Abstract
The Moscow Institute-lnternate for the disabled with distortion of motor organs is the first specialised higher educational establishment in Russia and in the world, which provides 'barrierless environmental' conditions for students with spinal distortions, amputees, with childhood cerebral paralysis, illnesses of osseous and muscular systems. Education is based on higher educational state standard programmes without any adaptation for the disabled youngsters. The Institute provides studies at 5 departments. Law, Economic, Foreign Languages, Editorial and Applied Mathematics. Total annual enrolment is 50 students. Period of studies is 5 years. Students come from different regions of Russia, from Belorussia and Ukraine. First enrolment took place in 1993. In 1998 there was celebrated first graduation of 37 specialists, in 1999 - 43 specialists and in 2000 there will be 38 specialists.
Education of students with limited moving abilities and some accompanying psychosomatic illnesses has become possible here since 1993 due to development and application of 'Medical Pedagogy', which accompanies learning process with medical (medicine, physical, psychological and logopedic) rehabilitation, which is provided with academic hours in the time-table. Strict adherence to 'Medical Pedagogy' results in a very small number of expelled students because of poor state of health. The work is interesting to people who deal with specialised education.
I have pleasure to begin my report at the Congress with presentation of the monograph entitled 'Medical Pedagogy', published in July 2000.
The Monograph is intended mainly for specialists from specialized schools and higher educational establishment for students with limited potential and psychosomatic illnesses.
True social interegration of the disabled youngsters is hardly possible withput professional education, especially higher education. It is necessary to create favourable conditions for the diabled to receive higher education.
Establsihed in October, 11, 1990, Moscow Institute-Internate for the disabled with injuries of motive organs (MII) of the Russian Ministry of Education is the first specialized full-time higher education institue in the country and in the world for students with spinal problems, amputations, childs celebral palsy and skeleton and muscular illnesses.
The reason for establishing the institute of special education in our country was lack of 'barrier-free' environment, i.e. poorly accommodated premises of acting institutes to the needs of persons with limited movement abilities, lack of city communications and transport facilities to meet requirements of disabled students.
Thus, out of the total number of full-time students in Russia in 1991/1992 (1 mln. 640 thousand) only 300 students suffered from motive organs disabilities. Besides lack of "barrier-free" environment Russia occupies a rather vast territory, where there is a great number of towns and settlements, which have no higher educational establishments at all and where severe frosts continue half a year.
MII is the first leading higher special educational establishment in the country. Its foundation took place before the acceptance of Federal Laws: "On Education" (1992), Changes and Supplements to the "Law on Education" (1996), "On Social Protection of Disabled Persons in Russian Federation" (1995), "On Higher and Post-Institute Professional Education" (1996). No law has so far been accepted "On Special Education".
Founded after MII were State Specialized Institute of Art under the Russian Ministry of Culture (Moscow), Institute of Social Rehabilitation of the Novosibirsk State Technical University of the Russian Ministry of Education, the Correspondence Institute of Rehabilitation and Professional Education for the Blind under All-Russia Society for the Blind (Volokolamsk, Moscow Region). Under modern conditions these institutes solve not only educational problems but also provide for socio-economic and medico-psychological protection of disabled persons.
In addition to special higher educational establishments already functioning there opened special education groups, faculties and centers for teaching disabled students within a number of acting Institutes. For example, for more than 60 years has been functioning a Center for educating engineers at Moscow State Technical University where deaf and persons with weak hearing (with the third group of disability) study. At Pedagogical Institutes within Defectologial Faculties deaf and weakly hearing students, blind and weakly seeing students (with the third group of disability) study. Teachers-defectologists are also being prepared here to teach at special schools. Educated at Moscow State University at philosophical department is a group of students where blind and weakly seeing students study. In addition to these at 16 institutes (in Krasnojarsk, Cheliabinsk, Vladimir, St. Petersburg and others) special departments and groups for disabled are opened.
Education of disabled persons at special institutes does not at all substitute their education at mainstream institutes. It is only a partial solution of the problem. However, under modern complicated economic conditions of Russia education of disabled persons at mainstream institutes practically limits opportunity for the disabled with motive organs students to obtain higher education. Enrolled in 1995/1996 at all 600 higher educational establishments in Russia (special institutes included) there were 450 disabled students having all kinds of illnesses. Thus, for your information, each mainstream institute has enrolled approximately 0.5 disabled students. For students disabled with motive organs this number is even less.
