Each type of adaptive physical culture – adaptive physical education, adaptive motor recreation, adaptive sports, physical rehabilitation – has its own tasks, means, methods and methodological techniques, forms of organization.
Forms of the organization of physical exercises are extremely varied, they can be systematic (lessons of physical culture, morning exercises), occasional (country walk, fishing), individual (in the hospital or at home), mass (festivals, festivals), competitive (from group to international), game (in a summer health camp). Some forms of exercise are organized and conducted by AFC specialists, others by public and state organizations, others by parents of disabled children, volunteers, students, and others independently by disabled people themselves.
The goal of all forms of organization is to expand motor activity at the expense of systematic physical exercises, to introduce them to accessible sports activities, interesting leisure time, to develop their own activity and creativity, and to form a healthy lifestyle.
The basic form of employment in all kinds of adaptive physical culture is the lesson form, which has historically and empirically justified itself.
Depending on the goals, objectives, and program content, lessons are divided into:
1) lessons of educational orientation, designed to form special knowledge, teaching a variety of motor skills;
2) Correctionally oriented lessons designed to develop and correct physical qualities and coordination abilities, movement correction, and correction of sensory systems and mental functions through physical exercises
3) health-improving lessons designed to correct posture, flatfoot, prevention of somatic diseases, sensory system disorders, strengthening the cardiovascular and respiratory systems;
4) therapeutic lessons designed to treat, restore and compensate for lost or impaired functions in chronic diseases, injuries, etc;
5) lessons of sports orientation, designed to improve physical, technical, tactical, mental, volitional, theoretical training in a chosen sport;
6) recreational lessons, designed for organized leisure, recreation, game activities.
This division is conditional, reflecting only the predominant orientation of the lesson. Actually each lesson contains elements of training, development, correction, compensation and prevention, i.e. complex lessons are the most typical for invalids and persons with limited functional abilities.
Non-periodic forms may not be regulated by time, location, number of participants, or their age. Classes can include persons with various motor impairments and are conducted separately or together with healthy children, parents, and voluntary helpers. Their main goal is to satisfy the children’s need for emotional motor activity, play activity, communication and self-actualization.
I. Adaptive physical education – the most organized and regulated type of AFC – is a mandatory discipline of all special (correctional) educational institutions. Physical education is carried out in the following forms:
– physical education lessons;
– rhythmics lessons (in the lower grades);
– physical exercises in general education classes (for removal and prevention of mental fatigue).
II. Adaptive physical recreation is carried out in the process of extracurricular and extracurricular activities. Recreational activities have two forms: in the daily routine and after-school activities.
In the mode of the day they are presented in the form of:
– morning gymnastics (before school);
– organized games at recess;
– Sports hour (after school).
Extracurricular activities have the following forms:
– recreational and health-improving classes at school (in groups of general physical training, groups of mobile and sports games and other forms), organized on a voluntary amateur basis in accordance with the capabilities of the institution and the interests of students;
– Physical education festivals, quizzes, contests and entertainment,
competitions such as “Happy Starts”;
– integrated holidays together with healthy children;
– walks and excursions;
– days of health.
In extracurricular time, adaptive physical recreation has the following forms:
– classes in summer and winter health camps;
– Classes and games in the family;
– classes at rehabilitation centers;
– activities in family health clubs.
III. Adaptive sport has two directions: recreational and health-improving sport and sports of the highest achievements. The first is implemented in school as extracurricular activities in sections of the chosen sport (table tennis, gymnastics, aerobics, dancing (including wheelchair), floor hockey, basketball, swimming, athletics, etc.). There are two forms of adaptive sports activities:
– training sessions;
Both the first and the second are implemented in sports and fitness clubs, public associations of the disabled, children’s and youth sports schools, and combined teams for sports within the system of the Special Olympics, Paralympic movement and All-Russian movement of the deaf.
IV. Physical rehabilitation in the conditions of special (correctional) educational institutions is implemented in two forms:
– LFC classes;
– LFC classes at medical institutions.
Physical rehabilitation of adults with disabilities is performed in hospitals, clinics, rehabilitation centers, sanatoriums, preventive clinics and other medical institutions, as well as independently.
Thus, the means and methods of adaptive physical culture, when used rationally, serve as a stimulant to increase motor activity, health and efficiency, a way to satisfy the need for emotions, movement, play, communication, the development of cognitive abilities, therefore, are a factor in the harmonious development of the individual, which creates real preconditions for the socialization of this category of people.
