Organization of speech therapy assistance in the social protection system. The main directions of formation and development of the system of speech therapy assistance in Russia

Correctional pedagogical (speech therapy) assistance

in the preschool education system

In Russia, the system of correctional assistance for children with speech disorders and developmental disabilities developed gradually. Since the 20s, systematic, comprehensive assistance to children with various types of speech pathology began to develop. In the field of defectology, scientific research has proven that early recognition of a defect and its correction are of great importance. In case of severe speech disorders, early correctional and educational work leads to significant compensation of the defect .

In preschool institutions for children with speech impairments, a clear organization of the entire correctional and pedagogical process is provided. It is provided by:

Timely examination of children;

Rational scheduling of classes;

Availability of frontal training plans;

Equipping the speech therapy room with modern equipment and visual aids;

The joint work of a speech therapist with a group teacher, specialists and parents .

In recent years, along with the existing system of speech therapy assistance that has been well developed over the years, speech therapy centers have been opened in preschool educational institutions. The goal of speech therapy centers is to help more children and their parents who need correction, consultation, and prevention of speech disorders.

The practice of speech therapy centers has shown many pressing problems. Let's look at some of them.

Parents of children with complex speech disorders, knowing that a speech therapist works in a preschool institution, are not interested in transferring them to special compensatory groups of other preschool institutions (especially if these kindergartens are remote from their place of residence). Teachers at speech therapy centers found themselves forced to work with such children “integrated” into mass preschool institutions, devoting much more time to them than to those who studied at the speech therapy center according to indications (mainly with disorders of the sound-pronunciation aspect of speech). In the newly opened speech therapy centers, speech therapists began to work more with children preparing to go to school. It was assumed that over time the main emphasis would be on speech therapy classes with children of primary preschool age. However, now it is not always possible to do this, since there are more and more children with problems in speech development. As a result, an acceptable moment to start classes is missed. By the age of five or six, children have formed incorrectly the pronunciation of many sounds (for example,[r]– throat,[l]– bilabial, interdental sibilants) and is already fixed in spontaneous speech. In preschool institutions, the number of teachers with speech defects has increased, which cannot but affect the formation of defective pronunciation in children by imitation. The teacher must have clear, correct speech.

The teacher must know individual deviations in the formation of the child’s speech, hear defects in the pronunciation and lexical-grammatical aspects of speech, and take into account the speech capabilities of each child in the process of educational and extracurricular activities .

In the process of dynamic observation, it is often revealed that children have erased manifestations of a speech disorder that is more complex than previously thought (for example, dysarthria). This means that the production and automation of sounds is delayed, which also complicates the work of the entire correctional and pedagogical process in a preschool institution . Absence from school due to illness in children plays a big negative role. Unfortunately, many unfavorable factors contribute to this: lifestyle, heredity, environment, medical and social assistance (health care). When examining the speech of all children, speech therapists are constantly faced with the fact that children know little about the surrounding reality. Children have a poor vocabulary and insufficient word formation and inflection skills. Many children use prepositions incorrectly, fail to cope with the tasks of composing a story based on a series of pictures or one plot picture, recite a poem, or retell a fairy tale. Often children do not know the names of primary colors, geometric shapes, and do not know how to count; more often than not, counting is mechanical. Often, children have weak memory, unstable attention, children do not know how to communicate, analyze, do not master choice operations, fine motor skills are poorly developed, etc. The working rate of educational psychologists in preschool educational institutions is reduced or minimal, so all correctional and developmental work is usually performed by a speech therapist or educator.

A speech therapist teacher in a preschool institution needs the support and assistance of colleagues (music and physical education directors, teachers, senior teacher, methodologist, head and parents) . But this is only possible under the necessary condition that the speech therapist teacher himself carries out educational and propaganda work on issues of speech development and correction, linking them with the general development of the child.

The main task of correctional pedagogical, speech therapy intervention for children with general speech underdevelopment is to teach children to express their thoughts coherently and consistently, grammatically and phonetically correctly, and talk about events from the surrounding reality. This contributes to successful learning at school, communication with peers, adults, and the formation of personal qualities .

For the efficiency of constructing work and monitoring the correctional pedagogical process, we have developed “Modules for organizing correctional pedagogical and speech therapy work in speech therapy centers and speech groups of preschool educational institutions.”

Diagnostic module

Identification of children at the initial stage with developmental problems in a preschool institution; Primary examination of the speech of preschool children in the speech therapy center of a preschool institution; Monitoring medical and pedagogical history, information about early development; Psychological, pedagogical and medical observation of young children with speech disorders; Examination of children with severe speech disorders in the conditions of primary medical education; Examination of children with pathologies of hearing, musculoskeletal system, vision, intellectual sphere in the conditions of the State Polytechnical Medical Center; Dynamic observation during the learning process, intermediate monitoring; Diagnostics of the effectiveness of the correctional pedagogical and speech therapy process.

Organizational module

Staffing speech therapy groups; Enrollment in speech therapy centers of a preschool institution; Submitting lists of children enrolled in classes to the head of the preschool institution. Registration of parents for the provision of advisory assistance from a speech therapist or psychologist.

Analysis and planning module

Analysis of diagnostic and acquisition results; Statistical report; Development of a strategy and correctional pedagogical process in a preschool institution - planning the work of a speech therapist for the school year; Pedagogical consultations on the problems of individual children, medical (consultations of children with speech problems with doctors of narrow specialties) . Choosing a method for organizing the correctional pedagogical process in a preschool institution: forming groups and subgroups based on manifestations of violations, planning individual work with children; Providing documentation;

Module of correctional and developmental classes

The work of a speech therapist to improve various aspects of speech; The work of a teacher psychologist to stimulate the psychological basis of speech (memory, attention, thinking, perception, constructive activity skills); The work of a teacher is related to cognitive development; The work of a music director in developing tempo-rhythmic organization. Logorhythmic exercises; The work of a physical education leader on the development of gross and fine motor skills; Individual routes of medical support for children with developmental problems .

