adreuli asakis bavSvis ganviTareba (aabg)

saxelmZRvanelo socialuri samuSaos samagistro programis studentebisTvis

avtorebi: zurab tatanaSvili, prof. qeTevan nemsaZe

Tbilisi 2008

winasityvaoba
gaeros bavSvTa fondis iniciativiT 2008 wlis oqtomberSi gadawyda, rom aucilebelia socialuri muSakebis CarTva adreuli asakis bavSvTa ganviTarebis sferoSi. socialur muSakebs xSirad uwevT iseT ojaxebTan urTierToba, romlebsac bavSvebis srulfasovani ganviTarebisTvis limitirebuli resursebi aqvT. ganviTarebul qveynebSi socialuri muSaki xSirad asrulebs Sualeduri rgolis rols ojaxebsa da eqimebs Soris. ganviTarebis xarvezebis adreuli niSnebis drouli SemCneva swored socialur muSakebs SeuZliaT maSin, roca isini TavianT yoveldRiur saqmianobas asruleben. gaeros bavSvTa fondma, saqarTvelos socialur muSakTa asociaciasTan da m. iaSvilis saxelobis bavSvTa centralur klinikasTan erTad, 2008 wlis oqtomberSi daiwyo muSaoba adreuli asakis bavSvebis ganviTarebis kursis Seqmnaze socialuri muSakebis magistraturis saswavlo programisTvis, romelic Semdeg saWiroebisamebr modificirdeba serTificirebisa da bakalavriatis kursebisTvis. es saxelmZRvanelo Seqmnilia Tssu-is pediatriis fakultetis studentTa saxelmZRvanelos bazaze, romelsac daemata sxvadasxva sakiTxi socialuri muSakebis samuSaos specifikis gaTvaliswinebiT. saxelmZRvanelos Sesadgenad gamoyenebulia inglisurenovani da qarTulenovani sxvadasxva saxis masala.

sarCevi

Sesavali ras niSnavs adreuli asakis bavSvis ganviTareba adreuli asakis bavSvoba multidisciplinaruli midgoma bavSvTa ganviTarebis Teoriebis istoria socialuri muSakis roli adreuli asakis bavSvTa ganviTarebaSi mikrodone prenataluri ganviTareba bavSvis dabadeba, pirveli Sexeba samyarosTan zogadi rCevebi mSoblebisTvis

5 5 6 12 12 15 18 18 22 25

0-3 wlis asakis bavSvis fizikuri ganviTareba da misi Sefaseba 27 0-3 wlamde asakis bavSvis motoruli ganviTareba da misi Sefaseba 34 0-3 wlamde asakis bavSvis kognituri ganviTareba da misi Sefaseba 43 0-3 wlamde asakis bavSvis emociuri da socialuri ganviTareba da misi Sefaseba bavSvebi maRali riskis qveS makrodone intervenciebi Temis doneze politika da media 67 67 69 54 65

Sesavali

ras niSnavs adreuli asakis bavSvis ganviTareba? Teoriebis mimoxilvamde aucilebelia gaviTavisoT is, rom bavSvebi ara mxolod zomaSi imateben, aramed viTardebian, ixvewebian da swavloben, Tu rogor gaugon mSoblebs da sxva adamianebs, rogor iarsebon cvalebad da gamowvevebiT aRsavse garemoSi. arsebobs ganviTarebis modeli, romelsac TiTqmis yvela bavSvi imeorebs, Tumca bavSvis ganviTarebis sxvadasxva maxasiaTebeli SeiZleba varirebdes bavSvidan bavSvze. am maCveneblebze uamravi faqtori axdens gavlenas, romelTa Soris aris sociumis kulturuli maxasiaTeblebi, romelic bavSvTa ganviTarebis miznebsac SeiZleba karnaxobdes. adreuli asakis bavSvis ganviTareba da masze zrunva moicavs ara marto imas, Tu ra etapebs gadis bavSvi zrdis procesSi, aramed imasac, Tu ra safexurze ra saxis zrunvas saWiroebs igi. bavSvis normaluri da jansaRi ganviTarebisTvis ar aris sakmarisi misi mxolod sakvebiT, usafrTxoebiT da janmrTelobiT uzrunvelyofa, aucilebelia masTan urTierToba/interaqcia, stimulacia, siTbo da SemecnebiTi aqtivobebi.
5

Sesavali

adreuli asakis bavSvis ganviTareba da masze zrunva moicavs Semdeg RonisZiebebs: mSoblebTan muSaoba, raTa gaZlierdes mSoblis unarCvevebi; ufros da-ZmasTan da ojaxis sxva wevrebTan muSaoba, raTa maT iswavlon bavSvis ganviTarebisTvis specifikuri saWiroebebis drouli aRmoCena da Sesabamisi daxmarebis gaweva; dRis zrunvis servisebis miwodeba da gaZliereba; adreuli asakis bavSvTa ganaTlebis da skolamdeli ganaTlebis iseTi programebis ganviTareba, romlebSic gaziarebulia holistikuri midgoma; Temis fizikuri, ekonomikuri da moraluri SesaZleblobebis ganviTareba, raTa daexmaron bavSvebs da ojaxebs.

adreuli asakis bavSvoba saerTaSoriso gagebiT, adreuli asakis bavSvoba iwyeba Casaxvidan da grZeldeba 8 wlis asakamde. aRsaniSnavia, rom sxvadasxva literaturaSi es asakobrivi zRvrebi SeiZleba sxvadasxva iyos. am asakobrivi jgufis moxsenieba terminiT `adreuli asaki~ ganpirobebulia ori ZiriTadi mizeziT: pirveli _ drois es periodi emTxveva ganviTarebis fsiqologiis Sexedulebebs da meore _ bavSvebi 8 wlamde saukeTesod swavloben, rodesac maT aqvT sagnebi, riTac SeuZliaT manipulireba, isini ZiriTadad am sagnebis meS6

Sesavali

veobiT aRiqvamen samyaros. isini iyeneben eqsperimentebs, iReben arasasurvel Sedegebs da xvdebian, rom meoredac am qcevis imave saxiT gameoreba imave Sedegis momtani iqneba. am dros aucilebelia, rom mSoblebma da mzrunvelebma maT konkretuli qcevebisTvis usafrTxo garemo Seuqmnan.

bavSvis ganviTarebis etapebis CarCo

asaki - 3 Tvemde

ras akeTeben am asakSi isini Tvals ayoleben sagnebs, iRimian, moswonT saxeebis da naTeli ferebis yureba. pirvelad xedaven zeda da qveda kidurebs, Tavs weven da abruneben xmauris mimarTulebiT, tirian, magram xSirad Cumdebian xelSi ayvanisas.

ra sWirdebaT fizikuri safrTxeebisgan dacva. adekvaturi kveba, adekvaturi jandacva (imunizacia, rehidrataciuli Terapia/ gauwyloebisgan dacva, higienuri normebis dacva), motoruli da sensoruli stimulacia, saubari masTan, mSoblis mxridan pasuxismgeblobiTa da grZnobebiT aRsavse damokidebuleba. fizikuri safrTxeebisgan dacva. adekvaturi kveba, adekvaturi jandacva (imunizacia,
7

4-6 Tvis

am asakisTvis bavSvebi xSirad iRimebian, mSoblebis da ufrosi da/Zmis danaxvaze gamoxataven dadebiT