Peculiarities of the organization of adaptive physical culture with children with disabilities
Features of the organization of adaptive physical culture with children with visual impairments
Tasks and means of adaptive physical education
The general objectives of adaptive physical education include:
– upbringing of a harmoniously developed child, – health promotion;
– education of volitional qualities;
– training of vital motor skills, skills;
– developing the physical qualities of speed, strength, agility, flexibility and endurance.
Special (correctional) tasks include:
– protection and development of residual vision;
– development of spatial orientation skills;
– development and use of the retained analyzers;
– development of visual perception: color, shape, movement (removal, approximation), comparison, generalization, selection; development of motor functions of the eye;
– strengthening the muscular system of the eye;
– correction of physical development deficiencies caused by visual deprivation;
– correction of stiffness and limitation of movement;
– corrective and compensatory development and improvement of the musculo-articular sense;
– activation of functions of the cardiovascular system;
– improvement and strengthening of the musculoskeletal system;
– correction and improvement of coordination abilities, coordination of movements;
– development of interdisciplinary knowledge;
– development of communicative and cognitive activity, etc.
In modern practice of adaptive physical education to solve both basic and special (correctional) tasks, there is a rich arsenal of physical exercises.
1. Movements: walking, running, hops.
General development exercises:
– without objects;
– with objects (gymnastic sticks, hoops, voiced balls, balls of different quality, color, weight, hardness, size, sandbags, dumbbells 0.5 kg, etc.);
– on projectiles (gymnastic wall, bench, balance beam, rings, crossbar, ribbed board, simulators – mechanotherapy, etc.).
3. Exercises for forming the skill of correct posture.
4. Exercises for strengthening the arches of the foot.
5. Exercises for developing and strengthening the musculoskeletal system (strengthening the muscles of the back, abdomen, shoulder girdle, lower and upper extremities). 6.
6. Exercises for the development of the respiratory and cardiovascular systems.
7. Exercises for development of balance, coordination abilities (coordination of movements of hands and feet, training of the vestibular apparatus, etc.). Unusual or difficult combinations of movements, exercises on simulators are used to improve coordination of movements. 8.
8. Exercises for development of accuracy of movements and differentiation of efforts.
9. Climbing and climbing (overcoming various obstacles).
10. Exercises for relaxation (physical and mental), muscle relaxation (muscle relaxation), a conscious decrease in the tone of various muscle groups. They can have both general and local character.
11. Special exercises for training in methods of spatial orientation on the basis of use and development of the retained analyzers (residual vision, hearing, sense of smell).
12. Exercises for development and use of the retained analyzers.
13. Exercises for the development of fine motor skills.
14. Special exercises for visual training: to improve the functioning of the muscles of the eye; to improve blood circulation of the tissues of the eye; to develop the accommodative capacity of the eye; to develop the skin-optical sense; to develop visual perception of the environment, etc.
16. Skiing training.
Auxiliary means of physical education include: hygienic factors (hygienic requirements for the learning process, compliance with the daily routine, visual load, etc.); natural forces of nature. Proper use of such natural factors of nature as the sun, air and water which have a beneficial effect on the physical development, health and hardening of students. The hygienic factors include all activities relating to the preservation of vision, health of schoolchildren.
The peculiarities of the corrective orientation of adaptive physical education of children with visual impairment include provisions that take into account the following information about the physical, somatic and mental state of students:
1) age and gender;
2) the result of medical examination and recommendations of doctors: ophthalmologist, orthopedist, surgeon, pediatrician, neurologist;
3) degree and character of visual impairment (stable and unstable remission); visual fields (central and peripheral visual impairment, narrowing of visual fields); visual acuity; congenital or acquired pathology, etc;
4) the child’s state of health (past infectious and other diseases);
5) the initial level of physical development;
6) state of the musculoskeletal system and its disorders;
7) presence of concomitant diseases;
8) ability of the child to spatial orientation;
9) availability of previous sensory and motor experience;
10) condition and capabilities of the intact analyzers;
11) ways of perception of learning material;
12) state of the nervous system (presence of an epileptic syndrome, signs of overexcitation, disorders of the emotional-volitional sphere, hyperexcitability, etc.).
Particular attention is paid to children of primary school age (7-11 years), when the eyes are adapting to increasing visual load and ophthalmic disease can progress. Therefore, the lesson must include special exercises for the protection of vision, to improve blood circulation in the tissues of the eye, to improve the work of the accomodation muscle, strengthening the muscles and sclera of the eyes, to relieve eye fatigue.
A person, having a highly developed nervous system, has a very large compensatory capacity. In this regard, the consequences of impairments can be largely overcome, and a blind person can achieve a high level of mental and physical development under certain conditions. Such conditions can include:
– The conditions of family and school upbringing,
– the state of health care, social security of rehabilitation centers, the level of technical progress and many other factors.
