Tap chi KHOA HQC DHSP TPHCM Li Thf Minh Hd imJC TR ĴVG CONG TAC CHAN DOAN TRE KHUYET TAT d MOT SO TRUOfNG CHUYEN BIET TAI THANH P H 6 HO CHI MINH Lt TH! MINH HA '''' T6M TAT Chdn dodn Id budc quan trgng[.]
Tap chi KHOA HQC DHSP TPHCM Li Thf Minh Hd imJC TR^JVG CONG TAC CHAN DOAN TRE KHUYET TAT d MOT SO TRUOfNG CHUYEN BIET TAI THANH P H HO CHI MINH Lt TH! MINH H A ' T6M TAT Chdn dodn Id budc quan trgng qud trinh ddnh gid tre khuyet tgt Chdn dodn phdi dugrc thirc hien thudng xuyen qud trinh gido due tre khuyet tdt Chdn dodn tre khuyet tdt nham xdc dinh logi khuyit tgt cua tre vd phdn logi tre theo miec dg tdt khdc Tren ca sd do, xdc dinh logi hinh dich vu can thi$p sdm hogc gido due dgc biet phit hop vdi tre Tie khda: chkn doan tre khuyet tat, trk nghi?m tri tue, thang hanh vi thich dng ABSTRACT The reality of diagnosis of disabled children at some special schools in Ho Chi Minh City Diagnosis is an important step in the process of assessing children's disability It must be done regularly during the educational process for these children Diagnosis of disabled children identifies the type of disability and classifies children according to different levels of disability In light of diagnostic results, an appropriate type of intervention or program will be determined Keywords: diagnosing children with disability, intelligent quesnel test, behavioral assessment system M9t so van de lien quan den chan doan tre khuyet tat LL Khdini^m Thugt ngit chan dodn dugc tiep nhan tir Y hpc Trong Tir dien Tiing Viet, chdn dodn dugc xem la "Viec xac dinh benh dua theo trieu chdng va kit qua xet nghidm" [3] Theo Tir dien Tam li hgc, chdn dodn (Diagnosis) la xac dinh ban chit ciia su khac thudng (khong binh thudng) ho£ic benh t^t Ngoai ra, chdn dodn cd thi coi la su phsin lo£ii ca nhan dua tren eg sd su khong binh thudng hoSc benhtat [l,tr 100] ' TS, Trudng Dgi hpc Su phgm TPHCM Tuy theo chuyen nganh va tieu chi lira chon, chung ta cd cac lo^ chan doan khac nhau, vi du chan doan tre khuyet tat, chan doan trieu chiing, chan doan hgi chung, chan doan benh, chan doan roi nhieu tam than, chan doan tam li Thugt ngit chan dodn tre khuyet tgt (CDTKT) Theo I A Korobeinikov, chdn dodn tre khuyet tdt (cdn ggi la chan doan chuc nang) la "su md ta tong quat cac dac diem phat trien tam li tre", cd sir "danh gia nhiing ket qua hien co va bieu hi?n cu thi cua nhiing roi loan cac chirc nang tam li va kT nang xS hgi co ban" (hanh vi thich img, hanh vi giao tiep, kT nang hgc t^p - nhan thuc) [6] Tap chi KHOA HOC DHSP TPHCM Theo Trin Thj LS Thu, chin doin tre khuyit tat dupc hilu m$t cdch chung nhat 14 xdc dinh logi khuyit tgt ciia tri vd phdn logi tri theo mice khuyit tgt khdc [4, tr.lOO] Trong qud trinh chlln dodn, c6 the phdt hi^n trS thu$c loai khuyit t^t cy thi ndo dd, chdng hjin nhu khuyit tat tri tu?, khiem thinh, khiem thi, da tat Nhd chan dodn, md c6 the biet tr^ khuyet tdt thupc muc dp nhe/trung