The use of the very concept of “norm” in relation to a developing child, to dynamic changes not only in individual mental processes and states, but also in changes in indicators of their interaction, is greatly questioned. K.M. Gurevich spoke about it this way: “The problem of the normativity of developmental diagnostics is far from being resolved and is connected with the problem of the normativity of mental development in different age periods, and it is very complex and little developed” 1 .

It is not entirely defined concept of norm, which, of course* must be correlated not only with the level of psychological and social development of the child in specific periods of his growing up, but also with the requirements imposed on the child by society.

All this is complicated by the constant global change in both the sociocultural demands placed on the child by those around him (changes in educational programs at all levels, family conditions and environment, changes in children’s and adolescent subcultures, etc.), and changes in the immediate psychophysical and physiological status of the child. The latter seem to modulate the already dynamic characteristics of development.

All this cannot but have a direct impact on the indicators of the so-called development norms, which are in one way or another included in the concept of a statistical norm.

The statistical norm is the level of psychosocial development of a person that corresponds to the average statistical (quantitative) indicators obtained from examining a representative group of people of the same age range, gender, culture, etc. The statistical norm represents a certain range of values ​​of any quality (physical or mental indicators, including the level of intelligence, its components, etc.),

Gurevich K.M. Psychological diagnostics. - M., 1997. - P. 218.

located around the arithmetic mean (x) within the standard deviation (+ a) in a situation where the distribution of all values ​​of a given characteristic is recognized as normative.

It is clear that people who have received diagnostic quantitative assessments characterizing one or another indicator of psychosocial development that go beyond the limits of (x + a) are recognized as being “slightly below the norm” (up to -2 a), and even more (up to -3 c) - as “significantly below normal.” Results that exceed the norm are interpreted accordingly. As can be seen from the above, the concepts of “slightly lower (higher)”, “significantly lower (higher)” in relation to the norm turn out to be to a certain extent subjective and ambiguous for specialists in terms of their qualitative content.

The main difficulty in using statistical norms in diagnosing the level of development of a child is that such assessments require (in relation to our country) truly gigantic research, a large number of relevant institutions, research institutes, etc. In addition, they must be carried out bysteadily and systematically, including due to the constantly changing social situation in almost every region. All this cannot but affect the characteristics of the distributions of quantitative indicators included in the definition of the statistical norm.

Thus, the use of the concept of a statistical norm (in its quantitative representation, for example, in points, percentages or in a level assessment using the concepts “high”, “average”, “borderline”, etc.) should be considered extremely limited, existing only for certain categories of children for whom this norm was obtained. The validity of transferring such standards to the pediatric population as a whole seems doubtful.

The rejection of the statistical norm when assessing survey results forces us to look for new meaningful criteria for assessing development. The latter should not be a score (or any other level or scale assessment), not a comparison of subjects with each other, but the degree of preparedness of each person to perform a certain criterion task. “The main task of these tests is to establish what an individual can do, and not his place in the sample.”

At the core criterion-based diagnosticski lies the idea of ​​the normativity of mental and personal development, which has been developed for a long time by a team of researchers at the Psychological Institute of the Russian Academy of Education under the leadership of Doctor of Psychological Sciences K.M. Gurevich. They put forward the concept of “social-psychological standard” (SPN), which is most adequate in modern conditions and has already proven itself in practice.

A socio-psychological standard can be defined as a system of requirements that society places on the mental and personal development of each of its members. ...the requirements that make up the content of the SPN... are an ideal model of the requirements of a social community of personality. ...Such requirements... are enshrined in the form of rules, norms, regulations... They are present in educational programs, in professional qualifications, in the public opinion of teachers, educators, and parents. Such standards are historical, they change along with the development of society... ...the time of their existence depends on their relevance to one or another sphere of the psyche, on the one hand, and on the pace of development of society, on the other.

In accordance with this criterion, the assessment of the survey results should be carried out according to the degree of proximity to the given time, culture, and geographical location of the SPN. The latter, in turn, is differentiated within educational and age boundaries.

Closely related to the concept of socio-psychological standards is the concept functional norm, which also applies to children with developmental disabilities. The concept of a functional norm is based on the idea of ​​the uniqueness of the development path of each person, as well as the fact that any deviation can be considered a deviation only in comparison with individual trend(trend, direction) of the development of each person.

A functional norm is a kind of individual development norm, which is the starting point and at the same time the goal of correctional and developmental work with a person, regardless of the nature of his characteristics. Achieving a functional norm is expressed in the fact that in the process of independent development, training or as a result of specialized assistance, harmonious relationships are observed between personal and

society and society, in which the basic needs of the individual are satisfied, and the individual fully satisfies the requirements that society places on it.

