Classes on social adaptation of young disabled people. Main directions of social rehabilitation
Activities aimed at achieving rational employment and successful social and labor adaptation of disabled people are carried out by employers, public organizations of disabled people, social support services for disabled people, rehabilitation centers and other institutions in accordance with the IPR.
These include:
· Improving sanitary and hygienic conditions, the severity and intensity of work, rationalization of the workplace, work and rest regime, adaptation of the technological process and work organization taking into account the characteristics of the pathology of a disabled person, redistribution of job and functional responsibilities, etc.;
· Compliance with labor legislation and legislation on social protection of disabled people, provision of individual production standards, their gradual increase as professional qualifications increase, etc.;
· Assistance in solving family and everyday problems, treatment, realization of spiritual and creative abilities, material and moral support;
· Providing assistance and support in normalizing intra-industrial relations with work colleagues, correcting socio-psychological attitudes, forming adequate forms and methods of behavior in the work team, etc.
Social rehabilitation program.
Social rehabilitation is a system of social, socio-psychological, legal and economic measures aimed at creating conditions for disabled people to overcome life limitations and social insufficiency by restoring social skills and connections, achieving free and independent life together and on an equal basis with healthy citizens.
Social rehabilitation measures include:
social, everyday and environmental adaptation, including:
· consulting on issues of social, everyday and environmental adaptation;
· teaching a disabled person basic social skills, including with the help of technical means of rehabilitation;
· adaptation of living conditions to the needs of a disabled person;
· provision of technical and other means of rehabilitation;
· training disabled people in the use of technical means of rehabilitation;
· Social and psychological assistance and support.
· Physical rehabilitation.
· Other types of social rehabilitation (legal assistance, training family members in skills to serve the disabled, etc.).
· Consulting on issues of social and social and environmental adaptation.
Conversation with a disabled person. Clarification of needs, obtaining information on the types and forms of social assistance and services provided in the administrative region of residence of a disabled person.
Performed by: social work specialists from the ITU bureau, social workers of territorial bodies and social protection institutions.
· Social skills training.
· Restoration, development and formation in a disabled person of everyday skills of movement, self-care, functions impaired or difficult as a result of impairment by forming a new stereotype of their implementation at the expense of other preserved functions based on exercises, training, repetition and other teaching tools and technologies.
· Performed by: children's and adult rehabilitation centers, specialized boarding homes, territorial social service centers, etc.
Financing of expenses for providing disabled people with technical means and other means of rehabilitation is carried out from the federal budget, the budgets of the constituent entities of the Russian Federation, and the Social Insurance Fund of the Russian Federation.
The technical and other means of rehabilitation provided for by the IPR for disabled people, provided to them at the expense of the funds from these sources, are transferred to disabled people free of charge for gratuitous use.
Additional funds to finance the costs of technical and other means of rehabilitation of disabled people provided for in this article may be obtained from other sources not prohibited by law.
Technical and other means of rehabilitation of disabled people are provided to disabled people at their place of residence by the relevant executive authorities of the constituent entities of the Russian Federation (social protection bodies, health care, education and other bodies), the Social Insurance Fund of the Russian Federation, as well as other interested organizations.
Tiflo - and marine engineering.
Typhlotechnical means: optical means for vision correction, means for orientation in space (canes, photoelectric probe, ultrasonic locators and alarms), means for reading and writing (devices for reading and writing using the Braille system, typewriters, special drawing instruments, measuring instruments , computers, etc.), household products (dispensers, sewing equipment, Braichev watches, etc.).
Signless equipment: vibrating, alarms, amplifying means of communication and information transmission, decor for televisions, telephones (with amplifiers, with a ticker, etc.)
The provision is provided by: audiology centers, boards of the VOS and VOG, the society of the disabled, territorial bodies of social protection of the population.
1.5. Training disabled people in the use of technical means of rehabilitation.
Performed by: rehabilitation centers, audiology centers, recovery centers at VOS and VOG, public organizations of disabled people, territorial bodies of social protection of the population.
2. Providing socio-psychological assistance:
Psychological consultation;
Psychocorrection of attitudes, motives, behavior, etc.;
Psychological training;
Training family members to communicate with a disabled person;
Psychocorrection of family and household relationships, etc. Performed by: MSE bureau, territorial centers for social rehabilitation of disabled people, territorial social service centers.
3. Physical rehabilitation:
Orientation to possible sports activities;
Teaching skills and technical elements in available sports;
Assistance in joining general and specialized sports clubs and societies;
Training in skills for recreation and leisure, participation in child sex, etc.
Performed by: specialists from the ITU bureau, territorial sports committees, sports schools, clubs and societies, territorial social service centers, etc.
4. Other types of social rehabilitation:
Placement in a boarding home (specialized or general type, shelter, orphanages, etc.);
Referral to rehabilitation centers (children, adults);
Referral to public organizations of disabled people;
Legal assistance;
Training family members in the skills of serving the disabled, etc. Performed by: territorial bodies of social protection of the population.
Conclusion on the implementation of an individual rehabilitation program for a disabled person.
The conclusion on the implementation of the IPR is made by a rehabilitation expert at the next re-examination or during the control appearance of the disabled person in the order of dynamic observation at the ITU office, but no later than a year after the issuance of the IPR to the disabled person.