Module of advisory and preventive work

In-depth medical examinations; Advisory assistance to parents of children with speech development problems; Preventive measures for oral speech in young children; Consultative sessions with children of primary preschool age who have age-related speech impairments; Testing using methods for early detection of dyslexia; Prevention of writing disorders. Organization of propaedeutic classes.

Methodological support module

Scientific and methodological base of literary support and assistance to preschool employees on correction issues; Study and implementation of variable forms of providing correctional assistance; Creation of a library of correctional pedagogical and psychological literature; Self-education of preschool teachers; Participation in the work of methodological associations of speech therapists ; Participation in conferences, seminars and workshops; Generalization of pedagogical experience in the field of correction.

Module for optimizing the correctional pedagogical process

Material and technical base of the educational process, equipment for speech therapy rooms; Creation of card files: games, exercises, articulation gymnastics, etc.; Using modern technical means, creating an audio and video library for speech therapy rooms.

Control module

Carrying out test sections; Information about the work of a speech therapist teacher on pedagogical and methodological councils; Information at group parent meetings (parent conferences); PMPC on issues of transfer and release of children from speech groups; Final interviews at speech therapy centers; Summing up the work for the academic year. Submitting an analysis report on the work done to the pedagogical council of the preschool institution.

Experience shows that high-quality, well-functioning correctional pedagogical (speech therapy) work in preschool educational institutions will be successful with an effective system of interaction between all specialists of the preschool institution.

Literature

Volkova L.S., Shakhovskaya S.N. Speech therapy. – M., 2003

Zhukova N.S., Mastyukova E.M. , Filicheva T.B. Speech therapy Overcoming general speech underdevelopment in preschool children. Ekaterinburg 2004.

Levina R.E. Fundamentals of the theory and practice of speech therapy. – M., 1968.

Handbook of preschool education. – M., 1980.

Yastrebova A.V., Bessonova T.P. Instructional and methodological letter on the work of a speech therapist at a speech therapy center at educational institutions. – M., 1996.

Speech therapy assistance to children of preschool and school age in the education system is provided in the following types of institutions: nursery-kindergarten for children with speech disorders, speech therapy kindergarten, groups for children with speech disorders at general kindergartens, educational complexes for children with speech disorders , speech therapy centers at secondary schools, groups for children with speech disorders at general orphanages.

The healthcare system for children with speech impairments provides the following structures: speech therapy rooms at children's clinics, “speech” hospitals and semi-hospitals at children's hospitals, dispensaries, specialized centers of medical institutes, children's sanatoriums, audiology offices, specialized nurseries.

The social protection system has specialized children's homes, the main task of which is timely diagnosis and correction of children's speech.

Kindergartens for children with speech disorders provide massive assistance to children with various speech development disorders. Their main task is the correction of speech disorders and preparation for education in a comprehensive school or a special comprehensive school for children with severe speech impairments.

In accordance with the standard regulations on preschool institutions and groups of children with speech impairments, three profiles of special groups are defined:

1. groups for children with phonetic-phonemic underdevelopment

2. groups for children with general speech underdevelopment

3. groups for children with stuttering

Correctional education involves the development of a range of knowledge and ideas about the environment, the development of vocabulary, sound analysis and synthesis, speech skills and abilities that must be acquired by children at this age stage.

In the process of training and upbringing, much attention is paid to the development of the child’s mental processes and functions: attention, perception, memory, thinking and inner speech, which are involved in the development of the child’s intelligence and personality as a whole. The work is aimed at developing all types of activities of the child, including speech as one of the types of activities. The impact helps to normalize the child’s relationship with others.

The kindergarten program provides for familiarization of children with the world around them, development of speech, familiarization with fiction, and development of elementary mathematical concepts. Classes are held in visual arts and design, physical education and music classes, which also provide great opportunities for correcting children’s impairments.

CONCLUSION

Since speech is a complex mental function, deviations in its development and disruption are usually a sign of serious changes in the state of the central nervous system. This means that not only speech suffers, but also all higher mental functions as a whole. Children with speech pathology tend to have greater or lesser learning difficulties.

Help for children with speech disorders is currently provided in the education, health and social care systems.

The overwhelming number of children with speech disorders study in secondary schools. First of all, children who have difficulties in learning and especially in mastering the process of writing and reading should be referred to a speech therapist.

Exercises aimed at developing the cognitive sphere should be included in the structure of the lesson and carried out in parallel with the implementation of educational and educational goals or in the form of independent exercises in the form of a game, conversation or exercise. Since cognitive processes develop in close interrelation with each other and represent complex systemic formations, each exercise addressed to a specific cognitive process simultaneously affects others.

In correctional programs, as a rule, work is highlighted in the following sections: motor development; perception; attention and memory; formation of spatial representations; criticality, control, programming of mental activity; development of thinking.

When communicating with students who have learning difficulties, the teacher must pay great attention to the quality of his speech, since the quality of children’s perception of educational material will depend on this. The teacher’s speech should be slow, measured, consist of short and clear sentences, and emotionally expressive. And most importantly, the general background of the teacher’s behavior and address to children (facial expressions, gestures, intonation) should be benevolent and make the child want to cooperate.

Considering that the number of children with speech disorders and learning problems is growing every year, a teacher’s knowledge of the basics of speech therapy will help him find adequate forms of training and education for such children.

