the degree of learning disabilities.

Pedagogical correction is aimed at developing and correcting the mental and physical functions of a disabled child using pedagogical methods and means. Pedagogical correction is carried out in the process of individual and group classes with a speech therapist, with a speech pathologist (typhlo-, deaf-, deaf-, oligophrenopedagogues).

Correctional education includes teaching life skills, personal safety, social communication, social independence, the use of technical means of rehabilitation, sign language for people with hearing impairments and their families, clear language for people with mental disabilities, rehabilitation social experience special pedagogical methods that take into account the disabilities of the disabled person’s body functions and limitations in their ability to learn.

Pedagogical education is the education of disabled people and members of their families, specialists working with disabled people, in the field of knowledge about disability, methods and means of rehabilitation and integration of disabled people into society.

Social and pedagogical patronage and support for disabled children and their families includes: supervision of the learning conditions of a disabled child in the family, opportunities for family members to help in the learning process of a disabled person, assistance in obtaining general and vocational education, information on issues of general and vocational education, organization of psychological, pedagogical and medical-social support of the learning process, assistance in the inclusion of disabled people in public organizations of disabled people.

Social and psychological rehabilitation of disabled children is aimed at restoring (forming) abilities that allow them to successfully perform various social roles (game, educational, family, professional, social and others) and have the opportunity to be actually included in various areas of social relations and life activities, to develop socio-psychological competence for successful social adaptation and integration of a disabled person into society.

Disabled children are provided with the following social and psychological rehabilitation services:

- psychological counseling oriented towards solving socio-psychological problems; is a specially organized interaction between a psychologist and a child (and/or his parent/guardian) in need of psychological assistance, in order to resolve problems in the field of social relations, social adaptation, socialization and integration;

- psychological diagnostics, which consists in identifying the psychological characteristics of a disabled person that determine the specifics of his behavior and relationships with others, the possibility of his social adaptation using psychodiagnostic methods and analyzing the data obtained for the purposes of socio-psychological rehabilitation;

- psychological correction, which consists of active psychological influence aimed at overcoming or weakening developmental deviations, emotional state and the behavior of a disabled person, as well as assistance in the formation of the necessary psychological and social skills and competencies of a disabled child, the natural formation of which is difficult due to limitations in life activity or characteristics of developmental conditions and the environment;

- psychotherapeutic assistance, which is a system of psychological influences aimed at restructuring the system of relationships between the individual of a disabled person, a deformed illness, injury or injury, and/or the parents of a disabled child and solving the problem of changing relationships, both to the social environment and to one’s own personality, as well as on the formation of a positive psychological microclimate in the family. Art therapy, psychodrama, family psychotherapy, bibliotherapy and other methods of therapy in group or individual form are widely used as methods of activating psychotherapeutic influence;

- socio-psychological training, which consists of an active psychological impact aimed at relieving a disabled child of the consequences of traumatic situations, neuropsychic tension, on the development and training of individual mental functions and personality traits, weakened due to illness, injury, injury or conditions of the social environment, but necessary for successful adaptation to new social conditions, to develop abilities that allow you to successfully fulfill various social roles (family, professional, social and others) and have the opportunity to be actually included in different areas of social relations and life activities in accordance with your age and stage of development;

- psychological prevention, which consists of assisting in the acquisition of psychological knowledge, increasing socio-psychological competence; formation of the need (motivation) to use this knowledge to work on oneself, on one’s problems of socio-psychological content; creating conditions for the full mental functioning of the personality of a disabled person, for timely prevention of possible mental disorders, determined primarily by social relations. Often necessary for parents of disabled children, as assistance in creating optimal conditions for the development and upbringing of the child;

- socio-psychological patronage, which consists of systematic monitoring of disabled people and the conditions of their development for the timely identification of situations of mental discomfort caused by problems of adaptation of a disabled person in the family, in society as a whole, and providing, if necessary, psychological assistance.

Sociocultural rehabilitation of disabled children is represented by a set of activities, the purpose of which is to help a disabled child achieve and maintain an optimal degree of participation in social relationships, the necessary level of cultural competence, which should provide the opportunity for positive changes in lifestyle and the fullest integration into society by expanding the scope of his independence.

The main goal of sociocultural rehabilitation of disabled children (as well as psychological and pedagogical) is to overcome or level out disharmonies in the mental development of children due to disabling diseases.

The peculiarity of determining the measures of sociocultural rehabilitation indicated for a disabled child is that it is based on medical, social and psychological factors, that is, personality disorders, the level of social adaptation of the disabled child in the public environment, his cultural interests, spiritual values, tendency to creative activity. Sociocultural rehabilitation programs are built taking into account differentiation by type of defect, personality disorders due to a disabling pathology, gender, psychophysical characteristics characteristic of a child at the appropriate age. Contraindicated factors are taken into account, for example, the use of products (glue, paper, etc.) that cause allergic reactions, piercing, cutting objects for epilepsy, etc.