Sesavali

emociebs, imeoreben qmedebebs, romlebsac maTTvis saintereso Sedegi mohyveba, ismenen yuradRebiT, pasuxoben, rodesac elaparakebian mas, icinian da kiskiseben, baZaven xmebs, Seiswavlian qveda da zeda kidurebs, pirSi ideben sagnebs, daxmarebiT SeuZliaT dajdoma, brundebian muclidan zurgze da piriqiT, xtebian wamojdimisas, swrafad moZraoben, itaceben sagnebs cera TiTis gamoyenebis gareSe. 7-12 Tvis bavSvebi imaxsovreben martiv movlenebs, cnoben sakuTar Tavs da aRiqvamen sakuTari sxeulis nawilebs, nacnob xmebs, cnoben sakuTar saxels da sxva sityvebs, amboben pirveli mniSvnelobis mqone sityvebs, Seiswavlian da aqneven xelSi aRebul sagnebs. jdebian da dgebian

rehidrataciuli Terapia/ gauwyloebisgan dacva, higienuri normebis dacva), motoruli da sensoruli stimulacia, saubari masTan, mSoblis mxridan pasuxismgeblobiTa da grZnobebiT aRsavse damokidebuleba.

fizikuri safrTxeebisgan dacva. adekvaturi kveba, adekvaturi jandacva (imunizacia, rehidrataciuli Terapia/ gauwyloebisgan dacva, higienuri normebis dacva), motoruli da sensoruli stimulacia, saubari masTan, mSoblis mxridan

Sesavali

damoukideblad, SeuZliaT siaruli, morcxvoben ucxo adamianebis danaxvisas. 1-2 wlis am asakSi bavSvebi baZaven mis garSemo myofi adamianebis qmedebebs, saubroben da esmiT sityvebi da am sityvebis azri. uxariaT rodesac raimes uyvebian da moswonT sagnebiT TamaSi, fexze dganan myarad da dadian, adian kibeze, darbian, moswonT damoukideblad moZraoba, aseve moswonT nacnob adamianebTan urTierToba. grZnoben sagnebis sakuTrebas, iZenen megobrebs, wyveten problemebs, gamoxataven siamayes miRweuli Sedegebisas. am asakisTvis bavSvebs uxariaT axali unarCvevebis SeZena, swrafad swavloben enas/metyvelebas,

pasuxismgeblobiTa da grZnobebiT aRsavse damokidebuleba. wina asakobrivi kategoriis saWiroebebTan erTad, bavSvebs sWirdebaT daxmareba moZraobebis asaTviseblad metyvelebasa da fiqrSi damoukideblobis ganviTarebaSi TviTkontrolis gasaZliereblad, zogadad TamaSis da sxva bavSvebTan TamaSis SesaZleblobebiT. janmrTelobis dacvis TvalsazrisiT mniSvnelovania Wiebisgan da sxva parazitebisgan gaTavisufleba.

2-3,5 wlis

wina asakobrivi kategoriis saWiroebebTan erTad, am asakis bavSvebs sWirdebaT

Sesavali

yovelTvis mzadyofnaSi arian imoZraon, srulad akontroleben xelebs da TiTebs, advilad Riziandebian, moqmedeben ufro damoukideblad magram mainc damokidebuli arian mozrdilebze, imeoreben nacnob qmedebebs. 3,5-5 wlis am asakisTvis bavSvebs ufro didxans aqvT yuradRebis dayovnebis unari, iqcevian daufiqreblad/ gauazreblad, xSirad iqcevian sulelurad, arian aRgznebulebi, amboben moulodnel rameebs, svamen uamrav kiTxvas, iTxoven zrdasruli adamianis sagnebs da qcevis SesaZleblobebs, gabedulad cdian sakuTar fizikur monacemebs, amJRavneben grZnobebs, roca TamaSoben Teatralur rolebs

Semdegi qmedebebis SesaZleblobebi: gaakeTon arCevani, iTamaSon Teatraluri rolebi, aTvalieron/ waikiTxon ufro da ufro rTuli wignebi, imReron sayvareli simRerebi, amoxsnan martivi gamocana/ amocanebi.

wina asakobrivi kategoriis saWiroebebTan erTad, am asakis bavSvebs sWirdebaT Semdegi qmedebebis SesaZleblobebi: natifi motorikis ganviTarebisTvis, metyvelebis dasaxvewad kiTxva da simRera, TanamSromlobis unarebis ganviTareba daxmarebisa Tu nivTebis Txovebis gziT, kiTxvisa da weris mcdeloba.

10

Sesavali

an roca imitireben, moswonT megobrebTan TamaSi, ar moswonT TamaSSi wageba, sxvas uziareben sagnebs da swavloben rigrigobiT TamaSs. 5-8 wlis am asakSi bavSvebs uviTardebaT mzardi interesi adamianebis da sxvadasxva movlenis/sagnis mimarT, ainteresebT ricxvebi/cifrebi, asoebi, wera da kiTxva. ufro metad rwmundebian sakuTar fizikur SesaZleblobebSi, laparakoben sakuTar grZnobebze, moswonT zrdasruli adamianebiviT moqceva, moswonT gareT TamaSi, TamaSoben sxva bavSvebTan erTad (TanamSromlobis reJimSi). wina asakobrivi kategoriis saWiroebebTan erTad, am asakis bavSvebs sWirdebaT Semdegi qmedebebis SesaZleblobebi: ganaviTaron werakiTxvis unari, monawileoba miiRon problemebis gadaWraSi, CaerTon jgufur muSaobaSi, ganiviTaron sakuTari unarebis rwmena, daakvirdnen sagnebs/movlenebs da gaakeTon maTi analizi, ganiviTaron sicocxlisTvis saWiro ZiriTadi unar-Cvevebi, daeswron saganmanaTleblo aqtivobebs.

saqarTveloSi adreuli asakis bavSvad miiCneva bavSvi sami wlis asakamde.

11

Sesavali

adreuli asakis bavSvebis ganviTarebis calke gamoyofa ganapiroba am asakSi bavSvis fizikuri, kognitiuri da socialuri ganviTarebis Taviseburebebma.

multidisciplinaruli midgoma adreuli asakis bavSvis ganviTarebis mimarT multidisciplinaruli da holistikuri midgoma gulisxmobs maTSi mimdinare fizikuri, fsiqoemociuri da socialuri cvlilebebis erTianobaSi ganxilvas, am ganviTarebaze zemoqmedi sxvadasxva saxis faqtoris gaTvaliswinebas. aqve unda iTqvas, rom politikis da sxva makrodoneebze aucilebelia am ganviTarebaze moqmedi faqtorebis gaTvaliswineba da Sesabamisi politikis gansazRvra/gatareba. fizikuri, fsiqoemociuri da socialuri ganviTareba ganxiluli iqneba Semdeg TavebSi.

bavSvTa ganviTarebis Teoriebis istoria bavSvTa ganviTarebis Sesaxeb Teoriebis istoria iwyeba ramdenime aseuli wlis win. unda vaRiaroT, rom bevri Sexeduleba iseve, rogorc garemo, sadac es Sexedulebebi gaCnda, Secvlilia da, Sesabamisad, dRevandel realobaSi ukve mxolod SemecnebiT xasiaTs atarebs. magaliTad, Sua saukuneebSi bavSvebs eqceodnen rogorc `miniaturul zrdasrulebs~. amerikaSi bavSvebs aswavlian ufro individualistur azrovnebas da midgomas, iaponiaSi ki koleqtiuri azrovneba aucilebeli pirobaa sociumSi TanaarsebobisTvis. Sesabamisad, SeiZleba gansxvavdebodes am qveynebSi Seqmnili Teoriebic.
12

Sesavali

sxvadasxva sferoSi sxvadasxva wliT daTariRebul literaturaSi SeiZleba inaxos eqimebis, filosofosebis, fsiqologebis Tu sxva profesiis warmomadgenlebis Canawerebi, romlebic cdilobdnen garkveulwilad aexsnaT bavSvis fizikuri, fsiqoemociuri da socialuri ganviTareba, daeyoT igi fazebad, raTa ufro praqtikuli da moxerxebuli instrumenti SeeqmnaT praqtikosebisTvis. magaliTad, zigmund froidis fazebis/safexurebis TeoriaSi aRniSnulia, rom bavSvebi ZiriTadad gadian ganviTarebis xuT fazas: 1. oraluri faza dabadebidan 18 Tvemde. am fazaSi siamovnebis ZiriTadi wyaro aris wova, RrRna, kbena, ReWva da a.S. 2. analuri faza 18 Tvidan 3-4 wlamde. Teoriis Tanaxmad, am fazaSi bavSvebs moswonT moTmena da Semdeg kuWSi gasvla. 3. falikuri faza (Phallic stage) 3-4 wlidan 5-6-7 wlamde. siamovnebis wyaro aris genitaliebi. xSiria masturbaciis-magvari qceva, genitaliebze xeliT Sexeba da a.S. 4. latenturi faza 5-6-7 wlidan pubertatul asakamde (12 weli +/- 1 weli) froidi fiqrobda, rom am fazaSi bavSvebi imdenad dakavebuli arian swavlis procesebiT, rom daTrgunili aqvT seqsualuri impulsebi. Tumca arsebobs sapirispiro mosazrebebic, romlebic amtkiceben, rom bavSvebis daaxloebiT 25% TamaSobs eqimobanas, rac SeiZleba swored seqsualuri impulsebis gamovlineba iyos.

