Sinusitis

Types and conditions of social adaptation of disabled people. Features of social adaptation of a young disabled person

Acquisition and improvement by disabled people of professional knowledge, skills and abilities, taking into account their acquired or existing specialty (profession);

Acquisition, restoration and development of the resources available to disabled people labor abilities and consolidating them in the process of labor activity;

Increasing the competitiveness of people with disabilities in the labor market;

Employment of disabled people in accordance with the acquired or existing specialty (profession).”

However, it is worth noting that these activities are largely aimed at employment and employment of mainly disabled people with physical limitations or light forms disabilities (hearing, vision, etc.), rather than people, for example, with intellectual, mental and multiple developmental disabilities.

The period of adaptation of disabled people to work can range from six months to one year. Often, due to the severity of the disability of a disabled person, all this time is spent not on adapting disabled people to work as such, but on “adapting” to the workplace, team, acquiring skills to interact with others, and becoming familiar with the production features of the organization.

Financing of measures to adapt disabled people to work from the Social Protection Fund of the Ministry of Labor and Social Protection of the Republic of Belarus is carried out by labor, employment and social protection authorities in the form of allocating funds to employers for:

Purchase of equipment;

Purchase of materials;

Purchase of workwear;

Compensation for the costs of paying disabled people.

Compensation for the costs of paying disabled people is made by labor, employment and social protection authorities to employers on a monthly basis. Which imposes certain obligations on the employer. Thus, employers submit a monthly certificate to the labor, employment and social protection authorities about the costs of remuneration for disabled people, indicating the period for which the payment was accrued. wages. At the same time, these costs include accrued wages for work performed and time worked, the amount of mandatory insurance contributions to the Social Protection Fund of the Ministry of Labor and Social Protection of the Republic of Belarus and insurance contributions for compulsory insurance from industrial accidents and occupational diseases. The body for labor, employment and social protection, within five days from the date of receipt of such a certificate, provides payment documents to the territorial bodies of the state treasury for the transfer of funds to compensate for the costs of paying disabled people to the current (settlement) account of the employer.

To carry out the adaptation of disabled people to work, it is mandatory that they have a specialty (profession) (except for types of activities that do not require professional training) in accordance with the individual rehabilitation program for a disabled person (hereinafter - IPR), formed by the medical and rehabilitation expert commission (hereinafter - MREK) .

In accordance with paragraph 17 of the Resolution of the Council of Ministers of the Republic of Belarus “On approval of the Regulations on medical and rehabilitation expert commissions” dated October 16, 2007 N 1341, specialized, interdistrict (district, city) commissions “carry out medical and social examination, including establishing the fact of the presence of disability, the group (degree of health loss in children), the cause, date of onset and duration of disability, make labor recommendations.” That is, it is the MREK specialists who issue a medical opinion (on admission to work in a certain specialty), on which the IPR is based. As for people with intellectual, mental and multiple developmental disabilities, they, as a rule, do not receive such a conclusion and, accordingly, are not recognized as unemployed.

The IPR is one of those documents that a disabled person must present to the employer when concluding an employment contract (Article 26 Labor Code Republic of Belarus). Hiring a disabled person without this document is not allowed. The IPR of a disabled person determines the complex rehabilitation activities, specific types and timing of rehabilitation of a disabled person, as well as those responsible for its implementation, and consists of three sections (programs):

Medical rehabilitation;

Vocational and labor rehabilitation;

Social rehabilitation.

The IPR determines the types of activities that are contraindicated for a disabled person to engage in, as well as recommendations for his social and labor rehabilitation. As a rule, it is the health of the disabled person that is taken into account first. Often, people with disabilities can be recommended those types of activities for which there are not enough vacancies in the regions of their residence, i.e. market conditions are not taken into account.

Not all disabled people who want to find a job turn to the employment service. This happens by various reasons. For example, the vacancies offered do not always require the level of qualifications that are available to disabled people with appropriate education who expect to receive a decent remuneration for their work. One of the reasons is also that people with disability groups I or II in practice cannot register with the employment service, since their degree of disability is too great. Or any job is not suitable for a disabled person, because... the workplace needs to be adapted to their individual needs.

Adaptation of disabled people to work can be carried out in accordance with the directions of labor, employment and social protection authorities on a contractual basis, both for individual entrepreneurs and in organizations of any legal form.

To organize the adaptation process, the employer must submit to the labor, employment and social protection authorities at the place of creation of the job:

An application indicating a list of specialties (professions) for which it is possible to organize the adaptation of disabled people to work, the number and list of vacant jobs, as well as the need to create new jobs and opportunities for further employment of disabled people;

Calculations of financial costs for organizing the adaptation of disabled people to work (purchase of equipment, materials, special clothing, wages for disabled people).

Department (department) for labor, employment and social protection of urban (district) executive committees prepares and sends to the committee on labor, employment and social protection of the regional executive committee (hereinafter referred to as the committee) a conclusion on the advisability of organizing the adaptation of disabled people to work, with documents attached, within three days from the date of receipt of the application. The Committee, in turn, reviews the submitted documents and makes a decision on the advisability of organizing the adaptation of disabled people to work for a given employer within seven working days from the date of their receipt, which is informed in writing by the labor, employment and social protection agency, which informs the employer. Thus, a list of employers who are ready to organize the adaptation of disabled people to work in specific specialties (professions) is being formed.

A disabled person, in turn, to receive a referral for adaptation to work must contact the labor, employment and social protection authority at the place of registration as an unemployed person.

The body for labor, employment and social protection, based on the IPR and taking into account the list of employers who are ready to organize the adaptation of disabled people to work in specific specialties (professions), taking into account the specialization (profession) of the disabled person, makes an appropriate decision and issues a referral to the disabled person to the employer for adaptation to work. In the event of a refusal to issue a referral to a disabled person for adaptation to work, he has the right to become familiar with the reasons for the refusal indicated in a written notification from the labor, employment and social protection agency.

After sending a disabled person for adaptation to work, the labor, employment and social protection body concludes an agreement with the employer on organizing the adaptation of the disabled person to work.

The employer also enters into a fixed-term employment contract for adaptation to work with a disabled person referred by the body for labor, employment and social protection, for a period determined by the agreement on organizing the adaptation of a disabled person to work. The employer is obliged to provide the labor, employment and social protection body with a copy of the relevant order within five days from the date of issuing the order to hire a disabled person. A disabled person is removed from the unemployment register from the date of his employment.

As for the “adaptation plan,” there is no unified system regarding its content. Sometimes in different regions of our country, employment centers require employers to provide adaptation plans that differ in content.

By the time of completion of adaptation to work, a disabled person, by decision of the employer, can be hired for a permanent job or fired. About his decision to dismiss or continue employment with a disabled person, the employer is obliged to submit to the labor, employment and social protection body a copy of the order on the dismissal of the disabled person or on his hiring within three working days.