Entry into the world of artistic culture for a disabled child, like healthy child, occurs gradually. The following stages of the formation of a child’s personality subculture are distinguished:

1. “The world and artistic culture around me” - covers infancy and early childhood, characterized by familiarity with the world of artistic culture through communication and interaction with the objective world.

2. “I am developing in the world of artistic culture” - preschool age, when artistic perception, action, communication and play are formed.

3. “I am learning the world of artistic culture” - age 7-14 years, when knowledge, including cultural values, dominates.

4. “The world of artistic culture in me and around me” - senior school age - a period of object-creative artistic activity, the need for ideological reflection, and the choice of a future profession.

Activities for the sociocultural rehabilitation of a disabled child include:

Teaching a disabled person how to spend rest and leisure;

Carrying out activities aimed at creating conditions for the full participation of disabled children in socio-cultural events that satisfy their socio-cultural and spiritual needs, to expand their general and cultural horizons, the sphere of communication (visits to theaters, exhibitions, excursions, meetings with literary and artistic figures, holidays, anniversaries, other cultural events);

Providing disabled children in institutions and assistance in providing disabled children served at home with periodical, educational, methodological, reference, information and fiction literature, including those published on tape cassettes, audio books and books with raised dot font Braille; creating and providing visually impaired people with the opportunity to use adapted computer workstations, the Internet, and Internet documents, taking into account the disabilities of a disabled child;

Assistance in ensuring accessibility for disabled children to visit theaters, museums, cinemas, libraries, the opportunity to familiarize themselves with literary works and information on the accessibility of cultural institutions;

Development and implementation of diverse leisure programs (informational and educational, developmental, artistic and journalistic, sports and entertainment, etc.) that contribute to the formation of a healthy psyche, the development of creative initiative and independence.

Sociocultural rehabilitation programs can also stimulate motor activity, develop and correct gross and fine motor skills, and incorrect pronunciation; develop speech, form the correct tempo, rhythm and intonation of speech; develop all types of perception - temporal and spatial ideas, ideas about the body diagram; develop graphic skills, prepare your hand for writing.

Either one or several institutions can be indicated as the executor of the IRP, based on where and what services the disabled child can receive. The program may simultaneously include activities that will be carried out by a social protection institution (for example, an orphanage) and a cultural and leisure institution

Technologies of sociocultural rehabilitation are currently not standardized and are largely determined by the real possibilities of implementing certain activities on the ground. The objectives of the technologies used include neutralizing and eliminating the causes of isolation of children with disabilities in the sociocultural sphere; introducing them to professional sociocultural activities, providing them with specific assistance in finding employment in accordance with their capabilities and interests; supporting children in the field of family leisure, intensifying their aspirations for leisure activities, taking into account ethnic, age, religious and other factors. Highly effective in the sociocultural rehabilitation of disabled children are various techniques creative psychotherapy: art therapy, isotherapy, aesthetic therapy, fairy tale therapy, play psychotherapy, bibliotherapy, literary therapy, music therapy, therapy for creative passion for physical education and sports, etc.

Social and everyday adaptation of disabled children is aimed at teaching a disabled child self-care, and also includes measures for arranging the home of a disabled person in accordance with existing disabilities.

Social and everyday adaptation is aimed at disabled children who do not have the necessary social and everyday skills and need comprehensive daily support in a microsocial environment.

The tasks of social and everyday adaptation of a disabled child are the formation (restoration) or compensation in the child of: the ability to carry out controlled excretion, personal hygiene, the ability to dress and undress, to eat, to prepare food, the ability to use electrical and gas appliances, to perform certain tasks household and garden work, mobility ability.

Social and everyday adaptation includes:

Teaching a disabled child and his family members the skills of personal hygiene, self-care, movement, communication, etc., including with the help of technical means of rehabilitation;

Information and consultation on issues of social and domestic rehabilitation;

Measures to arrange the home of a disabled person in accordance with existing life limitations.

Physical education and recreation activities and sports. Includes adaptive physical culture, physical rehabilitation of people with disabilities and people with disabilities, sports for the disabled (including the Russian Paralympic movement, the Russian Deaflympic movement, the Russian Special Olympics)

In general, adaptive physical culture (APC) is called upon, with the help of rationally organized physical activity, using preserved functions, residual health, natural physical resources and spiritual strength of a disabled person, to bring the psychological capabilities of the body and personality of self-realization in society as close as possible.