The assessment of the results of the implementation of the IPR is carried out:
1. According to the completeness of its implementation:
Completed in full, if all planned program activities are completed in full (the deadline for completion is indicated - day, month, year);
Partially completed - indicate the percentage of completed activities compared to those planned for all sections of the IPR;
Not fulfilled - indicate the reasons for non-compliance (refusal of a disabled person, refusal of an enterprise, institution or organization responsible for the implementation of rehabilitation measures, lack of funding for rehabilitation measures, etc.).
2. Based on the achieved results of implementing medical programs; professional and social rehabilitation (emphasize the achieved results indicated in the text “Conclusions”).
3. According to the dynamics of disability:
Disability is not established (full rehabilitation),
A less severe disability group has been established (partial rehabilitation);
The disability group remained unchanged (stable disability);
A more severe disability level (worsening of disability) has been established.
4. According to the degree of correspondence of the achieved results to the rehabilitation potential of the disabled person:
The rehabilitation potential has been fully realized (high efficiency from the implementation of IPR);
The rehabilitation potential has been partially realized (satisfactory effectiveness from the implementation of the IPR);
The rehabilitation potential has not been realized (lack of effectiveness from the implementation of the IPR).
The conclusion on the implementation of the individual rehabilitation program for a disabled person is approved by the head of the ITU bureau (signature, seal and date of approval of the conclusion are affixed).
Appendix 1
TABLE for determining body weight (MI G) I depending on height
| Height | 1kmspgt. | Healthy | "Slightly" | Excess | Obesity |
| weight | and:>life. ase | weight | |||
| cm. | KG. | KG. | m | kg. | KG. |
| 145 | 42 | 42-53 | 53-57 | 57-63 | 63 |
| 148 | 44 | 44-55 | 55-59 | 59-66 | 66 |
| 150 | 45 | 45-54 | 56-61 | 61-68 | 68 |
| 152 | 46 | 46-58 | 58-62 | 62-69 | 69 |
| 155 | 48 | 48-60 | 60-65 | 65-72 | 72 |
| 158 | 50 | 50-62 | 62-67 | 67-75 | 75 |
| 160 | 51 | 51-64 | 64-69 | 69-77 | 77 |
| 162 | 52 | 53-66 | 66-71 | 71-79 | 79 |
| 165 | 55 | 55-68 | 68-74 | 74-82 | 82 |
| 168 | 57 | 57-7! | 71-76 | 76-85 | 85 |
| 170 | 58 | 58-72 | 72-78 | 78-87 | 87 |
| 172 | 59 | 59-74 | 74-80 | 80-89 | 89 |
| 175 | o2 | 62-77 | 77-83 | 83-92 | 92 |
| 177 | 63 | 63-78 | 78-86 | 86-94 | 94 |
| 180 | 65 | 65-81 | 81-87 | 87-97 | 97 |
| 183 | 67 | 67-84 | 84-90 | 90-100 | 100 |
| 185 | 69 | 69-86 | 86-92 | 92-103 | 103 |
| 188 | 71 | 71-88 | 88-95 | 95-106 | 106 |
| 190 | 72 | 72-90 | 90-98 | 98-108 | 108 |
| 75 | 75-93 | 93-101 | 101-112 | 112 |
Appendix 2
INDICATORS OF NEUROPSYCHICAL DEVELOPMENT IN EARLY CHILDREN
INDICATORS OF CPD IN CHILDREN IN THE 1ST YEAR OF LIFE
10 days - Aa - keeps a moving object in my field of vision (step tracking)
Ao - flinches and blinks at a sharp sound
20 days - Aa - holds a stationary object in the field of vision (adult's face)
I month- Aa “short-term fixation of gaze on a bright object, smoothly follows a moving object
Ao - flinches at a sharp sound, listens to the voice of an adult
E - the first smile in response to an adult’s conversation
Before - tries to lift and hold his head while lying on his stomach
2 months- Aa - follows movement and toy for a long time (up to 1 meter)
Ao - listens (searching turns of the head during a long sound)
E - smiles in response to speech
Before - holds his head while in an upright position, lying on his stomach, holds his head for a short time
Ra - pronounces individual sounds
3 months- Aa - fixes his gaze on a stationary object in any position. Visual concentration.
Lo - auditory concentration
E - sounds + movement + smile (locomotion) complex of revitalization, and the response to communication with him
Before - holds his head lying on his stomach, rises, leaning on his forearms, there is support for his legs with support from the armpits
Dr. - accidentally bumps into a toy hanging above him
Ra is buzzing
4 months- Aa - the mother recognizes (rejoices)
Ao - turns his head towards the sound, finds with his eyes the invisible source of the sound
E - laughs loudly in response to communication
Do - the same as in E + turn from back to stomach
Dr - "grabs toys"
Ra - buzzes for a long time
N - holds the bottle, mother's breast when feeding
5 month- Aa - distinguishes between strangers and friends (reacts differently)
Before - stands without bending legs with support, rolls over from back to stomach
Ra - hums for a long time, loudly, melodiously
Dr - grabs, holds for a long time and plays with a toy, takes a toy from the hands of an adult
And - eats thick food from a spoon
6 months- Before “turning from stomach to back, crawling, sitting
Dr - takes toys from any position, uses them for a long time
engages, moves from hand to hand
Ra - first individual syllables (beginning of babble)
And - eats well from a spoon, taking it off, I write with my lips from a spoon
7 month- Do - crawls well in different directions
Dr - moves the toy from hand to hand, knocks the toy, waves it, throws it
Ra - syllables (denet), babbles for a long time
Rp - to the question “where?” finds a familiar object
8 month- Before - he sits down, sits, lies down, gets up, walks (stepping over)
Dr. - plays with toys for a long time and in a variety of ways, imitates the actions of an adult (rolls, knocks...)