A disabled person with whom the employer, after completing adaptation to work, did not enter into an employment contract, or with whom the fixed-term employment contract was terminated early, may be registered as unemployed again in established by law ok.

In conclusion, I would also like to note that if the employment relationship with a disabled person is not extended upon completion of adaptation to work, the disabled person has the right to rely only on himself and his family. Thus, the mechanism for adapting a disabled person to work is not focused on the “quality” of adaptation, because there is no further support for the disabled person, “adaptation” is not brought to its logical end, it is interrupted.

In my opinion, the success of a disabled person’s adaptation to work consists of a set of measures that have a positive effect on it. To achieve desired results(i.e., the employee’s eventual fulfillment of the requirements for his position) in the process of adapting a disabled person to work, a personal approach to the duration of adaptation of a disabled person is necessary in order to:

Inclusion of a disabled person in interpersonal relationships with colleagues;

Getting to know the staff, corporate rules of conduct;

Practical familiarization of the employee with his duties and requirements;

The completion of the adaptation process is characterized by the gradual overcoming of production and interpersonal problems and the transition to stable work.

Olga Triputen, PPU “Office for the Rights of People with Disabilities”

Social adaptation technology is a sequence of actions and methods of interaction between a social work specialist and a disabled person using individual and group forms of social work (games, social trainings, etc.) that promote the development of skills and abilities for inclusion in the living environment. Social adaptation includes a disabled person in an accessible social and professional sphere and the process of acquiring skills and communication skills in a small group. Social adaptation is simultaneously considered as social technology, process and result.

Social adaptation, among other things, includes a disabled person in small group and living environment, facilitates the assimilation of established norms, relationships, and patterns of behavior. A person with a disability is in search of a social environment that is favorable for his self-realization and the discovery of resources. In this case, the immediate environment of a person with disabilities health (family, club association, activists of a public organization, friends) is a small group, which are divided into formal and informal. The first ones are created according to developed regulations to carry out public, socially protective, state-sanctioned activities. These can be public organizations of citizens with disabilities, clubs, associations of families raising a child with disabilities, studios, etc. Informal small groups arise spontaneously under the influence of the common interests of disabled and healthy citizens, their joint activities and have a spontaneous organizational structure. These associations include communities of friends, educational and professional colleagues, etc.

The result of social adaptation of a disabled person is the emergence of a feeling of satisfaction with life, relationships with close circles, increased creative activity, achievement of success in communication and joint activities of a small group and living environment.

The use of technologies for social adaptation of a citizen with disabilities allows him to feel free in a small group and be involved in various types of activities. This allows a disabled person to enrich his inner world with the help of new values and social norms, and to use social experience when organizing activities in a small group.

There are several levels of social adaptation of a person with disabilities to the social environment: high, medium and low.

A high level of social adaptation is characterized by a creative attitude towards the norms and stereotypes that have developed in the environment (he makes proposals for improving communication, developing tolerance when building interpersonal relationships in a small group). A person with disabilities learns the values and norms of independent living by taking part in social, political and economic processes, free choice and access to housing, public buildings, transport, communications, insurance, labor and education. A disabled person himself is able to determine and make decisions, manage situations, he has life plans and prospects. He is satisfied with his lifestyle, strives to change his shortcomings, takes the initiative to eliminate them, and is an active participant public life. For high level The social adaptation of a disabled person is characterized by his achievement of complete self-care, a high level of health literacy, and precise implementation of medical procedures.

A disabled person with an average level of social adaptation adapts to the norms and values of a small group without changing them, assimilates generally accepted forms and ways of life characteristic of a given environment (family, club association, friends, activists of a public organization). As a rule, he is involved in activities and communication with the help of another person (parent, friend, social work specialist); his level of self-care may be slightly or moderately reduced.

A low level of social adaptation of a person with disabilities is characterized by self-isolation, seclusion, and limited contact with people due to a lack of desire to communicate and establish relationships. He does not know how to conduct a dialogue with his opponent and enters into conflict with him. He has a significant decrease in social skills and self-care skills, there is no or significantly limited leisure, labor, and professional activities, his behavior is dependent on other people, there is a lack of initiative and independence in overcoming life’s difficulties.

The following conditions contribute to the successful implementation of the technology of social adaptation of a person with disabilities: firstly, the environment of a person with disabilities contributes to the realization of his needs and the development of individuality; secondly, when the organizational culture of a small group is built on the manifestation of friendly support, respect, responsibility, and interest in each person; thirdly, the disabled person’s environment recognizes and gives positive assessment the results he achieves; fourthly, it ensures the participation of a citizen with disabilities in the social and cultural life of a small group and living environment.

The choice of technology for social adaptation of a disabled person largely depends on his life problem. For example, as a result of a previous illness, he does not always have the opportunity to be a member of a small group, engage in professional activities, visit theaters, museums that contribute to the formation social attitudes personality and introducing the disabled person to the cultural traditions and values of society. Such difficulties can be overcome with the help of complex work of social work specialists and psychologists using psychological and gaming correction methods aimed at integrating a person with disabilities into society.

The technology of social adaptation of disabled people can be implemented through such forms as games, social training, excursions, and conversations. A game as a form of technology for social adaptation of a disabled person imitates the real social environment in which a disabled person may actually find himself. In the process of social adaptation of citizens with disabilities, various types of business games are widely used: simulation games, “business theater”, etc.

Using game forms, you can imitate professional, creative activities, etc. With the help of an imitation game, a person with disabilities gains social experience in interacting with people, he masters new social roles of “student”, “manager”, etc., his range of skills expands. social skills and abilities, which allows him to be more prepared for real life. Through imitation of the social model set in play activities, a disabled person acquires forms of social behavior that were previously inaccessible to him.

The game “business theater”, as a form of technology for social adaptation of a disabled person, allows you to imitate a specific life situation and human behavior. The staging method, which is used in this game form, teaches a person to navigate various life conditions, give an objective assessment of his behavior, take into account the interests of other people, and establish contacts with them. To conduct the game, a scenario is developed that describes a specific life situation and explains to the players their functions, responsibilities and tasks.

Overall, in implementation gaming technologies, contributing to the social adaptation of a disabled person, several stages can be distinguished:

Stage I. Formation of a group and development of a game plot script. The size of the group depends on the severity of the consequences of disability and the nature of the problems of the participants, and, as a rule, consists of 2-5 people. The composition of the group is also determined by the strategy for selecting participants; it can be heterogeneous, that is, include participants with to varying degrees disability. Where the conditions of a social service institution allow, it is recommended to select participants with a similar life problem (for example, the same disability group, disease); in this case, a social work specialist will have a clear focus in choosing game forms and exercises.

Stage II. Carrying out the game. The introductory part of the lesson includes greeting and introducing disabled people to the plan for a set of games and exercises. The social work specialist meets the participants and is the first to greet everyone in a friendly, friendly manner. Then he plans the joint work, informs those gathered about the order, content and sequence of games and exercises. Next are game exercises according to the script.