binh/ndng/rat n ^ g Hi^n nay, cdc nhd chuyen mon nhiiu ITnh vuc da md rpng khdi niim chdn dodn, coi chdn dodn khdng chi nham xdc dinh bdn chdt va nguyin nhdn cUa su bdt binh thuang, md cdn du dodn suphdt trien hogc diin biin tiip theo cua qud trinh rdi logn nhdm dug duac nhOng di xudt, kiin nghi theo nhiim vu vdyiu cdu chung eiia chdn dodn L2 Npi dung CDTKT Dua tren cdc ITnh vuc phdt trien cua tre, CDTKT gom nhung npi dung sau: Van dpng tho; Van dpng tinh/nhdn thiic; N h ^ biet ngon ngG (ngon ngii tiep nhan); Giao tiep/dien dat ngon ngCt (ngdn ngu dien dat); Cd nhan va xd h$i NhGng kl ndng can ddnh gid a tre: kl ndng van dpng tho, ki ndng v^n dpng tinh, kl ndng nhan biet ngon ngG, kT ndng giao tilp, kl ndng cd nhan vd xd hji 1.3 Phuang phdp CDTKT Phuong phdp CDTKT phii hpp cdc phucmg phdp sau: Quan sdt tre; Phong vdn phy huynh; S6 37 nam 2012 Nghien ciiu h i so cila tre; Sil dung trdc nghi$m tri tuf vd thang hdnh vi thich iing chudn; Cdc bdng kiem tra dua vdo dp tuli vd chuong trinh day trS 1.4 Luc lufng tham gia CDTKT Nh6m da chile ndng, gom: Thdnh viSn tru cpt: TrS, gia dinh va gido vien; Thdnh vien h5 trp: Nhd tdm li - gido due, bdc sT, cdc chuySn gia ve cac tat khdc, nhu: ngon ngtt/khilm thinh/khiem thi/phyc hoi chiic ndng, vdt li tri lieu, dinhduftig 1.5 Dgc trimg cua chan dodn Ire Thuc hien tren mpt tre cu the; Chi thuc hien chan dodn d tre hdnh vi, hoat dpng, trang thai tam li cua tre CO nhimg lech lac, thieu sot nhdt dinh so vol chuan muc (chi so phdt trien) vd so vai chi tieu (chi so tmng binh ve mat thing ke); Chan dodn bao gio cflng nham tim nguyen nhan va cdch gido dpc tre, giiip tre khdc phyc thieu s6t, lech lac qua trinh phdt tri6n de phdt trien manh hon, hdi hoa hon cdc ndng l\rc, kT ndng Npi dung vd kit qua nghien cvu 2.1 Khdch the nghien ciru Khdo sdt dupc thyc hien tren 92 gido vi8n (GV), GV tai cdc truimg chuyen bipt (94,6%), trucmg hoa nh^p (5,4%) vdi phdn nhu sau: Tudi ddi: dudi 30 tuli (53,26%), tu 30-40 tuli (14,13%), tren 40 tuli (19,56%), 12 philu bo tring (13,04%) Tudi nghi: GV c6ng tdc ngdnh gido due ddc biet dudi nam Le Thi Minh Hd Tap chi KHOA HQC BHSP TPHCM (43,5%), 6-10 nam (14,3%), 10-20 ndm Trung tdm Djy nghe vd Tao vi^c lam cho (4,35%), bo trdng (33,7%) ngudi khuyit tat vd mpt sd trudng - So GV khao sdt thupc cdc trudng mdm non, tieu hgc: Mam non Qudn 10, tren dia bdn cdc quan: 1, 2, 3, 5, 6, 7, 8, Mickey vd Tiiu hpc Binh Hung Hda 1, 10, 12, Go Vdp, Binh Thanh, Tan Binh, Trin Qudc Todn, Rang Ddng 2.2 Ket qui nghiin ciru Tan Phil, Binh Chdnh Trong dd, cdc 2,2.1 Nhgn thirc cua GV ve muc dich truang chuyin biet: Hudng Duong, l/dc Mo, Suong Mai, Nguyin Dinh Chieu, CDTKT Mile dp nh|in thiic cua GV ve muc Mdi dm Nhat Hdng, Huynh De Nhdn dich CDTKT qua khdo sdt duoc thi hiSn NghTa, Da Thi?n, Anh Vuong, Anh d bieu dd sau ddy: Duong, Binh Minh, Niim Tin, Tu Do, Bieu Nhdn thirc citaGVvi muc dich CBTKT 413 II : Sang li,ic ire D^ng Muc Biiu