Ra - repeats syllables loudly
RP - but upon request, repeats previously learned “okay”, “goodbye”, “give me a pen”
N - he eats a cracker, a crust of bread, drinks from a cup held by an adult
9 month- Before - walks by the hands, maybe, holding on to move from the pre-
meta to the subject
Dr - acts with objects according to their intended purpose
Ra - imitates adults, repeating after them the syllables in his babble
RP - “knows its name, finds objects upon request, regardless of their location
N - “knows how to drink from a cup well, is calm about the process of sitting on a potty
10 month- Before - climbs and enters a low surface and then descends from there
Dr - opens, closes, takes out, puts in
Ra - imitates adults, repeating after them the syllables that
was not yet in his babble
Ri - knows the names of body parts, gives an item upon request
N - skills are consolidated 9 months
11 month- Before - stands independently, walks with the support of the first hand
Dr - stacks cubes, pyramids, performs actions according to the words of an adult
Ra - pronounces the first words of designation (dai, na, av, pa, ba, etc.)
Ree - the first generalizations in understandable speech (if asked, finds any balls, cars, watches), knows the elements of the requirement
N - drinks from a cup
12 month- Up to - walks independently, without support
Ra - knows 10 words, easily imitates new syllables
Ri - fulfills demands and instructions (find, give, bring, put in place, NOT), knows many names
N - takes the cup himself, drinks it himself, puts it on the table himself
INDICATORS OF CPD IN CHILDREN IN THE 2nd YEAR OF LIFE
I year - I year 3 months
Sensory development (C) - while playing, distinguishes between 2 objects of different sizes (for example, 2 cubes)
General movement (TO)) - walks for a long time, changes positions (squats, bends)
Game (I) - can reproduce learned actions in the game (feeds a doll, assembles a pyramid)
Active speech (RA) - uses babbling and lightweight words
(mashiya - "bi-bi", dog - "av-av"
Speech comprehension (RP) - the stock of understood words increases significantly
Skills (II) - independently eats thick food with a spoon
I year 3 months - 1 year 6 months
Sensory development (C) - from objects of different shapes (3-4) according to the proposed pattern and word, selects objects of the same shape (a cube to a cube)
General movements (GMO) - movements that are more coordinated - steps over an obstacle with an extended step (for example, over a stick lying on the floor)
Game (I) - can reproduce actions often observed in life (combing a doll’s hair, washing its face, etc.)
Active speech (RA) - in a moment of surprise or strong interest, names objects
Speech comprehension (RP) - finds a word among several outwardly similar objects - two identical in meaning, but different in color and size
Skills (N) - independently eats liquid and writes with a spoon
I year 6 months - I year 9 months
Sensory development (C) - while playing, distinguishes three objects of different sizes (for example, 3 cubes)
General movements (GMO) - can walk on a surface 15-20 cm wide.
at a height from the floor 15-20 cm
Game (I) - builds a “gate”, “bench”, “house”
Active speech (RA) - uses two-word sentences
Speech comprehension (RP) - answers an adult’s questions when looking at plot pictures
Skills (N) - knows how to partially undress with a little help from adults
1 year 9 months - 2 years
Sensory development (C) - selects 3-4 specific colors according to the image upon request
General movements (GMO) - steps over obstacles alternating
Game (I) - reproduces several sequential actions, i.e. beginning of the plot
Active speech (RA) - uses two-word sentences and pronouns in communication
Speech comprehension (RP) - understands the story without demonstration about events that were in the child’s experience
Skills (I) - partially puts on clothes, with a little help from an adult
INDICATORS OF CPD IN CHILDREN 3 YEARS OF LIFE
2 - 2.5 years Rag - (grammar) speaks in verbose sentences
Once - (questions) questions appear “where?” and “where?”
Sf - (shape) selects geometric shapes from various materials according to the image
Sc - (color) selects various objects of 4 primary colors according to the image
And - are of a plot nature, where the actions are interconnected and there are at least 3 scenes
K - (advisory activity) makes simple plot buildings from cubes or plasticine and names them
But - (dressing) is fully dressed, but not buttoned or laced
Nk - (feeding) eats carefully
Before - steps over an obstacle on the floor up to 20 cm with an extended step
2.5 - 3 years Rag - uses subordinate clauses, complex sentences
Rav - the questions arise “when?” and "why?"
