Kazakh model of providing complex services for disabled children

Public union of invalids “Kenes”Centre of social adaptation and labour

rehabilitation

Public union of invalids “Kenes”Centre of social adaptation and labour

rehabilitation

Almaty, 2011 годAlmaty, 2011 год

Kazakh model of providing complex services for children with psycho

neurological pathologies

Kazakh model of providing complex services for children with psycho

neurological pathologies

K 1

Imperfection of the system of providing special social services in KR before implementation of the

Standard of rendering of special social services

1. Absence of competitive environment

2. Limited alternatives and availability of special social services

3. Ineffective use of budgetary funds

4. Preferentially segregation system of providing special social services

1. Absence off succession in providing special social services during the life cycle

2. Absence of the inter-agency coordination in providing special social services

1. Inter-regional differentiation in the extent and quality of providing special social services

2. Imperfection of funding, of quality assessment monitoring of the provided special social services

1. Low level of professionalism

2. Low prestige of social worker

3. Absence of professionals on assessment and identification of the need in special social services

4. Imperfection of the educational and methodical base in training of professionals

State monopoly for providing special

social services

Absence of the complex approach in

providing special social services

Imperfection/ absence of the state

standards

Absence of the developed institute

of the social workers

K 2

Absence of developed institute of social workers

Absence of professionals on social work in different spheres of professional activities, including

social workers on assessment

Imperfection of program on education and training of

social workers

Absence of organization (creation) of practical

platforms for training of specialists of social work

Does not allow to create a system of escorting a person, in a difficult life situation and to organize a required set of services for his integration and

improvement of life level, with use of the methods of assessment of needs for services

K 3

Imperfection of (and in certain cases - absence) the standards of rendering of special social services

Differentiation of costs of Special Social Services per year (per one served person, per region)

Name of agencies and organizations Maximum Minimum

1. Houses for aged and handicapped people of the general type 862,4 338,2

2. Houses for adults with psycho neurological diseases 966,8 278,3

3. Houses for children with psycho neurological diseases 1115,5 452,7

4. Houses for the orphans and children without parental care 1451,9 126,1

5. Children villages for orphans and children without parental care (family type) 1110,5 436,1

6. Shelter for orphans and children without parental care 5083,3 309,9

7. Orphanages for orphans and children without parental care, (family type) 1542,0 148,7

Thousands of tenges

K 4

1. Reforming of the system of special social services : - transition to medical and social model of providing special social services - development of standards of rendering special social services - determination of the list and scope of special social services, both paid and free - determination of the categories of citizens for receipt of special social services - determination of the criteria of providing special social services

2. Improving of the institutional system of providing special social services : - implementation of the mechanism of state social order on providing special social services in non-

governmental sector - expansion of the market of providing special social services - development of the modern forms of institutional content for the people in difficult life situation

3. Forming of the institute of social workers

4. Improving of the system of funding of providing special social services (with consideration of new standards)

Aim of development of the Law of RK «On special social services»K 5

Improvement of financing system of providing of special social services

Structure of the costs for providing special social services (in %)

52,4

22,5 25,1

admin costs of institution payments for labour fund

costs for providing sercvices

19,8

16,5

10,1

28,4

25,2

admin costs of institution

food costs

psycho correction services

medical services

social services

Current Proposed, with new standards

K 6

3086 tenge

1743 tenge

Cost of services per 1 child in the boarding school of psychoneurological type (per day)

hospitalization daytime in-patient

at 42,6%

Improvement of institutional system of providing special social servicesK 7

Categories of citizens for receiving of special social services

People, discharged from

prison

Homeless people

Children with limitations of

early development

People, Suffering from socially

significant diseases

Unemployed

Lonely aged people

Orphan children

Socially disadapted children and

teenagers

Handicapped people

Activities on meeting of certain social needs of a person in a difficult life situation.

K 8

As a basis for the Standard of rendering special social services, there was used an author’s model of complex rehabilitation, developed by «Kenes» Public Association of Handicapped people, Center of social adaptation and labour rehabilitation

K 9

Structure of the author’s model of complex services in the semi in-patient conditions

Integration

Day, in-patient for

adultsSocial and

labour education

Social and domestic orientation

Social adaptation

K

Implementation of correction programmes

Integration programmes for children from 3 to 7 years old

Integration programmes for “special” children

Correction classes of IV level

Integration

Day, in-patient for adults

Social and labour

education

Social and domestic orientation

Social adaptation

K

Correction classes of IV level

Correction classes of V level

Correction classes of III level

Correction classes of V level

Impart cultural and hygienic and self-serving skills

Motion abilitation

Programmes of “Kenes” center

Integration

Day, in-patient for

adults

Social and labour

education

Social and domestic orientation

Social adaptation

K

Kinesitherapy

Motion abilitation (kinesitherapy)K 13

Motion activityK 14

Art-therapyK 15

Agro-therapyK 16

Zoo-therapyK 17

Author’s model of the centre of complex rehabilitation and inculcation of the vital skills to children with complex structure of defects (registration number # 875 of 07/05/03)

Stages of children development at “Kenes” Centre of Complex Rehabilitation

Integration programmes for children from 3 to 7 years old

Integration programmes for “special” children

Correction classes of IV level

Integration

Day, in-patient for

adults

SLE

SDO

Social adaptation

K

Correction classes of IV level

Correction classes of V level

Correction classes of III level

Correction classes of V level

Impart cultural and hygienic and self-serving skills

Motion abilitation Kinesitherapy

Early intervention :

Complex of the activities of medical, social, psycho correctional type, directed on achievement of the compensation of condition of a child and improvement of her micro social surrounding.