The introduction of the concept of SPN into the structure of assessing the results of the examination allows us to approach differently the principle of normative development (in particular, the normativity of mental development - the idea of ​​​​ideal mental age as the level of demands placed on a child by the school), which L.S. once spoke about. Vygotsky. Essentially, this forces us to fundamentally reconsider the ways in which the results of any psychological examination are processed. Quality becomes the priority analysis of results, which (with the content, conceptual apparatus, and stimulus material correctly incorporated into the methodology used) allows one to identify difficulties, developmental features, and certain content characteristics of the mental processes and states being studied.

From the foregoing, it becomes clear that in a situation of qualitative assessment of the child’s developmental characteristics, the priority and only adequate activity of a special psychologist becomes clinical approach and correspondingly, clinically oriented diagnostic techniques, providing the opportunity for an in-depth description of a specific case, a real child with his individual characteristics of mental activity and development. This is how a real assessment of the mental development of a particular child can be carried out.

With this approach we can talk about ideal norm as some kind of optimal personality development, implemented in optimal sociocultural conditions for it. Obviously, such a development is unlikely to actually be encountered in practice.

An ideal norm (ideal ontogenesis) is a non-existent formation in reality that has exclusively theoretical significance as an object that has a set of properties and qualities that exist in the consciousness of one person or group of people. An ideal norm (norm model) cannot serve as a criterion for assessing actually occurring processes or mental states, but it allows us to isolate objective patterns of mental development, necessary and sufficient conditions to ensure the success of their formation.

Such a model serves the purposes of an exclusively theoretical “programmatic” description of development. It allows you to determine the point from which the individual version of normative development (conditionally normative development) will “count” first, and then, when the indicators of mental development leave the area of ​​conditionally normative development (the area specified by the requirements of the average non-population social -psychological standard), - into the area of ​​development of the deviant.

In practice, an idea of ​​the ideal norm is needed to create a methodological basis that includes universal principles and approaches to assessing the general patterns of a child’s mental development and private, specific features characteristic of individual variants of dysontogenesis.

In the diagnostic activity of a psychologist, there is always a comparison, a kind of internal scanning of the results of assessing the development of a particular child with the psychologist’s own subjective idea of ​​the norm (“local” socio-psychological standard). A situation often occurs when, of several assessed indicators of child development, some satisfy the statistical (or even ideal) norm, while others go beyond its limits. The more indicators are assessed and analyzed by a specialist, the greater such discrepancies can be. How, in this case, should the child’s development be recognized?

Such a contradiction can be resolved by referring to typological analysis and use typological(or typical - according to O.E. Gribova) fashionwhether. Such typological models of development can exist for both conditionally normative and deviant development in all its variants. Of course, we are interested, first of all, in the model of deviant development (dysontogenesis).

Thus, we can talk about the following system of analysis: an ideal model of dysontogenesis - that is, a model that describes the defect in its pure (ideal) form; typological model - taking into account the most specific features for a given variant of deviant development; individual model - defining specific individual characteristics of the development of an individual child.

The typological model allows us to take into account the most likely manifestations of one of the variants of deviant development, considering the totality of symptoms that have already received the status of psychological syndromema, within the framework of the syndromic approach 1. It is the typological models of variants of deviant development that make it possible to make a psychological diagnosis and determine a probabilistic prognosis for the further development of the child. The most important thing is that it is typological psychological models that make it possible to develop adequate programs for the correctional and developmental work of a psychologist in relation to both group (subgroup) and individual work with a child.

It should be noted that the creation of an ideal model of deviant development in contrast to the model of ideal ontogenesis is an exclusively theoretical task. Based on the analysis and theoretical interpretation of facts, the basic, universal patterns of development are formulated, including the classification of the main types of deviant development. This allows us to talk about the presence of typological indicators of development, a kind of typological standards.

The concept of a typological standard defines a set of the most frequent (qualitative and quantitative) characteristics and characteristics of a child, reflecting a specific (typological) development option - a kind of psychological syndrome.

Thus, in relation to the concept of norm discussed here, the typological norm occupies an intermediate position between the statistical and functional norm.

A practical worker, working with a specific child, his individual characteristics of behavior and development that are specific only to him, advances in his analysis from this reality towards a typical model, taking into account the parameters and indicators characteristic of it. At the same time, real indicators of different

1 Borrowing from medicine the concept of “syndrome” is perhaps one of the few well-established concepts in psychology, the use of which by psychologists does not cause obvious rejection among physicians.

developments of the child and ideal (including statistical ones) within the framework of the ideal model of development. The final result of such an analysis is the “summarizing” of real indicators under

typological.

