History of medical pedagogy. General medical pedagogy.

Therapeutic pedagogy is a system of therapeutic and pedagogical measures aimed at preventing, treating and correcting various developmental disorders, neuropsychic and somatic disorders that can lead to permanent disability, school and social maladaptation.

Therapeutic pedagogy is a complex effect on the body and personality of the child. Its tasks include stimulation of mental and physical development, correction of existing deviations in development (retardation in mental development, behavior, speech, communication disorders, motor skills and other psychomotor functions) in order to comprehensively develop a sick child.

When carrying out medical and pedagogical measures, one should rely on the preserved functions and capabilities of the child.

Therapeutic pedagogy is closely connected with clinical medicine, primarily with pediatrics, child neurology and psychiatry, as well as psychotherapy, age-related physiology.

The main tasks of medical pedagogy are to develop special individual and group methods and programs aimed at correcting impaired functions and stimulating the child's psychomotor and emotional and personal development.

The most important task of medical pedagogy is also the psychotherapeutic impact on the child and his family with the development of individualized programs for family education, family psychotherapy, adequate, developing interaction between mother and child.

Based on the analysis of the structure of the leading disorders that cause a lag in the development and maladjustment of the child to the environment, curative pedagogy solves both general pedagogical and general educational tasks, as well as purely specific correctional ones, taking into account the specifics of abnormal development and the individual characteristics of the child and his family.

The main principle of therapeutic pedagogy is the close relationship between therapeutic and pedagogical processes.

Pedagogical and educational work is built taking into account general pedagogical and general educational tasks using specific pedagogical techniques and methods differentiated depending on the nature of the child’s disease, the specifics of impaired development, the structure of the leading disorder, the severity of secondary developmental abnormalities, the general level of physical and mental development, age, degree of social and pedagogical neglect and maladjustment. Therapeutic and corrective impact should have a positive impact not only on the child, but also on his family. This is especially important, since it is well known that in a family in which a sick child is brought up, a special psychological conflict is usually created, especially in cases where family members begin to feel the futility or low effectiveness of their efforts aimed at stimulating the development of the child. If there is also a decrease in the social status of the family, more often a mother caring for a sick child, then the family psychological conflict may deepen. In these cases, systematic family psychotherapy is necessary, one of the main links of which is teaching the mother special correctional techniques and involving her in work both with her child under the guidance of a psychotherapist and a speech pathologist, and gradually to work with other children as an assistant defectologist.

An important principle of medical pedagogy is the need for an individual approach to each child, taking into account the most intact, “healthy” neuropsychic functions and positive personality traits.

An important principle of curative pedagogy is the "principle of correspondence". This means that the requirements and loads imposed on a sick child must correspond to the state of his health, his physical and mental capabilities. Only under these conditions can a child develop self-confidence, an emotionally positive attitude towards classes. It is recommended that at the initial stages of work, pedagogical requirements even somewhat lag behind the psychophysical capabilities of the child, which will help increase his emotional tone.

The most important task of medical pedagogy is the mental education of the child, while it is especially important to develop mental abilities, and not just expand the amount of knowledge and ideas about the environment.

Distinguish between general and private medical pedagogy. Private medical pedagogy is based on the specifics of individual diseases and deviations in psychomotor development.

At present, the role of curative pedagogy in the education and training of children with developmental disabilities is increasing dramatically. This is due both to an increase in the number of children in need of special medical and pedagogical assistance, and to the humanization of education, which necessitates the creation of special conditions for the possibility of successful education for each child, including children with developmental disabilities, various neurological, mental and chronic somatic diseases. . The number of children who, without special training with the use of therapeutic and pedagogical measures, cannot successfully start schooling is increasing. Conventionally, they are united in a group of children with special needs. Among them there are children with a delay mental development, speech, sensory and motor defects, non-contact children, patients with chronic somatic diseases, including those with the so-called congenital immunodeficiency, when a child with normal mental development is characterized by a sharp somatic weakness and an increased tendency to various diseases internal organs. Many of these children are bedridden and are taught either at home or in inpatient children's hospitals.