Therefore, one of the main tasks of rehabilitation work in order to develop compensatory capabilities is qualified assistance to the child. The physical education teacher should know that with vision loss the compensatory function of vibration sensitivity increases, the blind are able to sense at a distance the presence of a stationary object that does not emit sounds and other signals. The development of spatial orientation skills comes to the forefront in the formation of basic motor actions in the blind. With total blindness the role of the vestibular apparatus for maintaining balance and spatial orientation increases significantly.
Adaptive physical education is based on an individual and differentiated approach to the regulation of physical activity, physical fitness and sensory capabilities of children, as well as on emotional intensity. The emotionality of lessons depends on the variety of exercises, the general tone of the lesson, the intonation and command of the instructor. The timbre of the sound changes (loudly, quietly, softly, strictly) taking into account the mental state of the students, their rapid fatigue, specific features of development and perception of the educational material. When teaching motor actions to the blind, albums with a relief image of various poses and movements, visual aids, and adapted sports equipment are used. For example, when forming orientation skills, a 4-5 cm wide silk strip is sewn on the cover along the length of the mattress for the purpose of self-monitoring. Non-traditional sports equipment includes sound balls, balls with a string attached to a belt so that a child who loses a ball can pick it up without assistance, a ball with a smell of vanillin, which is used as an olfactory landmark, “pedals” to develop balance and form the skill of correct posture, a cone to develop the vestibular apparatus. The use of sound, tactile, olfactory and other reference points has priority. Trainees should be trained to differentiate all of the above landmarks, as well as their application in everyday life. The process of adaptive physical education should begin with familiarization with the objects that fill the surrounding space, correction of visual perception, as well as mastering the skills of spatial orientation. To stimulate motor activity, situations of success are intentionally created, direct or indirect influence on the correction of motor disorders, activation of the work of the safe analyzers (visual, tactile, auditory, olfactory).
Most children with visual impairments (weakly expressed), which are corrected by optical means, study in mass schools. As a rule, these children cope with the program material However, the presence of visual deprivation does not allow them to adequately perceive the educational material in physical education. There is a need for physical education teachers to master the technology of teaching such children.
The conditions for the implementation of the methodological recommendations are:
a) medical and pedagogical control,
b) knowledge of ophthalmic and concomitant diseases, recommendations of doctors of specialists (ophthalmologist, pediatrician, neurologist, orthopedist, etc.),
c) comprehensive study of the child and consideration of individual features of his or her development in the process of educational and play activities, where children’s abilities and opportunities are best revealed,
d) increase in motor activity of children.
Depending on the varying degrees of impairment of central visual acuity, students use different ways of perceiving educational material. The visually impaired with visual acuity from 0.1 to 0.4 D (with optical correction on the better eye) visually perceive objects, phenomena and actions, orient in large space. Children with severe forms of visual impairment, but who have residual vision, use tactile-visual or visual-tactile methods. Totally blind children perceive the world around them in a tactile-motor-aural way.
All teaching methods are used in work with these categories of children, however, taking into account the peculiarities of their perception of educational material, there are some differences in techniques. They vary depending on the child’s physical capabilities, knowledge and skills, previous visual and motor experience, spatial orientation skill, ability to use residual vision.
The method of practical exercises is based on pupils’ motor activity. To improve certain skills of visually impaired children, it is necessary to repeat the studied movements many times (more than for normally sighted children). Taking into account the difficulties of perception of the training material, a visually impaired child needs a special approach in the learning process in the selection of exercises that evoke confidence in the students, a feeling of safety, comfort and reliable insurance.
The experience of work allows us to single out the following directions for the use of the method of practical exercises:
– performance of exercises in parts, learning each phase of the movement separately and then combining them into a whole, – performance of the movement under easier conditions (for example, running downhill, somersault forward from a small slide, etc.),
– Performing movements under more difficult conditions (e.g., the use of additional loads (dumbbells 0.5 kg), reduction of the support area when moving, etc.)
– Use of resistances (exercises in pairs, with rubber shock-absorbers, etc)
– use of landmarks when moving (audio, tactile, olfactory, etc.)
– use of imitation exercises (e.g., “bicycle” in the prone position, throwing without a projectile, etc.)
– imitative exercises (“how a bear or a fox walks”, “stork stand”, “frog” – squatting with hands on knees, etc.)
– use of a leader when walking, running (children are guided by the sound of the steps of a child running nearby or one step ahead of a child with residual vision),
– use of insurance, help and accompaniment, which give confidence to the child when performing the movement,
– Use of the learned movement in combination with other actions (for example, dribbling the ball in motion with the subsequent throw to the goal, etc.)