In the process of examination and subsequent analysis of the results, the psychologist must isolate from the resulting set of characteristics and individual indicators of the child’s development a system of differential characteristics (indicators), which, in comparison, on the one hand, with ideal (theoretical) and, on the other hand, with typological indicators, allow one to determine a specific the case of deviant development as one of its typical variants. It is in this case that we can talk about making a psychological typological diagnosis. And only in this case can we use the same standard correctional and developmental program and specific methods and technologies of work.

It should be noted that this approach implements the fundamental principle of “bottom-up” activity, which in this case can be extended to a systemic psychological analysis of development. In the theoretical development of methodological materials and tools, the no less fundamental principle of “top-down” analysis is used, which involves, based on the model of ideal dysontogenesis, the development of universal patterns and theoretical models in relation to typical development options.

Thus, as noted by O.E. Gribova: “...the interests of “theoretic” psychologists and “practicing” psychologists intersect at the level of “typical models”.” This approach makes it possible to quite effectively distinguish between areas and levels of competence of specialists, defining the objects of theoretical study and practical activity.

A prominent representative of pedology of the biologizing direction was the American psychologist A. Gesell. In his work “Pedology of Early Ages,” he calls one of the chapters “The Biological Meaning of Childhood,” where he examines the development of a child in comparison with the development of young animals. A. Gesell agrees with the position that in the early years
In life, a child, as it were, repeats the history of the development of the human race. But he argued that childhood is also a product of evolution. In the lowest animals there is practically no childhood; The childhood period is longer, the higher a given species is located on the evolutionary ladder. Not only does a person have the longest childhood, but it is qualitatively different.

A. Gesell noted that in comparison with the childhood of monkeys, human childhood differs not simply in the addition of one more floor on which the assimilation of language and symbolic thinking takes place; this addition leads to a profound restructuring of the lower floors, making them fundamentally different in comparison with similar ones in higher animals. However, the general function of the psyche is preserved - biological adaptation to environment. A. Gesell studied the problem of the relationship between environment and heredity in their influence on the mental development of the child, the dependence of the rate of development on hereditary characteristics.

He assigned the main role in the mental development of a child to the maturation of the nervous system. For A. Gesell, the main indicator of development is its pace. He formulated the law of development slowdown with age: the rate of development is maximum at the initial stages of development and minimum at the final stages. A. Gesell, as it were, completely removes the problem of environment and heredity and replaces it with the problem of the pace of development.

A. Gesell's significant contribution to child psychology is that he laid the foundation for the development of child psychology as a normative discipline. The normative approach in child psychology is focused on describing the child’s achievements in the process of growth and development, on building norms for the development of motor activity, speech, and the child’s relationships with the outside world and adults. To draw up norms of mental development, A. Gesell introduced a longitudinal method into child psychology - a long-term study of the same children at different stages of their development. Based on the compiled standards, A. Gesell developed a system for diagnosing the mental development of a child from birth to adolescence. He conducted systematic comparative studies of developmental norms and pathologies; one of the first in psychology to use the twin method to analyze patterns of mental development.

Let us note that A. Gesell explained age-related changes in children by hereditary factors, i.e., he remained within the framework of the biologization direction. But his approach to child psychology as a normative discipline is also important for modern psychology. Problems of norms and pathologies of development, the development of specific standards for the mental development of children at different stages of life are of great practical importance for various areas of social practice (health care, education).

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The topic of this article is children’s health groups and their characteristics. Let's try to figure out why this division is needed, what categories there are, and how to classify your baby into one of them.

Greetings, dear readers. If you have visited the pages of my blog, then most likely you are a parent. Children grow up very quickly. It would seem that just a week ago the baby just learned to crawl, just yesterday he walked and started talking. And today it’s time to get ready for kindergarten, or even school. On the one hand, this is wonderful! Firstly, an important event for a child who feels almost like an adult. Secondly, it is a relief for parents. Mothers can go to work, grandmothers can relax, because the child is under the supervision of teachers for at least half a day. But on the other hand, admission to a children's institution is always a huge number of formalities. Parents are forced to study all the intricacies of the internal rules of educational institutions.

It would seem that all children who begin their educational journey are equal to each other. However, this is not always the case. And here we're talking about not only about individual character traits, temperament and psychological type. One of the main criteria for “classifying a child” is the level of his health.

Children's health groups and their characteristics - what are we talking about?