Sf - correctly uses geometric shapes and knows their names
SC - knows the names of 4 primary colors
And - the role-playing game begins
K - plot buildings
Iso - (image) depicts simple objects with a pencil or paints and names them
But - fastens and ties with a little help
Nk - uses a napkin as needed without reminder
Before - steps over obstacles 10-15 cm high or 35 cm long in alternating steps
CPD INDICATORS FOR CHILDREN 4-8 YEARS OLD
Evaluation criteria: “corresponds to the norm” or “with deviations”
1. Thinking and speech.
Corresponds to the norm: Able to group simple objects, but to classes: furniture, dishes, animals, birds, etc.; classifies pictures and identifies the odd one among them (unlike the others); puts together cut pictures from 3 parts. Composes a story based on a plot picture, answering an adult’s questions - with deviations: Groups objects according to unimportant characteristics:
for example, by color.
2. Motor skills.
Corresponds to the norm. General: can jump on two legs at the same time, in place and moving forward; balances on one leg for about 5 seconds.
Manual: always or sometimes fastens buttons and zippers independently. Always or sometimes ties his own shoelaces.
With deviations: Cannot jump in place and moving forward:
pushes off with one leg or does not leave the floor. Never fastens buttons or ties his own shoelaces.
3. Attention and memory.
Corresponds to the norm. Attentive, collected. Poems according to age,
remembers quickly, firmly or slowly, after many repetitions, but generally successfully. Of the 4-5 objects shown, he remembers the names of 1-2 after the adult removes them.
4. Socialization.
Corresponds to the norm. Knows how to play with other children without quarreling and respecting
rules the game. Knows his first name, last name, gender.
With deviations. He often quarrels with other children, gets offended, and fights.
Avoids other children, likes to play alone, has no friends in kindergarten or in the yard.
5. Mental health.
Corresponds to the norm. No deviations
With deviations. The presence of deviations of a somatovegetative, emotional, psychomotor nature.
I. Thinking and speech.
Corresponds to the norm. Able to compose a story from a picture from several
sentences with open and hidden meaning. Correctly answers the question which hero is in this situation. Builds and composes various patterns based on samples (from blocks, mosaics, Legos).
4 deviations. When composing a story, he cannot answer the question of how
the hero finds himself in this situation, does not understand the meaning of the picture, listing the hero’s actions instead of retelling the plot.
2. Motor skills.
Corresponds to the norm. General: knows how to jump in place with one leg moving forward. Manual: dresses and undresses completely independently always or almost always. Draws a human figure from 3-6 parts.
Deviations. Can't jump on one leg. Never completely
does not dress or undress or does this very rarely.
3. Attention and memory.
Corresponds to the norm. Attentive, collected. Depending on your age, you memorize poems quickly, firmly, or slowly after many repetitions, but in general you successfully memorize tongue twisters or counting rhymes. Remembers the sequence of pictures laid out on the table (5) and finds identical details or objects in two pictures placed next to each other.
With deviations. Absent-minded, inattentive, often “switches off.” Has difficulty memorizing poetry.
4. Socialization.
Corresponds to the norm. Knows how to play with children of different ages, without quarreling, following the rules of the game.
5. Mental health
Corresponds to the norm. No deviations.
With deviations. The presence of deviations of a somatovegetative and emotional, psychomotor nature.
I. Thinking and speech.
Complies with the norm. He can compose a 2-3 picture story with the development of the plot, reflecting in it the events of the past, present and future. Solves simple logic problems (guesses riddles, picks up missing objects in a row).
Understands the meanings of all words from everyday vocabulary, names what individual objects are made of.
With deviations. When telling a story, he cannot answer the question of how the hero got into this situation and how it will all end.
2. Motor skills.
Corresponds to the norm. General: knows how to perform a standing long jump with a result of at least 40 cm. Manual: knows how to carefully paint a circle with a pencil with a diameter of 2 cm, in no more than 70 seconds. Draws a person from 6 parts.
With deviations. Does not know how to perform a standing long jump or shows a result of less than 40 cm. Inaccurately paints the circle (frequently and roughly crosses the line, many large gaps) or spends more than 70 seconds on it.
3. Attention and memory. - corresponds to the norm. Attentive, collected. According to age, he remembers poems and fairy tales quickly, firmly, or slowly, after many repetitions, but on the whole successfully. Remembers 68 words and single-digit numbers named by an adult.
With deviations. Absent-minded, inattentive, often “switches off.” It is difficult and fragile to memorize poetry.
4. Socialization. - corresponds to the norm.
Knows how to play with other children without quarreling and following the rules of the game. Evaluates the actions and behavior of others. Gives self-esteem. Knows the name and patronymic of his parents. Knows how to find his home, what to do if he loses someone else's toy, etc.
With deviations. He often quarrels with children, gets offended, and fights. Avoids other children and likes to play alone. Has no friends in kindergarten or in the yard.
5. Mental health. - corresponds to the norm.
With deviations. No deviations. The presence of deviations of a somatovegetative, emotional, psychomotor nature.
Appendix 3
SOCIAL DISADVANTAGE
Definition: Social disability in health is defined as a deficiency in an individual arising from an impairment or limitation in a life activity in which the person can perform only limited or cannot perform a role that is considered normal (depending on age, gender and social and cultural factors) for this individual.
Characteristics: Social handicap refers to the meaning given to an individual's position and experience when it is deviant from the norm. It is characterized by a discrepancy between an individual's actions or position and the expectations in this regard of the individual himself or the definition of the group of which he is a member. Thus, social disability is the socialization of an impairment or disability and, as such, reflects the cultural, social, economic and delusional consequences for the individual that flow from the presence of an impairment or disability.
