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BIEU HIEN ROI LO^N CUA TRE TlT KY TAI CAC CO s d GIAO DUC DAC BIET 6 THANH PHO HUE NGUYtN THI NGOC NHI^ Trudng Dgi hoc Suphgm Dai hgc Hue NGUYEN QUANG VAN Trudng Dgi hoc Supham Hd Noi Tom t5t Tre tir[.]
BIEU HIEN ROI LO^N CUA TRE TlT KY TAI CAC CO s d GIAO DUC DAC BIET THANH PHO HUE NGUYtN THI NGOC NHI^ Trudng Dgi hoc Suphgm - Dai hgc Hue NGUYEN QUANG VAN Trudng Dgi hoc Supham Hd Noi Tom t5t: Tre tir ky tai cac ca sa giao due dSic biet a Thanh Hue hien CO ty le roi loan nSng cao, the hien r5 a linh vuc giao tiep va kha nang quan he xa hoi Cho den nay, a cac ca sa van chua chan doan, xac dinh dirac miic va bieu hien roi loan cy the ciia cac linh vuc ma tre tu ky dang mac phai nen viec xay dung ke ho?ich cham soc va giao due tre chua phu hop va thi^u tinh kha thi Trong bai viet nay, chung toi giai thi?u ket qua nghien cuu, chan doan, danh gia miic nhung bieu hien roi loan ciia tre tu ki tai cac ca so giao dye dac biet a Thanh Hue, lam ca so de x3y dung ke hoach giao due phii hgp va hieu qua I.DATVANDE Tu ky la m6t dang r6i loan phat trifen lan t6a/r6i loan phat tri§n theo di$n rpng (Pervasive Developmental Desorder/PDD), gay nSn nhCmg h^n ch8 ca ban \h cac mat: quan he xa hgi, giao tiep va hanh vi, sa thich, l^m cho tre m3c hpi chijmg g$p kho khan kha nfing thiet lap quan h? xa hpi va phan ung phii hgp, tir nhien tnroc hoan canh song hang [1], [2] Vai nhung tre tu ky a miic dp nang, kha nSng va ca hpi hoa nhap cpng d6ng la Ai it Vi6c phat hi?n, chan doan va can thiep sam mot cdch hgp ly va lau dai se lam giam anh huong ciia roi loan tu ky den s\r phat triSn, giiip tre hi?n thuc hoa cac kha nSng ti£m tang ciia minh va co co h6i h6a nhap vao cudc s6ng Tai cdc CO so giao due d5c bi?t (CSGDDB) a Thanh Hue hien nay, cung voi tre co cac d^ng khuySt tat khac, tre tu ky dang dupc can thiep va h6 trg giao due theo nhifiu hinh thirc khac Tuy nhien, viec thieu vang cdc ke hoach gido due ca nhan dugc xay dung dua tren sir ddnh gid khdch quan va khoa hpc ve miic dp khuyet tSt, cdc dang rSi loan cu the cua tie da anh huong rat Ion den chat lupng va hieu qua ciia qua trinh giao due Vi vay, viee nghien ciiu, xdc dinh ro bieu hien roi lo?ui cua tre tir 1^ tiii cac CSGDDB Thanh ph6 Hu6, tren co so xay dung ke hoach giao due ca nhan phu hgp la mpt cong viec can thifit de ndng cao chat lugng va hieu qua qua trinh can thiep, h§ trg cho tre tu kv BIEU HIEN ROI LOAN Tl/ KY CUA TRE TAI CAC CO SO QIAO DUC D A C BIET THANH PHO HUE De nghien ciiu, chdn dodn, danh gid miic dp r6i loan tu ky cua tre tai eac CSGDDB o Thanh Hue, chiing toi da sir dung Thang lupng gia hpi chiing tu ky tre em (Children Autistic Rating Scale - CARS), ph6i hpp voi eac quan sat tren 15 tre tu6i tir 3-6 da dugc chan doan la tu ky dang theo hgc hoac tham gia chuong trinh can thien som tai Truong Chuyen biet Tuong Lai (56 Lam Hoing, Hue) vd Trung tdm Bretaae Tap chi Khoa hpc va Giao dye, Tni6ng Dai