13

Sesavali

5. genitaluri faza iwyeba pubertatuli asakidan da warmoadgens zrdasrulobaSi seqsualuri energiis sawyiss. siamovnebis ZiriTadi wyaro am dros aris sqesobrivi kavSiri. froidi fiqrobda, rom masturbacia, oraluri seqsi, homoseqsualizmi da seqsualuri cxovrebis sxva mravali forma iyo moumwifeblobis niSani. froidis Teoriis garda arsebobs kidev sxvadasxva Teoria, romlebic XIX-XX saukuneebSi Seiqmna. erT-erTia Jan piaJes Teoria, romelic farTod gamoiyeneba bavSvebTan muSaobisas sxvadasxva etapze. piaJe bavSvebis ganviTarebas Semdeg fazebad yofda: 1. sensomotoruli faza dabadebidan or wlamde grZeldeba. rogorc am fazis saxelwodeba gviCvenebs, bavSvebi garemos SemecnebisTvis iyeneben sensomotorul sistemas. iwyeben refleqsebiT da amTavreben rTuli moZraobebiT. 2. preoperaciuli faza iwyeba ori wlidan da grZeldeba 7 wlamde. am etapze bavSvebs uviTardebaT simboloebis aRqma da maTi gamoyeneba. 3. konkretuli operaciuli faza grZeldeba 7-dan 11 wlamde. am fazaSi bavSvebSi Cndeba logikuri azrovnebis iseTi elementebi, romlebsac zrdasrulebi iyeneben sxvadasxva problemis gadasaWrelad. 4. formaluri operaciuli faza 12 wlis zeviT adamianebi gadadian formalur operaciul fazaSi. am dros ukve intensiurad viTardeba abstraqtuli, hipoTezuri azrovneba.
14

Sesavali

am TeoriebTan erTad aris ramdenime Teoria, romlebic sxvadasxva WrilSi ganixilaven bavSvis ganviTarebis etapebs. fazebad dayofis ZiriTadi idea is aris, rom ganviTarebis TiToeuli fazis aRweram naTlad dagvanaxa am asakSi bavSvis saWiroebebi da am saWiroebebis dakmayofilebis SesaZlo gzebi. aseve, am fazebze da maT aRwerilobebze dayrdnobiT Tanamedrove praqtikosebs SeuZliaT droulad amoicnon sxvadasxva saxis CamorCena da paTologia, rac aucilebeli winapirobaa drouli Carevis da problemis drouli koreqtirebisTvis.

socialuri muSakis roli adreuli asakis bavSvTa ganviTarebaSi rogorc wesi, mikrodonis socialur muSaks ufro intensiuri kontaqti aqvs Tavis beneficiarebTan, vidre eqimebs da sxva specialistebs. Zalian mniSvnelovania am SesaZleblobis gamoyeneba bavSvis normaluri ganviTarebisTvis da zogadad misi sicocxlis xarisxis gaumjobesebisTvis. socialuri muSakis intervenciis done adreuli asakis bavSvTa ganviTarebaSi SeiZleba sxvadasxva iyos. Sesabamisad, gansxvavdeba misi samizne populaciac: bavSvi (pirdapiri) socialuri muSaki akvirdeba bavSvs, akeTebs winaswari niSnebis diagnostirebas da koreqcias an gadamisamarTebas. socialur muSaks unda SeeZlos paTologiebis da sxvadasxva donis ganviTarebaSi CamorCenis adreuli niSnebis amocnoba, damoukideblad koreqcia (Tu sxva specialistebis Carevas ar

15

Sesavali

moiTxovs, mag., qceviTi da emociuri gadaxrebi) da gadamisamarTeba Sesabamis servisebSi (Tu amis saWiroeba arsebobs). mSoblebi an sxva mzrunveli pirebi (arapirdapiri) socialuri muSaki iZleva rCevebs, aswavlis ZiriTad unar-Cvevebs, iZleva sxvadasxva saxis informacias konkretuli bavSvebis ukeT ganviTarebisTvis, TanamSromlobs ojaxis da individualur doneze. Temis done (arapirdapiri) Temis done SeiZleba ganvixiloT sxvadasxva mimarTulebiT. 1. dedebis (adreuli asakis bavSvebis) Temi _ am TemTan muSaoba SesaZlebelia sxvadasxva formiT, maT Soris, jgufebSi muSaobiT. efeqturia TanatolTa ganaTlebis elementebis Semotana jgufebTan muSaobaSi, rac gulisxmobs kulturuli, asakobrivi da sxva maxasiaTeblebiT samizne populaciasTan rac SeiZleba miaxlovebuli socialuri muSakis an `ganmanaTleblis~ SerCevas. 2. geografiuli Temis doneze _ Tu gaviTvaliswinebT imas, rom dedebi da bavSvebi gansxvavdebian geografiuli da kulturuli maxasiaTeblebiT, advili misaxvedria rom maTTan muSaobis strategia da normebic ki SeiZleba gansxvavdebodes. swored am maxasiaTeblebis gaTvaliswinebiT aris SesaZlebeli Temis doneze muSaobisas warmatebis miRweva. politikosebi da gadawyvetilebis mimRebni (arapirdapiri) am adamianebTan muSaobis ZiriTadi mizania miawodos informacia gadawyvetilebis mimReb adamianebs imis Sesaxeb, Tu ra xdeba qveyanaSi mikrodoneze,

16

Sesavali

ra saxis problemebs awydebian bavSvebi, ra aris am problemebis gamomwvevi mizezebi. socialurma muSakma proaqtiulad unda SeZlos daicvas da daxmareba gauwios bavSvis ganviTarebis sferoSi wamoWrili problemebis gadaWrasa da maTi gamomwvevi mizezebis aRmofxvras. am doneze momuSave socialuri muSaki asrulebs Suamavali rgolis funqcias mikro da makrodonis rgolebis dasakavSireblad. aucilebelia igi TanamSromlobdes mikrodonis socialur muSakebTan, raTa xeli Seuwyos makrodoneze swori da ganxorcielebadi gadawyvetilebebis miRebas. socialurma muSakma, pirvel rigSi, unda daicvas socialuri samuSaos eTikuri normebi (upirveles yovlisa _ `ar avno~ da konfidencialuroba), unda SeZlos sakuTari ufleba-movaleobebis gamijnva sxva specialistebis, mag., pediatris, iuristis, fsiqologis specifikuri uflebamovaleobebisgan.