Speech therapy is a special branch of pedagogy, which is aimed at the study, education and training of adolescents and adults suffering from speech pathology.

Traditionally, in pre-revolutionary Russia, assistance to children with developmental disabilities was provided by charitable organizations and individuals.

Speech pathology came into the range of scientific interests in the 20s. of our century. In 1920, at the First All-Russian Congress on the fight against childhood defectiveness, the principles of building a system for raising and training abnormal children were outlined. Since 1922, after the All-Russian Congress of Governors of Gubono, special institutions for children with developmental disabilities began to be created. 1924 became an important milestone in the development of defectology in Russia. By

On the initiative of L. S. Vygotsky, schools for abnormal children were reformed, the purpose of which was to correct the child’s personality as a whole and adapt him to social conditions. The year of birth of speech therapy in Russia can be considered 1933, when L. S. Vygotsky, together with the director of the Experimental Defectology Institute of the People's Commissariat for Education, I. I. Danyushevsky, created another branch of defectology, the object of research of which was children with speech disorders. A School and Speech Clinic appeared at the Experimental Defectology Institute.

Currently, our country has created and is constantly improving a system of assistance to children and adults with speech pathology. Speech therapy assistance to children and adults is provided through education, health care and social welfare.

IN education system assistance is provided to children with speech disorders of preschool and school age. For this purpose, special nurseries, kindergartens, preschool orphanages, preschool groups at special and general education schools, special groups in general kindergartens, schools for children with severe speech impairments (type V schools), speech therapy centers at general education schools have been created. .

Special preschool institutions accept children with speech impairments from the age of three with initially intact intelligence and normal hearing. Among these institutions there are kindergartens with round-the-clock attendance, which accept children from 4 years of age. The main goal of the work of preschool institutions for children with speech disorders in accordance with the “Model Regulations” is the comprehensive education of children, the development of their correct conversational speech, correct pronunciation and the preparation of children for school.

In light of the changes taking place in modern Russia associated with the humanization of education, with the development of a new stage of attitude towards persons with disabilities in physical and mental development, and the search for ways to reform the system of domestic special education, the analysis of the historical experience in the development of education for children with developmental problems becomes relevant.

The nature of society's attitude towards children with developmental disabilities is influenced by a number of numerous factors: the level of economic, political, moral, religious development of society, the state of education, health care, science and culture.

A retrospective look at the formation and development of the system of speech therapy assistance in Russia allows us to establish the relationship of the stages of development of this system with the socio-economic structure of the country, state policy in relation to children with developmental disabilities, and determine the role of speech therapy assistance in the state system of special education in our country.

N.N. Malofeev (1996) notes that wide coverage of the problem of development of the system of speech therapy care in Russia was hampered until recently by the lack of statistical data on the number of children with speech pathology in the country, on the percentage of coverage of needy children by the state speech therapy service due to the closedness and social markedness of the problem of accounting, education and teaching children with severe developmental disabilities (46).

The ideas of the ancient Slavs about speech disorders, methods of their treatment can be judged from chronicles, dictionaries, herbal books, proverbs, sayings, beliefs, etc. Judging by the monuments of the ancient Russian language that have come down to us, speech defects were designated according to descriptive criteria

or in consonance with a speech impediment (“stabby verbs” - speaking with difficulty, “humming” - speaking through the nose, etc.).

The ancient Slavs understood speech defects as a disease, illness, disfigurement, sent to a person by higher powers. The treatment of these ailments was therefore associated with superstitions, ceremonial rituals, spells, witchcraft, “magic words”, healing prayers, amulets, talismans, etc.

Handwritten herbal books advised the use of traditional medicine - herbs, minerals, products of animal and plant life - to eliminate speech disorders. For example, for voice disorders, crushed cabbage leaves with honey, baked garlic, tea with pepper were recommended, for stuttering - peaches and sage, etc. (67).

In Rus' they have always treated the poor, the poor, and the crippled humanely. Children and adults, whose development differed significantly from the generally accepted norm, aroused not only pity, sympathy and compassion, but were also considered “God’s” people, people marked with the seal of God. Therefore, people suffering from serious illnesses and having limited opportunities for life and activity in Russia were traditionally surrounded by an aura of martyrdom and holiness, and were the object of mercy and charity. In the early stages of the development of the Kiev state, a purely national phenomenon arose - public charity for “poor children.”

Many rich people engaged in charity “to save their souls”; Grand Duke Ivan Kalita personally distributed alms to the poor and poor. Since the 10th century, the Church has been assigned the task of public charity. A tenth of the profits was allocated to the clergy for the organization of shelters and almshouses for people with hearing, vision, intellectual disabilities, and cripples, where children with severe speech disorders were also kept.

As in the West, in Russia the movement in defense of abnormal children intensified towards the end of the 19th century. Doctors, teachers, and psychologists advocated for overcoming the inertia of the tsarist government in relation to the organization of public assistance to the anomalous, and demanded reforms in the field of education and health care. Among them are such pioneers

Russian defectology, like V.P. Kashchenko, G.I. Rossolimo, E.K. Gracheva, I.V. Malyarevsky, M.P. Postovskaya and others.

By the beginning of the 20th century, assistance to anomalous people was provided in Russia by charitable organizations. After the October Revolution, care for children with developmental disabilities became state-owned; they received the right to education, training and treatment. All state measures aimed at combating homelessness, handicap, protecting the rights, and general improvement of the younger generation began to be called “child welfare.” For the first time, the types of institutions for children with developmental disorders were defined in the resolution of the Council of People's Commissars of the RSFSR “On institutions for deaf-mute, blind and mentally retarded children and adolescents” (1926).