Stage III. Summing up the results of the game, when there is an analysis and generalization of the social skills that the participants have acquired.

It is possible to consolidate social skills acquired with the help of gaming technologies in the form of social training, which helps a disabled person to master social norms accepted in society, productive ways of behavior and interaction, and prepares for independent life. The effectiveness of social training can be assessed according to two criteria. The first of them is the level of mastering new social skills in accordance with the tasks set in the training program, the ability to freely perform them both in training sessions and in real life. The second criterion characterizes the correspondence of the learned social experience life goals disabled person

Before social training, a social work specialist conducts individual consultations to help people with disabilities determine to what extent new social skills ensure the realization of their life goals.

At the beginning, a social work specialist completes the group and, in accordance with the composition of the participants, determines the goal, objectives and develops a training program. At the same time, it contributes to the creation positive emotions, which ensure a person’s desire to come to this group and to this trainer constantly until the end of the program. Conducting social training promotes awareness of the personal characteristics, habits and ideas of disabled people about themselves. During the training, social skills are reinforced by the disabled person during play activities, when they are “played out” life situations, which need to be resolved using new social skills for the participants. At the end of the training, the social work specialist and participants analyze and evaluate the results of the work.

The sequence of inclusion of a citizen with disabilities into the living environment and his social adaptation is carried out through several stages: carrying out social diagnostics; inclusion in a social group; training in problem solving.

In general, social adaptation as a technological process allows: to include a disabled person in a small group, to help him learn established norms, relationships, patterns of behavior, to develop skills and communication skills, to join the social and professional sphere accessible to him.

Signs of social adaptation of a disabled person are: satisfaction with their position in the group, conscious maintenance of the norms and traditions that exist in a given community, desire and willingness to enrich the content, forms and methods of interaction with others in the association, tolerance.

Disability is a specific feature of the development and state of the individual, often accompanied by limitations in life activity in a wide variety of areas.

But nowadays disability is no longer a problem for a certain circle supposedly “inferior people” This is a problem for society as a whole. And this problem is determined at the level of legal, economic, production, communication and psychological characteristics interaction of disabled people with the surrounding reality.

There are about 16 million disabled people in Russia, i.e. more than 10 percent of the country's residents . Disability, alas, is not a problem of one person, but a problem of the entire society as a whole..

Unfortunately, in Russia, people around them most often treat people with disabilities with purely medical point of view, from the position of the “medical model”, and for them a disabled person is considered to be the person who limited to one degree or another in the ability to move, hear, speak, see, write. A certain paradoxical and absurd situation is created, and very offensive for disabled people, in which this man perceived as a persistently ill person, as not meeting a certain standard, which does not allow him to work, study, or lead a normal “healthy” lifestyle. And, in fact, in our society the opinion is cultivated and formed that a disabled person is a burden to society, its dependent. This “smacks”, to put it mildly, of “preventive genetics”

Let us remember that from the point of view of “preventive eugenics”, after the Nazis came to power in Germany in 1933, the “T-4 Euthanasia Program” began to be implemented, which, among other things, provided extermination of disabled people and sick people for more than 5 years as incapacitated.

Problems for disabled people in Russia, and even in the West, are associated primarily with the emergence of numerous social barriers that do not allow disabled people to actively participate in the life of society. Alas, this situation- only a consequence of incorrect social policy, focused only on the “healthy” population and, in most cases, expressing interests of this particular category of society. The structure itself production, life, culture and leisure, as well as social services often not adapted to the needs of people with disabilities.

Let us remember the scandals with airlines, not only in Russia, but also in the West, which refused to allow disabled people with wheelchairs onto flights! And in Russia and public transport, and the entrances of the houses are not yet in to the fullest equipped with special lifts and other means. Or rather, they are almost not equipped at all. This still happens in Moscow, and even then these lifts are locked with a certain key, just like in the metro. And in small towns? What about buildings without an elevator? A disabled person who cannot move independently is limited in movement - often cannot leave the apartment at all!

It turns out that disabled people are becoming special socio-demographic group with less opportunity to move (which, by the way, is contrary to the Constitution!), lower income, less opportunity to get an education and especially to adapt to production activities, and only a small number of disabled people have the opportunity to work fully and receive wages adequate for their work.

The most important condition social and especially labor adaptation is implementation in public consciousness ideas of equal rights and opportunities for people with disabilities. It is the normal relationship between disabled people and healthy people that is the most powerful factor in the adaptation process.

As foreign and domestic experience shows, often people with disabilities, even having certain potential opportunities to actively participate in the life of society and especially to work, cannot realize them.

The reason is that a part (and often a large part) of our society does not want to communicate with them, and entrepreneurs are afraid to hire a disabled person due to established negative stereotypes. And, in this case, even measures for the social adaptation of a disabled person will not help until psychological stereotypes are broken both on the part of the “healthy” and, importantly, employers.

Let us note that the very idea of social adaptation of disabled people is “verbally” supported by the majority, there are a lot of laws, but there is still complexity and ambiguity in the attitude of “healthy” people towards disabled people, especially towards disabled people with obvious “disabled characteristics” - those who are unable to move independently ( so-called “wheelchair users”), blind and visually impaired, deaf and hard of hearing, patients with cerebral palsy, patients with HIV. In Russia, people with disabilities are perceived by society as allegedly different for the worse, as deprived of many opportunities, which generates, on the one hand, their rejection as full-fledged members of society, and on the other, sympathy towards them.

And, importantly, there is an “unpreparedness” of many healthy people for close contact with disabled people in the workplace, as well as the development of situations where a disabled person cannot and does not have the opportunity to realize himself on an equal basis with everyone else.

Unfortunately, one of the main indicators of the socio-psychological adaptation of disabled people is their attitude towards their own lives - almost half of them rate the quality of their life as unsatisfactory. Moreover, the very concept of satisfaction or dissatisfaction with life most often comes down to the poor or unstable financial situation of a disabled person, and the lower the income of a disabled person, the more pessimistic his views on his existence and the lower his self-esteem.

But it is noted that Working disabled people have much higher self-esteem and “outlook on life” than the unemployed. On the one hand, this is due to the better financial situation of working disabled people, their greater social and industrial adaptation, and greater opportunities for communication.

But, like all of us, people with disabilities experience fear of the future, anxiety and uncertainty about the future, a feeling of tension and discomfort, and for them the loss of a job is a stronger stress factor than for a healthy person. The slightest changes in material disadvantage and the slightest difficulties at work lead to panic and severe stress.

In Russia, there is a practice of employing people with disabilities or, as they say, “people with limited physical capabilities” in both specialized (for example, for the blind and visually impaired) and non-specialized enterprises. There is also legislation obliging large organizations to employ disabled people in accordance with a certain quota.

