The role of health sector in ensuring the realization of the rights of children with disabilities. From the parallel working sessions of the 4th Child Protection Forum in Tajikistan, 2013.

1. ESTABLISHMENT OF EARLY
ASSISTANCE SERVICES FOR
CHILDREN AS BASIS FOR
INCLUSIVENESS IN UZBEKISTAN

2. REPUBLICAN CENTER FOR SOCIAL ADAPTATION OF
CHILDREN (RCSAC)
 RCSAD was founded by the Resolution of the Cabinet
of Ministers of the Republic of Uzbekistan “On
establishment of the Republican Center for Social
Adaptation of Children" No. 419 of September 7, 2004.
 RCSAD is an NGO studying of problems of social
adaptation of children, including:
-- children with limited physical abilities (disabled people, children
with physical and psychic disorders, children having severe chronic
illnesses;
-- children of groups of social and legal risk (orphans, children
deprived of parental care or persons, replacing them, children from
vulnerable families);
- - gifted children (in sport, arts, science, etc.);

3. DIRECTIONS OF ACTIVITIES
 Scientific-research activity in the sphere of social
protection of vulnerable children
 Development of targeted comprehensive programs to
solve the above problems, and reduce the negative
impact of the factors causing emergence of children
with high risk behavior
 Deep study of the country’s experience and the
experience of developed countries in the sphere of
support and social adaptation of children
 Providing support to children through
implementation of psycho-pedagogical, educational
and rehabilitation programs.

4. RCSAC:
Research and
practical work
Government
organizations
Child and
family

6. RCSAC OBJECTIVES AND SERVICES
 Scientific and methodical work: carrying out
scientific researches, development of targeted
programs
 Teaching and educational, consulting
services: psychological, correctional development,
legal, treatment and physical activities, medical
counceling
 Social and economic services: rendering
financial support (by charity foundations)
 Legal services: support in enforcement of the
violated rights of the child.

7. PRACTICAL SUPPORT RENDERED TO CHILDREN AND
FAMILIES ON THE BASIS OF INFORMATION AND
CONSULTING SERVICE OF RCSAD
 Sensor therapy, sand therapy, Montessori
pedagogics, fairy tales-therapy, music
therapy, rehabilitation pool, massage,
phytobar, legal consultations
 Services are provided by defectologists,
psychologists, lawyers, pediatricians, neuro-
pathologists, neuro-psychiatrists, orthopedic
traumatologists, specialists on methodology
of the physical activities and sports, etc.

11. Total number of children who have received comprehensive
support– 859
Including:
•Physical rehabilitation: 486 children
•Correctional and pedagogical work: 224 children
• Psychological consultation:143 children
Physical
rehabilitation
Correctional and
pedagogical work
Psychological
consultation
486
224
143

12. "THE SYNAPSES TO BE STIMULATED"
 Neurophysiological and psychological discoveries of
the end of the XX century considerably expanded the
ideas on possibilities of a comprehensive support to
children with development needs.
 Researches show that 75% of the brain develops till
three years of age.
 One of the most important discoveries of scientists –
is the identification in a newborn’s brain of the
neurons, which need various types of stimulation. If a
baby actively receives sensor information from the
outside, then the connections among the neurons
strengthen. It means that active development takes
place.

13.  Within the first 365 days the child should make an
enormous jump in all spheres of development:
intellectual sphere – emergence of the first words
and understanding of speech of people around; -
adequate manipulations with toys, subjects;
physical sphere – not only to gain the weight more
that three times, grow by 25-30 cm, to take the first
steps, etc.
 If there is no sufficient sensor stimulation, parts of
brain aren't involved fully, communication between
neurons weakens, synapses die off and these parts,
as a result, will disappear. They are called – "the
synapses to be stimulated". And it means the
delayed development of the child.

14. In the first three years of life the child’s organism
develops very quickly. It is important not to miss and
correctly diagnose possible developmental disorders
keeping in mind the child personality, as a whole.
Often because of continuous inclusion of the child with
special needs in "treatment“, the relation between the
adults and the child with developmental problems,
have a distorted character.
Efforts are made to "correct the child", but the issues
of his development and education are dropped until he
becomes "as the rest of us".
Thus, the most important years for the child’s
development are missed.

15. It is very important to involve the child in a
comprehensive program for receiving early psycho-
medico-pedagogical support.
Early diagnostics and intervention is a process of
study and identification of the child’s personal
physiological and social needs to create enabling
conditions for his development, with the help of the
team of experts.
Republican Center for Social Adaptation of Children
(RCSAC) was the first to introduce early interventions
for children in Uzbekistan.

16. EARLY INTERVENTION GOALS
 "Normalize" life of the child and his
family
 Help parents create enabling conditions
for development and education of the
early age children
 Prevent abandonment of the child and his
placement to residential institutions.