– change of such characteristics as tempo, rhythm, speed, acceleration, direction of movement, amplitude, trajectory of movement, etc,
– change of the initial positions for performing exercises (for example, bending and unbending arms in a prone position from a gymnastic bench or from the floor)
– use of small sports equipment for finger manipulation and development of fine motor skills (hedgehog ball, massage ring and ball, hand grip, for differentiation of tactile sensations – separation of rice from peas, etc.)
– changing the external conditions for performing exercises on increased support, running in the hall and on grass, skiing on loose snow and on a rolled track, etc,
– varying the state of the students when they do physical exercises under test conditions (self-control, mutual control, crediting lesson, etc.), in competitive conditions (within the class, school, district, city, etc.), use of learned motor skills in everyday life
– use of exercises which require coordinated and synchronized actions of partners (running in pairs with a ball passed to each other with a gradual increase of distance between partners, etc.)
– change of emotional state (running in relay races, in movement games, performance of exercises with recitatives, musical accompaniment, etc.).
There are three stages in the mastering of movement: first is the creation of a general idea of a motor action;
The second stage is when the initial skill is formed on the basis of the formed notion (here it is important to have the control, realized by the senses, for the accuracy and correspondence to the existing standard);
3-rd – the motor skill is improved by its repeated performance.
For visually impaired children, the most typical methodological technique for training is the word method: conversation, description, explanation, instruction, remark, correction of errors, instructions, commands, verbal assessment, etc. Explanation is widespread, thanks to which the student must realize and imagine a motor image. When describing it, the teacher not only tells the students the proposed material, but also gives spatial representations of objects and actions. Listening perception of speech allows a child with visual impairment to relate words to the objects and actions they denote. Speech practice with the help of auditory perception creates conditions for understanding the meanings of more and more words, terms used in mastering movements in the process of adaptive physical education.
Varieties of explanation are used: accompanying explanations – concise comments and remarks used by the teacher during the performance of the exercise by students in order to deepen perception; instruction – verbal explanation of the technique of the studied actions.
The method of remote control also refers to the method of words, it implies control of the student’s actions at a distance by means of the following commands: “turn right”, “turn left”, “walk forward”, “three steps forward, right, left”, etc. Children with visual impairments often use audio information. In the majority of exercises when interacting with a support or an object there is a sound on the basis of which it is possible to make an idea of the object. Sounds are used as conditioned cues to replace visual representations.
The method of exercises on application of knowledge built on the basis of perception of information in learning through the senses (sight, hearing, touch, smell). This method directs the child’s attention to the sensation (muscular-motor sense) arising in muscles, joints when performing motor actions, and allows the transfer of learned knowledge into practical activities. For example, it is possible to offer the child to run after the leader, to catch up with him or her, to draw the child’s attention to movement of hands, legs, to feel the muscular sensation, and then to offer the child to run independently, trying to reproduce the same muscular efforts which he or she felt when running after the leader.
The method of visualization occupies a special place in teaching the blind and visually impaired. Visibility is one of the specific features of the use of teaching methods in the process of familiarization with objects and actions. When looking at objects (sports equipment) at first it is proposed to look at the object in parts, the task is to determine its shape, surface, quality, color, and then an attempt is made to perceive the object or action as a whole.
Requirements for visual aids: large sizes of objects, saturation and contrast of colors. In the manufacture of visual aids used mainly red, yellow, green, orange. To form in children a full perception of the educational material, it is necessary to use the demonstration of motor actions and sports equipment. The visualization must necessarily be accompanied by a verbal description, which will help to avoid a distorted view of the subject, as well as activate the thinking activity of pupils.
The method of stimulation of motor activity – the absence of bright visual representations impoverishes the emotional life of children with visual impairments. It is necessary to encourage children as often as possible, to let them feel joy of movement, to help them get rid of an inferiority complex, fear of space, lack of confidence in their abilities. If possible, create conditions for success. It is desirable to involve the teacher in the game, which allows to keep the pace and activity of children. With proper guidance, visually impaired children master various motor skills that form an emotional perception of movements, especially in play activity, development of strong-willed qualities, courage and determination, self-confidence.
When teaching children with visual impairment very rarely any one method is used, usually a combination of several complementary methods is used in accordance with the objectives of the lesson. Priority is given to the one which best provides development of motor activity of children.
With binocular visual impairment children are often unable to perceive the volume of objects and actions, they have difficulties in tracking moving objects. Students with a narrowed visual field have impaired spatial perception and have difficulty performing precise motor actions.
The use of the retained analyzers is a common task for students of the whole class, and the content and methods of corrective work to implement it are different, through an individual, differentiated approach to each student taking into account his/her capabilities and abilities.