Classification: It is important to understand that the social handicap nomenclature is neither a taxonomy of social disadvantages nor a classification of individuals. Rather, it is a classification of circumstances in which persons with disabilities often find themselves, which place such individuals at a disadvantage, from the point of view of social norms, in comparison with other people.
List of meters
1. Social impairment due to limited physical independence
2. Social disadvantage due to limited mobility.
3. Social impairment due to limited ability to engage in normal activities.
4. Social disadvantage due to educational ability.
5. Social disability due to limited ability to perform professional activities.
6. Social insufficiency due to limited economic independence.
7. Social disability due to limited ability to integrate into society.
Social rehabilitation technology is a sequence of actions by a social work specialist consisting of a set of methods, techniques and procedures that contribute to the restoration of the social status of a disabled person and the achievement of his financial independence. It includes social and everyday adaptation, social and environmental orientation, socio-cultural, socio-pedagogical, socio-psychological rehabilitation, physical education and health activities and sports.
Social and everyday adaptation involves the formation of the readiness of a citizen with disabilities for self-care, movement and the development of his independence in orientation in time and space (orientation on the ground, knowledge of the infrastructure of a metropolis, city, rural settlement).
Social-environmental orientation is an algorithm for developing a disabled person’s readiness to communicate, independently comprehend the environment, solve life situations, build and implement life plans.
One of the main forms of social adaptation and social-environmental orientation of citizens with disabilities can be a practical lesson. This form of training for a disabled person is carried out under the guidance of a social work specialist and serves to consolidate social skills in the field of catering, body care, clothing and footwear, and housing. Clients explore enterprises and public service institutions and ways to spend their leisure time. During practical classes, a social work specialist prepares them for independent family life.
An important form of social adaptation and social-environmental orientation of disabled people are excursions. They can be divided into observation tours and workshops in accordance with the role of the disabled person (observer or practitioner) during the visit to the institution.
An observation tour can be carried out to familiarize yourself with the object being studied (shop, post office, library, etc.) During the excursion, disabled people develop ideas about social infrastructure. This type of excursion must be organized in such a way that disabled people not only observe the objects, but are also able to perform certain actions themselves, seeing the personal example of a social work specialist and the people around them. For example, when visiting a store, a disabled person develops not only orientation skills in the sales area, but also acquires knowledge about the purpose of various departments, the ability to choose a product that suits him at a price, ask for the required product from the seller, pay for a purchase, etc. The excursion allows you to include a person with disabilities in the social environment, bringing him as close as possible to the natural conditions of organizing life activities.
The workshop excursion involves organizing the use of social skills by a disabled person in a real situation. For example, when a disabled person goes to the store, chooses what to buy, calculates his budget and pays for the goods, he does it independently; a social work specialist is present here as an observer.
The development of social skills of a disabled person occurs in the socio-cultural environment. It is represented by social institutions (state, family, church, etc.), traditions, spiritual values, which perform the function of social orientation of a citizen with disabilities in society and are formed by summing up the social experience of many generations.
A disabled person’s holistic understanding of the world and people’s lives occurs as a result of visiting cultural and art institutions: theaters, museums, concerts, going to the cinema, etc. Social rehabilitation of a disabled person in this case is carried out with the help of spiritual values transmitted to him in a creative form. A person with disabilities has a feeling of joy from what he sees, a desire to try himself as an actor, musician, competitor, member of a circle, studio, club, etc.
List of measures for social rehabilitation in accordance with the order of the Ministry of Health and Social Development of the Russian Federation “On approval of the forms of an individual rehabilitation program for a disabled person, an individual rehabilitation program for a disabled child, issued by federal state institutions of medical and social expertise, the procedure for their development and implementation” dated August 4, 2008 . N 379 n includes sociocultural rehabilitation, which can be understood as a set of methods and techniques for organizing leisure time for people with disabilities (opening clubs, circles, sections, holding holidays, competitions, anniversaries and other sociocultural forms) aimed at restoring the social status of a citizen with disabilities. The forms of sociocultural rehabilitation of disabled people are: amateur art concerts; opening days of art exhibitions; classes in a musical and dramatic group, vocal studio, craft school, Decorative Costume studio, in embroidery, knitting, sewing, sculpture, choreographic studio, etc.
One of the forms of sociocultural rehabilitation is the international film festival about the life of people with disabilities “Cinema without Barriers,” which has been held since 2002 by the public organization of disabled people “Perspective.” The festival organizes master classes with directors, meetings with actors, and children's programs. This form of sociocultural rehabilitation allows young people with disabilities to see the life of citizens with disabilities who have an active life position, are self-confident and successful in life.
Sociocultural rehabilitation of disabled people is organized in the form of classes of a musical and dramatic group of citizens with disabilities. The regional public organization for social and creative rehabilitation of children and youth with developmental disabilities and their families “Circle” (Moscow) has developed an original model for introducing a child with disabilities into theatrical activities. At the beginning, role-playing games are held for children and youth with disabilities, and folk tales are staged. Subsequently, the young man, having experience in theatrical activities, comes to the studio, where a role-playing play is staged. The theater studio student is supported by a team of teachers and theater specialists (director, musician, artist, etc.). A young man with disabilities takes an active part in choosing a play and its analysis, works with the artist, participates in the distribution of roles, discusses his role individually with the director and in a group, and shows the performance together with the rest of the actors. The social rehabilitation effect of this form is ensured by the creative process, which captivates the disabled person; he comes to meetings at the theater studio with great desire and interest and is involved in the collective work of preparing the performance.