dd cho thay, so y litkienkhuvC'i chotai khuvel ring muc dich cua CDTKT nh§m can thiep sdm va ho trg tre chiem ti le cao nhit (64,1%), ki din la nhSm tim dang tat cua tre (41,3%) Cdc muc dich khac ciing dugc GV di cap den nhu xac (^nh mdc khuyit tat cua tre (19,5%), kha nang/han chi hien tai cua tre (15,2%), kham sang Igc tre (14,1%), nhien, cac ti le thap R§t it GV de cap den viec tim nguyen nh&i khuyet tat cua tr^ (8,6%), cd i• Isgujen Kha nang,' Bien phap h6 the doi nhin day khuyeila mgt hanviec che kho,Ira Ire hdi phai cd cac nha chuyen mon tham gia CDTKT Ngoai ra, mgt so y kien khic de cap dSn viec CDTKT nhim thu th^p thong tin ban dau di phat hien tre co nhiing khac biet bit thudng so vdi nhiing tre cdng tu6i, tren CO sd tiSn hanh danh gia Id luong hon tij cac iihi chuy&n mon va lua chpn mdi trudng g i ^ due phu hgp vdi tre Nhu vay, da so GV hi6u dugc muc dich ca ban cua vi8c CDTKT nhim xdc dmh dang tat va mdc tat ciia tre, kha ndng va han chi hien tm cua tre, tu sS 37 ndm 2012 Tap chi KHOA HOC BHSP TPHCM hudng can thi^p, hd trp thich hpp cho tre Dl thyc hi?n myc dich CDTKT, GV can biet va thyc hi?n npi dung CDTKT 2 Nhgn thue cita GV ve ngi dung CDTKT Miic dp nhan thiic cua GV ve ndi dung CDTKT qua khao sdt dupc thi hien d bilu dd dudi day: Bieu Nhgn thirc ciia GVvi ngi dung CDTKT IS.' ]S2 Mill khii>Ol Bieu cho thay muc nhan thuc cua GV vi ndi dung CDTKT chua cao, chi cd 33,7% GV de cap den cac mat phat trien nhan thiJC, ngdn ngu" va hanh vi ndi chung Da sd cac GV nhdm ldn giira muc dich vd ngi dung CDTKT Chdng han, 27,7% GV cho rdng ngi dung ciia CDTKT la sang lpc ban ddu, 15,2% tim dang khuyit tat vd kha ndng cua tre, hodc tim muc dp vd nguyen nhdn khuyet tat cGng nhu can thi?p sdm/hd trg tre Nhu vgy, GV chua phan bi^t dugc muc dich vd ngi dung CDTKT Myc dich ciia vi?c CDTKT Id xdc dinh logi khuyit tgt cua tre vd phdn logi tre theo muc khuyet tgt khdc De thyc hien dugc muc dich nay, GV can dya vao cdc m^t phat triin ciia tre nhu van dpng thd, van dpng tinh/nh$n thiic, nhan biit ngon ngii, giao tiep/diln dgt ngon ngii vd kT ndng ca kim nhan/xa hpi de chdn doan danh gid tre O ddy GV se phai dua vao cdc giai doan phdt trien tuong img vdi dp tudi ciia tre binh thudng (chuan) tren cac ITnh vyc phdt trien de phdt hien nh&ng dau hieu bdt thudng qud trinh phat trien ciia mgt diia tre cy the, sau dd xac dinh muc dg bat thudng d mgt ITnh vyc cy the va khd ndng phdt trien d cac Unh vyc khac ciia nd Tren ca sd do, xay dung ke hoach can thi^p vd hd trg tre Dd chinh la qud trinh thyc hi^n ngi dung chdn dodn danh gid tre 2.2.3 Si^ hieu biet cua GVve cdc phuang phdp CDTKT De thyc hien dugc n0i dung CDTKT, GV phai biit vd cd kT ndng thuc hi?n mpt sd phuang phdp CDTKT cy thi Kit qua khdo sat vi van di dugc thi hi?n d bieu dudi day: Tap chi KHOA HOC DHSP TPHCM Le Thi Minh Hd Bieu Sir hieu biet ciia GV ve cdc phuang phdp CDTKT 71 il I r^L- ni^lii^ni in m c i j t l u i i u