Health groups are conditional categories that unite children with different levels of physical condition. By assigning a person to one group or another, the doctor, as it were, gives a conventional sign to those people who will still work with the baby. First of all, the health group determines whether the child needs to be enrolled in a specialized educational institution or not. Based on this figure, the card for the child selects the appropriate type of physical activity, table (diet), and sets restrictions on engaging in certain activities.

The distribution of children into health groups, which logically follows from the above, is the prerogative of the pediatrician. And it is right. After all, only a doctor can assess the condition based on a complete, comprehensive examination, test results and functional tests.

It should be noted that there are newborn health groups. They are assigned to babies who are discharged from the maternity hospital. Based on this indicator, it is determined how many times in a given period of time the mother and child should visit the pediatrician. However, most often the doctor at the appointment indicates the date of the next visit. Therefore, this data is not so important for parents. Basically, the category begins to be “required” upon admission to kindergarten or school.

Formation of health groups

A logical question is: how are these groups formed in general? In order to classify a small patient as one or another, the doctor must “characterize” him on several points. Most full list looks like that:

1. Were there any abnormalities in the fetus during intrauterine development, recorded by ultrasound or using another method of prenatal diagnosis?
2. Does the baby have chronic diseases or developmental defects (congenital defects)?
3. How well do human organs and systems function?
4. What is the level of neuropsychic development?
5. What is the body’s resistance, how correct is the immune response (this takes into account, among other things, how many times a year the baby gets colds and other diseases)?

However, most often, to determine a group, the first criterion listed is not taken into account. It is taken into account to a greater extent for assigning a health category to a newborn.

Of course, not only the local pediatrician is involved in the examination of a little person. The baby undergoes a full examination, which includes consultation with the following specialists:

• surgeon;
• eye doctor;
• cardiologist;
• neurologist;
• dentist.

If specialists find certain deviations from the norm, an additional examination with the participation of doctors of other profiles is required.

Is it really an infringement of rights?!

One of the parents, taking into account the current trends of love of freedom and individualism, may say: isn’t this an infringement of the rights of my child? Why is it possible for someone to exercise and eat what is prepared for everyone, but not for us?! So, this opinion is completely wrong!

Children's health groups and their characteristics were developed by pediatricians exclusively in the interests of the children themselves!

After all, bans are not imposed on a whim or for money, but based on the baby’s condition, his physical capabilities take into account possible negative consequences.

Unfortunately, this system is imperfect. Often, an apparently healthy child is not examined often enough or not thoroughly. In addition, teachers and parents are in no hurry to take into account doctors’ recommendations. This is partly why there are episodes of child death right in physical education classes (which is unacceptable!), and the development of complications as a result of poor nutrition. And the baby’s condition may worsen due to non-compliance with the regime.

That is why it is necessary to realize the importance of such distribution! This is not done at the whim of doctors and not for the sake of “making life easier” for teachers. Not so that the teacher can do physical education with only half the class, because... the rest go to “ preparatory group" Not with the goal of dividing children into “healthy” and “not so healthy”, and then depriving some of them of care, focusing on others.

This practice was introduced in order not to miss the development of a disease or complication in a baby predisposed to a pathological process. In order to protect him from an unbearable load, giving the body time to rehabilitate and form. In order, in the end, to eliminate the too obvious difference in class between those who can easily cope with physical education standards and those who, without being lazy and irresponsible, are physically unable to fulfill them!

What are the options?

First of all, you need to find out what health groups children have. There are five of them in total, but some authors distinguish subgroups 2a and 2b in the second category. When analyzing the second group, I will mention them, but to a greater extent this division is typical, again, for newborns.

First category

Children's health groups and their characteristics begin with healthy children. Unfortunately, the crumbs that could be included here are becoming less and less common. It must be said that already in the maternity hospital, less than 15% of babies born can be considered completely healthy (focusing only on the Apgar scale * Newborn condition assessment scale), because only a few receive a rating of 10/10 or at least 8/10. Accordingly, even at older ages the indicators leave much to be desired.

Apgar: there are 5 criteria - breathing, heartbeat, muscle tone, reflex excitability, skin color. Each indicator can “receive” from 0 to 2 points. This assessment is given at 1 and 5 minutes after birth. If at 1 minute the baby receives from 0 to 3 points, or 5 to 6 points, this means that he needs urgent resuscitation.

So, who is included in the first health group? These are children who were not ill or were extremely rarely ill during the study period (usually the examination is carried out once a year). They do not have chronic diseases, as well as functional or anatomical problems in the functioning of all organs and systems of the body.