In 1995, the law “On social protection of disabled people in Russian Federation" In accordance with its 21st article, organizations with more than 100 employees are set a certain quota for hiring disabled people and employers are obliged, Firstly, allocate jobs for the employment of disabled people, and secondly, create working conditions in accordance with the individual rehabilitation program. The quota is considered fulfilled if disabled people are employed in all allocated jobs in full compliance with the labor legislation of the Russian Federation. At the same time, the employer’s refusal to hire a disabled person within the limits established quota entails the imposition of an administrative fine on officials in the amount of two thousand to three thousand rubles (Article 5.42 of the Code of Administrative Offenses of the Russian Federation).

Enterprises and employers employing disabled people are required to create special jobs for their employment, i.e. workplaces that require additional measures to organize work, including adaptation of main and auxiliary equipment, technical and organizational equipment, provision of technical devices taking into account the individual capabilities of people with disabilities.

However, most employers do not show enthusiasm when hiring people with disabilities, trying to provide them with the best various reasons, and even if hired, they will try to “get rid” of such an employee as soon as possible. The main thing that stops them is the risk associated with the ability of a person with disabilities to perform work at the proper level. And accordingly - “won’t I incur losses?”

A question related to risk: “Will a disabled person cope or not with the assigned work or task?” In general, this can be done in relation to any employee, especially since a disabled person is likely to perform his duties more diligently.

Of course, the employer will have additional difficulties and even expenses associated with providing a shortened working day, creating special conditions labor, creation of a workplace adapted for disabled people, etc. And the very adaptation of a disabled person in a work collective is more difficult than for a “normal” person, he is either “disgustedly bypassed” or “pityed”, and seeing his efforts at work, it is possible that a person with disabilities can quickly “make a living” enemies,” and around him will be fully created and provoked conflict situations and direct mobbing. But this is already a matter for the administration and team leaders, as well as “full-time” psychotherapists who “wipe their pants and skirts” in many large corporations.

Let us note that in many countries there are laws similar to the law “On social protection of disabled people in the Russian Federation”. For example, in the United States, in accordance with the law, an enterprise that refuses to provide work to a disabled person is subject to a significant fine, and companies that employ disabled people have tax benefits. However, in the USA there is no legislation on job quotas for people with disabilities, and each enterprise has the opportunity to determine its own policy in this regard.

The Swedish government encourages employers to pay individual subsidies for each disabled worker, and German labor exchanges perform professional consulting and intermediary functions in the employment of disabled people.

In Canada, there are many federal, regional and local targeted programs on various aspects of the rehabilitation of people with disabilities and special organizations that provide services for assessing the ability to work, consultation, career guidance, rehabilitation, information, vocational training and employment of people with disabilities.

Let us note that “people with disabilities” in developed countries work not only as seamstresses, librarians, lawyers, etc. You can also find mechanics and repairmen of heavy-duty vehicles moving in wheelchairs, which is simply unrealistic for Russia.

Let's consider the question of special workplace for disabled people. For example, the National Standard of the Russian Federation GOST R 52874-2007 defines this workplace for the visually impaired(clause 3.3.1):

This is a workplace where additional measures have been taken to organize work, including adaptation of main and auxiliary equipment, technical and organizational equipment, additional equipment and provision of technical means of rehabilitation, taking into account the individual capabilities of people with disabilities.

In addition, the composition of optimal or sufficient technical means and rehabilitation measures is determined for the creation and maintenance of a special workplace for people with disabilities in the context of expanding and changing the scope of their work using new technical means of rehabilitation and rehabilitation measures (clause 3.1.2).

Creation of a special workplace for disabled people includes selection, acquisition, installation and adaptation necessary equipment(additional devices, equipment and technical means of rehabilitation), as well as carrying out rehabilitation measures to ensure effective employment of disabled people, taking into account their individual capabilities in working conditions appropriate individual program rehabilitation of a disabled person to work (clause 3.1.3.).

Because Federal law“On the social protection of disabled people in the Russian Federation” dated November 24, 1995 No. 181-FZ provides for “professional rehabilitation of disabled people,” which consists of vocational guidance, vocational education, professional and industrial adaptation and employment, there is also a Code of Practice SP 35-104-2001 - “Buildings and premises with places of work for people with disabilities”, developed by order of the Ministry of Labor and Social Development of the Russian Federation. Buildings and structures must be designed taking into account accessibility for people with disabilities and “low-mobility groups of the population” (SP35-101-2001 “Design of buildings and structures taking into account accessibility for low-mobility groups of the population.” General provisions; SP35-102-2001 “Living environment with planning elements, accessible to people with disabilities"; SP35-103-2001 “Public buildings and structures accessible to visitors with limited mobility”).

But despite the laws and social rehabilitation programs that have not been adopted, the number of working disabled people in Russia continues to decline and has decreased by almost 10% over the past three years; less than a third of disabled people of working age have a job, although at enterprises in many industries, in various institutions and organizations there are professions and specialties that correspond to the psychophysiological characteristics of disabled people of various categories.

One of the main areas of support for people with disabilities is vocational rehabilitation and adaptation in the workplace, which is the most important integral part public policy in the field of social protection of disabled people and including the following activities: services and technical means - career guidance (career information; career counseling; vocational selection; vocational selection); psychological support for professional self-determination; training (retraining) and advanced training; assistance in employment (for temporary work, for permanent work, self-employment or entrepreneurship); quotas and creation of special jobs for the employment of people with disabilities.

Of course, professional rehabilitation of disabled people with their subsequent employment is economically beneficial for the state, since funds invested in the rehabilitation of disabled people will be returned to the state in the form of tax revenues resulting from the employment of disabled people.

But if the access of disabled people to professional activities is limited, the costs of rehabilitation of disabled people will fall on the shoulders of society in an even greater amount.

However, “legislation regarding persons with disabilities” does not take into account one thing the most important fact – what the employer needs is not a disabled person, but an employee.” A full-fledged labor rehabilitation and adaptation consists in making a worker out of a disabled person, for which you first need to train, adapt, and only then employ him, and not vice versa! Near 60% disabled are ready to participate in the labor process after receiving the appropriate specialties and labor adaptation, and, accordingly, receiving a decent salary.

The adaptation of a disabled person in the workplace itself is defined as a logical adaptation to a specific job or workplace performed by him, which allows a qualified person with a disability to perform his duties in his position. That is adaptation of a disabled person involves finding a way in which it becomes possible to overcome obstacles created by an inaccessible environment; it is overcoming barriers in the workplace, which is achieved through a targeted approach to solving a given problem.

Despite the presence of appropriate legislation in the Russian Federation, a quota system and rehabilitation infrastructure, the low level of working disabled people indicates that there are certain factors that interfere with their employment and although there is a policy to encourage the employment of people with disabilities, nevertheless, psychological, physical and social barriers often prevent its implementation.