Among children with special needs, a large group is made up of children with neuropsychiatric diseases and developmental disabilities. These are children with mental retardation, speech, sensory and motor defects, non-contact children, or children with communication disorders, behavioral disorders, mental and neurological diseases such as childhood schizophrenia, epilepsy, myopathy and many others. A special group is made up of children with complex developmental disorders who have several abnormalities or diseases. For example, a combination of mental retardation with impaired vision, hearing, behavior, diseases of the musculoskeletal system or internal organs, endocrine and other disorders.

Great value for school and social adaptation These children have not only the nature of the disease itself or a variant of abnormal development, but, above all, the time of the start of treatment, correction and developmental measures. It has now been established that early and systematic treatment and correctional measures and training can significantly contribute to the more successful development and social adaptation of children, including children with disabilities with the most severe developmental disabilities and diseases.

The specificity of carrying out treatment and correctional measures at an early age, both in the family by parents and in special classes by teachers, psychologists and speech therapists, is little developed. This is especially true for children with chronic somatic diseases, which are often combined with neuropsychiatric disorders, as well as children with communication disorders (RDA), mild developmental disabilities and complex, multiple defects.

Despite the presence of specific developmental and learning difficulties in each of the children of these groups, some common difficulties and patterns of disturbed neuropsychic development are also revealed in them. First of all, these are low mental performance, lack of concentration, memory, immaturity of the emotional-volitional sphere, emotional instability, lag in the development of speech, limited stocks of knowledge and ideas about the environment, lack of motor functions, lag in the development of spatial representations.

Some of them are characterized by affective excitability, motor disinhibition, for others, on the contrary, lethargy, passivity, insufficient motor and mental activity, indifference to the environment.

Most of these children are characterized by insufficient expressiveness of cognitive interests, violation and slowing down of reception and processing of sensory and speech information. By the beginning of schooling, many of these children's hand is "not ready" for writing.

Large individual differences in the specifics and severity of these developmental disorders are largely due to the nature and time of CNS damage, the specifics of a mental, neurological or somatic disease, as well as genetically determined characteristics of the child's organs.

Of great importance for the further development of a child with developmental disabilities is not only the nature or variant of abnormal development, but, above all, the time of the start of treatment, correction and developmental measures. At present, it has been established that systematic medical and pedagogical corrective measures, started early and carried out, can significantly contribute to the more successful development and education of the child. This is due to the fact that it is in the first years of life that the child's brain develops most intensively.

In addition, in the early stages of development, children more easily learn motor, speech and behavioral stereotypes. If, in the absence of medical, pedagogical and corrective measures, these stereotypes were initially formed and fixed incorrectly, then it is extremely difficult to correct them later.

Therapeutic and pedagogical impact involves both overcoming existing deviations in development and preventing possible disorders associated with overexertion of the nervous system, as well as various mental traumas that lead to the emergence of special painful conditions of the nervous system that easily occur in children of early and preschool age - neuroses. . How younger child, the less significant stimuli can lead to mental trauma. This determines the need to train parents and teachers in the correct interaction with a young child in the process of his upbringing and education. This requires special medical and pedagogical correctional and developmental programs for the interaction of mother and child; proofreader teacher and child.