hpc Su pham Hu4 ISSN 1859-1612, S6 04(20)/20n:tr 126-133 B E U H E N ROI LOAN CLA TRE TL' KY TAI CAC CO SO GIAO DUC DAC BET (16 kiet Tam Thai, Hue) dudi su quan ly ciia VSn phong Tu vdn di tmySn va H6 tro tre khuyet tat cua Dai hpc Y khoa Hue Ngodi chiing toi ti^n hanh di8u tra bing anket, phong van cha me, giao vien, nha qudn ly cdc CSGD da tim hiSu bifiu hien r6i loan a cac tre tu ky-, phan loai ty 1^ va nhung npi dung lien quan d€n qua trinh cham soc, h5 trg giao due tre tu ky tai gia dinh vd CSGD K6t qua nghien ciiu nhu sau: 2.1 Mirc ty ky cua tre tai cac C S G I ^ B a TP Hui Theo kk qud chdn doan bing thang CARS, 15 tre pham vi nghien ciru dkn thupc dang tu ky dien binh, khong co cac bpi chiing khac ph6 tu ky (Asperger, Rett hay roi loan bdt boa nhap tuoi du flia-.) Trong co 06 tre r6i lo^n tu 1^ a miic nhe - viia (mirc didm tir 33,5-36), 09 tie l^i a mirc nang (tir 38,5-51 digm) Ty le tre em nam mac chting tir ky nhieu ban tie em nu K6t qua nghien ciiu cho thdy co 13/15 tre dugc nghien cuu la tre nam (chi&m 80%) va tie nu (chi^m 20%) Ket qua chan dodn, danh gia tren cho thdy ty le tre ty ky a miic dg ndng cao Nguyen nhan ciia thyc te la tre ty k> khong dupc phdt hien va chin dodn sdm, chua dupc can thiep, h6 trg kip thoi, thieu tinh khoa hoc va khong ben vimg Di6u gay nen kho khan cho cong tac h6 trp giao due ciing nhu kha ndng hoa nhap cgng d6ng a ye 2.2 Bieu hien roi loan ta ky cua tre tai cac CSGDDB & Thanh phd Hui Nhung bieu hien roi loan dien hinh cua tre tu ky duoc nghien cuu tren lmh vyc: quan he - tuang tac xa hpi, ngon ngiJ - giao tilp va sa thich, hanh vi Tir kit qua dilu tra bdng anket vl miic bieu hien roi loan ty ky cac ITnh vuc neu tren danh cho cha me tre va giao vien cho thdy: 2.2.2 Linh vuc quan hi - tuang tdc xd hpi Nhiing roi loan iTnh vyc the hien o nhu cau va khd ning thilt lap quan he xa hpi va khd ndng tuong tac cam xiic voi nguoi khdc - Ve Nhu cdu vd khd ndng thiet lap mdi quan hi xd hdi, ket qud ddnh gid the hien bang sau Bang I Kit qud ddnh gid nhu cdu vd khd nang thiet lap quan he xa hgi cua ire luky Stt \hu cau va kha nang thiel lap mdi quan hi qua lai v&i ngttiri khac X SD Kha nang dap tta co nguoi hoi chuyen Kha nang tiep xuc bang mat Kha nang hieu va thuc hien yeu cau phii hop Kha nang sii dung ngon ngu cii chi moi quan he tuong tac voi ngudi khac Nhu c4u va klia nang thiet lap moi quan he voi nguoi Ion (co giao/bfi me) Nhu can va kha ndng thiet lap moi quan he voi ban/anh chi em 2.20 2,00 2,04 1,80 0.45 0.39 0.48 0,48 2,10 0,36 2.38 2,09 0.55 0,36 Chme{X) Ghi chu: X : Gia tri trung binh; SD: Do lech chudo bac NGUYEN THI NGOC NHI - NGUYEN QUANG UAN Kho khan nhilu nhdt ma cdc tre gap phai la khd ndng vd nhu cdu thiit lap mdi quan hi v&i bgn, anh chi e'" ddng lua (X = 2.38) Theo • le ngi dung hd trg ma cac CSGDDB da tien hanh ve co ban phii hpp, rieng ITnh vyc quan he - tuong tdc xa hpi la thieu phii hpp va it dupc dau tu Bdi le ddy la dudng giiip tre thich