5. Evaluation of the results

When analyzing the results of a survey of the child is important to consider the factors influencing the effectiveness of implementation of tasks: especially memory, concentration (attention), the regulation of their actions by voice control, orientation in the workplace, coordination of movements, especially fine motor skills.

Every intelligent and practical action of the child must be considered from the standpoint of:

- Forms of execution (mentally, with the help of visual aids, expanded instructions, display, etc.);

- The degree of generality (collapse or expand the operation);

- Degree of development (start-up phase of training, the level of automation and differentiation, etc.).

In drawing up the final conclusion of the specialists commission must analyze and nature of the errors:

- Whether they are systemic in nature (manifested in all activities) or random;

- Whether there is fragmentation, the surface, distorted, incomplete perception of the information;

- The conditions under which the number of errors increases (the length of time, the growing exhaustion of the nervous system, distracted by extraneous stimuli, etc.)

- Under what types of assistance occurs error correction.

At the end of the child's examination procedure is recommended to have an exchange of information between all experts agree on and generalize it, to formulate a final conclusion and recommendations. Meeting conducts Chairman, members of the Commission have to put a signature in the minutes of observation of the examination of the child and deliver their chairman. In case of dispute, to discuss results of the survey carried out without the presence of stakeholders (parents, representatives of the OU, etc.). At the end of the agreed joint decision of the commission, subject to the consent of the parents (legal representatives), the Secretary draws up the minutes, specialists can carry out individual consultations, explanations for parents (legal representatives), teachers, heads of DU on the organization of a special psychological and educational assistance.

to professional training requirements

A very important aspect of the quality of the psychological, medical and pedagogical work is not only the presence of the commission of specialists (speech therapists teachers, educators, psychologists, social workers, etc.), But in the first place - an adequate level of professional competence in related fields of scientific knowledge.

Knowledge of the legal and regulatory framework, the essence of pedagogical, psychological, medical, social concepts necessary skill for close understanding in the Commission, the ability to navigate, negotiate and coordinate their conclusions and recommendations, with the main goal - implementation of protection of interests of the child with disabilities.

Sufficient level requires a minimum of knowledge in the following disciplines:

1. Special (correctional) pedagogy

2. Special Psychology

3. Basics of psychopathology, child neurology, neurophysiology

4. Psycholinguistics

5. Psycho

Special Education (preschool, on areas, educational levels of welfare activity) forms of knowledge about the organization and methods of teaching children with impaired speech, hearing, vision, intelligence).

Special psychology gives the concept:

- The general and specific regularities of mental development of children with disabilities;

- Typological characteristics of children with delayed, Deficits, distorted or disharmonious development;

- A complex defect structure (the relationship of primary and secondary disturbances in development);

- The theory of compensation of disturbed functions, and others.

Pathopsychology give an idea about the laws of decay of mental activity or the individual qualities of the person, on the distortion of brain (neural) activity on specific disorders of personality: perception, memory, thinking, mental health, etc.

Neuropathology generates ideas about the structure of the nervous system, its functions (higher nervous activity), for neurological and psychiatric diseases and their impact on child development.

Neuropathology reveals the concepts of the role of leading analyzers in the formation of the child's psyche:

- On the structure and functions of the speech motor analyzer, a speech disorder caused by impairment of the central nervous system (alalia, aphasia, nasality, dysarthria) and their influence on the formation of speech and writing, adaptation, mental development of the child;

- On the structure and function of the visual analyzer, its violations and the impact on mental development, training, adaptation of the child;

- On the structure and functions of the auditory analyzer, its abuses and the effects of these disorders on learning, adaptation and mental development of the child.

Psycho diagnostics forming methods of examination of children with disabilities, the knowledge of the method of study of higher mental functions, interpretation of the results.

Lecture 15. Clinical examination methods: survey; examination of the child; anthropometry; palpation. Clinical and genealogical research method. Laboratory testing methods. Instrumental methods of research.

Objective: to give information about the clinical examination methods

Plan:

1. Clinical examination methods: survey; examination of the child; anthropometry; palpation.

2. Clinical and genealogical research method.

3. Laboratory testing methods.

4. Instrumental methods of research.

Diagnostics - a key step in the treatment of any disease. From fidelity and accuracy of the diagnosis depends on further treatment strategy. All the diagnostic methods of examination can be divided into two categories:

• Clinical methods - are held directly by your doctor.

• Additional (or paraclinical) - carried out by a physician using specific diagnostic methods.

patient diagnosis is established on the basis of clinical and paraclinical studies.

Clinical methods of examination include history taking, examination of the patient, palpation, percussion and auscultation.

anamnesis

History - is information about the history of the patient's disease, which is obtained by questioning the patient and / or his loved ones. In certain situations the doctor may need medical history and / or history of the patient's life.

History of the disease - a collection of information about the beginning and course of the disease. When collecting medical history doctor discovers the nature of the patient's complaints and their change over time. A short history usually indicates the presence of an acute illness and anamnesis lasting usually indicates chronic pathologic process.

Life history - is to collect data on the physical, mental and social status of the patient throughout his life. History taking in patients with mental disorders provides for subjective (from the patient) and objective information, which can be obtained from the patient's friends.

PATIENT EXAMINATION

There are general and special inspection. General inspection carried out in all cases, regardless of the patient's complaints. Special inspection is carried out by specialists (eg, gynecologist, urologist, ophthalmologist) using the special tools.