During the years of Soviet power, many decrees, resolutions, and legislative acts were adopted in our country aimed at improving the situation of children and protecting motherhood and childhood. For example, documents such as the “Action Plan of the Ministry of Education to Improve the Conditions of Education and Education of Children with Defects of Mental and Physical Development” (1970), “On the State and Measures for the Further Development of a Network of Special Schools, Boarding Schools, Preschool Institutions and Complete coverage of education and upbringing of abnormal children" (1983).

In 1990-1995 The scientific and methodological Council under the State Committee on Education adopted a comprehensive program - “Socio-psychological support, training and education of children with mental and physical disabilities.”

In modern conditions, the problem of providing full-fledged speech therapy assistance to children, especially children with developmental disabilities, who for the most part have specific features and speech impairments, does not lose relevance, which impedes their social adaptation and rehabilitation.

History of the formation and development of the system of speech therapy assistance in Russia short-lived and unique. The formation of the prerequisites for the emergence of the system occurred in the pre-revolutionary period; its formation corresponds to the period of social upheaval.

The main directions... of the speech therapy system help...

Seny, and the legislative and organizational design of the system occurs during the Soviet period. N.N. Malofeev in his study identifies three periods of formation and development of the system of speech therapy assistance in Russia (46).

1st period- second quarter of the 19th century. - first quarter of the 20th century. - “the period of prehistory and formation of prerequisites.” In 1838, the first work of the domestic author X. Laguzen was published - the monograph “On Stuttering”.

In the second half of the 19th century. from the cycle of medical sciences a special field of knowledge is distinguished - speech pathology, works of authors studying almost all forms of speech pathology appear (A. Kozhevnikov, 1874; V.M. Tarkovsky, 1867; I.A. Sikorsky, 1889; I.K. Khmelevsky, 1897; M.B. Bogdanov-Berezovsky, 1909 etc.).

At the end of the 19th century. - early 20th century in the depths of logopathology is born speech therapy as a science that integrates knowledge at the intersection of three sciences - medicine, psychology and pedagogy. In 1896, for the first time in Russia, courses were organized for stuttering students of the Siberian Cadet Corps according to the stuttering correction system developed by I.A. Sikorsky. Departments are being opened at medical institutes to research speech therapy issues. So, in 1908 it was opened Department of Deaf Education and Speech Therapy Psychoneurological Institute in St. Petersburg, headed by D.V. Feldberg. The experience of organizing the education and upbringing of children with developmental disabilities served as a scientific and practical basis for creating a system of speech therapy assistance in Russia in the future. Thus, in deaf pedagogy, many methodological and organizational components of the speech therapy service have been formed. However, the speech pathology rehabilitation programs proposed by domestic scientists did not find legislative and financial support from the state at that time. The legislative system of speech therapy assistance was formalized only after the revolution.

In the spring of 1918, short-term speech therapy courses, mandatory for all teachers and doctors of preschool institutions in Moscow, were organized. In Petrograd, at the Psychoneurological Academy, the Otophonetic Institute was created under the leadership of D.F. Feldberg. In July 1920, at the First All-Russian Congress to Combat Childhood

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efficiency, crime and homelessness, a decision was made: to consider the training of personnel for special institutions the most important state task, and to carry out this training in higher educational institutions.

Two higher educational institutions were created in Moscow: the State Institute of Defective Children of the People's Commissariat of Health (September 1920) and the Pedagogical Institute of Children's Defects of the People's Commissariat for Education (October 1921), which in 1930 were transformed into the defectology faculty of the Moscow State Pedagogical Institute. In 1925, the Department of Deaf Education and Speech Therapy was opened at the defectology department of the 2nd Moscow State University in Moscow, headed by Professor F.D. Pay. The order of the People's Commissariat of Education of the RSFSR dated June 8, 1931 ordered the introduction of universal primary education for speech therapists, the organization of special courses, groups and schools for them.

The result of the 1st period the formation and development of the system of speech therapy care resulted in the following achievements: the emergence and development in Russia of the prerequisites for the formation of a system of speech therapy care, speech therapy as a science; public awareness of the need to provide special assistance to children with speech pathology and the state’s readiness to organize this assistance legislatively and economically.

2nd period - early 30s - late 60s. - the period of formation and development of the system of speech therapy assistance, the main directions of which were: organization of speech therapy work in a auxiliary school, specialized assistance to children with stuttering, hearing and speech impairments; training of speech therapists, etc.

One of the first directions in the development of school speech therapy was organization of speech therapy work in auxiliary school. In 1936 in Leningrad, 79% of needy mentally retarded children were covered by speech therapy assistance.

In 1930, on the initiative of V.A. Gilyarovsky at the neuropsychiatric hospital named after. Solovyova was opened first speech therapy group for stuttering preschoolers, and then a semi-inpatient speech therapy facility.

In 1933, in Moscow, at the hearing-speech training and treatment plant, first specialized clinic for patients with hearing and speech impairments.

The discovery on the initiative of L.S. was important for the formation and development of domestic speech therapy. Vygotsky at the Experimental Defectology Institute in 1933. speech clinics, which was headed by R.E. Levin, where the theoretical aspects of speech therapy were developed and practical work was carried out on the diagnosis, treatment and training of children with speech disorders.

In the 1946-47 academic year at the defectology faculty of Moscow State Pedagogical Institute. V.I. Lenin, the first university system was opened speech therapy department. Cooperation between two departments begins: education and health care within the framework of an integrated medical-psychological-pedagogical approach to overcoming speech disorders.