It is important that children should not lag behind age norms in neuropsychic development. Here we are not talking about individual character traits (for example, someone is slower), but only about objective signs. There are norms and rules for assessing the compliance of a child’s behavioral reactions with these norms. In particular, in order to determine neuropsychic health, everyone is advised to consult a neurologist. And only if this doctor discovers any abnormalities, the mother and child are referred to more specialized specialists - a psychologist, a speech therapist.

Such children do not have any defects or developmental anomalies. It should be taken into account that tiny babies who, for example, have a defect in the structure of the auricle that does not affect hearing (protruding, elf ears), are included here. That is, something that absolutely does not worsen a person’s condition and does not require medical intervention is acceptable.

Second category

What does 2 (second) health group mean for a child? This “diagnosis” is made in cases where the baby has functional deviations from the norm. This means that the problem is not organic (not tumor, inflammation or tissue destruction), but only in the functioning of the organ. This happens when biochemical mechanisms and immunity fail, and the body’s ability to adapt decreases. Most often, violations are caused by the fact that the baby grows very quickly, and the organ systems (especially the cardiovascular) do not have time to rebuild. After all, they now need to work for greater growth (the systemic circulation increases), but they still don’t have enough strength.

Another criterion by which it can be determined that a child has health group 2 is frequent acute illnesses. “Frequent” means more than 4 times a year. They are characterized by a long period of recovery and recovery. For a long time, the baby’s appetite does not return, there is lethargy and drowsiness. Ear complications often occur after a cold. An integral part is functional disturbances in the gastrointestinal tract after any treatment.

Children of the second group should not have severe deviations from the norms of mental development. The indicators are either within acceptable limits or are very slightly removed from these limits. But these children have no chronic diseases, defects or developmental anomalies at all.

According to some data, there are two subgroups of this category - A and B. Child health group 2b - these are precisely the children who fall under the description above. Here are some conditions that make it possible to classify a baby into group 2b:

• damage to the central nervous system during childbirth, resulting in minor deviations in mental development;
• constitutional anomalies (diathesis);
• functional heart murmurs;
• low hemoglobin (pre-anemic state);
• disruption of the gastrointestinal tract.

Subgroup A includes those who do not have the above-mentioned deviations, but have a complicated medical history.

Anamnesis (from the Greek ἀνάμνησις - memory) is a set of information obtained during a medical examination by questioning the person being examined and/or people who know him.

This could mean that:

• the family has children with serious developmental disabilities;
• the mother was over 35 at the time of the birth of her son or daughter;
• there were complications during pregnancy and childbirth;
• there was a multiple pregnancy;
• baby is premature/post-term;
• low or too high birth weight;
• there was an intrauterine infection;
• state of rehabilitation after serious conditions, operations, diseases.

In fact, this is to some extent the most favorable “company”. Such kids do not get sick, but are under close medical supervision, much more attentive than the children from group 1. The chance of missing a developing pathology is very low.

Third category

What does 3 (third) health group mean for a child? This is the so-called compensation state. As you can see, children’s health groups and their characteristics reflect not only the presence of certain diseases in children, but also the degree of their severity. In this case, we are talking about the fact that there is a chronic pathology. However, it implies rare exacerbations of it, which are not severe, and can be easily stopped (removed with the help of medications or manipulations).

These may also be developmental defects that do not entail a significant limitation of capabilities. Functional changes in the functioning of the body are also quite possible here. However, they concern only the system that is developed incorrectly (“sick”). These deviations have little or no effect on the overall standard of living and activity of a person.

Acute diseases in such children occur quite rarely and are not severe. An extended recovery period is possible (especially if the pathology is associated with the initially affected system). As for psycho-physical development, it may be normal or slightly behind the norm.

Significant deviations are usually not observed; children from group 3 are quite socially adapted and easily find a common language with their peers. However, such babies are characterized by stage 1 or 2 underweight, short stature, and some muscle weakness.

Health group 3 in a child is absolutely not a death sentence. The most important thing is not to miss visits to the doctor and follow the recommendations. Children in this category usually do not have incurable diseases; everything is amenable to medical correction. But maximum care and concern is required from parents. This is also important in order to prevent the development of existing diseases.

Fourth category

The fourth (4) health group in children is the “intermediate” stage, the so-called subcompensation. This term implies the absence of life-threatening conditions and does not mean that patients are incurable.

The children of this “company” are characterized by quite serious congenital malformations. They already have an impact on a person’s life rhythm. Pathological changes affect not only the initially “wrong” system, but also organically healthy organs. There are chronic diseases (often more than one). Exacerbations of these disorders develop frequently, usually with complications.