The next form of sociocultural rehabilitation of disabled people is a competition. An example is a beauty contest for women with disabilities, which was held in Yakutsk and was called “Mistress of Fate.” During preparation for the competition, the participants developed the script for their performance together with the organizers. Women with disabilities learned self-presentation skills from stylists and designers. They demonstrated their talents in four categories: “Business Card”, “Intellectual”, “Hobbies”, “Style and Image”.
It is necessary to note the special importance in the technology of social rehabilitation of disabled people of various associations (clubs, circles, sections, etc.). The internal motive that promotes the inclusion of a person with disabilities in the work of the association is based on interest in what happens at meetings, collective affairs, where the participant develops independence in expressing his thoughts, views and achieves self-realization in joint activities.
An important means of technology for social and sociocultural rehabilitation of disabled people is an association (club, circle, studio, etc.). Good experience has been accumulated in the youth club for disabled people “Nika” of the Center for Rehabilitation of Disabled People “Izgelek” (Naberezhnye Chelny). The following social and rehabilitation activities are held for young disabled people and members of the association: a personal exhibition of artistic works by one of the club members; holiday Birthday Day; concert dedicated to Mother's Day; charity evening “We Can”; participation in the sports competition among disabled athletes. Members of the Nika club make home visits and establish friendly relationships with young disabled people with limited mobility. The association has a club council, which includes activists from among young disabled people who have their own responsibilities: maintaining financial records, organizing events, taking photographs, and providing transportation. The inclusion of all members of the association in the work of the club is achieved through the organization of small groups of non-permanent composition to organize and conduct the most important events. For example, to prepare for “Birthday Day,” the head of the club forms a small group of 3 girls or young men. They develop a scenario for the holiday, prepare the hall, invite guests, give tasks to the rest of the holiday organizers (prepare the decoration of the room, buy everything necessary for the event, distribute invitations, etc.).
In the already mentioned order of the Ministry of Health and Social Development of the Russian Federation on the approval of the forms of an individual rehabilitation program for a disabled person (2008), social rehabilitation includes measures for social and pedagogical rehabilitation that contribute to providing assistance to disabled children and teaching them self-service skills, behavior in everyday life and public places , self-control, communication skills and other categories of life activity.
Social rehabilitation of disabled people also includes measures for socio-psychological rehabilitation (psychological counseling, psychodiagnostics and personality examination of a citizen with disabilities, psychological correction, psychotherapeutic assistance, psychoprophylactic and psychohygienic work, psychological trainings, involving disabled people in self-help groups, communication clubs, emergency (by telephone) psychological and medical-psychological assistance). The result of socio-psychological rehabilitation of disabled people is the development of their ability to navigate social situations, correctly determine the personal characteristics and emotional states of other people.
Physical education and health activities and sports are also included in the list of social rehabilitation activities for citizens with disabilities and are used to restore their health, develop self-discipline, strong-willed qualities, etc. As a rule, social rehabilitation of a disabled person through physical education and health activities is organized by a specialist in physical education and sports. The tasks of his activities include: conducting physical education and health activities, informing and consulting citizens with disabilities regarding the choice of a list of physical education exercises and the type of sport that is most suitable for him. For example, disabled people with diseases of the visual, hearing, and musculoskeletal system can engage in biathlon, bowling, cycling, judo, wheelchair basketball, wheelchair volleyball, horse riding, athletics, table tennis, swimming, archery, sit-hockey, chess, football, etc.
A physical education and sports specialist individually teaches a disabled person the skills to perform physical education exercises. Individual physical education and health work with a disabled person is carried out taking into account the following recommendations: the duration of the lesson and physical activity depend on the health status of the disabled person, the lesson begins with a repetition of the exercises mastered in the previous training. If a person with disabilities cannot repeat the exercise, the instructor needs to offer him an easier option for completing the task or return to the difficult exercise later. It is important that a physical education and sports instructor use game techniques in teaching disabled people to ensure that they develop interest and desire to attend physical education and health activities.
To develop strong-willed qualities and demonstrate the level of sports training of disabled people, physical education classes are conducted in health groups consisting of 2 to 5 people. A specialist in physical education and sports can organize master classes for people with disabilities and, as a coach leading a master class, invite a professional athlete in a sport that is practiced by citizens with disabilities. Physical education classes are usually held in the gym of a social service institution, where there are exercise machines and sports equipment. All physical education and health activities for disabled people are organized by a specialist in physical education and sports under the supervision of a doctor and nurse.
The technology of social rehabilitation of a disabled person is carried out using the following stages:
Stage I. Organization of social counseling for citizens with disabilities. A social work specialist studies an individual rehabilitation program for a disabled person and provides him with social and advisory assistance. In accordance with the Federal Law “On Social Protection of Disabled Persons in the Russian Federation” dated November 24, 1995 No. 181-FZ, an individual rehabilitation program for a disabled person includes types, forms, volumes, terms and procedures for the implementation of medical, professional and other rehabilitation measures.