From January 1, 1949, 120 were opened at secondary schools in large cities speech therapy centers consisting of 1 speech therapist teacher with higher defectology education. In the early 50s. schools for children with severe speech impairments are appearing. In 1970, an order of the Ministry of Education approved the “Model Regulations on Preschool Institutions and Groups for Children with Speech Impairments.”

Result of the 2nd period- organizational design and development of the system of speech therapy assistance in the country. The scientific platform of speech therapy is being strengthened, scientific centers and specialized pedagogical and medical institutions are being created, the status of a speech therapist is being determined, and the issue of training speech therapists is being resolved.

3rd period - the end of the 60s - the 90s - a period of further development and improvement of the system of speech therapy assistance. Having started in a planned economy, it continues during the socio-economic and political transformations that determine the direction of development of the special education system in general and speech therapy services in particular.

Since 1972, the “Nomenclature of preschool institutions for abnormal children of the system of the USSR Ministry of Education” has been approved - kindergartens and groups for children with hearing, speech, vision, intelligence, and musculoskeletal impairments. Since 1975, the legislation has opened speech therapy groups at kindergartens about

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general type and specialized kindergartens, nurseries. In 1976, the “Regulations on the formation of speech therapy centers in secondary schools” were adopted.

In the 1977-1978 academic year it was opened speech therapy department at the defectology faculty of Leningrad State Pedagogical Institute named after. A.I. Herzen. Currently, about 20 higher educational institutions in the country train defectologists (correctional teachers), where students receive an additional specialty - speech therapy.

There are two interrelated areas in the system of speech therapy assistance. On the one hand, the creation and improvement of a network of special institutions for children with speech disorders, on the other hand, correctional work with children carried out in mass educational institutions. In recent decades, they have become widespread preschool speech therapy centers(Seliverstov V.I., 1988; Stepanova O.A., 1994, etc.).

Result of the 3rd period- a widely developed differentiated system of speech therapy assistance to the population, provided in public education and healthcare institutions. However, it should be noted that speech therapy service institutions are unevenly distributed throughout the country - more in the European part of the country, in large cities; The rural population is poorly covered by speech therapy assistance. Regular speech therapy assistance is not provided to children with profound developmental disorders and a complex structure of the defect; children with mild developmental disorders are not included in the system of complex and differentiated, comprehensive (speech, personality, behavior) correctional and pedagogical influence; the educational standard dominates the development of the child’s personality, etc.

In the 90s, a new, 4th period began in the development of the system of speech therapy assistance, a period of transformation of existing organizational forms and the search for new ones that are adequate to the needs of society at the present stage of its development.

The current stage of development of our country is characterized by radical political transformations, democratization of society, rethinking by the state and society of human rights, the rights of the child, and the disabled. Allow

Private charitable initiatives, church patronage have been improved, and the rights of parents of children with developmental disabilities have been expanded. In today's incredibly difficult economic conditions, the problems of families with children with developmental disabilities have become aggravated and complicated, especially in connection with the transition to independent financing of many educational institutions. A whole range of medical, psychological, pedagogical, social, legal problems, and technical support issues that would allow the integration of children with developmental disabilities into society remain unresolved. Medical care is provided irregularly; the network of institutions for restorative treatment, medical, psychological and social rehabilitation for various types of disabilities in children is not sufficiently developed.

The attitude that has existed for many years towards the education and upbringing of children with mental and physical disabilities in specialized institutions alienates the child from the family and society. This negatively affects the establishment of contacts between children and parents, leads to the destruction of intra-family relationships, disruption of the formation of social and everyday orientation, social experience and adequate behavior of the child in various life situations. There is no advisory service created where parents could receive recommendations on working with a child with deviations in psychophysical development. The problem of employing mothers who bear heavy burdens of caring for disabled children is an extremely pressing issue; the issue of rest for a family with a disabled child, etc., has not been resolved.

The 80-90s of the 20th century brought a number of important achievements in the field of preserving life, protecting, and ensuring the development of children in general and children with developmental disabilities in particular:

1) dissemination of information and carrying out a number of actions during the International Decade of Persons with Disabilities (1983-1992), declared by the UN;

2) implementing a policy of mass immunization against six major childhood infections;

3) conclusion of an International Agreement at the World Meeting of Heads of State and Government on the problem

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mothers of childhood, setting the goal of reducing child mortality and disability from disease and hunger by the year 2000 and ensuring the protection of the normal physical and mental development of all children; 4) acceptance Convention on the Rights of the Child The UN General Assembly and its entry into force as an international law in September 1990, which talks about the rights of children to life, to protection, to development. In Art. 23 of the Convention declares the rights of children with physical and mental disabilities to a full life; to conditions that ensure the preservation of personal dignity, maintaining self-confidence and promoting the child’s active participation in the life of society; for special assistance, guaranteeing the involvement of all possible sources, individual focus of assistance depending on the condition and living conditions of the child.

Unfortunately, children with developmental disabilities and their families often still encounter psychological, bureaucratic, and official barriers in all spheres of life. It is necessary to form a positive attitude towards people with disabilities, especially children, with the help of media.information; We need to help the world set its priorities and put the vital interests of all children, including children with developmental disabilities, first in all respects. In this regard, the problem of social rehabilitation becomes extremely important.

Social rehabilitation- this is genuine compassion for a sick person, especially for a child. Is our society ready for this? Without real attention, genuine care, mercy and compassion, social rehabilitation, and even more so integration, is impossible. The point of rehabilitation is not to determine impairment and assign appropriate monetary compensation, but to identify the potential opportunity of a child with developmental disabilities to enter society as far as possible and realize his abilities to the maximum, so as not to become a burden to society and its outcast (67).