17

mikrodone

prenataluri ganviTareba prenataluri ganviTareba dinamikuri procesia, romlis meSveobiTac adamianis erTujrediani zigota gardaiqmneba 100 trilioni ujredisagan Semdgar zrdasrul organizmad. dReisaTvis mkvlevarebisaTvis cnobilia, rom mravali yoveldRiuri moqmedeba, Sesrulebuli zrdasruli organizmis mier, yalibdeba fexmZimobis periodSi, xSirad _ dabadebamde didi xniT adre. Sobis wina momwifebis periodi sul ufro xSirad aRiqmeba, rogorc mosamzadebeli dro, romlis ganmavlobaSic adamianis ganviTarebadi organizmi iZens mraval struqturas da avarjiSebs mraval unar-Cvevas, romelic saWiroa Sobis Semdgomi gadarCenisaTvis. adamianis fexmZimoba, Cveulebriv, 38 kviramde grZeldeba dawyebuli ganayofierebis, anu Casaxvis momentidan dabadebamde. ganayofierebis Semdgomi pirveli 8 kviris ganmavlobaSi adamianis ganviTarebad organizms embrioni ewodeba, rac
18

mikrodone

`SigniT mzards~ niSnavs. aRniSnul dros, romelsac embrionuli periodi ewodeba, axasiaTebs organizmis umTavresi sistemebis Camoyalibeba. 8 kviris Sesrulebidan fexmZimobis bolomde `adamianis ganviTarebad organizms `Canasaxi~ ewodeba~, rac niSnavs `jer arSobil STamomavlobas~. aRniSnuli drois ganmavlobaSi, romelsac Canasaxis periodi ewodeba, organizmi izrdeba da misi sistemebi funqcionirebas iwyeben. ganvixiloT, Tu rogor xdeba muclad yofnis periodSi adamianis ganviTareba Tveebis mixedviT:

Tve pirveli

ganviTarebis maxasiaTeblebi kvercxujredis ganayofiereba, zigotis inplantireba saSvilosnos kedelSi, ujredebi intensiurad mravldeba, embrionaluri stadia grZeldeba 2-dan 8 kviramde, nervuli sistema iwyebs ganviTarebas. guli da sisxlZarRvebi viTardeba, swrafi tempiT viTardeba Tavis midamo, xdeba Tvalebis detalebis formireba, viTardeba Sinagani organoebi, gansakuTrebiT, saWmlis momnelebeli organoebi, sasqeso organoebi viTardeba swrafad da yalibdeba bavSvis sqesi, zeda da qveda kidurebi viTardeba da izrdeba, iwyeba sustad gamoxatuli guliscema. Tavi swrafad izrdeba, iwyeba Zvlebis formireba, saWmlis momnelebeli organoebi iwyeben funqcionirebas, zeda da qveda kidurebi, TiTebi iwyeben spontanur moZraobebs. sigrZe _ 75 mm, wona _ 28 g.

meore

mesame

19

mikrodone

meoTxe

sxeulis qveda nawilebi swrafad izrdeba, Zvlebi ukve garCevadi xdeba rendgenis qveS, refleqsuri moZraoba ufro SesamCnevi xdeba, guliscema ukve kargad SesamCnevia, sasqeso organoebi bolomde Camoyalibebulia. sigrZe _ 18 sm , wona _ 140 g. deda iwyebs Svilis refleqsuri moZraobis SegrZnebas, viTardeba yurebis da cxviris xrtilebi, yalibdeba xelis da fexis frCxilebi, iwyeben cera TiTis wovas, slokins da fexebis dartymas. sigrZe _ 30 sm, wona _ 400 g. Tvalebi srulad Camoyalibebulia, viTardeba kanqveSa cximovani qsovili. sigrZe _ 36 sm, wona _ 900 g. intensiurad viTardeba Tavis tvinis qerqi. sigrZe _ 43 sm, wona _ 1.4 kg. cximovani fena Camoyalibebulia, frCxilebi scdeba TiTis kideebs. sigrZe _ 43 sm, wona 2.2 kg. amodis Tmis safari, organoTa sistemebi aqtiurad muSaobs, bavSvi iRebs dabadebisTvis saWiro pozicias, TaviT qvemoT. axalSobili unda iyos sigrZiT 53 sm, woniT _ 3.1 kg.

mexuTe

meeqvse

meSvide merve

mecxre Tve

am cxrilis gamoyenebisas unda gvaxsovdes, rom nervuli qsovilis Camoyalibebis etapebi yvelaze mgrZnobiarea, Tumca ar unda vifiqroT, rom sxva etapebi naklebmniSvnelovania. kargad unda gaviTavisoT isic, rom dabadebamde dedis sxeuli bavSvis garemos warmoadgens. swored am gadasaxedidan yvelaferi, rac qalis sxeulSi xdeba, aisax20

mikrodone

eba bavSvis janmrTelobaze, fsiqoemociur da socialur ganviTarebaze. ufro metic, arsebobs Teoriebi, romlebis Tanaxmadac, erTi SexedviT umniSvnelo faqtorebsac ki SeuZliaT Zlieri zegavlena moaxdinon bavSvis cxovrebaze dabadebidan ramdenime aTeuli wlis Semdegac ki. Tu am yvelafers gaviTvaliswinebT, gasagebi xdeba, rom aucilebelia deda uzrunvelyofili iyos srulfasovani kvebiT, rac, rogorc wesi, niSnavs bavSvis srulfasovan kvebas; Tavidan unda iqnes acilebuli yvelanairi daavadeba da yoveli wamlis miRebisas aucilebelia eqimTan konsultireba. garda amisa, orsuls unda hqondes medikamentebis CamonaTvali, romlis miRebac dasaSvebia misi mdgomareobis gaTvaliswinebiT. orsuloba TavisTavad did cvlilebebs iwvevs da yoveli damatebiTi daavadeba kidev erTi stresia qalis organizmisTvis. orsuls unda Seeqmnes SeZlebisdagvarad jansaRi fizikuri da fsiqosocialuri garemo, raTa Tavidan iqnes acilebuli iseTi problemebi, rogoricaa Tandayolili daavadebebi, naadrevi mSobiaroba da iseTi paTologiebi, romlebmac SeiZleba Tavi iCinos wlebis Semdeg. erT-erT yvelaze gavrcelebul risk-faqtors warmoadgens orsulebis mier sigaretis moweva. Tambaqos kvamli embrionze an nayofze damazianeblad moqmedebs da iwvevs sxvadasxva organosa da sistemis, maT Soris, sasqeso organoebis ganviTarebis mankebs.

21

mikrodone

bavSvis dabadeba, pirveli Sexeba samyarosTan rodesac bavSvi ibadeba, igi xvdeba sruliad axal garemoSi, romelSic funqcionireba man jer ar icis. ukve 10 dRis asakidan bavSvi gare samyarosTan urTierTobas amyarebs ara marto refleqtorulad, aramed is aqtiurad swavlobs Tavisi sensorebis gamoyenebas. kerZod, bavSvebis umetesobas sococxlis meore kviris naxevrisTvis ukve SeuZlia mxedvelobis areSi daiWiros moZravi sagani, magaliTad, daaxloebiT 10 sm. diametris feradi saCxakuno. Tu Tqven amgvar sagans moaTavsebT zurgze mwoliare bavSvis mkerdis doneze (daaxloebiT 40-50 smis manZilze) da daiwyebT saTamaSos nela gadaadgilebas marcxniv da marjvniv, SeamCnevT mzeriT rogor afiqsirebs bavSvi saTamaSos. gava mxolod ramdenime kvira da bavSvis maorientirebeli mxedvelobiTi reaqciebi ufro daxvewili gaxdeba sami kviris asakis axalSobils Cveulebriv ukve SeuZlia daafiqsiros met-naklebi sididis umoZrao sagnebi, magaliTad, mozrdili adamianis saxe. scadeT miuaxlovdeT zurgze mwoliare bavSvs daaxloebiT 40-50 sm-is manZilze da miipyroT misi yuradReba laparakiT, Semdeg ki gaCumdeT da darCeT uZravad Tqven dainaxavT, rogor gayuCdeba TqvenTan erTad patara adamianic, SeaCerebs Tavis isedac arcTu Cqar moZraobebs, Tan yuradRebiT da gamomcdelad SemogaCerdebaT saxeSi. sicocxlis pirveli Tvis bolos axalSobils ukve kargad SeuZlia mzeris midevneba Tu CaatarebT zemoT aRweril