Jii hdiilivnliiJiimL: Bieu dd cho thdy GV biet den mdt sd cdng cu nhu trdc nghiem tri tue va thang hdnh vi thich iing (Denver, PEP, "Timg budc nhd", M-chat, ABA, ABSS:2, TEACH, Oregon) chiem ti le cao nhdt: 71,7% Trong dd, 41,3% GV cho biet hp dupc hpc chuyen de "Chdn dodn danh gid tre khuyet tdt" chuong trinh dao tao ciia Khoa Gido dye ddc biet Trudng Dai hpc Su pham TPHCM vd 8,7% GV hpc tai Trudng Cao ddng Su pham Trung uong TPHCM Ngodi ra, GV cQng bilt mdt sd phucmg phdp CDTKT khdc nhu quan sdt tre (44,6%), phdng vdn phy huynh (38%) hp dupc hpc/tap hudn tai mdt sd truong/trung tdm, benh vien Vdn cdn mdt sd GV (30,3%) chua bilt cdng cy nao CDTKT, nhQng GV chua dupc hpc hoac tap hudn vl CDTKT Rdt it GV biet den phuong phdp nghien ciiu hd so cua tre (4,3%) CDTKT Ddy la phuang phdp kha phd biln, nhung doi hdi GV phdi cd thdi quen I phiihiiMili hi> xay dyng ho so ca nhan tre tiep xuc vdi tre lan dau tien Ho so tre co day du thdng tin ve tre thai kl, sy bat thudng liic sinh va sau sinh, cac bieu hien cua tre ve giae ngii, an udng, cac dac diem phat trien van dpng thd, van dgng tinh, nhan thiic, cam xiic, ngon ngii, cdc kT nang ca nhdn, xa hpi Hd so tre cung chua dung nhinig thdng tin lien quan den gia dinh tre, dac biet la mdi quan h% ciia tre vdi ngudi cham sdc tryc tiep vd vdi nhiing ngudi xung quanh Chi cd 8,7% GV biit sii dyng bang kiem tra hanh vi danh gid tre (ddnh gia khong chinh thiic) Bang kiim tra hanh vi cua tre thudng dugc gido vien xay dyng dya theo kien thiic va kT ndng can thiet cho tre Nd giiip ludng vd gidi thich su tien bg cua tre ve cdc mat phdt trien cu the, ddc biet ho trg gido vien thiit ki cdc chiin luge can thifp va hd trg thich hgp vdi tre Kit qua khao sdt cho thay cd qud it GV nhdc den phuang phdp danh gia ndy S637nSm2012 Tap chi KHOA HOC BHSP TPHCM cd thi), cung cdp thdng tin dl xdy dyng chuong trinh can thipp/hd trp vd tu van phy huynh lya chpn loai hinh can thifp/gido dye phu hpp vdi tre Da so GV cdc trudng chuyen bipt cd hilu biet ve mft si phuong phdp vd cdng cy chin dodn ddnh gid tre Kit qud khdo sdt vifc GV dp dyng cdc phucmg phdp chan dodn thyc tl dupc trinh bdy d bieu sau day: Bieu do4.GV thifc hiin CDTKT Tom lai, ket qud khdo sdt cho thdy GV CO biet mpt sd cdng cy vd phuong phap co bdn CDTKT Tuy nhien trdn thyc te, hp cd thyc hi$n CDTKT hay khong Id van de can tim hieu 2.2.4 Viic thuc hiin CDTKT Thyc hien CDTKT giup xdc djnh lo^i khuyet t§t vd phdn logi mile dp tdt cua tre, phdt hi?n nhflng h^i chiing hodc bfnh di kim, nguySn nhdn gdy bfnh (nlu I I Bieu dd cho thay so GV cho rang trudng cua hp chu-a thuc hien CDIK I chiem ti 'le cao nhat (57.6%), chi co 34,8% GV cho biet trudng ciia ho co thuc hi?n CDTKT Thuc irang cho tha> cdng tdc CDTKT chua dugc Ihuc hien d mpt sd trudng mac dii !a nhirng trudng cd day tre khuyC-i lai Bieu Cdc phuang phdp Trae nghidm n va Ihang doHV Quan sal tre 2.2 Nhung phuang phdp dugrc GV sir dung CDTKT Tim