Until now in Russia there are many barriers to the employment of people with disabilities: there is no physical access to the workplace and appropriate equipment, people with disabilities are paid the minimum wage, without expecting them to work with dignity, which, in general, is not true, is practically non-existent accessible transport, and many stereotypes towards people with disabilities persist among employers. And the disabled themselves, as we noted above, still suffer from low self-esteem, are not ready to enter the labor market on their own, and when they start working, they often cannot cope with the job due to lack of support and even direct mobbing.

In the US and UK, for example, the main types of work adaptation are: flexibility in the approach to labor management, increasing accessibility of premises, restructuring of duties (including working hours), entering into fixed-term contracts with disabled people, and purchasing or modifying equipment. Note that in Western European countries about 40-45% of disabled people work, and in Russia best case scenario- only 10%, many at home, practically illegally and for extremely low wages...

Although work adaptation may be unique to each individual case, for most Russian disabled people The main need for priority adaptation in the workplace and in the work team is scheduling - for example, flexible hours and regular breaks, as well as, in some cases, reducing the number of certain actions.

But the most serious barrier in Russia to the ability of a disabled person to work is the loss of social benefits (“allowances”) or even the disability pension itself. Let us note that, according to existing legislation, people with disabilities in Russia have the right to receive free medicines, free travel on public transport and commuter trains, sanatorium and resort treatment, partial payment for housing and communal services, etc. And a disabled person can lose all this by officially getting a job! And often this is the main reason why people refuse to work, especially if work cannot compensate for the loss of a pension and all benefits. In addition, a disabled person receiving a pension supplement has no right to earn extra money anywhere, even temporarily; the “social protection authorities” will immediately remove it and even fine you! So does it make sense for a disabled person to lose his bonus by tripling his work? Most often not, if the salary is too low and does not compensate, or only slightly compensates for this premium.

For example, a person with cardiovascular disease or endocrine system, who most often received a disability, already having enormous experience in scientific or teaching activities, may well perform his usual work, but... “social protection bodies” designed precisely to “protect” the disabled person, nevertheless, on the contrary, deprive him of the opportunity to work, or although working part-time or temporarily, for example, under a contract, at the same university, university, research institute or other organization.

Another barrier to the employment adaptation of a disabled person is the physical environment in which people live, which prevents them from going to work; about 30% of people with disabilities indicate this as a serious problem lack of adequate transport.

There is the concept of “physical environmental barriers”, which include many factors: from the inaccessibility of transport to the lack of flexible hours and a reduction in physical labor in the workplace. It is clear that the need for a flexible schedule is explained by the fact that during the day a disabled person faces many problems outside of work or preparing for it, in particular getting to and from work, and at work he may be less mobile - even going to the toilet takes a wheelchair user several times longer.

When hiring a person with a disability, employers should provide certain basic activities required in the workplace and use creative assistive technology. For example, disabled people who are unable to move independently are less able to perform work related to computers.

Let’s think about it, but it’s wasteful to entrust a healthy person with a job that a disabled person can do! And disabled people feel their labor isolation as completely unnecessary to society. For them, it is important not just to exist, receiving a meager pension, but to live and work fully, it is necessary to be in demand by society, to have the opportunity to self-realize!

In developed countries, one dollar invested in solving the problems of people with disabilities brings 35 dollars in profit!

It is not disability itself that is a person’s misfortune, but the trials that he endures due to the fact that the surrounding society limits freedom of choice in employment. Theoretically, a disabled person has all constitutional rights, but in practice, the vast majority of them cannot get an education or get a job, much less a decently paid one.

And most importantly, assistance to society itself in the adaptation and normal work of a disabled person is even more important than for the disabled person himself. A person must see that if something happens to him, he will not be thrown to the sidelines of life, and he must remember that no matter how life turns out (and, alas, it is not predictable), this problem can affect everyone.

Historically, the concepts of “disability” and “disabled person” in Russia were associated with the concepts of “disability” and “sick”. And often methodological approaches to the analysis of disability were borrowed from healthcare, by analogy with the analysis of morbidity. Since the early 90s traditional principles State policies aimed at solving the problems of disability and people with disabilities due to the difficult socio-economic situation in the country have lost their effectiveness.

Russia's transition to a fundamentally new socio-economic way of life has put forward the need for the formation of a system of social protection of the population that is most consistent with modern tasks of social development. These tasks include creating decent living conditions for young disabled people, who are unable to fully or partially provide for their life needs without outside help, with a rich, active and satisfying life, and awareness of themselves as an organic part of society.

The independent life of disabled people presupposes the removal of dependence on the manifestations of the disease, the weakening of the restrictions generated by it, the formation and development of independence, the formation of skills and abilities necessary in everyday life, which should enable integration, and then active participation in social practice, full-fledged life in society.

A person with disabilities should be considered an expert who actively participates in the implementation of their own adaptation programs. Equalization of opportunities is ensured with the help of social services and organizations that help overcome specific difficulties on the path to active self-realization, prosperous emotional state in society.

Activities aimed at social adaptation of persons with disabilities are based on:

1. Compensation for opportunities missing from birth, or lost due to illness or injury. Due to the delegation of missing functions to other people, and the creation of conditions for overcoming previously inaccessible environmental obstacles.

2. Organization of work with all participants in interaction: with a disabled person, his family, and immediate environment.

3. Integration into joint activities of people with disabilities and people without health problems. This principle should be implemented in almost all types of services.

4. Mutual assistance - wide participation in the work of volunteer helpers and voluntary mutual support.

Social adaptation occupies a significant place in the social rehabilitation and integration of disabled people, since it allows solving the problem of human survival and adaptation to environmental processes. In fact, social adaptation is the goal of social rehabilitation.

The process of social adaptation of the individual? this is the hardest thing social phenomenon, which includes various aspects of human life. For a disabled person, adaptive processes are associated primarily with what is new to him social role and finding a new place in society in accordance with one’s status.

It should be taken into account that the social environment, as a rule, is hostile to a disabled person and there are no conditions for timely and successful adaptation. Delays and disruptions in this process lead to a decrease in the stability of families of disabled people, an increase in morbidity, a psychological phenomenon defined as the formation of the status of a disabled person. The needs of disabled people can be divided into two groups: - general, i.e. similar to the needs of other citizens and - special, i.e. needs caused by a particular illness. The most typical of the “special” needs of people with disabilities are the following:

In the restoration (compensation) of impaired abilities to various types activities;

On the move;

In communication;

Free access to social, cultural and other objects;

The opportunity to gain knowledge;

In employment;

In comfortable living conditions;

In socio-psychological adaptation;

In material support.

Satisfying the listed needs is an indispensable condition for the success of all integration activities regarding people with disabilities. In socio-psychological terms, disability poses many problems for a person, so it is necessary to especially highlight the socio-psychological aspects of persons with disabilities.

Disability is a specific feature of the development and state of the individual, often accompanied by limitations in life activity in a wide variety of areas.