Until recently, many children with severe developmental disabilities were viewed as unteachable and parents were generally encouraged to place them in welfare institutions. At present, the situation has changed. The development of techniques and methods of therapeutic pedagogy shows their high efficiency when applied early, and especially in those cases when a mother becomes an active participant in the therapeutic and pedagogical work, well-oriented not only in the problems of her baby, but also in the main correctional areas of therapeutic pedagogy. We pay special attention to the role of properly organized emotional and developmental interaction between mother and child and to the stimulation of his mental, speech and motor development in the process of this interaction. Therefore, it is important that the mother of a sick child master the basics of medical and pedagogical work with her baby and carry it out systematically in the process of emotional interaction with him. When conducting medical, pedagogical and corrective measures with children with developmental disabilities, it is important for specialists to observe the following basic principles.
1. Based on the observance of the rights of the child, enshrined in the Convention on the Rights of the Child, strive to the maximum extent possible to realize the right to education, aimed primarily at the development of personality, mental and physical abilities, as well as the right of a child with special needs to preserve their individuality.
2. Inclusion in correctional and developmental classes of all, including the most difficult children with multiple developmental disabilities, developing an individual developmental and correctional program for each of them.
3. When evaluating the dynamics of a child's progress, do not compare him with other children, but compare him with himself at a previous stage of development.
4. To create an atmosphere of goodwill for the child, to form a sense of psychological security, to strive for the safe acceptance of the child with an understanding of the specifics of his difficulties and developmental problems.
5. Correctly and humanely evaluating the dynamics of the child's progress to realistically provide further opportunities for development and social adaptation.
6. Determine the pedagogical prognosis on the basis of an in-depth understanding of the medical diagnosis, but always with pedagogical optimism, striving to find in each child the safe potential, the positive aspects of his mental and personal development, which can be relied upon in pedagogical work.
7. All children, and especially those who are physically weak, easily excitable, unbalanced, should be treated calmly, evenly, kindly.
8. To develop for each child, together with the doctor, a program for the rational organization, hygiene of mental and physical activity, aimed at preventing fatigue.
9. Remember that signs of overwork, along with a decrease in concentration, deterioration in motor coordination, are sleep disturbances. When overworked, the child often falls asleep badly or, conversely, quickly falls asleep, but then wakes up soon and may not sleep all night. When overworked, the child's nervous excitement and irritability increase, tearfulness is often observed, and all the disorders that he has are intensified.
10. Each child must be accustomed to a certain daily routine. All activities of the child must be built according to a specific schedule.
11. All personnel working with a child must comply with professional ethics. The diagnosis and prognosis of each child should be the subject of professional secrecy of specialists.
12. When conducting correctional and developmental education and upbringing, it is important to strengthen and develop the positive unique originality of each child, his individual abilities and interests.
13. Develop a dynamic individual developmental and correctional program for each child.
14. Stimulate mental and emotional development based on the mental state of joy, calmness, looseness.
15. Gradually but systematically include the child in self-assessment of their work.
16. Patiently teach the child to transfer the existing mode of action to similar conditions, switch from one mode of action to another, stimulate creativity and ingenuity when completing each task.

When developing a special methodology for pre-preschool and pre-school education and training, rely on general and specific patterns age development in both normal and developmental disabilities.

Observe the basic principles of a methodical approach to upbringing and education: create special conditions to ensure the motivational side of activity, implement a communicative orientation of education, strictly individualize education, comprehensively develop all productive activities in a child: drawing, modeling, manual labor, applications, etc.

In corrective work, use special techniques and techniques based on various types of activities: subject-practical, gaming, elementary labor, all types of productive activities, but focus on the game as the leading activity of this age stage of development. When carrying out medical and pedagogical work in pre-school and preschool age scientific and practical substantiation of each type of occupation is necessary, depending on individual, personal, emotional and intellectual capabilities and characteristics this child: individual, subgroup, frontal, as well as differentiated use of various games: didactic, role-playing, dramatization games, musical rhythmic, etc.

Proper upbringing of a child with developmental disabilities is possible only if parents and teachers understand his problems correctly and at the same time the family, and especially the mother, maintain peace of mind. Only such a mother becomes an active assistant to the teacher and, above all, to her baby. She tries to understand the problems of her child as best as possible, carefully listens to the advice of specialists. Such a mother often keeps a diary of observations of her baby. Keeping a diary is very important not only for parents, but also for specialists who observe the child.

A necessary condition for proper upbringing and the most favorable development of a sick child is an adequate attitude of those close to his condition. Therefore, parents who have children with developmental disabilities need the qualified help of specialists, the moral support of others.

For the development of a healthy and especially sick child great importance you have his communication with the mother, during which the child develops emotional and communicative behavior, which is important for all further mental development.