At this stage, a social work specialist provides information on the list of social services that provide a solution to the problem of a disabled person. A citizen with disabilities makes a decision to receive social services and fills out an application to provide him with the necessary assistance.
Stage II. Conducting social diagnostics aimed at studying the problem of a disabled person. During social diagnostics, a social work specialist studies the communication of a disabled person with others (family, friends, neighbors, colleagues, etc.), his role position in the family, interpersonal relationships outside the home; compliance by a citizen with disabilities with moral, ethical, social, legal, sanitary and hygienic standards. At the end of this stage, the social work specialist fills out a social diagnostic program for the disabled person and plans together with him the date for visiting him at home.
Stage III. Conducting social patronage for citizens with disabilities. A social work specialist, conducting an examination of a disabled person at home, assesses the social and living conditions of his place of residence.
Stage IV. Implementation of an individual rehabilitation program for a disabled person. At this stage, a multidisciplinary team (doctor, psychologist, physiotherapist, speech therapist, social work specialist, etc.) carries out measures for the medical, professional, social rehabilitation of a citizen with disabilities. A social work specialist, in accordance with the existing potential of a disabled person, taking into account his age characteristics, promotes recovery after the loss (due to an illness or injury) of sanitary and hygienic skills, the development of motor skills, and coordination of movements.
Training a disabled person in skills and abilities takes place in a room for social adaptation, where there is a gas stove, running water, appropriate equipment with items and tools for cooking, an electric iron, ironing board, washing machine, communication equipment (telephone), audio, video equipment: TV, audio recorder, video recorder. To train a disabled citizen in independent living skills, you can use a residential module (hallway, living room, bedroom, kitchen, bathroom, toilet), equipped with furniture and technical rehabilitation equipment.
In practical classes, a citizen with disabilities gains an understanding of social infrastructure services and learns how to use them, namely, studies the purpose of:
– food and department store stores (including rules of conduct and procedures for purchasing the necessary goods);
– household services (shoe repair shops, sewing workshops, dry cleaners, laundries);
– savings banks where utility bills are paid;
– railway and bus stations;
– communication institutions (post office, telegraph, internet club);
– polyclinics, public and private outpatient healthcare institutions, hospitals;
– cultural and educational institutions (libraries, theaters, exhibition halls, museums, professional higher, secondary specialized educational institutions).
A disabled person can voluntarily, at his own request, take part in socially useful and labor activities (work in production workshops, improvement of the territory of a social service institution). Depending on the degree of employment and type of work activity, payment for his work is possible. He is subsequently included in everyday activities organized in a social service institution, which involves being on duty in the dining room, maintaining order and good sanitary and hygienic condition of his room, helping more weakened clients, etc.
Training a citizen with disabilities in social-environmental orientation skills begins with studying the rules of communication in various spheres of life (in the family, educational institution, public organizations, healthcare institutions, cultural institutions, enterprises, etc.). A social work specialist consolidates the acquired knowledge of a disabled person about the rules and methods of communication by simulating life situations (meeting with a familiar person; visiting a cafe; making a request to a stranger, etc.). Here, citizens with disabilities learn social independence based on the skills of independent living (managing money, exercising civil rights, participating in public activities, etc.). A social work specialist, cultural organizer, and physical education and sports specialist train people with disabilities in leisure, physical education, and sports skills. A person with disabilities acquires knowledge about various types of sports and leisure activities and learns to use special technical means for this. The result of social rehabilitation of a disabled person can be the full or partial achievement of the ability to self-care, the restoration of his skills in everyday activities and social status.
Stage VI. Social and everyday life of a citizen with disabilities. This stage involves equipping the place of residence of a disabled person with the necessary equipment and technical means for his independent, comfortable life. A social work specialist provides social patronage to a disabled citizen at home and provides assistance in establishing relationships with close circles (neighbors, relatives, friends, etc.).
One of the effective examples of organizing social and living arrangements for people with disabilities is the organization of social apartments at the state institution “Comprehensive Center for Social Services for the Population of the Admiralteysky District” in St. Petersburg. The residential building has two collective apartments for citizens with disabilities, which have the necessary equipment (washing machine, food processor, electric cooker, etc.). There is a 24-hour presence of a social worker who provides the necessary assistance to a disabled person if he encounters difficulties during his independent living.
Social rehabilitation of disabled people, consisting of social-environmental orientation, social and everyday adaptation, socio-cultural rehabilitation, socio-pedagogical and socio-psychological rehabilitation, physical education and recreational activities and sports, creates and provides conditions for the social integration of a disabled person, restores his social status, his abilities to independent social, family and everyday activities.
Social and everyday adaptation involves the formation of an individual’s readiness for everyday, work activities and the development of independence with orientation in time and space (orientation to the area, knowledge of the infrastructure of a metropolis, city, rural settlement).
Social adaptation is facilitated by the creation of the necessary conditions for the independent existence of a disabled person. The living environment for a disabled person is of enormous importance, since in it he spends most, if not all, of his life.
Social and living conditions constitute an important component of social and living rehabilitation, reflecting the state of providing a disabled person with basic comfort in residential and auxiliary premises. Providing a comfortable and safe living environment is currently receiving special attention from government agencies. Legislation for disabled people provides for an increase in sanitary standards for living space and its architectural and planning changes.