22

mikrodone

tests feradi saCxakunoTi, Tqvenda sasixarulod SeamCnevT, rogor advilad afiqsirebs mzeriT bavSvi saTamaSos da warmatebiT `acilebs~ mas TvaliT marcxniv da marjvniv 30-40 sm-mde manZilze, Tan yoCaRad atrialebs Tavs saWiro mxares. bavSvis Tvalis kaklebis moZraobac ufro sagrZnoblad koordinirebuli xdeba. aranakleb efeqturad `krefs siCqares~ axalSobilis meore sensorTan smenis organoebTan dakavSirebuli reaqciebi. Tu Tqven daadgebiT 10 dRis asakis bavSvis mxedvelobis ares gareT da 30-40 sm-is manZilze ramdenjerme xmamaRla SemokravT taSs, maSin janmrTeli bavSvi moaxdens smenis gamaRizianebelze reagirebas SextomiT da Tvalis daxamxamebiT. aucilebelia am testis Semdeg bavSvis Seqeba da mofereba, radgan zrdasruli adamianisTvisac ki Zalian stresuli da arasasiamovnoa mWaxe xmebi, romelic mxedvelobis aris gareT warmoiSoba. sicocxlis mesame kvirisTvis axalSobili gare samyaros xmebs gacilebiT did mniSvnelobas aniWebs isini mis tvins aswavlian miiRos pirveli gadawyvetilebebi. Tu bavSvi mousvenradaa, xmamaRla tiris da slukuniT gamoTqvams Tavis ukmayofilebas, SeecadeT bavSvis mxedvelobis ares gareT daaCxakunoT saTamaSo, an imRereT, an xmamaRla waikiTxeT nawyveti maiakovskis raime nawarmoebidan. ramdenime wamis Semdeg patara adamiani dawynardeba misi `bortkompiuteri~ Secvlis prioritetebs. bavSvi wynarad iwveba da miayuradebs ramdenime wamis ganmavlobaSi, ris Semdegac SeiZleba isev daiwyos cxovrebiT ukmayofilebis demonstrireba, Tu am ukmayofilebas marTlac aqvs saTanado
23

mikrodone

mizezebi (magaliTad, Sia). sicocxlis pirveli Tvis bolos bavSvis smeniTi orientacia ucxo xmebze ufro gamoxatuli xdeba da aRwvs mTel 10-15 wams! mxedvelobiTi da smeniTi saorientacio reaqciebis Sesafasebel testebs aqvT didi mniSvneloba imdenad, ramdenadac isini exmareba mSoblebs darwmundnen TavianTi Svilis Sesabamisi sensorebis normalur funqcionirebaSi. sicocxlis pirveli Tvis bolos patarebi Tavis mSoblebs axareben ara marto sensorebis muSaobis progresirebadi gaumjobesebiT, aramed maT mimarT pirveli dadebiTi emociebis gamovleniT. erTi Tvis bavSvs ukve SeuZlia praqtikulad `Segnebulad~ gauRimos dedas an mamas misTvis, rogorc Zvirfasi arsebisTvis mosaferebeli mimarTvebis pasuxad. am asakSi saWiroa mSobeli ecados bavSvTan gaataros Tavisufali drois mniSvnelovani nawili. zogjer erTi Tvis bavSvis mSoblebs SeiZleba bedma gauRimos da gaigonon... bavSvis sicili. ra Tqma unda, es Zalian sasiamovnoa, magram Tu es ar moxda pirvel Tves, dedas da mamas aRelvebis mizezi absoluturad ar aqvT. amasTan erTad bavSvi sicocxlis pirvel TveSi cdilobs aswios da daiWiros am mdgomareobaSi Tavi, Tu mas daawvenT mucelze (swor, zomierad rbil zedapirze). zogierT bavSvs SeuZlia Tavi daiWiros ramdenime aTeuli wamis ganmavlobaSi. amas garda, ukve erTi Tvis Cvilebi xSirad cdiloben `ilaparakon~ gamoscemen sxvadasxva bgeras mozrdilebis mxridan `saubarSi~ gamowvevaze sapasuxod moyvanili unarebidan bavSvma zogierTi icoda jer kidev muclad yofnis periodSi.
24

mikrodone

zogadi rCevebi mSoblebisTvis bavSvTan saubari. yvelaze metad bavSvs uyvars adamianis xmis mosmena. miesalmeT mas, rodesac SedixarT oTaxSi, gamoiyeneT masTan saubris yvela SesaZlebloba. ilaparakeT xmamaRla, rodesac gindaT miipyroT bavSvis yuradReba da ilaparakeT xmadabla, rodesac gindaT misi damSvideba. xmis tembris SecvliT dablidan maRla da piriqiT, SeiZleba SeinarCunoT pataras interesi sakmaod didxans. mamis TamaSebi. deda da mama sxvadasxvanairad TamaSoben bavSvTan. radganac orives Seaqvs raRac Tavisi bavSvTan urTierTobaSi, mniSvnelovania, rom orivem miiRos monawileoba mis aRzrdaSi. cvaleT bavSvis mdebareoba, ecadeT moaTavsoT bavSvi ise, rom mis garSemo iyos sxvadasxva sagani. magaliTad, Tu Tqven gaaseirnebT bavSvs avtomobiliT, manqanis savarZelze dadeT raime feradi sagani, raTa gauRviZoT mas warmodgena. (yovelTvis, rodesac bavSvTan erTad mgzavrobT avtomobiliT, darwmundiT, rom manqanaSi aris yvela saSualeba bavSvis usafrTxo mgzavrobis uzrunvelsayofad). kvebis dros cvaleT bavSvis mdebareoba. Tu bavSvs boTlidan kvebavT, ecadeT ise moaTavsoT bavSvi, rom mas SeeZlos dainaxos garSemomyofi sagnebi sxvadasxva kuTxidan. bavSvma unda SeZlos Seexos boTls kvebis dros. banaobis dros gaukeTeT bavSvs masaJi. misi sxeulis masirebis dros wynari iavnana imRereT. Tqveni Sexeba da simRera bavSvs miscems saSualebas modundes da Tavi usafrTxod igrZnos. Cvilis dabanis da Sexvevis dros iTamaSeT masTan.

25

mikrodone

dakideT ramdenime msubuqi saTamaSo bavSvis Sesaxvevi magidis zemoT. garkveuli droiT patara damSviddeba da dakavdeba yoveli saTamaSos SeswavliT. sunTqviT gauTbeT bavSvs xelebi da muceli. plastmasis rgols miamagreT mokle, feradi lentebi da dakideT bavSvis sawolTan. xanmokle dasveneba. daisveneT bavSvTan erTad. moxerxebulad mokalaTdiT sawolze an xaliCaze, daiwvineT bavSvi mkerdze. Tqveni mSvidi, riTmuli sunTqva daamSvidebs bavSvs. socialuri muSaki unda daexmaros ojaxis wevrebs zemoT CamoTvlili rCevebiT, raTa maT SeZlon ganuviTaron bavSvs zemoT CamoTvlili unarebi. damatebiTi informaciisTvis ixileT: www.9months.ge