The essence of sports and recreational work with disabled people is continuous physical education, taking care of your health throughout your life. In the development of physical fitness and sports for people with disabilities, it is fundamental to formulate a disabled person’s conviction in the usefulness and expediency of sports and health activities, a conscious attitude towards the development of physical education, the development of motivation and self-organization of a healthy lifestyle.

Adaptive physical education traditionally includes four types: adaptive physical education (education); adaptive physical recreation; adaptive motor rehabilitation ( physical rehabilitation); adaptive sport. Also, new directions have been identified in adaptive physical culture - creative (artistic and musical), body-oriented and extreme types of physical activity.

Limb amputations;

- consequences of polio;

- cerebral palsy;

- diseases and injuries of the spinal cord;

- other lesions of the musculoskeletal system (congenital malformations and defects of the limbs, restrictions on joint mobility, peripheral paresis and paralysis, etc.)

- post-stroke conditions;

- mental retardation;

Hearing impairment;

Pathology of the organ of vision.

Absolute medical contraindications to adaptive physical education and sports are given by different authors (Table 7)

Table 7

Absolute medical contraindications to adaptive physical education and sports

Absolute contraindications (Muzaleva V.B., Startseva M.V., Zavada E.P. et al., 2008)

Absolute contraindications (Demina E.N., Evseev S.P., Shapkova L.V. et al., 2006).

Feverish conditions;

Purulent processes in tissues;

Chronic diseases in the acute stage;

Acute infectious diseases;

Cardiovascular diseases: ischemic disease heart, angina pectoris of exertion and rest, myocardial infarction, aneurysm of the heart and aorta, myocarditis of any etiology, decompensated heart defects, cardiac arrhythmias and conduction disorders, sinus tachycardia with heart rate more than 100 per minute; hypertension stages II and III;

Pulmonary failure;

Threat of bleeding (cavernous tuberculosis, peptic ulcer of the stomach and duodenum with a tendency to bleeding);

Blood diseases (including anemia);

Consequences of an acute disorder cerebral circulation and disorders of spinal circulation (localized in the cervical region);

Neuromuscular diseases (myopathies, myosthenia);

Multiple sclerosis;

Malignant neoplasms;

Gallstones and urolithiasis disease with frequent attacks, chronic renal failure;

Chronic hepatitis any etiology;

High myopia with changes in the fundus.

Any acute diseases;

Glaucoma, high myopia;

Tendency to bleeding and threat of thromboembolism;

Mental illness in the acute stage, lack of contact with the patient due to his serious condition or mental illness; (decompensated psychopathic syndrome with aggressive and destructive behavior);

Increased cardiovascular failure, sinus tachycardia, frequent attacks of paroxysmal or atrial fibrillation, extrasystoles with a frequency of more than 1:10, negative ECG dynamics, indicating worsening coronary circulation, atrioventricular block II and III degree;

Hypertension ( arterial pressure over 220/120 mmHg), frequent hypertensive or hypotensive crises;

The presence of severe anemia or leukocytiosis;

Severe atypical reactions of cardio-vascular system when performing functional tests.

For a detailed study of the main types and elements of physical culture and recreational activities and sports, indicated and contraindicated for people with disabilities with various pathologies, the information presented in the works of E.N. Demina, S.P. Evseev, L.V. Shapkova et al may be useful. , 2006.

Adaptive physical culture and sports activities are usually held in:

Rehabilitation centers for social rehabilitation of disabled people and disabled children of the social protection system;

Children and Youth Sports Adaptive Schools (YUSASH);

Departments and groups for adaptive sports in institutions additional education children engaged in activities in the field of physical education and sports;

Schools of higher sports excellence, Olympic reserve schools, sports training centers that train high-class athletes in adaptive sports;

Clinics, hospitals, institutes, rehabilitation centers, orphanages run by health authorities;

Educational institutions;

Stationary social service institutions;

Sanatorium and cultural institutions, holiday homes, etc., under the jurisdiction of tourism and resort development authorities;

Physical education and sports clubs for people with disabilities and other physical education and sports organizations operating, including within the framework of public organizations.

Various bodies, institutions, organizations or the disabled person himself (legal representative) are indicated as executors in the program of psychological and pedagogical rehabilitation in the IRP of a disabled child. Indicative wording for entries in this section is presented in Table. 8.

Table 8

Indicative wording for entries in the section
Social events rehabilitation IPR disabled child

List of psychological and pedagogical rehabilitation activities

Possible performers

Social and environmental rehabilitation

Rehabilitation organization

Educational organization

Organs executive power subjects of the Russian Federation (in the field of social protection) and local governments (if the issue of arranging housing for a disabled child is being decided in accordance with existing life limitations)

Social and pedagogical rehabilitation

the child’s need is indicated (if necessary, its specific type)