K 20

Goals and tasks of Early K 21

Goal:Maximal development of a child for

each concrete case Tasks:

•Prevention of social orphanage;

•Provision of a child with the complex maintenance;

•Support of continuity and consistency of the complex maintenance, including among professionals;

•Constant training of the parents;

•Prevention of disabling pathologies

(Early intervention)

Main types of children: 1) bad affection of The

Central Nervous System (CNS);

2) deep retardation of the development of different etiology;

3) motional disorder (Infantile Cerebral Paralysis);

4) hereditary non progressive disease;

5) Down’s syndrome.

K 22

(Early intervention)

Main objects of :

Child–the characteristics

of its development (mental state, motional, cognitive development)

Family– emotional support, training of the skills of correct care of the child with special needs

K 23

of medical section:

Psychoneurologist; pediatrician;

exercise therapy trainer; psychotherapist;

of psycho correctional section :

Psychologist; teacher pathologist; teacher – pathologist on the development of sensory skills (ergotherapist);

of social section :

social worker on child’s care;

specialist on social work (consultant).

(Early intervention) Personnel

K 24

( Early intervention)

Work content :

Diagnosis (primary examination bypsychoneurologist, pediatrician);

development of individual plan of work(with the following correction at each stage of the complex

maintenance);Treatment

(medication, non medication);psycho correctional maintenance :

(development of fine motor coordination, sensor integration).

K 25

(Early intervention)

Organization aspect :

1) Cooperation with the state institutes (maternity hospitals in Almaty city, institute of molecular medicine, polyclinics);

2) Family patronage and, when necessary, appointment at PUI «Kenes»;

3) Groups of «Early development».

K 26

(Early intervention)

290 families are involved in «Early intervention» project.

From them, children with:

1) Down’s syndrome– 69;

2) motional disorder (ICP) – 95;

3) perinatal encephalopathy (PEP), deep retardation of psychomotor development (RPMD) – 91;

4) retardation of speech development (RSD) – 30;

5) epilepsy – 5.

K 27

Groups of «Early Development»

1) Transfer from family patronage to adaptation outside of home;

2) Communication between children;

3) Communication of parents (as the result - creation of the “Family School” project).

K 28

Recommendations on organization of «Early development» groups work :

1) Conduct the lessons twice a week by 2 hours from 9.00 to 11.00 AM;

2) Children’s age is from 1,5 to 3 (3,5) years old;

3) Number of children in the group is 5-6 children;

4) Each child should be escorted by an adult;

K 29

(Groups of «Early development»)

5) Lessons are conducted by 2 teachers;

6) Each lesson consists of a strict structure;

7) Beginning and the end of the lesson, as well as the change of the types of activity are clearly marked;

8) Transfer from one stage to another is marked by an audio signal, for example, by a ringing bell.

K 30

Experience of inclusion of children with the special needs into the

environment of typical children

K 31

Children type

Children with:

1) hypertensionic and hydrocephalic syndrome;

2) myotonic syndrome;

3) motor disorder (ICP);

4) chromosome pathology (Down’s syndrome).

K 32

Three main components for inclusion of children with the special needs into the environment of typical children:

1) well formed skills of self-service;

2) adequate emotional and will sphere;

3) corrected behavior.

K 33

Inclusion:

1) Gives an opportunity to our children, in a full scope, to participate in the life of the kindergarten group;

2) Has resources directed at stimulation of the equalization of rights of children and their participation in all the aspects of group’s life;

3) Is directed at the development of children’s abilities, required for communication.

K 34

Principles of inclusion :

1) Value of a person does not depend on his abilities and achievements;

2) Every human is able to feel and think;

3) Every human has a right on communication and a right to be heard;

K 35

(Принципы включения)

4) All humans need each other;

5) Real education can only be gained in the context of real relationship;

6) Everyone needs support and friendship of the coevals;

7) For all learning children achievement of the progress is rather in what they can do, then in what they cannot;

8) Diversity enhances all the sides of the human’s life.

K 36

Results of inclusion:1) Every child has an opportunity for meaningful, active and constant participation in the all of the activities of education process;

2) Adaptation is imposed as little as possible and does not contribute to generation of stereotypes;

3) Individual help does separate, do not isolate the child;

K 37

(Results of inclusion)

4) Abilities for generalization and share of the skills are appearing;

5) Professionals of the multi disciplinary team are assigning the duties on planning, conducting and assessing of the activities;

6) Existing procedure of assessment of efficiency allows to periodically follow the dynamic of the development of a child.

K 38

Inclusion is not integration. Inclusion is more than integration :

1) All children are learning together;

2) The multi disciplinary team of specialists is working to help the children;

3) The atmosphere of relations among children is changing (tolerance, amicability);

4) The attention is given to the individual needs of a child;

5) The human differences are interpreted as a common thing;

6) The children get an opportunity to leave together with their parents.

K 39

Structural components of the model of complex maintenance of children with special needs, realized by the «Kenes»

Center:Early intervention– from 0 to 3 years old («the normalizations» model);«Early development» groups– from 1,5 to 3 years (adaptation of the «normalization» model to the «inclusion» model);Pre-school education groups - from 3 to 7 years («inclusion» model);Semi-hospital (daytime)– from 3 to 18 years (specialized education of the children difficult structure of defects according to the author’s program);Occupation center– from 18 years old and older (socialization of the pupils of the Center).

K 40

«Happiness is life!» Balandin Roma, 20 years old

K 41