Education of disabled persons in Russia takes place at educational establishments under four Ministries: Ministry of Education, Ministry of Labour, Ministry of Culture and Ministry of Health. No data banks are existent for disabled children up to 16 years of age and disabled students. No clear records for the dynamics of their education; no fixed numbers of those who entered and finished school, college or institute. There is a wide difference in educational programs, financing and supply of material and technical aids to educational institutions of the above Ministries. It is necessary to coordinate educational processes of these Ministries, development of a unique policy of continuous education: pre-school, school, Institute and Postgraduates.
The problem of "barrier-free" environment at MII is solved in such a way that living rooms and class-rooms occupy one and the same floor in two buildings which are have not got any lifting accommodations and these rooms are prescribed to the same students for all five years of studies. Students on wheel-chairs live in separate rooms and attend classes on the first floors of the buildings where there are computer classes, library and the dining hall. It is possible to accommodate for studies and living here 250 disabled students.
Labour, Foreign Languages, Book Publishing and Applied Mathematics. Period of studies is 5 years. Annual enrollment at all five departments is 50 disabled persons of the age from 16 to 30. Educations is provided on the bases of state education standard for higher professional education at mainstream institutes without any adaptation of programs to the state of disability. What should be adapted here are living accommodations and technical aids.
Education is accomplished by 80 highly-qualified specialists. Accomplished in July 2000 was the eighth enrollment of 50 disabled persons. Total enrollment during eight years of institute function constituted 412 students from various regions of Russia, Byelorussia and the Ukraine.
Distribution of students according to the disability groups is as follows: 25% - the first group, 50% - the second and 25% - the third. Out of them 70% are the students who suffered children's cerebral palsy.
In 1992/93 there functioned preparatory courses at which there were enlisted 48 listeners (24 of them attended classes at the institute, the rest - studied at home: they moved in wheel-chairs) Medico-psychological and pedagogical control showed unfavorable results as to their basic knowledge of middle special school subjects and state of health. Along with main pathological illnesses disabled with motive organs have various psycho-somatic illnesses, which develop due to lack of active movement, stresses and very low level of free of charge medical care.
Neither at home nor abroad there existed any practice of wide-scale (250 students) full-time higher education for disabled with motive organs and weak health students (75 % of them have the first and the second group of disability) at one and the same institute. To persons disabled with motive organs belong those with innate disability (cerebral palsy) and with acquired disability (spinal problems, amputations, illnesses of skeleton and muscular systems). Special pre-school and school education is meant for children with light forms of cerebral palsy. Problems of education and bringing up of this category of children were studied at Research Institute of Correctional Pedagogy (earlier called Defectology) of Russian Academy of Education. Special Pedagogy, Defectology, Correctional Pedagogy based their research results on investigation of children of pre-school and school age. Problems connected with full-time higher education of adult disabled persons either with innate or acquired disability was not investigated at Scientific Research Institutes of Russian Academy of Education. For the first time these problems were taken up as objects of research by the author of this paper in 1988 in connection with the establishment of MII.
In the field of special education following terminology is used: Special Pedagogy, Medical Pedagogy, Rehabilitation Pedagogy, Defectology, and Correctional Pedagogy. "Special Pedagogy" as a subject deals with specific difference of various types of distortions in the development of children and development of pedagogical approaches to them.
The term "Medical Pedagogy" appeared in the beginning of the twentieth century in Germany. It applied to curing different distortions down to "curing the soul" (in scientific research papers of Rudolf Steiner, 1861-1925) for disabled children with problems in their development and behavior. According to specialists in "Medical Pedagogy" a child suffering from cerebral palsy is considered to be one of a seriously ill persons ("pupil"). Investigation of children suffering from cerebral palsy showed that some part of these children are well intellectually developed and, consequently, they may undergo ordinary process of learning and education.
In the twentieths of this century there came into being the term "Defectology" and from the ninetieths this term has been used parallel with the term "Correctional Pedagogy", which are connected with the use in the lessons of special methodology: "Surdopedagogy" for deaf and weakly hearing, "Typhlopedagogy" for blind and weakly seeing, "Logopedics" for persons with faulty speech and "Oligofreno Pedagogy" for oligophrenics.
Beginning from 1991 the author has continually developed new investigation in pedagogy at special higher educational institute for education of students with motive distortion organs - "Medical Pedagogy", where the process of education is supported by medical (medicine, physical, psychological and logopedical) help, which is supplied with academic hours included in the timetable.