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Ministry of Education and Science of the Russian Federation Federal State Budgetary Educational Institution of Higher Professional Education "Chuvash State Pedagogical University named after. AND I. Yakovlev"

Department of Correctional Pedagogy

TEST

BY DISCIPLINE Speech Therapy

Subject:“Organization of speech therapy assistance in the system of the Ministry of Health and Socialon the development of the Russian Federation»

Completed by: 2nd year student

correspondence department

directions of SDO

Golubeva Elena Petrovna

Checked by: Associate Professor Guseva T.S.

Cheboksary 2014

Introduction

1. Speech therapy assistance to children in the healthcare system

2. Speech therapy assistance to adults in the healthcare system

3. General requirements for the design of a speech therapy room

Conclusion

References

Introduction

Speech therapy assistance (Greek logos word, speech + paideia education, training) is a type of medical and pedagogical assistance provided to persons suffering from speech disorders of functional or organic origin (dyslalia, logoneurosis, aphasia, dysarthria, etc.). Timely therapeutic and corrective measures can accelerate the development of speech in children or eliminate acquired speech disorders in adults, and prevent secondary changes in intelligence caused by speech disorders.

Speech therapy assistance is provided by speech therapists - specialists who have received higher pedagogical (defectological) education in the specialty "speech therapy", who work closely with doctors of medical institutions (pediatricians, psychiatrists, neurologists, otorhinolaryngologists, psychotherapists, etc.). Doctors identify people suffering from speech disorders, carry out clinical monitoring of them, and promptly refer them to speech therapists to provide specialized care.

Speech therapy assistance is provided in educational, health and social welfare institutions. The following specialized speech therapy institutions operate in the education system: nurseries and kindergartens for children with speech disorders, speech therapy groups in regular kindergartens, boarding schools for children with severe speech disorders. A network of speech therapy rooms has also been deployed in auxiliary schools, sanatorium boarding schools for children with psychoneurological diseases, schools for children with mental retardation, boarding schools for children with consequences of polio and cerebral palsy, schools for children with visual and hearing impairments, as well as in secondary schools.

Speech therapy assistance in the healthcare system is provided in outpatient, inpatient and sanatorium-resort institutions. Outpatient care is provided in speech therapy rooms of city clinics (mainly for children), as well as in psychoneurological dispensaries (departments). In accordance with the needs of the population, one speech therapy room is designed for 100 thousand adults (20 thousand children and adolescents). The main functions of the office: early identification of children and adolescents with speech disorders, advisory work in organized children's groups, correctional work, dispensary registration, observation and timely referral of those in need to inpatient and sanatorium specialized treatment. In large outpatient clinics, day hospitals are being created to provide speech therapy assistance and audiology rooms. Inpatient speech therapy assistance is provided in specialized units of psychoneurological hospitals, as well as in neurological, neurosurgical, and otorhinolaryngological departments of large multidisciplinary hospitals. To provide speech therapy assistance at the sanatorium stage, a network of specialized children's sanatoriums has been deployed, and specialized pioneer camps operate in the summer. The All-Union organizational, methodological and scientific center of speech pathology in the system of the USSR Ministry of Health is the Department of Speech Pathology of the Moscow Research Institute of Psychiatry.

The social security system includes orphanages for severely mentally retarded children and adolescents and orphanages for the deaf-blind. Disabled children are admitted to the institutions, and comprehensive correctional and educational work is carried out with them, an integral part of which is speech therapy.

1. Speech therapy assistancechildrenin the healthcare system

Issues of improving speech therapy assistance to the population, improving the quality and effectiveness of treatment for people suffering from speech disorders are being successfully resolved in the system of the country's Ministry of Health. Based on the Order of the Ministry of Health No. 465 of April 8, 1985 “On measures to further improve speech therapy care for patients with speech disorders,” directions for the development of specialized care were determined: expanding the network of speech therapy rooms, rehabilitation treatment departments in children's clinics, and psychoneurological dispensaries. They provide assistance to people of different ages with functional and organic speech disorders.

In the order of the Ministry of Health No. 1096 of August 19, 1985. Estimated standards of service for speech therapists have been determined:

* when working individually with persons with severe speech disorders (aphasia, dysarthria, stuttering, etc.) - 1--5 visits per hour, when conducting group speech therapy classes - 8--10 visits per hour;

* when working individually with people suffering from dyslalia - 4 visits per hour, when conducting group speech therapy sessions - 10-12 visits per hour;

* 1 speech therapist rate per 100 thousand adult population, 1 rate per 20 thousand children and adolescents.

The Federal Center for Speech Pathology and Neurorehabilitation (Moscow) operates successfully. Its main task is organizational and methodological assistance to health authorities and institutions in organizing the work of speech therapy rooms in polyclinics, psychoneurological dispensaries, and specialized departments of hospitals for the treatment of patients with speech pathology.

The center’s employees study the prevalence of speech pathology among the population, the need for speech therapy assistance, develop proposals for the organization, development and improvement of speech therapy assistance for children and adults, study proposals for equipping speech therapy rooms and hospitals, develop instructional and methodological materials, study, generalize and disseminate best practices work of speech therapy rooms and hospital departments for the treatment of patients with speech disorders.

Speech therapy room at a children's clinic

The main link of speech therapy care in the healthcare system is the speech therapy room of a children's clinic.

The work of a speech therapist at a clinic is structured in accordance with the “Regulations on the speech therapy office of a children’s clinic,” which defines the areas of his work:

1. Pedagogical work to correct speech defects is carried out in systematic and advisory classes.

2. Clinical examination of organized and unorganized children.

3. Participation in staffing speech therapy institutions in the healthcare and education systems. Registration of speech therapy characteristics for each child.