nghi, hoa nhap cupc sdng, ndi dung can dupc chii ypng nhilu hon Day cd the la nguyen nhan khien cho tre gdp nhilu kho khdn yong ITnh vye Hinh thuc giao due dugc su dyng chu yeu la thdng qua hogt ddng sinh hogt hdng ngdy, dgv thdng qua viec to chirc gid hgc/tdp luyin cu the Rieng viec phoi hap vdi gia dinh viic hd trg gido difc tre it dupc quan tam Ddy la ban che ldn vi khong tao dupe moi trudng giao due thdng nhat \'a thieu sy lien ket, bd yp de cimg thyc hien muc dich chung Cac phuang phap sir dung day hpc danh cho ye ty ky cdn ngheo nan Kit hgp giira ngdn ngU v&i tranh dnh, cir chi hay makaton la phuong phap ddc lap duoc sir dimg chu ylu, hoat ddng tri lieu la phuong phap thii hai dupc sir dung kha nhieu, tri lieu ngdn ngfi chua dugc chii trpng \ i da sd tre d day khdng cd kha nang ngon ngir, mat khac khong dii nhdn lyc thyc hien NGUYEN THI NGOC NHI - NGUYEN QUANG U 4N Tim hieu chat lugng hd yp giao due cua giao vien danh eho tre ty ky tren ITnh vye tre ty k>' gap khd khan, nhin chung, chit lupng ho trg giao dye d cac ITnh vyc deu dat ket qua tot, yong dd lmh vyc quan he - tuang tac xa hpi dat miic cao nhat ( X chimg = 3,0 dilm) Linh vuc s& thich hdnh vi mirc dat kha cao (X chung = 2,89 dilm) Thip nhit la chit lupng hd trg cho Hnh vuc ngdn ngd - giao dip (X chung = 2,7 diem) So sanh trpng s6 npi dung dupc hd trp vdi chit lugng dat dugc cho thdy: hnh virc quan hi - tuang tdc xd hdi cd s6 lugng hd trp giao due thap nhdt nhung chat lupng, hieu qua thyc hien tdt nhdt Trong liic dd, linh vuc s& thich hdnh vi va sir dung ngdn ngir cu chi giao tiip la nhiing ndi dung dugc day nhilu ban nhung chdt lugng, hieu qua dat dugc chua tdt Thyc \& neu tren cho thay sy dau tu chua phu hgp vl mat ndi dung, hinh thiic va phuong phap ho trg ttiieu da dang da anh hudng den chit lupng ciia nhirng ho trg giao dye danh cho tre ty ky Vi vay, dieu chinh lai cac npi dung trpng tam phii hgp vdi thyc te kho khdn cua tre cd the nang cao dugc chat lugng, hifu qua giao due tai eae CSGDDB KET LUAN Hdu het tie ty I^ tai cdc CSGDDB d Thanh phd Hui co miic dp khuylt t^t ndng, dilu gay nen kho khan Uong cdng tac cham soc, hd yp giao due cho tie Trong Unh vuc dugc chin doan, ddnh gid, ye ty k\ gap kho khan nhieu nhat d ITnh vyc ngon ngir giao tiep, tiep den la quan he - tuong tac xa hpi Da so tre thieu vang ngon ngir hoac ngdn ngii giao tiep, do keo theo nhiing han che giao tiep va kha nang quan he xd hdi d tre Trong llnh vyc quan he xa hdi, kha nang tuong tac cam xiic d ye it kho khan hon nhu cdu va khd nang thiet lap moi quan he qua lai vdi ngudi khac Cd sy khdc biet mang y nghTa thong ke giiia cha me ye vdi giao vien d^ih gid nhu ciu va kha ndng quan he xa hpi d tie, GV nhan thdy ye cd khd khan ban CM tre Hanh vi, sd thich la ITnh vyc eac tre it gap kho khdn nhit nhung vdn t6n tai hanh vi, sd thich dinh hinh, tdng dgng, tu htiy, kho khan thay ddi thdi quen d gia dinh \ a cac CSGDDB da tiln hdnh mpt sd ho trg giao due thilt thuc eho