Physical condition of badly moving students with distortion of motive organs is accompanied by some psycho-somatic illnesses, which have determined creation and functioning at MII some special divisions, whose activities are directed at recreational and stabilizing effects. There functions a problem laboratory, with a staff including psychologists, sociologists and teachers. There is also students' rehabilitation department at City Polyclinic ? 41. Rehabilitation process is carried out by research workers from the problem laboratory, staff members working at the Chair of Physical Culture and medical personnel of the Clinic.
In 1993 beginning from the first year of studies all MII students were taken care of according to the principles of "Medical Pedagogy". This made it possible first, not to prolong the term of studies above 5 years, which brought essential economic effect in spending on education. It stands to reason to remind here that at shools-internates the period of studies for children suffering from cerebral palsy is equal to 12 years, i.e. one year more than at ordinary schools. Secondly, prolongation of the term of studies would decrease annual enrollment due to limitation of living space at the institute. Thirdly, the students enrolled at the institute posses the first category certificate (spinal and heavy forms of cerebral palsy), which means that they have never attended schools but studied at home. The fourth - dismissals from the institute due to somatic illnesses during the period of studies is very low.
"Medical Pedagogy" helps to preserve health of students and to increase their workability. Teaching is accomplished on high standard without any adaptation of curriculums and decreasing the requirements to the knowledge of students.
The direction of research developed at MII differs widely from traditional "Correctional Pedagogy" ("Defectology") from its notional terminology, methodology of the subject matters for investigations and ways of response. The concept of "Correctional Pedagogic" where learning process is accompanied by surd translation for deaf students and Braille alphabet for blind is naturally not applied to disabled students with poor moving abilities.
Emphasize here that due to creation of "free-of-barrier" environment, development and application of "Medical Pedagogy» at MII was achieved and practical results show the possibility of providing higher education for students with distortion of motive organs. The essence of the author's model of education in accordance with "Medical Pedagogy" lies in the fact that the educational block for students disabled with motive organs (along with main pathology many of them suffer from psycho-somatic illnesses) is supported by medical block the components of which are medicine, physical, psychological and logopedical rehabilitation and supplied with additional academic hours for practical work in this field.
When teaching of some other categories of disabled persons is concerned, for instance, deaf or blind, logopedics is naturally substituted by surdopedagogy or typhlopedagogy. In case of teaching ordinary "healthy" children or students, medical, physical and psychological help are remain.
Pedagogical model of educational system at MII is developed with the account of main discrepancy of pedagogical process, which consists mainly in poor health, potential strength and possibilities, life experience of the students at the earlier period of their studies and the necessity to achieve high level of professional skill. Overcoming this discrepancy is actually the main criteria in achieving the competitiveness of disabled persons on labour force market and thus securing their social protection.
Scientific approach included in the subject "Medical Pedagogy» is developed on the basis of 7-year long practice of teaching persons disabled with both innate and acquired disability.
As a result of this new approach to the structure and methods of education developed on the basis of modern achievements of pedagogical, psychological, medicine and physical rehabilitation sciences.
Medicine part of "Medical Pedagogy" is carried out by students' rehabilitation division of City Clinic ? 41, which operates in close contact with problem laboratory (probing of modern diagnostic and curative modern technique, psychological and pedagogical methodologies), the Chair of Physical Culture and Moscow Medical Stomatological Institute.
Main object of rehabilitation division in the system of supporting the pedagogical process is control of the dynamic of students' health, prescription and therapeutic curing in accordance with indicated medicine and physio-therapeutic procedures.
Complex study and control of somatic health and neurological state of disabled students is regularly taken place at the institute. Investigations show that overwhelming majority of disabled students have that or other psycho-somatic pathology.
Analyses of accompanying illnesses made it possible to determine frequency of their appearance and on this basis organize proper medical help. Regular control of neuro-muscular system and the dynamics of moving ability: improvement of motion ability in the joints, stabilization of supportability, improvement of workability of organism as a whole, teaching of correct breathing, stabilization of movement activity, improvement of body stature (posture) and bearing, training of balancing system, improvement of coordination of motive organs is carried out in accordance with principal illness.
As long as the middle school does not insist on attending classes by pupils with disable motive organs, main purpose of Physical Culture Chair is the normalization of movement activity, development of stabilized and depression of tonal muscular reflexes.
The program of individual physical rehabilitation includes all principal means, most prospective among them are: kinesotherapy, postisometric relaxation, bioplayback effect, walking, curing by lying posture, mechanotherapy on polyfunctional training instruments.