26

mikrodone

0-3 wlis asakis bavSvis fizikuri ganviTareba da misi Sefaseba fizikuri ganviTarebis Sefaseba bavSvis janmrTelobis Sefasebis erT-erTi mniSvnelovani momentia; bavSvis fizikuri ganviTarebis Sefasebis mizniT gamoiyeneba 4 ZiriTadi meTodi: saorientacio empiriuli formulebi; standartuli, e.w. parametruli, anu sigmuri cxrilebi; araparametruli, anu centiluri cxrilebi; centiluri cxrilebis safuZvelze agebuli e.w. zrdis mrudebi; kriteriuli cxrilebi. fizikur ganviTarebaze moqmedeben rogorc egzogenuri (gare), ise endogenuri (Sida) faqtorebi; anTropometruli monacemebis SefasebisaTvis yvelaze gavrcelebul meTods warmoadgens monacemebis ganawileba asakisa da sqesis mixedviT. ganawilebis diapazoni dayofilia gansazRvrul zonebad, ris safuZvelzec xdeba monacemTa Sefaseba. SefasebisaTvis gamoiyeneba ori ZiriTadi meTodi parametruli, anu sigmuri, da araparametruli, anu centiluri. fizikuri ganviTarebis parametrebis cvlileba, rogorc daqveiTeba, ise momateba, SeiZleba ganapirobos sxvadasxva daavadebam.

fizikuri ganviTarebis Sefasebis meTodebi bavSvis fizikuri ganviTarebis Sefasebis mizniT gamoiyeneba 4 ZiriTadi meTodi:
27

mikrodone

standartuli, e.w. parametruli, anu sigmuri cxrilebi; araparametruli, anu centiluri cxrilebi; centiluri cxrilebis safuZvelze agebuli e.w. zrdis mrudebi; kriteriuli cxrilebi.

ukanasknel periodSi fizikuri ganviTarebis Sefasebis mizniT janmos (jandacvis msoflio organizaciis) rekomendaciiT iyeneben gadaxris maCvenebels, anu e.w. Z qulas, romelic gamongariSeba Semdegi formuliT:
Z qula=
bavSvis anTropometrul maCvenebels _ standarti Sesabamisi gadaxris (sigmis standarti)

saSualo normad miRebulia, Tu Z qula 1 sigmis farglebSi, saSualoze met gadaxrad miCneulia gadaxra 1 -dan 1,9 sigmis farglebSi, xolo 2 sigmiT gadaxra aSkara paTologiaze miuTiTebs. ukanasknel wlebSi ufro xSirad iyeneben araparametrul, anu centilur cxrilebs, romlebic paramatrul cxrilebTan SedarebiT ufro zustad asaxaven niSnis ganawilebas janmrTel bavSvTa kontingentSi da yovelgvar gadaxras. centili gviCvenebs am asakis bavSvTa ramden procents aReniSneba esa Tu is cifrobrivi maCvenebeli, anu centiluri cxrilis svetebi gviCvenebs anTropometruli niSnis sazRvrebs, romelic damaxasiaTebelia mocemuli asakis da sqesis mosaxleobis garkveuli procentisaTvis. uxSiresad gamoiyeneba stuartis Skala, romelSic gamoyofilia sazRvrebi 3, 10, 25, 75, 90 da 97 centilis fargleb28

mikrodone

Si. saSualo normad miRebulia maCveneblebi, romlebic aReniSneba am asakis bavSvTa 50%-s, e.i. Tu maCvenebeli 2550-75 centilis farglebSia. maCveneblis moTavseba 10-dan 25 centilis farglebSi miuTiTebs, rom igi normaze dabalia, 75-dan 90 centilamde normaze maRali. bavSvebs, romelTa maCvenebeli 3-dan 10mde an 90-dan 97 centilis farglebSia, paTologiasTan momijnave mdgomareoba aqvT da maT esaWiroebaT pediatris meTvalyureoba. Tu romelime parametri 3 centilze naklebia an 97 centilze meti, es paTologiaze miuTiTebs da specialur kvlevas saWiroebs.
SesaZlo variantebi zona 3 centilamde derefani Sefaseba Zalian dabali maCvenebeli, janmrTelebSi gvxvdeba Zalian iSviaTad (3%-mde). aseTi bavSvi aucileblad saWiroebs specialur gamokvlevas. dabali maCveneblis zona, romelic gvxvdeba bavSvTa 7%-Si. mizanSewonilia konsultireba da sxva gadaxrebis arsebobis SemTxvevaSi bavSvis gamokvleva. saSualoze dabali zona, damaxasiaTebelia bavSvTa 15%saTvis.

3-dan 10 centilamde derefani

10-dan 25 centilamde derefani

29

mikrodone

25-dan 75 centilamde derefani

saSualo zona, gvxvdeba bavSvTa 59%-Si da amitom yvelaze metad damaxasiaTebelia aRniSnuli asakobriv-sqesobrivi jgufisaTvis. saSualoze maRali zona, damaxasiaTebelia bavSvTa 15%saTvis. maRali maCveneblis zona, damaxasiaTebelia bavSvTa 7%saTvis. samedicino gadawyvetileba damokidebulia sxva niSnebis arsebobaze. Zalian maRali zona. damaxasiaTebelia bavSvTa 3%saTvis, aucelebelia konsultacia da gamokvleva.

75-dan 90 centilamde derefani 90-dan 97 centilamde derefani

97-ze maRali derefani

ramdenime anTropometruli niSnis, magaliTad, sigrZis, wonis da gulmkerdis garSemowerilobis Sefasebis safuZvelze SesaZlebelia msjeloba bavSvis ganviTarebis tempze. aseT Sefasebas somatotipi ewodeba. mis dasadgenad ajameben im derefnebis (zonebis) maCveneblebs, romlebSic xvdeba gamosakvlevi bavSvis parametrebi. Tu zonebis jami 10 qulaze naklebia, bavSvi mikrosomatur tips ekuTvnis, Tu jami 11-15 qulaa mezosomatur tips, Tu jami 16-20 qulaa makrosomatur tips. SedarebiT iSviaTad iyeneben sxvadasxva anTropometrul indeqss.

30

mikrodone

ketles indeqsi sxeulis masis (gr.) Sefardeba sigrZesTan (sm.) gamoiyeneba mxolod axalSobilebSi. misi normaluri maCvenebelia 50-60. am maCveneblis 50-ze metad daqveiTeba Tandayolili hopotrofiis maCvenebelia, xolo 70-ze metad mateba paratrofiis. sxeulis masis indeqsis gamoTvla xdeba sxeulis masis (kg) gayofiT simaRlis (metrebSi) kvadratze. arCeven: smi < 18.5 sxeulis masis deficiti; smi 18.5 25.0 sxeulis masis normaluri maCvenebeli; smi 25 30 _ sxeulis Warbi masa; smi > 30.0 _ gamoxatuli simsuqne.

pediatriaSi smi-s iTvlian specialuri cxrilebis gamo yenebiT.

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mikrodone

sxeulis masis da zrdis darRveva

sxeulis masis yvela darRvevas distrofia ewodeba. irCeven minus-distrofias, roca wona normasTan SedarebiT mniSvnelovnad daqveiTebulia da plus-distrofias, rodesac wona asakobriv normasTan SedarebiT mniSvnelovnad matulobs. distrofiis gamovlenis mixedviT arsebobs Tandayolili (prenataluri) da SeZenili (postnataluri) distrofia. Tu aRiniSneba mxolod masis daqveiTeba, vlindeba mwvave hipotrofia; simaRleSi CamorCena SeiZleba miuTiTebdes gadatanil kvebiT deficitze, xolo orive maTganis arsebobis SemTxvevaSi saqme gvaqvs kvebis qronikul deficitTan (cilovan-energetikuli deficiti). erTferovani, naxSirwylebiT mdidari kvebis pirobebSi viTardeba hipotrofiis garkveuli forma, e.w. kvaSiorkori, romelic cxoveluri cilis da vitaminebis deficitiT gamowveuli daavadebaa. rodesac masa asakobriv normas aRemateba, aRiniSneba paratrofia. 10 wlamde asakSi simsuqned iTvleba, Tu bavSvis wona metia 120 %-ze, 10 wlis Semdeg _ Tu bavSvis masa aRemateba ketles indeqsis cxrilis 97 centils. simaRleSi CamorCena SeiZleba iyos pirveladi da meoradi, proporciuli da araproporciuli. simaRleSi paTologiuri mateba aseve SeiZleba iyos proporciuli (gigantizmi) da araproporciuli (akromegalia).