When using and developing residual vision a combination of general and special exercises is appropriate, contributing, first of all, to the protection of vision, the formation of visual perceptions, training of the visual functions of the eye. It is advisable to teach the use of residual vision in the recognition of familiar objects, recognition of visual signs of sports equipment in the gym (by color, shape, size); develop visual representations in turns of 90°, 180°, analyzing the change in spatial relationships. Visual perception is developed by varying the distance of objects in space when throwing balls, long jumps and other exercises.
Of great importance is the development and use of the auditory analyzer, which in the absence of vision is one of the main compensatory systems. By perceiving sounds, a child with a visual impairment navigates the environment, determines the direction and location of the sound, it gives him or her an opportunity to learn about the world around him or her. The following sound cues are used in lessons in the elementary grades: metronome, tambourine, whistle, claps, the teacher’s voice, the sound of the person in front, voiced balls (of different sizes and textures), voiced toys, rattles. In the majority of exercises, when interacting with a support or an object, there is a sound by which one can make an idea of the object. For example, using a voiced ball, one can determine its size (small, large, medium) and quality of covering (leather, rubber, plastic, etc.). Listening to the sounds accompanying the jumper, it is possible to trace the whole process of jumping: quite sound running at the beginning, then slowing down and the growing sound when pushing away. Children can estimate the length of the jump by the duration of the flight from pushing off to landing. Regular “listening” by children to themselves and their companions in physical education classes while doing various exercises develops orientational hearing.
Children should be taught to link their muscular sensations to the background sound. The source of sound, such as a metronome, is set at the level of the student’s face, as at this height the sound is easier to catch. Systematic sound control assists in the compensatory development of the auditory analyzer: auditory perception, differentiation of various sound signals, localization of sounds in space, and in the movement of the sound signal. It is important to teach children how to use these skills, not only in learning activities, but also in their daily lives.
With the help of touch, children with visual impairments in physical education lessons are able to get an idea of the roughness, hardness, pressure and temperature of objects. Touch acts as an object-cognitive tool. When mastering the techniques of tactile perception of educational material, there are three main methods of examination: hand, palm, finger.
It is known that when examining it is advisable to use both hands, as it not only accelerates and facilitates, but also increases the quality of work, clarifies the volume, direction and relationship of parts of the perceived. Tactile examination of adapted visual aids (relief posters, gym plans, “ABC of movements” album, sports equipment) is used at the lessons. Children are taught to distinguish objects by the nature of the surface (wood, fabric, leather, rubber, plastic, ribbed board, etc.); weight and volume; to determine the characteristics of the ground with their feet (wooden covering, carpeting, linoleum, asphalt, grass cover, tamped or loose snow, etc.). On the basis of sole sensation (places of connections of carpets form a tangible strip) children line up, find other landmarks in the gym. With the help of touch, by touching the main tactile landmarks on the route with the hand, the students can move independently around the gym and the athletic field. Beforehand the children get acquainted with the place of training, with the tactile landmarks encountered along the route, they form ideas about objects, sports equipment, the location of windows, doors, exercise equipment, and other landmarks. This contributes to overcoming fear in confined spaces and feelings of insecurity about their abilities.
It is necessary to teach blind students to distinguish heat sources (the sun, heating devices) and their location by the nature of heat conductivity. Temperature sensitivity increases 10-15 times as a result of training.
Exercises for the development of sense of smell, which plays an important role in the process of spatial orientation, can be used at physical education lessons. The sense of smell, as well as hearing, can remotely signal the presence of an object.
Physical education classes and remedial activities have great opportunities to develop sensorimotor skills, musculo-motor sensitivity, which is one of the leading factors in the process of physical education classes. In order to develop musculomotor sensitivity it is first offered to do the exercise with the teacher, with an emphasis on the muscle group that is involved in doing the exercise, then the exercise is done independently with an emphasis on the same muscle group.
Particular attention should be paid to the combination of the work of the preserved analyzers (visual, auditory and tactile). They simultaneously excite the motor area of the cerebral cortex, which causes an increase in the effectiveness of the lesson, as well as a transfer to reality of the formed feelings of confidence and satisfaction from the possibility to move independently.