hieu ve viec GV thudng sii dung phutmg phap nao c!te thuc hien CDTKT chung toi nhan dliig^ikit qua nhir a bien dudi &d\: '-': '" < GV sir dung CDTKT 16 Phong van phu hu>nh I Tgp chf KHOA HQC DHSP TPHCM Li Thi Minh Hd Bieu cho thdy GV su dyng tren cdc tieu chi khoa hpc cung phdi ket phuang phdp quan sat tre chiim ti le cao hgp vdi phuang phdp phdn tich tdm li nhat (34,8%), ki din Id phuong phdp gido due hpc vd cdc phuang phdp khdc phdng vdn phy huynh di tim hiiu thong Tuy nhien thyc tr^g khdo sat cho thdy, ti tin vi tre (26,1%), cd 23,9% GV da tim 1? GV thyc hi?n cdc phuang phdp hieu tre thong qua viec nghien ciiu hd sa CDTKT cdn rdt thdp Ddy la mpt thirc cua tre va 21,7% GV cd su dyng mot so tr^ng dang lo ngai, dieu d6 cho thay giiia cdng cy (test Denver, PEP, 'Timg budc vide GV biet vd viec van dung cdc nhd") CDTKT phuang phdp CDTKT vdn cdn la m^t khodng cdch Trong CDTKT, vi§c sdc d^ng h^ 2.2.6 Nhii'ng ngudi thyc hi^n CDTKT thong cdc phuang phdp chan dodn ddng bp dug^c xem Id mgt nhihig Tham gia CDTKT gdm nhieu nguyen tdc ca bdn nhdt, cho phep md ta phan gpi Id nhdm da chirc ndng, bao gdm ti mi va ddnh gid dung cdc d^c diem phdt cac thdnh vien trg cgt (tre, gia dinh va trien tam li ciia tre mpt cdch todn dien vi GV) vd thdnh vien ho tra (nha tam li cdc mat phat trien ciia tre nhu van dpng, gido due, bdc sT, cdc chuyen gia ve cdc tdt tri tue, xuc cdm, hanh vi va kT ndng, tinh khac nhu ngon ngii/khiem thinh/khi6m trang giae quan va cd lich su phdt trien thi/phuc hdi chuc nang, vat li tri lieu, ciia tre Trac nghiem chi la mpt kT thuat dinh dudng ) Thyc te hien nay, nhimg nhd toan bg he thdng phuang phdp thdnh phdn ndo thudng tham gia Trac nghiem nhat thiet phdi di ciing vdi CDTKT? Ket qud khdo sdt ve vdn de quan sat tam li va phdng vdn ngudi than dupc the hien d bieu dd sau ddy: Quan sat tam li mgt cdch khdch quan dua Bieu Luc luang thamgia CDTKT tgi cdc truang Hi Ban giam hi^uy Hicu nho CM GiSo vitin BGI I vnGV Bilu dd cho thdy, GV tham gia thyc hifn CDTKT chiim ti If cao nhdt (26,1%), kl din la Ban gidm hifu (21,7%), nhung cd Ban gidm hifu vd GV cung thuc hifn thi chiim ti If rdt thdp •13%), cdc nhd chuyen mdn (bdc si, ^ ^ ^ • g i a tdm li - gido dye) cung chiim I Chuyen Eia (bai: sT nha [iim til Phn hu>nh Khnnj i;han dnnn mpt ti if thdp (14,1%), chi cd 5,4% GV de cap den vifc phy huynh tham gia CDTKT Kit qua khao sat cho thdy chua cd sy kit hpp cdc luc lupng trSn mpt nhom da chile ndng dl CDTKT Nhu vay, vifc CDTKT tji cdc trudng chuyen Tap chl KHOA HOC DHSP TPHCM bift hifn hau nhu chi GV hodc Ban gidm hifu thyc hicn Das Id mpt thyc trang can sdm dupc cdc chuyen gia y Ic tdm li gido dye phy huynh vd GV quan tam Thyc trang tren cdn cho thay vifc CDTKT d TPHCM ndi chung vd t?i cac trudng chuyen bift ndi rieng, chua cd sy phoi hpp gifla cdc thdnh \icii can thilt nhdm CDTKT Theo lieu chuan cua Td chirc Y te The gidi, vifc chan dodn ddnh gid cac rdi loan phdl trien