The social welfare of disabled people is provided not only in individually equipped apartments, but also in specially equipped modified houses with a range of social services or in specialized boarding houses. When constructing or reconstructing a room intended for a disabled person, it is necessary to take into account the aesthetic appearance and interior, which create a feeling of psychological comfort and convenience; comply with standards for space and equipment with technical rehabilitation equipment and assistive care devices.
Adapting the home of a disabled person to its functionality and equipping the premises with special auxiliary devices to facilitate self-care are of great importance. An individual approach to a disabled person and creative solutions on the part of nursing staff in the manufacture of various devices that simplify self-service are important here. The disabled person must also be provided with individual technical means of rehabilitation and devices that facilitate movement, orientation, and communication.
It is also important to train and educate family members of a disabled person on various issues: the nature of the disease that a disabled person has, emerging limitations in life, associated socio-psychological and physiological problems, types and forms of social assistance for disabled people, types of technical means of rehabilitation and features of their operation . Relatives and persons providing assistance to a disabled person must be trained to use technical means, especially those designed to facilitate the care of a disabled person.
Social and everyday adaptation consists of the following elements: self-service, independent movement, work activity, readiness to work with household appliances and communications.
Self-care presupposes the autonomy of the individual in organizing a balanced diet, the ability to perform daily household activities, the development of personal hygiene skills, and the ability to plan one’s daily routine, fully combining work activity and rest.
Independence of movement is the autonomy of the individual when moving in space, knowledge of the purpose of vehicles to achieve their goals within the framework of everyday, social, professional activities, orientation on the terrain, knowledge of the general patterns of organizing the infrastructure of any settlement.
Inclusion in labor activity involves the development of readiness and internal motivation for professional activity with the aim of self-sufficiency and economic independence. Forming the ability to work involves creating conditions in the family, social service institution, ensuring the acquisition of social experience, encouraging the individual’s activity in mastering skills that ensure the client’s subsequent self-realization and success in future professional activities. The client must be able to realize the personal and social significance of his work, which also ensures the achievement of self-realization. A person who finds himself in a difficult life situation must invest his own resources in order to ensure his life. Without activating the client's resources, socio-economic assistance of any kind leads to dependency.
The client’s social and everyday adaptability, formed in this way, presupposes the development of his ability to autonomously organize provision for himself and his family, socio-economic independence from government institutions, readiness to change his life, professional activities in accordance with changing aesthetic, cognitive needs and self-actualization needs.
The sequence of formation of social and everyday adaptability is determined by the following stages.
First stage. Conducting social diagnostics. A social work specialist determines the client’s level of readiness for work, self-service, and socio-economic independence.
Second stage. Accompanying the client to achieve autonomy in organizing everyday life. At this stage, there is development or recovery after the loss of sanitary and hygienic skills, development of motor skills, and the ability to coordinate one’s movements.
Third stage. Accompanying the client to achieve autonomy when moving in space. The social work specialist continues to promote self-care and personal hygiene skills through individual and group activities.
Fourth stage. Accompanying the client to achieve his autonomy in his work. In accordance with the client’s internal motivation, it is necessary to create appropriate conditions in a social service institution or through cooperation with industrial, agricultural and other enterprises and firms. Labor activity ensures the client’s self-realization, presupposes results and contributes to a feeling of joy from the work performed. Depending on the degree of employment and type of work activity, payment for his work is possible.
The priority forms of social adaptation are workshops organized in the conditions of a social service institution, as well as excursions. They need to be organized in such a way that clients not only observe certain objects, but are also able to perform certain actions themselves, seeing the personal example of a social work specialist and the people around them.
Thus, to summarize, we can say that social adaptation has the ultimate goal of adapting a person to living conditions in his new status of “disabled person.” This process involves not only a specialist who helps a person with changed physical capabilities adapt to carrying out life activities in familiar conditions, but also a disabled person, who must independently strive to find ways to achieve a relatively independent lifestyle. Social adaptation is carried out taking into account the individual characteristics of the client. When constructing workshops, the specialist is based on the existing level of development of the client’s ability to autonomously organize provision for himself and his family, the ability to carry out daily household activities, independently organize his daily routine, and also gain work experience.
3.3.9. Social and everyday adaptationThis section examines the current state and dynamics of the child’s development of social skills and abilities, his adaptability to the conditions of the surrounding reality. For quantitative assessment, two subscales are proposed: “Self-service skills” and “Social and everyday orientation.” The assessment is made within 10 points, the average score is included in the overall scale. Information about the child’s achievements and difficulties, the formation of new skills, etc. is entered into the “Comments” section of the program on the “Social and Everyday Adaptation” scale.
Self-care skillsCriteria for monitoring the development of self-care skills:
- personal hygiene;
- dressing and undressing
- meal.
- Level 1 (0-2): does it only with the help of an adult, cannot cope independently;
- Level 2 (3-5): Can handle a lot of things independently, but requires help or support.
- Level 3 (6-8): copes independently.
- Level 4 (9-10): copes independently, helps and teaches others, actively cares for the less capable.
Criteria for monitoring the development of social and everyday orientation skills:
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