We have already noted that the mother's stress, which occurs at the birth of a sick child, interferes with the establishment of normal relationships with her baby. Such a mother is constrained, tense, she rarely smiles, is extremely inconsistent and uneven in her handling of the baby. As a result, in this situation, not only is it difficult to carry out therapeutic and pedagogical measures aimed at correcting existing violations and deviations in development, but the child also develops secondary neurotic reactions, he grows nervous, excitable, and his developmental lag is even more pronounced. , speech development is especially delayed.

In order for parents to be good assistants to the teacher, it is important that they do not become isolated in their grief, but, remaining active members of society, gradually introduce the child into it, constantly expanding its contacts with the outside world. It is important that a sick child does not feel exclusive or deprived. It is also necessary that the mother does not feel guilty or inferior, remains attractive and sociable, retains her interests and hobbies, acquaintances and friends. In no case should the interests of healthy brothers and sisters of a sick child be infringed upon. Often healthy child in such families they pay little attention, they demand that he always yield to the patient, not complain about his inadequate actions. All this adversely affects the development of the personality of both a sick and a healthy child, as well as the psychological climate of the family.

The irritability of adults towards a sick child is also completely unacceptable. Parents should not be allowed to shout at a child for nothing, punish him unfairly, while setting a healthy brother or sister as an example and not taking into account limited opportunities sick baby.

When raising a child with developmental disabilities, it is very important to develop his self-service skills in a timely manner, to include him in the life of the family.

Parents of a sick child should be in their family not only specialists in curative pedagogy, but also psychotherapists. To create a normal psychological environment in every family that has a child with developmental disabilities, the union of parents in associations helps. Currently, all over the world, including in our country, the network of associations of parents of children with developmental disabilities is expanding.

Therapeutic-pedagogical and correctional work with a child with developmental disabilities is not an easy task. It is very important that parents and teachers treat him naturally, whatever his defect.

Thus, the success of medical and pedagogical and corrective measures depends on the possibility of proper joint work of a teacher-defectologist, speech therapist, doctor, psychologist and parents.

Important integral part therapeutic and pedagogical measures is an early restorative and developmentally stimulating treatment. Early use of special treatment stimulates development and helps to prevent irreversible changes in the nervous, muscular and skeletal systems. Many children with developmental disabilities need early comprehensive treatment, which involves specialists from various fields: a pediatrician, a pediatric neuropathologist, a child psychiatrist, an orthopedist, a doctor or a methodologist therapeutic gymnastics. Often, consultation and treatment of an ophthalmologist, audiologist, endocrinologist, geneticist is also necessary.

Especially important is specialized care and treatment in the first years of life, when the most intensive development of the child's brain takes place.

Parents play an important role in the treatment of a young child with developmental disabilities. First of all, they should realize that the treatment of a child with damage to the nervous system and developmental disabilities is a long process that should be carried out in close conjunction with the conduct of special pedagogical classes, speech therapy, classes physical therapy. The mother must be taught the special skills of caring for the child, taking into account the specifics of his disease, the basic techniques of massage, therapeutic exercises, the rules of the orthopedic regimen, and the methods of speech therapy.

Uskova Olga Mikhailovna

Medical pedagogy.

I work with children who are being treated at the Talitsky Children's Tuberculosis Sanatorium. Children from 2.5 to 18 years old come here. In 2010, the school of the sanatorium was transferred to the ordinary city school MOAU secondary school No. 20 in Kirov. We teach children from grades 1 to 11. The children's team changes 4 times a year. A children's sanatorium is a specialized medical and educational institution that provides rehabilitation treatment, schooling, physical, moral, aesthetic education of children suffering from tuberculosis or having a predisposition to this disease. Under the influence of the disease and anti-tuberculosis drugs, the main functions of the body are disorganized, its reactivity changes, the central nervous system is depleted, which becomes more vulnerable, incapable of an adequate response to ordinary stimuli. Successful rehabilitation of sick children is possible with well-placed pedagogical work with a rationally combined treatment and preventive work.