Children with visual impairments need a cautious approach to physical activity. When regulating physical activity it is advisable to adhere to the following recommendations:
– Use both standard (same speed, tempo, and weight) and variable (changing during the course of the lesson) types of exertion;
– To vary the forms and conditions of the performance of motor actions;
– vary the volume of the load, depending on the health of the pupils, their level of physical fitness
– to refrain from prolonged static load with lifting weights, exercises of high intensity which can cause increase of intraocular pressure, deterioration of ciliary muscles, ischemia, especially in children with glaucoma, high myopia and other diseases,
– to take into account the sensitive periods of development of physical qualities;
– use psychogymnastics to improve the psychosomatic condition;
– monitor the well-being of the students; moderate fatigue is not a contraindication, but as a result of irrational organization of work (physical, mental, visual) overfatigue can occur;
– in the presence of epilepsy syndrome, to exclude exercises on stimulation of the respiratory system, on increased support, games of high intensity, all that can provoke a seizure;
– take into account that disorders of the emotional-volitional sphere, hyperactivity are commensurate with exercises for relaxation, for the regulation of the respiratory system, for the removal of visual and emotional fatigue, an exercise for the eyes – “palming”.
Motion and sports games are also a good means of regulating physical activity. For example, the use of games of low and average intensity (“The Quieter You Ride, the Further You Will Be,” “Frontier Guards,” “Do Please,” etc.), performance of attention tasks (10 steps forward, 9 steps back, 9 steps forward, 8 steps back, etc.) Also subject-role plays and movement games with a corrective orientation are used (ball games, games aimed at the development of the auditory-tactile analyzer, at the development of spatial orientation skills, etc.).
Indications and contraindications for physical exercises
For children with visual impairments (for some diseases) the following restrictions are provided, sharp inclines, jumps, exercises with weights, acrobatic exercises (somersaults, stands on the head, shoulders, arms, head down), and bouncing from equipment, exercises with body shake and head tilt, sudden changes in body position and possible head injuries, high intensity exercises, long muscle tension and static exercises, loads with high intensity in running, moving on skates.
Restrictions apply to the following conditions: Fresh trauma to the eyeball membranes, retinal degeneration or detachment, corneal dystrophy, brain or eye tumors, glaucoma, cataracts, aphakia, high degree myopia (above 6.0 D with complications on the eye fundus), in the early postoperative period after lens replacement (first six months), subluxation (displacement) of the lens that occurs due to weakness or tearing of the ligament that supports it in the eye. The following sports are contraindicated in the presence of these diseases: diving, weightlifting, boxing, wrestling, hockey, soccer, basketball (only safe elements of soccer, basketball, hockey are allowed), cycling, skiing, motorcycling Excessive physical activity can lead to retinal detachment, hemorrhages on the eye fundus and other complications.
A low degree of myopia (up to 3.0 D) is not an obstacle to practicing sports Swimming (not everyone can dive and jump from the tower, from a night table), skiing (ski racing), athletics (some kinds), table tennis, calisthenics, tourism, a checkers, chess, goalball, badminton, etc. are not only shown without restrictions, but also have a positive effect. The choice of any sport for activities is coordinated with the ophthalmologist.
In high school due to an increase in the volume of the school program, the shortage of free time, the reduction of motor activity the importance of physical culture increases. Nevertheless, a number of authors recommend some restrictions for young men with 3 to 6 D myopia to exclude overcoming the obstacle course, classical wrestling, power exercises on the bar, pulling up and lifting from the hang point, replacing them with rope climbing using the legs. High school students with myopia over 6 D study in special groups. Physical activity restrictions are recommended for students with complicated myopia, coordinated with an ophthalmologist.
Concomitant diseases of children with impaired vision also dictate certain restrictions. In the presence of hydrocephalus, excessive physical activity can cause an increase in intraocular pressure. With epilepsy, excessive interest in physical exercises for breathing, on elevated support (log, bars, etc.), sports and outdoor games of high intensity can provoke a seizure syndrome, and with disorders of the emotional-volitional sphere of children cause their hyperactivity. Under pyelonephritis, hypothermia is contraindicated (outdoor exercise in the fall and winter period, swimming in the pool).
Despite some limitations, it should be noted that it is not the type of movement that is dangerous for health, but the method of doing it. Visually impaired children can engage in the following sports: swimming, cross-country skiing, athletics, gymnastics, certain types of wrestling, checkers, chess, arm-wrestling; sports games for blind children of high school age (13-18 years old) – goalball, rollerball.) The participation of school-age children in competitions provides for mandatory admission and control of doctors: an ophthalmologist and a pediatrician.
Peculiarities of the organization of adaptive physical training with hearing-impaired children
Permanent hearing disorders in children can be congenital or acquired. The congenital hearing impairment is much rarer than the acquired hearing impairment. The role of the hereditary factor as a cause of congenital hearing loss has been exaggerated in previous years.
Other causes of congenital hearing loss include infectious diseases in the mother during pregnancy. Of particular importance are viral infections (measles, influenza). The most dangerous for the developing rudiment of the auditory organ is a disease that occurs in the mother during the first three months of pregnancy.