Acute disorders are difficult to treat, after which the child takes a long time to recover, and he requires special rehabilitation conditions. Often such children find it difficult to be in society, because... their diagnoses leave an imprint on their character, worldview, and physical capabilities.

As for neuropsychic development, it can be absolutely normal. Deviations are completely unnecessary; such children, on the contrary, are often more intelligent than others (due to the lack of opportunity, for example, to run around and play around). However, deviations from minor to severe are also common. Characterized by a deficiency of body weight, height, and muscle strength.

Very often, such children require training in specialized institutions. And even if this is not the case, they are shown significant restrictions on educational and physical activity. Almost always, some kind of maintenance therapy on an ongoing basis is required (medicines, exercise therapy, etc.).

It is worth recalling that children’s health groups and their characteristics do not oblige parents to send their baby to specialized institutions. But if such advice is given, it is better to listen to it. Contrary to popular belief, a not entirely healthy child who is in the company of “ordinary” peers does not recover faster. On the contrary, he begins to realize a certain inferiority, complexes develop, the little person withdraws into himself (and what if he is also subjected to ridicule?). But being in a special institution where trained teachers work with him, he can make great progress. And no one said that in a couple of years such a child would not be able to study in a regular school!

Fifth category

What does 5 (fifth) health group mean for a child? This category includes children with very serious physical disabilities. Be it severe chronic diseases, with rare periods of clinical remission (lack of symptoms), or developmental abnormalities. These kids are at risk of disability or have already received it.

Such children have damage to all (or almost all) organs and systems, and the pathology is both functional and organic. Frequent infectious and inflammatory processes with a large number of severe complications.

Acute diseases are a practically permanent condition for them. This means that in a year they seek medical help more than 8-10 times.

It must be said that developmental anomalies can be not only congenital. This group also includes children who have undergone severe mutilating operations, injuries, and diseases. Without fail, the fifth health group of a child includes cancer patients. Moreover, both during the treatment process, and at the stage of early rehabilitation, and in the post-rehabilitation period (up to 5 years).

Education of such children in general education schools and preschool institutions is excluded. They require an individual approach. For such children, education at home or in highly specialized educational institutions would be optimal. These children require constant supervision, constant assistance and care. Most often they are socially maladapted (especially at an early age, when they spend most of their time in hospitals).

Health groups and risk groups - is there a difference?

Separately, I would like to mention two similar concepts: health group and risk group. Despite their similarities, we are talking about different things. In the first case, we are talking about the real, present, current state of a person. And the second concept characterizes children who have “more opportunities” to get this or that disease, more pathogenic factors.

When divided by risk level, this is a category of children prone to developing a particular pathology. This division is quite old, dating back to the 90s of the 20th century, but sometimes this data is still referred to today. There are 5 main risk groups and 4 additional ones. If a patient is classified as a risk category, his medical examination schedule is changed, and consultations with specialized specialists are added to the recommendations.

In essence, group unit 2a is one risk group. And it includes all the crumbs that are predisposed to the formation of one or another pathological process.

Determining the health group

As already mentioned, the distribution of children into categories is carried out by a pediatrician. Each baby registered at the site must be “classified” according to this criterion.

How can you determine a child’s health group yourself? Is it possible to do this? In principle, yes, although it doesn’t make much sense. After all, your child will still have to undergo a medical examination before kindergarten and school. However, materials on the topic of children's health groups and their characteristics are available to everyone. To avoid confusion, let's try to derive a strict algorithm for determining categories.

To begin with, every parent needs to know that group membership is determined according to the most severe disease. If, for example, the baby does not have any diseases other than a heart defect, which does not cause concern, he should be classified in group 3.

Secondly, a table can help with the definition. Essentially, this is the same data that was presented above in text form, but more condensed.

Children's health group - table by disease

It is worth mentioning that such distributions by category are relevant up to 17-18 years of age. Upon reaching this age, a person moves into an adult network, and there is already its own division.

Determining the category is an important step. You cannot “relax”, even if your child is assigned to group 1. It is necessary to undergo a medical examination on time. Be sure to remember that issuing a category number is not signing a verdict. There is a way out of every situation. Children's health groups and their characteristics are serious, but not final. Most diseases today can be treated, but this must be dealt with scrupulously, for a long time, daily. And then parental work will be rewarded with the health of the child.

When it comes to deviations in human development, it is necessary to define the essence of the concept of “norm”. Personally oriented approach how the strategy of national education requires the teacher to provide an individual path of development not only for the average child, but also for those who are unique.