On examination, the patient's condition is assessed overall, his body position, posture, facial expression, skin color, height, weight, gait. We examine the head, face, neck, trunk, limbs, genitals, assessed the state of the adipose tissue, bones, muscular system and lymph nodes.

PALPATION

Palpation - tactile method of study patients. With palpation is possible to determine the place of the location of their consistency, the nature of mobility, flexibility, local temperature. Also, in some cases, palpation reveals abnormal formation in the various cavities of the body.

Palpation is superficial and deep. The latter is carried out only after the superficial palpation.

In carrying out systematic surveys conducted palpation of the skin, muscles, bones, chest, abdomen and lymph nodes. In the study of the internal organs can be used special palpation techniques: transrectal palpation of the pelvic organs, kidneys bimanual palpation, vaginal palpation of the uterus and others.

PERCUSSION

Percussion - survey method based on the rapping parts of the body and further interpretation of the sound produced during the examination. Percussion is often used in cases of suspected presence of compacted fabrics, definitions Hollow, flexibility and lightness of tissues and organs.

AUSCULTATION

Auscultation - the method of clinical diagnosis, which is based on listening and further interpretation of the sounds that are produced by the various bodies. There are direct and indirect auscultation. Direct auscultation involves attachment doctor ear to the patient's body surface. Indirect auscultation - is the use of special tools that enhance the sound.

Normal operation of the internal organs is characterized by certain sounds, and the development of pathological process is changing the nature of sounds that allows the physician to suspect the presence of diseases.

The data from all clinical diagnostic methods allow the doctor to identify the proper benchmark in the way of diagnosis. If necessary, the doctor refers the patient to carry out further special examination methods.

Clinico-genealogical method

One of the prerequisites the correct and timely diagnosis, prevention and treatment of hereditary diseases, as well as the determination of genetic risk and clinical prognosis for the patient's relatives is the use of clinical-genealogical method.

For the first time this method has been introduced in medicine F. Galton in the last century. In our country, the most complete and widely pedigrees analysis method applied in clinical practice excellent clinician, geneticist and neurologist, Professor SN Davidenkov.

Clinico-genealogical method is based on an analysis of the nature of transmission of various symptoms and diseases in a single family with an indication of kinship between members of the pedigree. Clinico-genealogical method helps to make a correct diagnosis and therefore to choose adequate treatment and time to carry out targeted preventive measures. Therefore, going to the doctor-genetics, the couple should be well prepared. It is necessary to ascertain the state of health or the cause of death of the nearest and distant relatives from both the wife and by the husband. It is desirable to know not only the maiden names of women pedigree, but also age, and even better - the date, place of birth and residence of their ancestors.

For families the parents of the patient, or just the consulted person in a geographically isolated area in closely spaced areas suggesting a common ancestor, which may contribute to the accumulation of more of the same genes, helps to identify the presence of the family of consanguineous marriages. Marriages between close relatives increases the risk and are of great importance when considering diseases with hereditary predisposition. In addition, the doctor-genetics should be told about the ethnic origin of the family, for persons of different ethnic groups (eg, Jews, Uzbeks, Finns and others.) Have increased susceptibility to certain hereditary diseases. Correctly and accurately collected data gives the doctor information and often serve as the basis for the diagnosis of hereditary diseases.

It is known saying: "How many families, so many secrets." Practical experience proves that often families are hiding the facts of diseases, providing false information about fatherhood and so on. N. Pedigree is based on a sense of trust relationship to the doctor, cross-comparison of data surveys and inspections relatives. Therefore, you should not be surprised if the doctor-geneticist (after mandatory consultation with Consult) invite for an interview and clinical examination of his relatives, assigning them additional clinical and instrumental examination, ask to provide for the study of photographs of family members, if necessary - medical documents confirming or absence of a disease. It should be understood that this is done only in the interests of the consulting! After all, only in the case of reliably collected pedigree specialist can determine the type of inheritance of the disease and thereby confirm the diagnosis, identify those in need of medical and genetic counseling, to determine the clinical prognosis for the patient and his relatives, and to develop a plan of treatment, rehabilitation and prevention, taking into account individual and family characteristics of the disease.

Each family is pedigree, which are used for certain symbols. Graphical representation of the pedigree is accompanied by "legend" (information), which highlighted the details of each family member and symbols used in the scheme. After anamnesis and graphic pedigree conducted clinical and genealogical analysis, which allows to determine the hereditary nature of the disease, the type of his inheritance, the outlook for posterity, to find out who the members of the pedigree of the most threatened in terms of the appearance of the same pathology. Appoint additional diagnostic measures necessary to complete consultations determined prognosis of the disease and its possible complications, selected the optimal therapeutic measures.

The use of clinical-genealogical method involves along with the collection of family history thorough clinical, laboratory and instrumental examination as possible of all family members.

Clinico-genealogical (genealogical) method is based on data obtained from the proband and his family members during the initial appointment with a doctor. This method is an integral part of the initial reception.

Genealogical method refers to the oldest methods of medicine, but still is and will remain one of the most sought after.

This method is relatively simple and available. Its essence is to collect physician genealogical data necessary for the subsequent compilation and analysis of the proband's family pedigree.

The collection of such data is aimed at identifying and studying the symptoms of hereditary and congenital disease that appeared in the proband and his patients and healthy relatives.

The procedure for collection of genealogical data and the nature of the questions asked of the proband and his close relatives are given below. During data collection, it is desirable to use family photo albums, medical records and other documentation.