cila mpt tre bao gdm ndm thdnh vien tham gia (phy huynh, chuyen gia y le chuyen gia tdm li - gido due, GV vd chuyen gia chuyen sdu ve cdc ITnh vyc khuyet tat) Cac vien cua nhdm ddnh gia phdi cflng theo ddi tre thdi gian tdi thieu la mdt thdng d ba mdi trudng khdc (phong kham/trung tdm, gia dinh, cdng ddng) Dac bift, sy cdn thiet phai phdi hpp gifla hai ngdnh y khoa vd tdm li hpc chan dodn danh gid tre khuyet tat dang ngdy cdng trd nen rdt cdn thiet Bdi vi, cho den nay, cdc dich vy gido due ddc bift, tri lifu tdm li van dupc lien hanh chya cd cdc chdn dodn ddnh gid, dieu dnh hudng tieu eye den qyd trinh can thif p vd hd trp tre khuyet tat Kit luan Budc ddu nghien cuu thyc trang CDTKT d mpt sd trudng chuyen bift tai S6 37 nim 2012 T PHCM, chiing tdi nhdn thdy GV thupc cdc don vj khdo sat diu hieu myc dich cua vifc CDTKT vd bilt mpt sd phucmg phap CDTKT Tuy nhien, hp van cdn nham lan gifla myc dich vd npi dung CDTKT Da s6 GV cho rdng trudng minh chua thuc hiin CDTKT (57,6%) Chi cd 34,8% GV cho rdng trudng minh cd thifc hiin CDTKT, dd chu yeu la su dyng phuong phap quan sdt tre va phdng van phy huynh, sd GV su dyng trdc nghifm tri tuf vd thang hdnh vi thich ling rdt it (21,7%) Lyc lupng chinh tham gia thyc hifn CDTKT la GV va Ban gidm hifu, so chuyen gia va phu huynh cdn rdt it Tu thyc trang tren, chiing tdi xin de xudt mdt sd y kien nhu sau: Day manh vifc td chuc bdi dudng vd tap hudn CDTKT cdc co sd giao due tre khuyit t%t l?i TPHCM; dao tao, bdi dudng chuyen sdu ve chdn dodn vd danh gid tre khuyet t?it cho cdc khoa giao diic ddc bift vd cac trung tam ngudn tai TPHCM; tiep tyc md rpng nghien Cuu sdu hon ve thyc Irang CDTKT tai cdc co sd y tl tai TPHCM; phoi hpp cdc co sd gido dye, y tl, phy huynh va cac chuy€n gia chuyen sau cdc ITnh vuc khuyet tdt khdc tham gia CDTKT cho cac trudng/trung tdm cd d^y tre khuyit tjt TAI LI$U THAM KHAO Truong Thj Xuan Huf (2006), Tdm li hgc chdn dodn tri khuyet tgt, Tdi lieu luu hdnh npi bp, Trudng Cao ddng Su ph^m Mau gido Trung uong Moira Pieterse, Robin Treloar, Sue Caims, Diana Uther, Erica Brar (1989), Small Steps and Early Intervention Program for Children vith Developmental Delays, Macquarie University, Sydney, (Bdn djch tiing Vift: Ton NO Thuy Nhung (2001), Tirng bude nhd, Trung tdm Nghien ciiu Tre khuyet tat Thanh phi Hd Chi Minh) (Xan tiip trang IS) ... lan gifla myc dich vd npi dung CDTKT Da s6 GV cho rdng trudng minh chua thuc hiin CDTKT (57,6%) Chi cd 34,8% GV cho rdng trudng minh cd thifc hiin CDTKT, dd chu yeu la su dyng phuong phap quan... CDTKT qua khdo sdt duoc thi hiSn NghTa, Da Thi?n, Anh Vuong, Anh d bieu dd sau ddy: Duong, Binh Minh, Niim Tin, Tu Do, Bieu Nhdn thirc citaGVvi muc dich CBTKT 413 II : Sang li,ic ire D^ng Muc... thi Kit qua khdo sat vi van di dugc thi hi?n d bieu dudi day: Tap chi KHOA HOC DHSP TPHCM Le Thi Minh Hd Bieu Sir hieu biet ciia GV ve cdc phuang phdp CDTKT 71 il I r^L- ni^lii^ni in m c i j t