The norm presupposes such a combination of the individual and society when she carries out leading activities without conflict and productively, satisfies her basic needs, while meeting the requirements of society in accordance with her age, gender, and psychosocial development.

Orientation to the norm is important at the stage of identifying developmental deficiencies in order to determine special assistance. Several meanings of this concept are relevant.

Average norm- the level of psychosocial development of a person, which corresponds to the average qualitative and quantitative indicators obtained from examining a representative group of the population of people of the same age, gender, culture, etc.

Functional norm- individual development norm. Any deviation can be considered a deviation only in comparison with the individual development trend of each person.

The essential difference between normal and abnormal people is that the mental traits of the former are an accidental symptom from which they can easily free themselves if they are willing to make the appropriate effort.

Researchers consider a child normal under the following conditions:

§ when his level of development corresponds to the level of most children of his age or older, taking into account the development of the society of which he is a member;

§ when a child develops in accordance with his own general path, which determines the development of his individual properties, abilities and capabilities, clearly and unambiguously striving for the full development of individual components and their full integration, overcoming possible negative influences from one’s own body and the environment;

§ when a child develops in accordance with the requirements of society, which determine both his current forms of behavior and further prospects for his adequate creative social functioning in the period of maturity (Pozhar L.).

Let's consider the conditions for normal child development. G.M. Dulnev and A.R. Luria considers the following indicators to be the main ones:

1) normal functioning of the brain and its cortex. Pathogenic influences disrupt the normal ratio of irritable and inhibitory processes, analysis and synthesis of incoming information, interaction between brain blocks responsible for various aspects of human mental activity;

2) normal physical development of the child and the associated preservation of normal performance, normal tone of nervous processes;

3) the preservation of the sense organs that ensure the child’s normal communication with the outside world;

4) systematic and consistent education of the child in the family, in kindergarten and in secondary school.

Under defect(from Lat. Defectus - deficiency) is understood as a physical or mental defect that causes a disruption in the normal development of the child.

A defect in one of the functions disrupts the child’s development only under certain circumstances. The influence of a defect is always twofold: on the one hand, it impedes the normal functioning of the body, on the other, it serves to enhance the development of other functions that could compensate for the deficiency. L.S. Vygotsky: “The minus of a defect turns into a plus of compensation.” Two groups of defects should be distinguished:

§ primary defects, which include particular and general dysfunctions of the central nervous system, as well as discrepancies between the level of development and the age norm (underdevelopment, delay, asynchrony of development, phenomena of retardation, regression and acceleration), disturbances in interfunctional connections. It is a consequence of disorders such as underdevelopment or damage to the brain. The primary defect manifests itself in the form of hearing impairment, vision, paralysis, impaired mental performance, brain dysfunction, etc.;

§ secondary defects, which arise during the development of a child with disorders of psychophysiological development in the event that the social environment does not compensate for these disorders, but, on the contrary, determines deviations in personal development.

The mechanism of occurrence of secondary defects is different. Functions directly related to the damaged one are subject to secondary underdevelopment. For example, this type of speech disorder occurs in the deaf. Secondary underdevelopment is also characteristic of those functions that were in a sensitive period of development at the time of damage. As a result, different injuries can lead to similar results. So, for example, in preschool age Voluntary motor skills are in the sensitive period of development. Therefore, various injuries (previous meningitis, skull trauma, etc.) can lead to delays in the formation of this function, which manifests itself as motor disinhibition.

The most important factor in the occurrence of a secondary defect is social deprivation. A defect that prevents a child from normal communication with peers and adults inhibits his or her acquisition of knowledge and skills and development in general. In general, the problem of social deprivation is characteristic of all types of deviations in physical and mental development.

A special place in the group of secondary defects is occupied by personal reactions to the primary defect. Several types of personal response are possible.

Ignoring- often found in mental retardation, associated with underdevelopment of thinking and insufficient criticism of the success of one’s activities.

crowding out- refers to a neurotic type of response to a defect and manifests itself in a conscious non-recognition of its existence with a subconscious conflict and the accumulation of negative emotions.

Compensation- this type of response in which the defect is realized and the lost function is replaced by more intact ones.

Overcompensation- enhanced development of intact functions, combined with the desire to prove that the defect does not lead to any problems.

The asthenic type of response leads to a low level of aspirations, low self-esteem, and fixation on the awareness of one’s inferiority.

By exposure time pathogenic factors are divided into:

§ prenatal (before the onset of labor);

§ natal (during labor);

§ postnatal (after childbirth, especially in the period from early childhood to three years).