tre, nhien thilu sy tuang xiing giua ty ypng diu tu vdi hieu qua dat dugc npi dung hd trg chua xdc hgp vdi thyc trang khd khdn cua tte Siic manh tap thi thdng qua sy phdi hgp gido due giua ca sd vdi gia dmh, cdng ddng va xa hpi chua duge phat huy Viec phdn chia ldp hpc chi dya vao sy danh gia chung, chua xuit phat tii nhirng chin dodn, danh gid khoa hpc, xac thyc ve miic dp bieu hien kho khan cu thi Vi vdy, 6k nang cao chit lugng vd hieu qua cdng tac can thiep, hd yp gido dye cho tre ty ky tai eac CSGDDB d Thanh pbd Hue can thyc hien cac bien phap ey the sau: Sur dung phdi bop cac cdng cu chdn dodn, danh gia danh cho tre ty ky dl xac dinh muc dp bieu hi?n rdi loan cua tre Chia nhom hpc theo miic dp bilu hi$n rli loan tu kv dl cd nhung ho trg cu tbI, sat vdi timg nhdm miie dp khd khdn khae Xdc dinh ndi dung bien phap ho trp giao dye phii hgp cho timg nhdm Ddng thdi xay dyng kl hoach va hd' trg ca nhdn theo dac diem phat trien cua timg ye vdi nhirng hd yg trudc mdt va lau dai dya tren nhirng khd khdn, thuan lgi rieng ciia moi tre Co sd giao due, gido vien nha tri lieu phdi hgp, tu van, hudng dan cha me tre yong cdng tac giao due dl ndng cao chit BIEU HIEN ROI LO.^N CUA TRE TU'KY TA] CAC CO SO GIAO DL C DAC BET lugng hd trg giao due cung nhu sy phat trien nhanh chdng, ddng bd cho ye Danh gia thudng xuyen, dinh k>" viec thyc hien ke hoach de Viec thyc hien dong bd cac bien p h ^ ed the nang cao hieu qua can thiep hd trg giao due danh cho tre tu V^ Ket qua nghiai cuu da cung cap nhimg chin doan, ddnh gid cu the ve tie la co so de xay dyng ke hoach can thiep, hd yg giao dye phii hgp - dilu kifn dl ndng cao chit lupng cdng tac giao due danh cho Ire tu [^ tai cac CSGM)B TAI LIEU THAM KHAO [I] [2] Nguyin Van Thanh (2006) Tre em lu ky - phucmg thuc gido due NXB Ton giao, TP Ho Chi Minh Kolvin, I (1971) Studies in the childhood psychoses: I Diagnostic criteria and classification British Joumal ofPsychiati^ p 8-11 Title: EXPRESSION OF AUTISM DISORDERS OF CHILDREN IN SPECIAL EDUCATION INSTITUTIONS IN HUE CITY Abstract: At present, the rate of serious disorder of autistic children in special education institutions in Hue city is so high and clearly shown in the fields of communication and capacity of social relation So far, in these institutions, there are not diagnosis and determination about the extent and expression of specific disorders in the fields that autistic children Uouble with, so thattheplansof education and taking care ofthese children are unsuitable and lack of viabihty In this article, we inUoduce the results of research, diagnosis, assessing the extent of disorder expression of autistic children at the special education institutions in Hue city, as a basis to draw up plans for consistent and effective «iucation NGUYEN THI NGOC NHI Hoc vien Cao hpc, Trucmg Dai hpc Su pham - Dai hoc Hue DT: 0935.453.282 Email: ngngnhi.05@ gmail.com GS TS NGUYfiN QUANG U A N Nguyen GV Trudng Dai hoc Su pham Ha Npi