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mikrodone

bavSvis fizikuri ganviTarebis Sesaxeb arsebuli internet-resursebi:

www.childdevelopmentinfo.com www.pbs.org/wholechild/abc/physical www.psychiatry.emory.edu/PROGRAMS/GADrug/parenting_phys_dev_topics. www.kinderstart.com www.cdc.gov/ncbddd/child/development www.cdipage.com/development

33

mikrodone

0-3 wlamde asakis bavSvis motoruli ganviTareba da misi Sefaseba motoruli ganviTarebis Sefaseba bavSvis janrTelobis Sefasebis erT-erTi mniSvnelovani momentia; motoruli ganviTareba _ bavSvis unari sxvadasxva jgufis kunTebis gamoyenebiT Sesarulos esa Tu is moZraoba. igi moicavs uxeS da natif motorikas. uxeSi motorika bavSvis unari ganaxorcielos msxvili kunTebis kontroli, romlis saSualebiTac igi axerxebs Tavis daWeras, jdomas, siaruls da sxv. natifi motorika bavSvis unari ganaxorcielos wvrili kunTebis (xeli, Tvali) kontroli, romlis saSualebiTac igi axerxebs Tavli gaayolos sagnebs, moeWidos saTamaSos da sxv. motoruli ganviTarebis Sefaseba bavSvze dakvirvebis Tanmimdevruli procesia, romlis drosac profesionali afasebs bavSvis asakis Sesabamis miRwevebs, unar-Cvevebs motorul sferoSi, axdens `saSiSroebis niSnebis~ droul identificirebas.

motoruli ganviTarebis Tavisebureba bavSvebSi

motoruli ganviTareba iseve, rogorc zogadad fsiqomotoruli ganviTareba garkv euli kanonzomierebiT xasiaTdeba. mag.: sanam bavSvi dajdeba, is Tavis daWeras swavlobs, sanam dadgeba, jer jdomas iTvisebs da sxva. moZraobiTi Cve vebi kranio-kaudaluri (zemodan qvemoT) mimarTulebiT
34

mikrodone

viTardeba _ jer iwyeba mzeris fiqsacia, Semdeg _ Tvalis koordinirebuli moZ raoba, Tavis daWera, mere zeda kidurebis, tanisa da bo los qveda kidurebis moZraoba. Tavidan moZraoba arakoordinirebulia, rac Tan daTa n mizanmimarTuli moZraobebiT icvleba. mag.: Tu Tavda pir ve lad bav Svi mTeli sxeuliT cdilobs miwvdes saTamaSos, Sem deg igi mxo lod xels iyenebs.

motorul ganviTarebaze moqmedi faqtorebi

Tandayolili daavadebebi; SeZenili daavadebebi; adekvaturi kveba; garemo bavSvis stimulacia, asakis Sesabamisi aqtivobis waxaliseba bavSvs unda mieces damoukideblad moqmedebis saSualeba (mag.: cocva, skamze asvla da a.S.); dRenakluloba/tyupebi.

35

mikrodone

bavSvis fizikuri da motoruli ganviTarebis maCveneblebi

asaki 0-1 weli uxeSi motorika 1 Tvis _ mucelze wolisas cdilobs Tavis wamowevas. 2 Tvis _ uWiravs Tavi sworad, mucelze wolisas gulmkerds wevs magididan. 3 Tvis _ mucelze wolisas eyrdnoba idayvebs, Tavisuflad uWiravs Tavi. 4 Tvis _ brundeba zurgidan mucelze. 6 Tvis _ brundeba muclidan zurgze, jdeba daxmarebiT. 7-8 Tvis _ jdeba damoukideblad. 8 Tvis cocavs. 9 Tvis _ dgeba daxmarebiT. 11-12 Tvis _ damoukideblad dgas sayrdenis gareSe. 12 Tvis dadis. natifi motorika 1 Tvis _ afiqsirebs mzeras sinaTleze. 2 Tvis _ Tvals ayolebs moZrav sagans. 4-4,5 Tvis cdilobs ori xeliT miwvdes saTamaSos da miitanos pirTan. 5 Tvis _ mSoblebis xelidan iRebs saTamaSos. 6 Tvis _ erTi xeliT iRebs saTamaSos, gadaaqvs erTi xelidan meoreSi. 7 Tvis _ aTvalierebs da erTimeores urtyams saTamaSoebs 9 Tvis _ saTamaSos iWers 3 TiTiT. 10-11 Tvis _ saTamaSos iWers 2 TiTiT. 12 Tvis _ aRebs da xuravs yuTs, usvams fanqars qaRaldze.

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mikrodone

1-3 weli

15 Tvis _ adis safexurze, SeuZlia moZraoba ukan svliT. 18 Tvis _ darbis, SeuZlia joxze gadabijeba, winaRobaze gadasvla. 24 Tvis _ darbis, adis da Camodis kibeze dauxmareblad (orive terfis erT safexurze moTavsebiT). 2-2,5 wlis sirbili, ukusvliT siaruli, winaarmdegobaze gadabijeba. 3 wlis _ fexis monacvleobiT abijebs 30 sm-is simaRlis bariers.

1,5 wlis agebs koSks 2-3 kubiT, Cxapnis, acmevs da xdis Tojinas, SeuZlia wignis gadafurcvla, Cacmis dros exmareba ufross xelebis da fexebis win wamoweviT. 2-2,5 wlis agebs koSks 4-7 kubisagan, damoukideblad Wams, TviTon ixdis fexsacmels, windas, quds, SeuZlia wignis gadafurcvla. 3 wlis SeuZlia wyliani Wiqis gadatana, xatavs horizontalur da vertikalur xazebs, ixatavs wres.

37

mikrodone

motoruli sferos gamokvlevis meTodebi

motoruli sferos gamosakvlevad fasdeba kunTTa tonusi, pa siuri da aqtiuri moZraoba, myesTa refleqsebi. kunTTa tonuss amowmeben pasiuri moZraobiT. afaseben moZraobis sifarTes, axde nen kunTebis palpacias kidurebis moxris da gaSlis dros. axal Sobilebsa da Cvili asakis bavSvebSi aRiniSneba momxrel kun TTa fiziologiuri hipertonusi, rac maT embrionis pozas unar Cunebs. kunTTa moSveba-moduneba metyvelebs hipotoniis, kun T Ta daWimva da simkvrive ki _ hipertoniis arsebobaze. aqtiur moZ raobaze msjeloben imis mixedviT, Tu rogor dgeba bavSvi fexze, rogor jdeba, dadis, rogor iRebs sagnebs xelSi da sxv.

denveris testis Sefaseba

25

50

75

90

testi moicavs 4 kategorias. TiToeuli maTgani warmodgenilia sxvadasxva moqmedebis aRmniSvneli mcire SkaliT, romelic asakobriv farglebSia moqceuli, roca bavSvTa populaciis 25-dan 90%-s SeuZlia mocemuli moqmedebis ganxorcieleba. Skalis marcxena sazRvari gviCvenebs asaks, rodesac mocemuli asakis bavSvTa populaciis 25%-s SeuZlia misi Sesruleba, patara xaziT aris aRniSnuli is asaki, rodesac moqmdebas asrulebs bavSvTa 50%, daCrdiluli nawilis marcena kideSi mocemulia 75%, xolo marjvniv aris 90%is aRniSvna, rodesac am asakis bavSvTa 90%-s SeuZlia testis gavla. marcxad iTvleba, Tu bavSvi ver axorcielebs
38

mikrodone

im moqmedebas, romelsac asrulebs am asakis bavSvTa 90 %, Tumca es yovelTvis ar niSnavs CamorCenas.

kubebis testi (Accardo)

testze arsebuli struqturebis demonstrirebis Semdeg bavSvma damoukideblad unda SeZlos maTi ageba.