4. Conducting speech therapy sanitary and educational work: conversations with parents, work with pediatricians and kindergarten teachers, publication of speech therapy bulletins, production of visual teaching aids.

Specialized nurseries for children with speech disorders

Specialized nurseries for children with speech impairments are an independent healthcare institution and are aimed at raising children and carrying out activities aimed at the correct development of speech or the correction of its defects.

Nurseries are managed by local health authorities, which manage their work and monitor the proper organization of services for children.

Selection for nurseries for children with speech disorders is carried out by a special commission consisting of a pediatrician, a psychiatrist (neurologist, psychoneurologist) and a speech therapist. Children are sent to the selection committee with the following documentation: an extract from the history of the disease, a conclusion from a psychoneurologist and a speech therapist at the clinic, a certificate from the place of residence, a certificate from the parents’ place of work on the amount of wages.

Admission to specialized nurseries is carried out:

a) for children with delayed speech development throughout the year as places become available; speech therapy pedagogical speech

b) for people who stutter - once every 6 months; in special cases, the period of a child’s stay in a group for people who stutter can be extended to one year.

Specialized nurseries accept children with stuttering and delayed speech development on an organic background.

Contraindications for use are: severe mental retardation (mental retardation, mental retardation associated with progressive mental illness), seizures, severe motor dysfunction.

The work of specialized nurseries is based on the type of institutions with 24-hour stay for children. Specialized nurseries accommodate children under 4 years of age (accepted up to 3 years of age).

Groups are formed according to speech defects (stuttering, delayed speech development).

Discharge from specialized nurseries is made home, to a special kindergarten or general kindergarten (according to indications).

Specialized children's home

The main task of a speech therapist in the Children's Home is the prevention of deviations in speech development (starting from the pre-speech period - from 3 months to 1 year), timely diagnosis and correction of the speech of children in all age groups.

The speech therapist takes an active part in medical, psychological and pedagogical commissions, examines all children by types of speech and non-speech activities, describes the level of development of each child, draws up an action plan to ensure the timely development of speech or its correction, for each subgroup of children and individually.

He works daily with children of all age groups (starting from 3 months of age) in subgroups and individually (in accordance with methodological guidelines for teaching young children), and evaluates the effectiveness of training.

Children's psychoneurological sanatorium is a sanatorium-type medical and health institution.

The children's psychoneurological sanatorium is located under the district, city, and republican subordination. General management is carried out by the Ministry of Health, regional and city health departments.

Children 4-7 years old are admitted to a preschool psychoneurological sanatorium; children from 7 to 13 years old go to a school psychoneurological sanatorium.

The selection of children for a children's psychoneurological sanatorium is carried out in accordance with the “Indications and contraindications for the treatment of children in local sanatoriums and resorts.”

Indications for sending children to a psychoneurological sanatorium:

* neuroses and neurotic forms of reactive states; asthenic, cerebrosthenic, neurosis-like conditions as a consequence of early organic damage to the central nervous system; skull injuries, neuroinfections, somatic diseases;

* neurosis-like forms of mental illness in the stage of incomplete compensation;

* initial manifestation of psychogenic pathological personality formations and pathological character traits without pronounced behavioral disorders and social adaptation;

* general underdevelopment of speech at all levels with concomitant reading and writing impairments; dyslexia, dysgraphia, dysarthria, dyslalia, rhinolalia; delayed speech development; stuttering (with accompanying disorders of sound pronunciation, reading and writing), mutism.

The duration of stay in the sanatorium is 3 months. Repeated treatment is possible after 6 months.

Recruitment is carried out according to age principle.

The goal of the sanatorium is to carry out therapeutic, recreational and speech therapy activities in order to correct speech disorders and deviations in the mental development of children. School-age children are taught general education subjects according to their grade level.

Main sections of medical and health work:

* therapeutic-protective and therapeutic-training regime, taking into account the age and condition of the children;

* rational nutrition;

* psychotherapy;

* physiotherapy and exercise therapy;

* drug therapy;

* speech therapy correctional classes;

* rhythm;

* occupational therapy.

The work is planned by those responsible for each section of work (teacher, doctors, speech therapist) and is coordinated by the chief physician.

Modern therapeutic and speech therapy methods are used (rational psychotherapy, hypnotherapy, etc.).

There is a close connection with schools in the nearby area, leading medical institutions in the city, region, and republic.

The direct management of a children's psychoneurological sanatorium is carried out by the chief physician (psychoneurologist or pediatrician).

2. Speech therapy assistance for adultsin the healthcare system

In recent years, the healthcare system has been intensively working to improve speech therapy care for adults suffering from various speech disorders. Particular attention is paid to the problems of speech restoration in patients who have suffered a severe stroke, brain surgery, etc.

The system of speech therapy assistance for adults includes institutions of various types:

1. Inpatient (neurological departments at hospitals).

2. Semi-stationary (occupational therapy rooms).

3. Outpatient (methodological rooms at district clinics of the city).

Reception of patients at the clinic is planned at the rate of 4-6 people per working day. Once a week, the clinic’s speech therapist visits patients at home. The course of rehabilitation training in an outpatient setting covers from 10 to 17 people at a time. The number of sessions per week with each patient is planned from 1 to 5 times and is determined by the patient’s condition. The course of speech restoration lasts on average 3 months. If there are appropriate indications for the patient, the training course can be repeated. Monitoring and observation by a neurologist is constantly carried out, and systematic frontal and individual speech therapy classes are conducted. At the same time, a complex of physical therapy, massage and physiotherapy is prescribed. The opening of semi-inpatient facilities with the widespread use of occupational therapy for patients with aphasia makes it possible to more successfully resolve issues of social adaptation and psychotherapeutic influence.