Before me, as a teacher, the tasks are:

Create conditions for learning curricula in the disciplines of elementary school;

Contribute to the rapid adaptation of children to new conditions;

Create an atmosphere of interest for each student in the lesson;

Create pedagogical situations for student success in the classroom.

1. The concept of curative pedagogy

1. L.G. Kogan notes: “The essence of medical pedagogy lies in the fact that in the selection of methods of treatment and rehabilitation of a sick child, the thought of a doctor and teacher should be directed primarily and mainly to the use of natural healing factors and physiological protective properties and mechanisms of the child’s body and healing effect on his psyche of a general calm state and joyful mood.
2. IN general pedagogy It is written: “By curative pedagogy, we mean a system of methods and techniques that, having a beneficial effect on the child’s psyche, contribute to his treatment and recovery.”

"Therapeutic pedagogy is not a ready-made recipe, but a creative idea."

This makes it possible to use various methods and programs related to recovery. Therapeutic pedagogy enables the creativity of the teacher, at the same time requires him to good knowledge pedagogy, psychology, methods. Everyone who works on issues of curative pedagogy needs to know what can be demanded from a child, how to build work in accordance with his psychological features sick and frequently ill child.

The health of the child depends not only on external conditions, but also on the internal mental life. All life difficulties, psychological overstrain, negative emotions lead to diseases.

1. The health of the child is normal if he:

1. In physical terms, he knows how to overcome fatigue, health allows you to act in the optimal mode;
2. In intellectual terms - shows good mental abilities, curiosity, imagination, self-learning;
3. In moral terms - honest, self-critical, empathic;
4. In social terms, he is balanced, able to be surprised and admired.

1. Tasks of the teacher:

1. must master the methods of correcting psychophysical deviations, increasing the stability of the nervous system in order to overcome difficulties for children;
2. to direct all attention to the inner feelings of children, realizing that in children involuntary attention prevails. They are able to focus only on what he likes, and not on what we “need”.

1. Principles of curative pedagogy:

1. Treatment with joy;
2. Influence accounting mental factor on children's health;
3. Individual approach;
4. The principle of vigorous activity combined with rest;
5. Unity of work of medical and pedagogical personnel

1. Treatment with joy.

What can bring joy?

1. A friendly children's team, he brings the joy of communicating with peers.
2. Compliance with the active mode, organization of leisure filled with games, entertainment, holidays. I spend physical minutes at the lesson, and active games during the breaks. With the guys we are preparing holidays for March 8, “Farewell to the ABC”, etc.
3. Implementation of comprehensive aesthetic education. Aesthetic therapy includes landscaping and decoration of the territory, interiors. Beauty is manifested both in behavior and in relationships between people. Along with the healing effect, aesthetics forms a moral character. All these points I draw the attention of my students.
4. Carrying out various forms of physical education brings motor joy to the child. These are health paths, walking micro-tourism, sports games, etc. I spend all this as part of the lesson time in physical education and the world around me.
5. Occupational therapy. I start with self-service during lessons and end with work on the school grounds.
6. Music therapy.
7. Smooth and calm treatment of adults, service personnel with children. The power of a kind word is so great that no punishment can compare with it. Everyone who communicates with children must satisfy this need for love. “When working with children, give them your heart,” said the teacher Sukhomlinsky.

1. Accounting for the influence of psychological factors on health.

The psychological factor is, first of all, mental health and the conditions that are necessary for a child to have it.

Conditions for healthy mental development:

1. Creating a calm environment, the goodwill of adults, the ability to create and support good mood learn to find joy.
2. Satisfaction of vital needs for love, affection, attention.
3. The presence of incentives for healthy mental development,

strengthening faith in oneself, one's significance, one's ability;

1. Organization of exciting activities. Passivity, uncertainty, anxiety arise during the absence of an interesting business.

The factor of hospitalization leads to a regression of the personality and the body from inactivity.

1. The child receives a variety of vivid experiences, impressions, ideas and concepts about the outside world.
2. Development of cognitive processes: attention, imagination, memory, thinking, perception.