In general, work on social adaptation of young disabled people includes several main aspects: legal; social-environmental, psychological, socio-ideological aspect, anatomical-functional aspect.

The legal aspect involves ensuring the rights, freedoms and responsibilities of people with disabilities. The President of Russia signed the Federal Law “On Social Protection of Disabled Persons in the Russian Federation.” Thus, the especially vulnerable part of our society is given guarantees of social protection.

Figure 1 Main aspects of work on social adaptation of young disabled people

Of course, the fundamental legislative norms regulating the position of a disabled person in society, his rights and responsibilities are necessary attributes of any rule of law state. Disabled persons are entitled to certain conditions for obtaining education; provision of means of transportation; for specialized housing conditions; priority receipt land plots for individual housing construction, farming and gardening, and others.

For example, living quarters will now be provided to disabled people and families with disabled children, taking into account their health status and other circumstances. Disabled people have the right to additional living space in the form of a separate room in accordance with the list of diseases approved by the government of the Russian Federation. However, it is not considered excessive and is subject to payment in a single amount.

Another important provision is the right of people with disabilities to be active participants in all those processes that relate to decision-making regarding their life activities, status, etc. Social-environmental includes issues related to the microsocial environment (family, labor collective, housing, workplace, etc.) and the macrosocial environment (city-forming and information environments, social groups, labor market, etc.).

In Russia, a federal target program has been formed and is being implemented “ Accessible environment for the disabled." A criterion for assessing disability policies may be the accessibility of the physical environment, including housing, transport, education, work and culture, and the availability of information and communication channels.

The Law “On Social Protection of Disabled Persons in the Russian Federation” obliges the authorities to create conditions for disabled people free access to objects social infrastructure. Currently, provisions that take into account the interests of people with disabilities and other groups of the population with limited mobility are contained in the current building codes and regulations, adjusted to take into account the requirements for the accessibility of buildings and structures for people with disabilities.

According to the law, local authorities must not issue licenses to transport companies that refuse to equip their buses with lifts. A long-term plan for the improvement of the city is considered to be a phased reconstruction of streets and intersections, taking into account the requirements of people with disabilities.

Airports, railway and bus stations, sidewalks and road crossings should also be equipped with special devices to make life easier for people with disabilities. There should be separate parking lots and rooms for disabled vehicles, and special toilets, which has already become common in many countries of the world.

The psychological aspect reflects both the personal and psychological orientation of the disabled person himself, and the emotional and psychological perception of the problem of disability by society. Disabled people belong to the category of so-called people with limited mobility and are the least protected, socially vulnerable part of society. This is due, first of all, to the defects of their physical condition caused by diseases that lead to disability.

Psychological problems arise when disabled people are isolated from the outside world, both as a result of existing illnesses and as a result of the unsuitability of the environment for disabled people in wheelchairs.

All this leads to the emergence of emotional-volitional disorders, the development of depression, and behavioral changes.

The socio-ideological aspect determines the content of the practical activities of state institutions and the formation of state policy regarding people with disabilities. In this sense, it is necessary to abandon the dominant view of disability as an indicator of the health of the population, and perceive it as an indicator of the effectiveness of social policy, and realize that the solution to the problem of disability lies in the interaction of the disabled person and society.

The anatomical and functional aspect of social adaptation of disabled people involves the formation of a social environment (in the physical and psychological senses) that would perform a rehabilitation and adaptation function and contribute to the development of the rehabilitation potential of a disabled person.

Thus, taking into account the modern understanding of disability, the focus of the state’s attention when solving this problem should not be violations in the human body, but the restoration of its social role function in conditions of limited freedom.

The main emphasis in solving the problems of people with disabilities is shifting towards rehabilitation, based primarily on social mechanisms of compensation and adaptation. Thus, the meaning of adaptation of disabled people lies in a comprehensive multidisciplinary approach to restoring a person’s abilities for everyday, social and professional activities at a level corresponding to his physical, psychological and social potential, taking into account the characteristics of the micro- and macro-social environment.

A comprehensive solution to the problem of disability involves a number of measures. We must start by changing the content of the database on people with disabilities in state statistical reporting with an emphasis on reflecting the structure of needs, range of interests, level of aspirations of people with disabilities, their potential abilities and opportunities of society, with the introduction of modern information technology and techniques for making objective decisions.

It is also necessary to create a system of comprehensive multidisciplinary rehabilitation aimed at ensuring relatively independent life activities for people with disabilities. It is extremely important to develop the industrial basis and sub-sector of the social protection system that produces products that make the life and work of disabled people easier.

A market for rehabilitation products and services must emerge, determining supply and demand for them, creating healthy competition and facilitating targeted satisfaction of the needs of people with disabilities. It is impossible to do without a rehabilitation social and environmental infrastructure that helps disabled people overcome physical and psychological barriers to restoring connections with the outside world. And, of course, we need a system of training specialists who are proficient in the methods of rehabilitation and expert diagnostics, restoring the abilities of disabled people for everyday, social, professional activities, and ways of forming the mechanisms of the macro-social environment with them.

Thus, solving these problems will make it possible to fill the activities of those created today with new content. public services medical and social examination and rehabilitation of disabled people for their successful adaptation and integration into society.

The problem of psychosocial development of a disabled person in the family and society remains one of the most difficult problems social psychology. Both the disabled person and his family suffer psychological trauma.

If a child is born with cerebral palsy, there is high risk parental (including maternal) rejection, distance and aggression. The appearance of such a child in the family threatens marital relationships and can negatively affect the psychological state of other children in the family.

Blind babies cannot follow the facial expression of the person caring for them and smile back.

The behavior of deaf children can be mistaken for disobedience.

Children with other serious disabilities are unable to respond to signals from the outside world in the same way that healthy children do.

Obvious deviations in children that are noticeable from the moment of birth, such as Down syndrome and cerebral palsy, create considerable adaptive and psychological difficulties for all family members, especially for young parents. Teaching these parents and other family members patience and communication skills with a sick child facilitates parent-child dialogue, attachment formation, and all subsequent socialization.

The little man was born disabled... Valid- translated from English - “having force.” Disability is “lack of strength,” if translated literally. It sounds like a verdict... However, this verdict cannot be considered final!

During the neonatal period and infancy, a disabled child feels pain and discomfort (inconvenience). The ill health of a child often causes parents to abandon him...

But man is a rational being! Parents are obliged to cope with their feelings about the birth of a “flawed” baby, take control of the situation with their conscience and begin to care for the baby. This is very difficult.

In such a situation, the support of a group of parents raising children with disabilities can significantly help. Valuable advice from parents who find themselves alone with the same grief is very important.

What problems does a family with a disabled child face?