Certain chemicals can have a harmful effect on the developing hearing organ of the fetus. Alcohol consumed by the mother during pregnancy is of practical importance in the occurrence of congenital hearing impairment, and of drugs – streptomycin and quinine.
Hearing organ disorders can be caused by fetal trauma, especially in the first months of pregnancy, when the rudiment of the auditory analyzer is particularly vulnerable.
Acquired hearing loss comes from a variety of causes. Severe hearing loss usually occurs when there is damage to the hearing apparatus (inner ear, auditory nerve), while mild to moderate hearing loss can occur when there is damage only to the sound-conducting apparatus (middle ear).
Among the causes of hearing loss in children, the first place is occupied by the consequences of acute inflammation of the middle ear (acute otitis media). Hearing damage in these cases is caused by persistent residual changes in the middle ear, leading to a disturbance of the normal mobility of the eardrum and the auditory ossicular chain. In some cases, after acute otitis media, there is persistent perforation of the eardrum and prolonged pus from the ear – chronic suppurative otitis media. This disease is usually accompanied by a significant reduction in hearing.
Frequent causes of hearing loss in children are diseases of the nose and nasopharynx and related disorders of the eustachian tube.
Lesions of the inner ear and the auditory nerve trunk play a major role in the etiology of severe forms of persistent hearing loss. Lesions of the nuclei of the auditory nerve, its pathways in the brain, as well as the cortical auditory centers are of relatively less importance both in terms of frequency and the degree of hearing impairment arising from them.
Acute infectious diseases play an important role in the occurrence of permanent hearing impairment. Most infectious diseases that cause hearing damage occur in childhood, and therefore the role of these diseases in the etiology of hearing loss in children is particularly important. Of the infectious diseases that cause permanent hearing damage in childhood, the most important are cerebrospinal meningitis, measles, scarlet fever, influenza, mumps. Some infectious diseases (meningitis, viral influenza, mumps) cause damage to the nerve apparatus of the auditory analyzer (the corpus organ or the trunk of the auditory nerve), while others (measles, scarlet fever) affect mainly the middle ear, and the resulting inflammatory process not only leads to impairment of the middle ear sound-conducting apparatus, but may also cause diseases of the inner ear (serous or purulent labyrinthitis) with partial or complete death of the receptor cells of the corium organ.
Hearing impairment and usually simultaneously developing disorder of the vestibular apparatus in cerebrospinal meningitis is caused by an inflammatory process in the inner ear – purulent labyrinthitis, resulting from the spread of purulent infection from the meninges through the internal auditory canal to the auditory nerve sheath. Damage to the inner ear in epidemic cerebrospinal meningitis usually occurs in the first days of the disease: sometimes as early as the first day there is complete deafness, usually bilateral.
It is worth mentioning a relatively rare but very severe hearing loss, which sometimes occurs with another viral disease – inflammation of the parotid salivary gland (epidemic parotitis, or the so-called mumps). The lesion is usually unilateral, but in some cases we can observe complete bilateral deafness. According to most researchers, the basis of deafness in epidemic mumps is the death of the receptor apparatus in the inner ear (hair cells of the corpus corneum).
A pathological process in the auditory system changes the function of the vestibular apparatus, and vestibular disorders in turn affect the formation of the motor sphere.
The vestibular analyzer perceives signals about the position of the body and head in space, changes in speed and direction of movement, provides a unified function of perception and orientation in space, and has a constant effect on muscle tone.
The inner ear consists of the cochlea and the labyrinth, the labyrinth in turn consists of three semicircular canals and the foramen, which includes sacculus and utriculus sacs. The bony and membranous parts of the semicircular canals and the vestibule have the same shape. The cavities of the membranous labyrinth are filled with endolymph. It is accepted that the movement of endolymph in the semicircular canals and otoliths of the sacculus and utriculus is influenced by acceleration. The nerve endings branched out in this part of the inner ear are specialized in evaluating the movement of the body in space with a certain acceleration. The semicircular canals respond mainly to angular acceleration (rotation), and the adequate stimulus of the otolith apparatus is the beginning and end of rectilinear movement, as well as the force of gravity.
Otolith receptors participate in the complex process of analyzing the otokinesesthetic state of the body and providing motor reactions aimed at maintaining equilibrium.
Interrelation of the auditory and vestibular analyzers is traced in close anatomical unity of their orientation: as it is known, the peripheral part of the auditory system is located in the labyrinth, the same place where the peripheral receptors perceiving vestibular stimuli, signaling the body optics in space are.
The 8th pair of cranial nerves, performing the transmission of excitation from the cortical organ (cochlea), contains not only the auditory fibers, but also the vestibular branch.