The provision of speech therapy assistance in the neurological department to patients with severe speech disorders (aphasia, dysarthria, stuttering, etc.) is carried out in stages. Early corrective action increases work efficiency and has great preventive value.

The length of stay of patients in a neurological hospital is 1-3 months.

A comprehensive examination (speech therapist, neuropsychologist, etc.) and analyzes of its results help to identify the extent, nature and location of the lesion, and compensatory possibilities.

Subgroup and individual classes are conducted with patients suffering from aphasia: their frequency, nature and content depend on the individual capabilities of the patient and the degree of speech disorder. The duration of speech therapy sessions in the first weeks is 10-15 minutes (1-2 times a day). Somewhat later, the duration of classes increases to 45 minutes daily; for subgroup classes, the period is extended to 1 hour. The patient’s speech record records the dynamics of speech therapy work (current epicrisis) twice a month.

The effectiveness of speech therapy work is largely determined by the contact of the speech therapist with the doctor and the patient’s relatives.

3. General requirements for the design of a speech therapy room

Individual, group and frontal speech therapy classes are conducted in specially equipped rooms, the placement and area of which must comply with the instructions on the design of special institutions. Speech therapy rooms are financed by regional, city and district departments of public education according to the estimate of the institution where the speech therapist works.

The speech therapy room must have: a cabinet for manuals and literature, tables and chairs for conducting classes. The number of tables should be at least 4, not counting the large table for the speech therapist, and the number of chairs should be at least 8-10.

The speech therapy room should have a hanging board, half of which is lined; in addition, it should have devices for placing pictures, a flannelgraph, objects and other equipment for classes. The necessary equipment for a speech therapy room is a wall mirror with a curtain measuring 70x100 cm for group work on sound production and small mirrors 9-12 cm for individual work (at least 10 pieces).

For ease of use of didactic aids, the speech therapist prepares a special file cabinet.

The equipment of the speech therapy room additionally includes:

1. Special aids for the development of phonemic differentiation (a set of paired subject pictures corresponding to words with initial sounds that are close and distant in sound, and of varying sound and syllabic complexity); sets of pictures corresponding to words with different letter locations: at the beginning, in the middle, at the end.

2. Sets of various words and pictures for making sentences; a set of reference phrases for composing stories; phrases with omissions of words that differ in their grammatical affiliation and degree (the nature of their connection with the phraseological context).

3. Sets of sentences corresponding to various logical-grammatical structures, and spatial patterns of prepositions.

4. Sets of words with missing letters; texts of sentences and stories with missing words; dictation texts.

5. Sets of words: antonyms, synonyms and homonyms.

6. Sets of letters in different fonts; numbers; elements of letters and numbers, sets of arithmetic examples and elementary problems; sets of geometric shapes and shape elements for design.

7. Poems, proverbs, fables with questions developed for them, sayings, humorous stories.

8. Sets of texts with a missing beginning, middle, and end.

9. Pictures depicting objects and actions; story pictures of varying complexity; sequential series of pictures reflecting gradually developing events; reproductions of works of art (paintings); sets of subject pictures with missing elements.

10. Books for reading, collections of dictations, alphabet books, geographical maps, sets of records.

Conclusion

The effectiveness of speech therapy work depends on the teacher’s expression when demonstrating exercises; it is very necessary, because it facilitates imitation and emotionally charges children. Work must be organized in different ways. There can be no standard. A teacher-defectologist needs to constantly change “roles”: from actor to conductor-observer. Emotions, feelings, images must be shown to children. They believe in the image and perceive the material emotionally and figuratively. Boring, monotonous activities should be excluded: what is interesting is easier to remember.

All exercises for the tongue, lips, fingers should be turned into an exciting game, and not into mandatory training, into a game that strengthens and develops not only the speech apparatus, but also attention and memory. In organizing correctional work, you need to start from the child, and not to the child with your own demands, and pay more attention to unplanned activities initiated by the child himself.

The intensity of children's speech development depends on the nature of the relationship with the teacher, on the characteristics of communication with him.

Praise and encouragement should be a natural part of daily work to create a sense of success and progress in the child.

The office should be “homely”, cozy, bright and spacious.

The work of a speech therapist requires greater efficiency in each lesson. The desired result can be achieved through careful and economical selection of material and more thoughtful and serious processing of correctional work techniques. The entire educational process should be built on a diagnostic basis.

References

1. Volkova L.S. - Speech therapy. Methodological heritage: A manual for speech therapists and defect students. faculties of pedagogical universities. /. M.: Vlados, 2006

2. Dubrovina I.V., Andreeva A.D., Danilova E.E., Vokhmyanina T.V.; edited by I.V. Dubrovina - Psychocorrection and developmental work with children: Proc. manual for students of secondary pedagogical educational institutions / 2nd ed., stereotype. - M.: Academy, 2001

3. Zueva L.N., Shevtsova E.E. -Handbook for speech therapist: reference and methodological manual - M.: Astel, Profizdat, 2005

4. Strebeleva E.A., Venger A.L., Ekzhanova E.A. et al.; Ed. E.A. Strebeleva., Special preschool pedagogy: Textbook / 2002.

5. Filicheva T.B., Chirkina G.V. Elimination of general speech underdevelopment in preschool children. Practical guide. - M.: Iris-Press, 2007

6. Shashkina G.R., Zernova L.P., Zimina I.A. Speech therapy work with preschoolers. - M.: Academy, 2003

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Organization of speech therapy assistance in the social protection system. The main directions of formation and development of the system of speech therapy assistance in Russia

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