It is important to consider several aspects of the problem:

Firstly, this is the mother-sick child relationship;
Secondly, mother - sick child - father;
Thirdly, a sick child means healthy children;
Fourthly, mother - healthy children;
Fifthly, a family with a disabled child and other relatives;
Sixth, the family with a disabled child and society;
Seventh, a constructive decision to create an association of families with disabled children.

Life, of course, poses many other questions to these families, but let’s consider the problem specifically in socio-psychological aspect.

The family was faced with a fact: there was a disabled or seriously ill person in the family.

Relatives are oppressed by feelings of fear, guilt, and depression; disappointment, as well as rage caused by the intractability of the disease problem itself. These family reactions are not aberrations, but normal human reactions to a situation that is extremely complex, frustrating, incomprehensible, and clearly beyond their control.

The family in this case faces objective and subjective difficulties.

1) Objective: high cost of medications and treatment, i.e. increased family expenses, disruption of the rhythm and order of family life, additional stress on healthy family members.

2) Subjective: various experiences in connection with the illness of a family member (grief, guilt, despair, fear), i.e. emotional reactions (stress).

The load between members of a family that includes a seriously ill or disabled person is distributed like a “layer cake.”

First, inner, layer- this is usually one person (mother, grandmother, etc.) - the family member who takes on the role of the main “guardian” and who bears the brunt of everyday care, maintenance, and upbringing. The life of this family member is entirely focused on the patient: day and night he thinks about the needs and wants of the patient, takes care of their satisfaction, and the comfort of the patient.

This family member reads medical articles, visits the doctor, communicates with similar families to learn something useful for their patient. More than other family members, this pecun suffers from all fluctuations and changes in the disease, from any deterioration. It is he who “bores” the attending physician, social workers- goes into details of treatment, into little things, accuses others of inaction.

His life is a continuous stream of affairs and thoughts related to the patient. And the worse things go for the patient, the more activity is required from the caregiver. There are frequent cases when the mother of a disabled child is so “busy” with his care that it becomes a threat to the existence of the family as a whole. Husband and other (healthy) children feel acute shortage attention, participation, and sometimes obvious aggression on the part of the mother: the woman accuses her family of insufficient attention to the patient; there is a constantly painful atmosphere in the house. There is a rift between the primary caregiver and other family members. There is no cohesion - the family collapses.

The deterioration of the patient's health worsens the situation in the family. Here it is very important for the rest of the family to understand that for the mother this sick child is of paramount importance, it “dominates” in her brain as the most important thing.

The rest of the family members "second layer of layer cake", they manage to “deviate” from the painful home atmosphere at work, study, communicating with friends, etc. They seem to create a “protective barrier” from this traumatic situation, they run away from this painful atmosphere. In such families, the joy of life often disappears, and grief takes over.

How can we positively resolve this situation?

Let us give an example from the practice of one of the Centers for Social Adaptation of Disabled People.

A young woman, mother of two children: one girl is 7 years old, the other girl is 1 year old. The youngest suffers from cerebral palsy. Until then, friendly loving friend friend, the family has been in a state of hopeless grief since the birth of their youngest girl. The mother devotes herself entirely to her sick child, the eldest first-grader girl and the father of the family experience the mother’s alienation and aggression. The father tries to be at home less often and as little as possible; under any pretext he tries to get away from the traumatic situation. He lacks care and “home warmth”. In addition, a colleague who “sympathizes” with his grief appears on the “horizon” and is not averse to “caressing and pitying” the father of the family. The situation, frankly speaking, is critical... Fortunately, the young mother found the strength in herself and came for a consultation with a psychologist. As a counselee, she needed to talk out her troubles, she needed an analysis of the situation and specific advice that could save the family. It is not easy to convince an adult, offended and tired person - the mother of a sick child.

Analysis of the situation as if “from the outside”, supported by figurative examples from Holy Scripture, allowed a woman to understand her family differently, to assess reality more positively. After all, in this family the atmosphere of joy of life has disappeared, and the sin of despondency has settled.

After several conversations, the mother of the sick child said with gratitude:

“As soon as my worldview changed, the attitude of the rest of the family members towards me also changed: my daughter and husband. I chose the course of treating others kindly. The main thing now is the life of those living next to you. Only through their good will you receive your happiness. Stay close to your family, they will help you in difficult times. And together we are strong! There is no need to be afraid to seek help from specialists in such difficult life situations.”

How do healthy children feel in a family with a disabled child?

Healthy children are characterized by manifestations of anxiety. Their emotional connection with the patient and his problems is not as strong as that of the main “caregiver”. Healthy children continue to study, and when they leave home, go about their professional or educational activities, everything associated with illness becomes psychologically distant from them. But they are afraid that the degree of ill health of the patient will force them to interrupt their numerous professional, educational, personal and other activities. Fear of this can develop into fear of the primary caregiver. There is a desire to “leave, hide on desert island”, i.e. alienation as a result. Here the role of the main guardian in a positive solution to the problem is great.

The following example is from the practice of the Adaptation Center.

The youngest child in this family suffered from a severe oncological blood disease, his life was calculated in months. The mother and father of this child, having learned about the diagnosis from oncologists and after consulting with a psychologist, decided to create an atmosphere of joy for the patient and other children in the family. They glued together Christmas decorations, the whole family went on short trips, showed a puppet theater at home. Everywhere we tried to be together, to saturate the children’s lives with little joys. Psychologically, it was most difficult for the parents, as they realized the inevitability of the outcome. They found the strength to preserve the feeling of mutual care and kindness until the last day, without betraying their grief in any way. And this requires great courage and willpower. The unity of the family allowed them to more easily endure the bitterness of loss, and the sick baby to live a short but happy life.

We must not forget that small, even healthy children may develop a complex of lack of attention, a kind of jealousy in relation to the attention paid to a sick child.

Due to the individual characteristics of a particular healthy child, his illnesses are possible, caused by stress, the desire for attention from other family members: frequent colds, weakened immunity, lung and kidney diseases.

Third layer (subgroup), which concentrates around the patient - these are close and distant relatives. Their gossip often boils down to the fact that the cause of the illness was the wrong actions of the main caregiver and other family members. As a result, their opinions and actions complicate the situation of the primary caregiver and other family members, increasing their feelings of guilt and helplessness.

Family members become increasingly dissatisfied family life, alienation in the family is growing.

What is driving this global family dissatisfaction? Firstly, a feeling of guilt for the illness: a family experiences an illness especially hard if its members blame themselves or the patient for what happened. Kenneth Terkelsen in 1987 described the two most common family views on the causes of illness:

a) Biological: families who consciously or unconsciously adhere to this theory see the causes of the disease in some mutations-changes in the body independent of the patient’s will. In this case, the family overestimates the possibility of drug treatment, and is often tormented by fear for genetic heredity, or fear that, contrary to all the doctor’s assurances, the disease is contagious.

b) Psychological: its supporters blame themselves, all family members or the disabled person for everything. There is hidden aggression of all family members towards each other.