17. PRIORITIES OF THE DEVELOPMENT OF THE EARLY
INTERVENTION SYSTEM IN UZBEKISTAN
 Joint work of interdisciplinary group with
families and children
 Capacity development of the team of experts
 Improving access to complex services of early
intervention for children and families at their
residence place, particularly in the rural
areas
 Introduction of innovative forms and methods
of work with children and families.

18. PRIORITIES OF THE DEVELOPMENT OF THE EARLY
INTERVENTION SYSTEM IN UZBEKISTAN
 Involvement of parents in programs of early
intervention
 Provide information and legal support to
families
 Prevention of abandonment of children with
special needs in development
 Support for an effective transition to inclusive
preschools and schools.

19. EARLY INTERVENTION SERVICES IN UZBEKISTAN
Outcomes of the project “Establishment of the Early
Intervention Model in Uzbekistan“ ( 2009-2011).
Early Intervention Services have been organized in
Tashkent in the Yakkasaray district Regional Medical
Association, Chilanzar district family policlinic No. 39
and the Republican Center for Social Adaptation of
Children to provide support to children and the families,
which have children with special development needs.

20. SCIENTIFIC METHODOLOGICAL WORK
 The principles and methods of work of Early
intervention services are defined
 The map of psycho-social development with
consideration of regional specifics has been
developed
 The methodology of correctional development
work with children with problems of
development aged 0 to 12 months, from 13 to
24 months, from 25 to 36 months has been
developed and tested.

21. 95111
2 3 7 16 27
9 28
10
225
10 10
1 17
SERVICES PROVIDED TO CHILDREN AND FAMILIES IN
PILOT POLICLINICS OF TASHKENT CITY
TOTAL NUMBER OF CHILDREN – 596

22. 21%
41%
38%
Achievements for 2012-2013.
Specialized kindergartens
Development dynamics has imrpoved
Regular kindergartens

23. Development
of speech
Undetstanding
of speech
Minor motor
functions
Overall motor
functions
22,1% 21,1%
16%
45%
ACTIVITIES OF THE EARLY INTERVENTION SERVICES
IN POLICLINICS HELPED REDUCE DELAYS IN
DEVELOPMENT OF CHILDREN BY:

24. ORGANIZATIONAL ACTIVITIES:
 include various forms of work with
parents (consultations, group work)
 Supervision
 Planning, reporting and monitoring

26. NEXT STEPS FOR PROMOTION OF
EARLY ASSISTANCE SERVICE
 Opening of early assistance services in health care
system (in central multi-profile policlinics) in
Uzbekistan.
 Opening of early assistance service in education and
pre-school education system in Uzbekistan (groups of
early consultative-methodical support to parents,
having children with special needs).

27. EXPECTED RESULTS OF INTERAGENCY
COOPERATION ON THE BASIS OF EARLY
ASSISTANCE SERVICES
 100% identification of children of high risk groups
having development disorders
 100% coverage of children of high risk group with
comprehensive psychological, medical and
pedagogical abilitation
 100% coverage of the early age children with a
comprehensive abilitation that will improve their
health.

28. EXPECTED RESULTS OF INTERAGENCY COOPERATION
ON THE BASIS OF EARLY ASSISTANCE SERVICES
 Ensuring continuity of the work of experts on
children's development in health, educational and
social protection institutions
 Establishment of the interagency data bank on the
early age children of high risk groups
 Development of an individual abilitation/
rehabilitation program for the child and the
rehabilitation plans of all team members with an
active participation of parents.

29. RESULTS OF COOPERATION OF THE RCSAC WITH MINISTRY
OF HIGHER AND SECONDARY SPECIAL EDUCATION
Special modules were developed and included into the
bachelors’ degree curriculum of Tashkent State
Pedagogical University (TSPU) named after Nizami:
 «Vocational guidance for children with special needs»;
 «Normative-legal framework on social protection of children
with special needs».
 Special courses were developed and included into the
bachelors’ degree curriculum of TSPU named after
Nizami:
 «Integration of children with special needs»,
 «Social work with children with special needs and their
families».
New subject was developed and included into the bachelors’
degree curriculum of TSPU:
 «Training and upbringing of children with special needs».

30. RESULTS OF COOPERATION OF THE RCSAC WITH MINISTRY
OF HIGHER AND SECONDARY SPECIAL EDUCATION
The following new topics were developed and
included into the bachelors’ degree
curriculum of TSPU named after Nizami
 Training and upbringing of children with severe
mental disorders»
 «Early diagnostics and abilitation»
 «Inclusive education»
 «Speech rehabilitation therapy»
 «Rehabilitation of children with special needs»
 «Family psychology of the special school students».