The unity and the general principle of work of vestibular and auditory systems is observed: transformation of mechanical vibrations into a nervous impulse by influence of endolymph at moving on nerve endings of auditory nerve cells, located in a labyrinth.
It is important to say about the capabilities of the vestibular sense in auditory perception. The auditory analyzer is very ancient; it was initially formed as a system for analyzing vestibular stimuli, and only later a separate subsystem dedicated to the analysis of sounds was separated from it. However, the primitive auditory functions of the otolith organ were not lost. Neurophysiological studies show that the otolithic division of the vestibular analyzer responds to tones from 16 Hz to 1000 Hz and is able to replace, in some cases, cochlear (cochlear) activity. Disturbances of vestibular function were observed in both deep and less pronounced changes in auditory perception. There were separate cases of high stability of the vestibular apparatus at sharply reduced auditory function, and on the contrary, at relatively good preservation of the auditory analyzer – sharply reduced function of the vestibular apparatus.
A pathological process in the auditory analyzer changes not only the function of the vestibular analyzer, but also the function of the kinesthetic analyzer, which also determines features of motor activity of the deaf. Persons with low vestibular stability have significantly impaired coordination of movements, equilibrium, reduced ability to maximize motor skills and spatial orientation under the action of various kinds of accelerations, rotations, inclinations.
Auditory perception is better in the ear where the vestibular analyzer is less affected, with bilateral lesions. It is important to keep in mind a high degree of compensation for vestibular disorders. Compensation is made at the expense of the central parts of the analyzer and its interaction with other sensory systems, especially with the visual system. Training of the vestibular system with specially selected physical exercises increases the functional stability of the vestibular analyzer to the impact of unfavorable factors related to inner ear disorders.
In the process of physical therapy work with children who have hearing and speech impairments, the main focus should be on revealing the child’s uniqueness, on creating an individual corrective and developmental program for the child, based on a comprehensive comprehensive comprehensive study of the features of their development. The main goal of early diagnosis and assistance to the child is to ensure the child’s social, emotional, intellectual and physical growth and to achieve maximum success in developing his or her capabilities.
The variety of developmental disorders in the hearing impaired child is not the result of limited access to sound stimuli alone. It is only impaired speech development that results as a direct consequence. Speech acts as a means of connecting people to the world around them. Disruption of this connection leads to a reduction in the information received, which affects the development of all cognitive processes and thus affects primarily the process of mastering all types of motor skills.
The main pathology can cause a chain of consequences, which, having arisen, become the causes of new disorders and are concomitant. It was found that hearing loss in children is accompanied by disharmonious physical development in 62% of cases, in 43.6% of cases – by defects of the musculoskeletal system (scoliosis, flat feet, etc.), in 80% of cases – delayed motor development. Concomitant diseases are observed in 70% of deaf children.
Deaf preschoolers differ from their hearing peers by somatic weakness, insufficient motor mobility. It is established that deaf children of preschool age lag behind their peers in psychophysical development by 1-3 years.
The peculiarity of the development of attention and perception of children with hearing impairments noticeably affects memory activity. Children are dominated by visual perception, so the whole process of remembering is mainly based on visual images, while hearing children have an auditory-visual process and rely on active audio speech.
Lagging in sensory development of hearing-impaired children is associated with secondary defects: underdevelopment of object activity, and lag in the development of communication with adults, both verbal and non-verbal. These children cannot independently analyze the situation, isolate the properties and relations of objects that are essential for this activity. Only in the third year of life practical orientation on the properties of objects begins to form in children’s activity, which is mainly manifested in activities with didactic toys. Object activity does not become the leading activity in children at an early age.
The lag in the development of object and instrumental activity not only affects the formation of the sensory basis, but is also reflected in the level of development of visual thinking in children with hearing impairments. The study of the state of visual forms of thinking in children indicates a lag not only in the development of visual-imaginative, but also in visual-actual thinking. The formation of visual-actual, practical thinking occurs with a significant time lag and with some quantitative and qualitative differences from its formation in normally developing children, despite the presence of general developmental trends.
The method of speed and strength orientation of the educational process is based on the principle of conjugate development of coordinative and conditioned physical abilities. To strengthen the corrective influence, the technique includes exercises for the development of balance, activation of mental processes and impaired auditory function exercises are performed under rhythmic beats of a drum, tambourine. At first, the sound is perceived by children visually and then only by hearing. Means of development of speed and strength qualities in the correctional process in a physical training session are different types of running, jumping, throwing, exercises with balls (stuffed, volleyball, tennis). The main methods – game and competitive – include relay races, movement games, repetitive tasks, story game compositions, a circular form of organization of classes.