Development of an early comprehensive care system for children with disabilities in educational and healthcare institutions
Authors: Butko G. A. , Katelson T. A. , Oltu S. P. 
Published: December 2019

Introduction. The article discusses various models of early comprehensive care for children with developmental disabilities in healthcare and educational institutions, modern approaches to their comprehensive support. Early comprehensive care is a new, rapidly developing field of interdisciplinary knowledge that integrates the theoretical and practical foundations of integrated support for children with developmental disabilities and children at risk from the first months of life. The timely appearance in the child’s mental development of the necessary age-related achievements depends on a number of conditions: the normal functioning of the brain, the physical health of the baby, the safety of the senses, the well-being of the social environment, and upbringing.

Recently, there has been an increase in the number of infants with a low rate of psychomotor development. Many researchers believe that the cause of this is perinatal damage to the central nervous system. Knowledge of this fact allows us to predict the possibility of adverse psychophysical development of the child in the future. In this regard, early diagnosis and monitoring of the child’s neuropsychic development is important, which allows timely and targeted correction of the revealed violations. The prevention of disability and the reduction in the degree of limitation of vital functions and working capacity in a person’s future life depend to some extent on the effective organization of early comprehensive care.

Materials and methods. The article summarizes the experience of the Moscow City’s early assistance services, which were part of the experimental site of the North-Eastern Administrative District “Enabling Children with Pre-school and Early Childhood Care in the Educational Space” in 2012-2014, as well as the currently functioning early-warning services of the city of Moscow. Dzerzhinsk, Moscow region. The analysis of the contingent of children attending early care services is carried out, follow-up data for these children are given, the effectiveness of these forms of early comprehensive care for children with disabilities is shown. Approaches to accompanying an infant and young child in health care are considered from the point of view of multi-stage, systematic and continuity.

Results of the research. An analysis of the activities of various organizational forms of early support for children with disabilities and children at risk in educational institutions has shown the effectiveness of this area in helping children with developmental disabilities. The most important result of the work of such services is to improve the social adaptation of children with disabilities, and, above all, their inclusion in the educational environment.

The healthcare system of the Russian Federation is the initial link in the provision of early assistance to children with disabilities. One of the reasons for the need for early comprehensive care for infants is the steadily growing number of deeply premature babies and a high percentage of their early disability. Among them, the majority are children born deeply premature at the 27-34 week gestation period. Subsequently, such children experience mental and speech development delays, various speech disorders, learning difficulties, and in the most severe cases, cerebral palsy and multiple developmental disorders. In this regard, all the measures for the habilitation and rehabilitation of deeply premature babies in health facilities acquire special social significance. The article provides a qualitative analysis of the content of the work of hospitals of the first, second and third stages of nursing of newborns with perinatal damage to the central nervous system.

Discussion and conclusions. The activities of early assistance services based on educational organizations are currently considered as a social program for children from 2 months to 3 years of age with a lag or risk of lag in development, where a large role is given to the family and mother in implementing individual child development routes. This program is based on the principles of: humanism; personality-oriented approach to the child; taking into account the individual needs of each child; registration of neoplasms and leading activities of age; early detection and correction of developmental abnormalities; active inclusion of the family in the process of correctional development work.

Medical and psychological and pedagogical assistance to children of the first year of life with developmental disabilities is in the form of a comprehensive rehabilitation. Rehabilitation of children of the first year of life is not only the restoration or compensation of impaired body functions, but also the creation of conditions for an adequate age-related formation of all organs and systems, timely recovery of psychomotor skills. Comprehensive rehabilitation of an infant child implies a wide range of long-term medical-psychological-pedagogical measures aimed at the child and carried out in the process of coordinated work of specialists of various fields: neonatologist, neurologist, orthopedist and other doctors, psychologist, teacher defectologist, social educator, as well as family psychologist. In order to ensure the development and effective adaptation of children with disabilities, the interaction of specialists is necessary not only with the child, but also with his entire family, since parents experience many specific difficulties associated with providing constant care and organizing treatment and development [24].