1. Individual approach.

Pedagogical work should be consistent not only with the nature of the disease, but with individual characteristics. Only then will our work give the proper effect and become an element of treatment.

The teacher needs to know the basics of psychology, types of the nervous system, be able to organize the adaptation of "difficult" children, develop an appropriate approach and behavior correction.

So, for example, doctors distinguish 3 groups of children according to the reaction to the disease and hospitalization (adaptation).

1 group. Children with pronounced arousal, which is expressed in crying, refusal of toys, unwillingness to contact, bad dream. Such children do not get used to government walls well. The course of the disease in these children is uneven. They are restless, attention is unstable. This group is the hardest.

In relation to such children, it is necessary to apply special techniques in order to establish contact with them, calm them down, and give their activities a calm, productive character.

2 group. These are lethargic, inhibited children; they react too calmly to admission to the hospital. They are completely oblivious to their surroundings. Their faces are very pale. Such children usually refuse toys, or take them, but do not play. They sleep welland during the day, as if half asleep. In such diseases, they take a protracted character.

Such children need to be activated, and direct contact with the child is necessary. This brings good results.

3rd group. These are calm, balanced children. They react actively to hospitalization, but calmly, do not cry, easily come into contact, answer questions, willingly taketoys and are engaged with them, feel at home. The disease in such patients proceeds smoothly, without complications.

Thinking and caring about everything, big and small, on which the success of the treatment and recovery of the child depends, his general state and mood, it is necessary to attach importance to absolutely every little thing, everything important and great is made up of little things.

Observing students during admission to the sanatorium, I single out children who require special attention, I talk with parents or persons replacing them. Then every day I conduct individual conversations, games-exercises for adaptation. Systematic work helps children quickly integrate into a new team, adapt to new conditions, and survive separation from home with minimal stress.

1. The principle of vigorous activity combined with rest.

Our school has developed a system of various games: mobile, educational, sports, all kinds of tournaments, meetings, competitions, holidays. When developing events, we try to develop cognitive processes: memory, attention, imagination, thinking, movement, etc.

Teachers should, from the first days of their stay, educate the ability to organize their leisure time correctly and interestingly.

8. Unity of work of pedagogical and medical personnel.

Therapeutic pedagogy requires the workers of the sanatorium to perform not only what is "required", but also a lot of things that are not provided for by any standards - inspirational, creative work. It is for these reasons, as L.G. Kogan noted, that medical pedagogy in medical institutions is being introduced slowly. Such work is not for everyone.

A medical worker in a children's sanatorium should also be a teacher, and the teacher should be well versed in matters of medicine. But the most important thing is that everyone can understand and appreciate the work of their colleague. For the employees of the sanatorium, the words of A. Makarenko are especially suitable: “Selecting personnel is half the battle, it is more difficult to create a team of like-minded people in which everyone, trying to contribute to the common work, at the same time constantly learns from their colleagues.”

Conclusion:

Knowledge of the content of medical pedagogy allowed me to build a system of work with children of a frequently changing team and get positive results. In my work system, I pay special attention to:

1. Adaptation period
2. Emotional upbringing.
3. Sensory education (especially for first graders).
4. Development of cognitive processes in different types activities (games, occupational therapy, music therapy, art therapy, etc.)

For confidence in my abilities, I remember

10 commandments of education

(V.A. Karakovsky)

1. The main goal of education is a happy person.
2. Love not yourself in the child, but the child in yourself.
3. Education without respect is suppression.
4. The measure of upbringing is intelligence - the opposite of rudeness, ignorance, redneck.
5. Say what you know, do what you can; at the same time, remember that knowing and being able to never again is harmful.
6. Develop originality in yourself: children do not like "pies with nothing."
7. Don't be boring, don't whine and don't panic: it's better to be difficult than boring.
8. Treasure the trust of your pupils, take care of childish secrets, never betray your children.
9. Do not search magic wand: education should be systematic.
10. Children should be better than us, and they should live better.