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Ivan DVOJAKOV

Marika SOTIROVSKA-SIRVINI

Gorica LEVENSKA

EARLY DETECTION OF CHILDREN WITH DEVELOPMENTAL DIFFICULTIES AS BASE FOR SUCCESSFUL REHABILITATION

            In the composition of one well imagined axis, the approach towards the children with developmental difficulties, integrated rehabilitational system, the most important place takes the basic element, the early and adequate detection and evidence of these children, as essential condition for successful realization of the remained segments in the whole system i. e., building of the whole strategy of the children with developmental difficulties.

            The main goals of this presentation are:

·         the objective condition in the early detection, evidence and registration of children with developmental difficulties in the Republic, focusing on the present deficiency and partial solutions in this moment.

·         our professional and personnel possibilities as base for improvement of this segment;

·         the objective needs and organizational perspectives for a global system of detection of children with developmental difficulties;

·         the central evidence of these children, excluding the elements of improvisation and partial working.

            Absence of one unique methodology of detection, registration and central evidence of these children although there is a legislative regulation for their registration (in the centers for social affairs) it puts us in a position only to predict the expected number of children with developmental difficulties ( according to WHO, about 5-7 % in pre-school population ).

            The results of the commissions for categorization, as well as the number of persons with developmental difficulties, can’t be equal with the real position  of early detected and evidenced, at this moment.

            Stressing the importance of the early detection and evidence, as a segment in the preventive health care, from one point of view, and pointing out the insufficient engagement of the health workers (doctors), from another point of view, automatically gives the conclusion, that this problem must be solved  at health level, giving directions and education of the teaching staff, on the level of health care of children, prime health care institutions which get in contact with every child (regular examinations, immunization, medical check-ups etc.).

            With the opening of the Developmental advisory centers in Skopje and Bitola, the condition is getting better. The Developing advisory centers which are product of the  pediatrical services in the prime health care, appears as “ core “ of the organized approach in the early detection, evidence and following  the children born with some factor of risk and children with developmental difficulties.

            The concept of the Developmental advisory centers allows animation and involvement of all the segments, necessary for detection, evidence and registration of children riskborn  and children with developmental difficulties, according to equal standards, criteria and methodology of work of  GAK and the central register of the risk born and impaired children for the whole Republic. Also the involvement of the commissions for categorization and the centers for social affairs.

            Thus, set concept requires legislative regulations, obtaining legislative obligation of  every subject and continuity in the work.

            The perspective essential obligations which would be performed in the most rational way and step by step, only if they become a legislative regulations are:

I-st  step:    Preparation and constitution of necessary documentation on the level of the Republic.

II-nd  step: Establishment of regional developmental advisory centers ( gradually, according to the needs and possibilities ) in the larger cities, with regional registers of risk and impaired children, team work and equal methodology for the whole Republic.

III-rd step: Central evidence, linking of the regional registers  in the Developmental advisory centers, in one central Republic register of risk born and children with developmental difficulties.

            This project represents a very complex and hard work. In the frames of realization it requires compulsory participation of the Ministry of Health, Ministry for labor and social affairs, socio-humanitarian organizations. It will be necessary to establish an coordinative body from the neonatal participants and before all, for coordination, following, realization and evaluation of the results from the whole project.

            The effects of the successful realization of this concept, will be seen in overpassing  of some weakness in its segment, and the same time will present the real timely, and modern approach in the “syndrome” child with developmental difficulties.