It is important to understand all this and try to relieve irritation and aggression in the family. The accumulation of knowledge and experience leads to the fact that the family can gradually free itself and cease to be emotionally dependent on temporary fluctuations in the course of the disease.

Particular attention should be paid to families in which one of the members has a severe neuropsychic disorder. Let's consider the dynamics of such a family. Significant internal and external pressure on this family, a state of neuropsychic tension, anxiety, unhealthy feelings of guilt - all this leads to the fact that the structure of such a family is unstable.

This situation is perceived as difficult to bear, and family members are intensely looking for a way out of it.

The family in this case can either fall apart or mobilize in the face of misfortune, such as the mental illness of one of its members.

What problems does such a family face? Firstly, understanding the patient and establishing the level of requirements for him.

To keep the patient from inappropriate behavior, the family is looking for ways to influence him.

Example. Patient N. - in March 1999. Refusal of food for 3 days, difficulty in swallowing, depressed state, combined with the need to “run wherever one looks”, asthenia. History: asthenic-neurotic syndrome. The drug therapy prescribed by the doctor (atarax, coaxil, relanium) did not give any effect. Periodic monthly disruptions in the premenstrual phase. Family members' reaction: The family mobilized to solve this problem. Massage, magnetic therapy for 20 days, conversations with the patient, forcing one to take one’s mind off the fear of an “attack of illness.” Every year a family with modest income goes to the sea as “savages”, as this gives remission for about 4 months.

This constructive solution to the problem, although it did not bring complete recovery, did allow the family to relieve tension and unite.

A destructive version of such a case is the collapse of L.’s family, where the mother of three children developed a mental illness after suffering stress.

The emotional climate in the family is very important. Conducted in recent years Studies of families where there is a patient with schizophrenia have shown that the presence or absence of a relapse of the disease largely depends on how much the family is able to understand and take into account the increased sensitivity of the patient. This was first discussed in studies by the Medical Research Council's Social Psychiatry Unitin London (1962), and the phenomenon was given the name EE-expressiveness of emotions. It was proven that in “emotionally agitated” families, there were more frequent relapses of the disease, and the calmer the climate in the family, the less frequent were the exacerbations of the disease. It is very important for families to master emotionally gentle statements.

Examples of emotional statements...

sparing:

Maybe you can do it differently
Sorry, I didn't quite understand you
I have a hard time concentrating
This should have been done a little differently

hard:

You did everything wrong
What are you saying?
Stop making noise and disturbing me
You ruined everything again

When a family decides to use gentle language, it helps avoid negative emotions based on bitterness, resentment, and resentment.

Dominant negative emotions can develop into behavioral antipathy towards the patient and the desire to “get rid of” him. Concentrating the family's attention on the positive, preserved aspects of the personality of an individual with pronounced neuropsychiatric disorder gives rise to a motive of care, “Exupery Motive” (“We are responsible for those we have tamed”).

Werner1989 proved that in prosperous families children with serious postpartum complications showed a slight lag behind healthy children, while in a dysfunctional family the child remains “Wild”.

Since the 70s of the 20th century, programs for comprehensive assistance to disabled children and members of their families have been tested in the United States (Broussard 1989, Sasserath 1983). These programs have allowed parents of disabled children to develop effective ways to manage their attention, increase their learning ability with the most necessary skills, to identify even small changes for the better in their developmentally delayed child.

Unfortunately, in small regional towns of Russia and rural populated areas work with disabled children and their families is of a purely formal “entertainment” nature (excursions to nature, to the theater), there are few training programs, and there are no psychosocial rehabilitation instructors for working with disabled children and their families. Most often, the chairman of the society for the disabled only manages to deal with the organizational aspects of events for these children. When should we care about their physical development?

By the time healthy children begin to walk kindergarten, school, communicate with each other, disabled children remain uncommunicative. Why? It's just very difficult for them to find friends. Such a child is clearly different from the rest: less dexterous, less mobile and less strong. It is the latter aspect that greatly influences the attitude of his peers towards him. After all, a “children’s” society is akin to a primitive one: the law of “who is better,” the law of the leader, operates here. When communicating with healthy peers, a disabled child may experience anxiety and fear, excessive stress, and a feeling of inferiority. Little children are very cruel people. Many have not yet learned to have compassion for their neighbors. Therefore, a sick child often turns into an outcast among healthy peers.

In these conditions, it is important for parents, educators, and teachers to achieve the following goals:

Creating a friendly atmosphere in communication between healthy and sick children.
Learn to recognize and relieve stress reactions in children. Restore the child's self-confidence through warmth and affection, encourage the child to be frank.
Don’t stop, but try to understand why the child sucks his finger, bites his nail, or hides his head under the blanket. Affection, care, a kind word coming from the heart will calm and encourage the baby.

Among disabled children there are also children who are unable to learn due to the specific nature of their illness. These are children with dyslexia who have difficulty writing. Children with hyperactivity are those who cannot sit still for a long time. With each failure, such children believe less and less in their ability to learn something. Some become withdrawn, others become cheeky and aggressive. However, it should be noted that Thomas Edison, Nelson Rockefeller, and Hans Christian Andersen suffered from dyslexia in childhood. They managed to overcome themselves. Currently, numerous correction training programs are being developed, based on the need to create a sense of self-confidence in the child.

In their youth, older children begin to understand that there are various types human body and his various ideals. They develop a fairly clear idea of their body type, its proportions and dexterity. Teenagers pay much more attention to their bodies. During this period, young people acutely feel the need for the attention of the opposite sex. Here a disabled teenager faces bitter disappointment. Wheelchair, crutches or a hockey stick attract the attention of healthy adolescents only as an object of curiosity.

Despair takes hold of young people with disabilities. In this situation, trusting relationships with loved ones are important.

In this situation, a reasonable solution is possible. Important with early childhood develop the talents of a disabled child. This will be very useful at a young age, it will give you a feeling self-esteem, a sense of consistency as an individual, a person. It is important that disabled children make friends with each other.

The development and upbringing of a disabled child is undoubtedly a complex process that requires a lot of effort from parents and educators. However, it is very important to instill in a person the confidence that disabled people are people called upon by life to be tested, and not outcasts of society.

Conclusions

Experience shows that the use of psychological rules allows a family with a disabled person to survive. In addition, the mindset for success significantly facilitates the social adaptation of the disabled themselves and their family members. These are the rules.

Don't lose hope and believe in victory over difficulties. Rejoice in every small victory over the disease.
Try to understand the patient better than he understands himself.
Allies in your fight against the disease are the trust and frankness of the patient. Try to win them over.
Look for approaches to the patient, analyze failures and mistakes when communicating with a sick family member.
Look for allies - organize your social “habitat” (clubs for the disabled, sports sections for the disabled, classes in clubs, etc.). Develop the talents of a disabled child.
“Fight and search, find and not give up” - this is the motto of those who have followed this path.