The most severe underdevelopment of mental functions occurs as a result of brain damage in the early stages of embryogenesis, since this is a period of intense cellular differentiation of brain structures.

Risk factors insufficiency of psychophysical development:

§ biological (hereditary abnormalities, infectious, viral and endocrine diseases of the mother during pregnancy, toxicosis, hypoxia, etc.);

§ genetic (lack or excess of chromosomes, chromosomal abnormalities);

§ somatic (neuropathy);

§ social (alcoholism, parental drug addiction, unfavorable environment);

§ index of brain damage (encephalopathy);

§ early, up to 3 years, environmental influences, current environmental influences (L.V. Kuznetsova).

Lecture. The problem of school failure. Norm and deviation in mental development.

Literature.

1.Brother B.S. Personality anomalies. M.: Mysl, 2008.

2. Developmental and educational psychology: Reader / Comp. IN AND. Dubrovina and others - M.: Academy, 2009.

3.Zeigarnik B.V. Pathopsychology: textbook. aid for students higher textbook establishments. - 5th ed., erased. - M.: Publishing center "Academy", 2008 p.

4. Kravtsova E.E. Psychological problems children's readiness for school. – M.: Pedagogy, 2001.

5. Craig G. Developmental Psychology. – St. Petersburg: Peter, 2000.

6. Leites N.S. Age-related talent of schoolchildren. – M.: Academy, 2000.

7.Marilov V.V. General psychopathology: textbook. aid for students higher textbook establishments. - 2nd ed., erased. - M.: Publishing center "Academy", 2010. - 224 p.

8. Theoretical foundations of the learning process / Ed. V.V. Kraevsky. M., 2008.

Addressing the problem of the norm and deviations from it is traditional for psychology (and especially age-related). In classical literature one can find indications that, in general, norm and pathology (deviations) are social concepts. K. Jung wrote about this in the “Tavistock Lectures”, K. Horney in “The Neurotic Personality of Our Time”.

From the point of view of D.B. Elkonin and L.S. Vygotsky, the development norm is not the average for a given age group, but the optimal level from the point of view of society.

D.B. Elkonin argued that the norm is the highest level of achievement that can happen if I start to act (if I don’t act, then this will not happen).

L. Pozhar offers the following criteria for normality.

The child is considered normal:

When his level of development corresponds to that of most children of his age;

When a child develops in accordance with his own general direction (development of individual abilities and capabilities)

When a child develops in accordance with the requirements of society.

The problem of normative development is closely related to the problem of norms. L.S. Vygotsky offers a symptomology of childhood, highlighting a number of reliable signs. According to L.S. Vygotsky, the normativity of development should be understood as a sequence of successive age stages of ontogenetic development. When assessing whether the level of development corresponds to the “age norm”, three characteristics must be taken into account:

1) features of the social situation of development (type of educational or training institution, the child’s social circle, including peers, adults, family environment, etc.);

2) the level of formation of psychological new formations at this stage of age development;

3) the level of development of leading activity as an activity that plays a decisive role in development.

That. deviation– this is a discrepancy with a certain norm, values, attitudes, considered as a manifestation of development difficulties. This is going beyond a certain norm.

In 1927, Schwalde first used the term dysontogeny, denoting deviations in the intrauterine formation of body structures from normal development. Subsequently, this term acquired a broader meaning; it began to designate various forms of ontogenetic disorders.

Abnormal children– these are children who have a significant deviation from normal physical and mental development caused by serious congenital or acquired defects.

Defect– a physical or mental disability that causes a disruption in the normal development of the child. The presence of one or another defect does not predetermine abnormal development. For example, hearing loss in 1 ear and vision loss in 1 eye do not yet lead to a developmental defect, because the ability to perceive sound and visual signals is retained. These defects do not interfere with communication with others and do not interfere with mastery educational material and education in a public school, these defects are not the cause of abnormal development.

Defects in an adult who has reached a certain level of mental development cannot lead to deviations, since the development of his psyche proceeded under normal conditions.

Thus, children with mental development disorders due to a defect and those in need of special training and upbringing are considered abnormal.

1. Children with hearing impairments (deaf, hard of hearing, late-deafened)

2. Children with visual impairments (blind, visually impaired).

3. Children with severe speech impairments (speech pathologists)

4. Children with intellectual development disorders (ID, children with mental retardation).

5. Children with complex disorders of psychophysical development (deaf-blind, blind UO, deaf UO)

6. Children with musculoskeletal disorders.

7. Children with psychopathic forms of behavior.

In the process of abnormal development, special positive adaptive abilities of the child are manifested (blind children have an acutely developed sense of distance and auditory perception).