Rehabilitation process creates inner motivation, i.e. obtaining of such knowledge, abilities and skills, which would lead to the achievement of these targets in their future professional activity and somehow stimulate it. Psychological comfort, continuous positive impressiveness give disable students belief in their own power and the possibility of developing their own compensational functions and after educational period successfully begin their professional activity, which would make it possible for them an independent every day activity and communication with ordinary people.
Psychological work with disabled students on the basis of "Medical Pedagogy" continued parallel with scientific research in this direction during 7 years of education in MII. This stage was necessary for further development on the basis of expected results addressed programs of psychological support (psychotherapeutic, psycho-correctional, psycho-pedagogical) and optimization of pedagogical process.
Psychological problems of "Medical Pedagogy" stipulated by progressively increasing number of persons suffering from children's cerebral palsy, multitude of biologically based defects (defective movement, faulty speech, writing, perception, memory, attention, thinking, behavior and health) which prevent learning process and require development of specifically directed programs, and multifarious support of learning process.
Students disabled with cerebral palsy have complexo-deficital psycho-physiological basis for education which evokes a socio-pedagogical dilemma: either easing requirements of the programs for studying, i.e. actual disregard of proper higher education or strengthening the process of education with the help of medical rehabilitation (which is actually non-existent at ordinary institutes) and not lowering the requirements of learning programs.
The second way, which has been put into practice at MII is new for higher educational establishments as health, intellectual development and personality of young disabled persons suffering from cerebral palsy have never been studied as complex problems.
The results of research have lead to a very important practical conclusion: young persons with cerebral palsy are in some cases able to study at mainstream institutes, but concentration of all of them together (on competitive basis) can study only at those higher educational establishments of special education which practice the system of "Medical Pedagogy".
The problem of improving the process of education for disabled students within the context of "Medical Pedagogy" is closely connected with rendering the students defectological aid. This problem is also new for higher educational establishments as long as defectology has been the object of attention only for children of pre-school and school age and not for adult disabled persons.
MII has some actual problems connected with the fact that part of the students with cerebral palsy has difficulty with speech, writing and handle typewriting on a personal computer, which prevent normal education. Application of technical aids at MII made it possible to develop scientific and methodological bases for correcting speech habits of the logopatic` students, accomplish approaches to the correction of writing technique, teaching to write on a typewriter and composing summaries of the lectures.
In conclusion we can state the following:
Moscow Institute-Internate, founded in 1990 is the first in the country and in the world special full-time higher educational institute for students disabled with motive organs. New scientific direction in pedagogy of higher education for students disabled with motive organs - "Medical Pedagogy", which deals with preservation of health, improving workability of disabled persons having the first and the second group of disability has been elaborated. Thanks to "Medical Pedagogy" the institute is able to enroll 250 students (out of which 75% are disabled persons having the first and the second groups of disability due to innate or acquired illnesses). They all study at five Departments without any adaptation of standard curriculums used at mainstream institutes. In 1998 and 1999 the institute graduated 80 specialists (16 of them received diplomas with honors). Out of them 65 specialists got their jobs in national economy (5 graduers were enlisted to working MII as teachers and staff-members of problem laboratory). Thus, real integration of disabled high-class specialists into society has been accomplished. Third graduation of 36 students (5 of them were awarded diplomas with honors) took place in June 2000 and 37 specialists must be graduated from MII in 2001. Practical results obtained due to introduction of "Medical Pedagogy" make it possible to increase the number of students at MII up to 450 people, when new modern block of living accommodations will be built (the project is ready at hand).
The concept of "Medical Pedagogy" is universal and applicable also in cases of education of other categories of disabled persons, who possess the symptoms of psycho-somatic illnesses.
According to official statistics there are 11 mln. disabled persons in Russia. Out of them 1.8 mln. are children. Worsening of health of school children, persons, who reached the age of going to the ranks and students are noticeable all over the country. Application of "Medical Pedagogy" will make it possible to preserve health and workability of young generation of the nation: school-children and students having psycho-somatic illnesses at mainstream and first and foremost at special establishments for disabled persons of middle and higher school professional education.
"Medical Pedagogy" is an independent scientific and pedagogical discipline and it is necessary to educate specialists at different level educational establishments.
This year institute started to work at the research "Distant education for students with distortion of motive organs".
With a view to introduce integrated learning at MII we are investigating the idea of enrolling 50 able-bodied students. This idea is closely connected with the solution of organizational and financial problems.
From October 11 to 13, 2000 Russian Ministry of Education organizes in Moscow All-Russian Conference on "Professional Education of Disabled".
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