saSiSroebis niSnebi
uxeSi motorika 3 Tvis _ ver iWers Tavs. 4 Tvis xelis mokidebis da wamowevisas ar iwevs dasajdomad. 5 Tvis _ ar brundeba zurgidan mucelze.
39

mikrodone

8 Tvis _ ver jdeba damoukideblad. 11 Tvis _ daxmarebiTac ver dgeba fexze. 15 Tvis _ ar dadis calxelmokidebuli. 18 Tvis _ ar dadis damoukideblad. 24 Tvis fexs ar urtyams burTs. 36 Tvis _ kibeze ver adis daxmarebis gareSe.

natifi motorika 2 Tvis _ ar afiqsirebs mzeras saganze. 5 Tvis _ ar SeuZlia saTamaSos daWera. 7 Tvis _ ar SeuZlia saTamaSos erT xelSi daWera da meoreSi gadatana. 9 Tvis _ ar SeuZlia saTamaSos xelidan xelSi gadatana. 10 Tvis _ ar SeuZlia saTamaSos daWera ori TiTiT. 15 Tvis _ ar SeuZlia sagnis aReba an dadeba. 24 Tvis _ ver atarebs borblian saTamaSos. 36 Tvis _ ar SeuZlia swori xazis gasma, ver ixatavs wres.

motoruli ganviTarebis Sefasebisas gaTvaliswinebuli unda iyos is faqti, rom zogjer bavSvi `tovebs~ zogierT niSansvets. mag.: SeiZleba ar daiwyos xoxva da pirdapir daiwyos siaruli. da es ar iTvleba paTologiad. motoruli ganviTarebis Sefasebisas gaTvaliswinebuli unda iyos bavSvis gestaciuri asaki dabadebisas. Tu bavS40

mikrodone

vi daibada dRenakluli, misi ganviTarebis Sefasebisas 2 wlamde asakSi aucilebelia asakis koreqcia _ am mizniT mis realur asaks akldeba kvirebis (Tvis) is raodenoba, rac mas aklda 40 kviramde (9 Tvemde). mag.: 12 Tvis (52 kviris) dRenakluls, romelic daibada gestaciis 30 kviraze, 40 kviramde aklda 10 kvira, anu misi koregirebuli asaki iqneba 52-10=42kvira, Sesabamisad, is unda asrulebdes im niSansvetebs, romelic Seesabameba 42 kviras da ara 52 kviras.

konsultaciis meTodebi
motoruli ganviTarebis xelSewyoba aucilebelia bavSvis moZarobebis waxaliseba: 1 wlamde sawolTan saTamaSoebis Camokideba, raTa bavSvi Seecados miswvdes maT. xelSi saTamaSos Cadeba, raTa bavSvma daiWiros is. xoxvis `teqnikis~ dasauflebad gaSlili sivrcis uzrunvelyofa, saTamaSoebis ise moTavseba, rom bavSvs saTamaSos xelSi Casagdebad misken moZraoba dasWirdes. kovzis xelSi micema da `Wamis~ procesSi monawileoba.

1 wlisTvis skamze, taxtze, savarZelze acocebis xelSewyoba. burTis gagoreba da gadagdeba.

41

mikrodone

burTze fexis dartyma. iseTi TamaSebi da saqmianobebi, romlebic xelis kunTebis ganviTarebaSi daexmareba: mag., msxvili sagnebis yuTSi Calageba da gadmoyra, koSkis awyoba, damoukideblad Wama, xatva da sxv.

qaRaldis daxeva.

2-3 wlisTvis funjiT xatva, makratliT gamoWra, Zerwva. `wera~. wvrili saTamaSoebis yuTSi Cayra. xtunva, burTiT TamaSi, askinkila, TiTis wverebze siaruli. comiT `TamaSi~. wignis `kiTxva~.

sarekomendacio literatura: 1. n. xerxeuliZe, bavSvTa daavadebaTa propedevtika, 2004. 2. janmrTelobis msoflio organizaciis vebgverdi http:// www.who.int/topics/child_development/en/ 3. http://www.aap.org/healthtopics/stages. 4. Georgetown Bright Futures Provider Guidelines http://www.brightfutures.org/bf2/pdf/index.html 5. http://www.gpnotebook.co.uk/simplepage.cfm 6. http://www.fpnotebook.com/
42

mikrodone

0-3 wlamde asakis bavSvis kognituri ganviTareba da misi Sefaseba ganviTareba mudmivi da Tanmimdevruli procesia, romelic Ca sa xvidan iwyeba da sicocxlis bolomde mimdinareobs. ganviTareba gulisxmobs motoruli, kognituri (SemecnebiT), socialuri, emociuri sferoebisa da TviTmomsaxurebis Cvevebis Camoyalibebas. kognituri _ SemecnebiTi ganviTareba _ bavSvis unari aRiqvas, analizi gaukeTos, daimaxsovros, miiRos gadawyvetileba da SeZlos problemis gadaWra. kognitur sferos ganviTarebaze aris damokidebuli saskolo mzaoba. bavSvTa adreul asakSi kognituri sferos ganviTarebaze miuTiTebs metyvelebis ganviTareba. ganviTarebis niSansvetebi _ termini gamoiyeneba bavSvis asakis Sesabamisi miRwevebis aRsaniSnavad, magaliTad, damoukideblad gadatrialeba, damoukideblad wamojdoma, xoxva, siaruli. bavSvis ganviTareba SeiZleba CaiTvalos normis Sesabamisad, Tu igi saTanado asakSi aRwevs ganviTarebis yvela sferos niSansvets. ganviTarebis globaluri Seferxeba _ mdgomareoba, rodesac bavSvs CamorCena erTdroulad 2 an met sferoSi aReniSneba. mocemuli termini gamoiyeneba 5 wlamde, radgan am asakSi ar aris sarwmuno bavSvis inteleqtualobis koeficinetis (IQ) Sefaseba. 5 wlis asakis Semdeg gamoiyeneba termini menataluri retardacia. bavSvis ganviTarebis Sefaseba ar unda eyrdnobodes mxolod anamnezur monacemebs, dedis subieqtur mosazrebas;
43

mikrodone

aucilebelia ganviTarebis Seferxebis saSiSroebis niSnebis da ganviTarebis calkeuli sferos asakis Sesabamisi niSansvetebis Seafaseba, dedisa da bavSvis urTierTobaze dakvirveba. ganviTarebis Sefasebis skriningisaTvis msoflios sxvadasxva qveyenaSi rekomendebulia Semdegi instrumentebi, magaliTad: denveris ganviTarebis skrining-testi II, beilis Cvilis neiroganviTarebis skriningi-Sefasebis sqemebi, brigansis skrining-testi, batlis ganviTarebis testi, bavSvis ganviTarebis statusis mSoblismieri Sefasebis testi da sxv. mocemuli testebis gamoyeneba saqarTveloSi moiTxovs maT adaptacias, validurobis dadgenas, sensitiurobis da specifikurobis gansazRvras, rac am etapze ar aris Sesrulebuli. aqedan gamomdinare, sadReisod SesaZlebelia pirveladi jandacvis rgolSi gamoyenebuli iyos janmrTelobis msoflio organizaciis mier rekomendebuli Sefasebis cxrilebi. bavSvze dakvirvebisas gaiTvaliswineT, rom misi asakis Sesaferisi motoruli aqtivoba 4-5 Tvis asakSi mniSvnelovan informacias iZleva misi zogadi ganviTarebis statusze. Tu bavSvi ver asrulebs asakis Sesabamis niSansvets, saWiroa Sefasdes ganviTarebis Seferxebis saSiSroebis niSnebis arseboba; unda gamoiricxos aRmzrdelobiTi xasiaTis mizezebi (bavSvi SeiZleba ver xoxavdes, Tu mas amis saSualebas ar aZleven, bavSvi SeiZleba cudad iWerdes an ikavebdes saTamaSos, Tu mas arasdros aZlevdnen saTamaSos).

44

mikrodone

bavSvis ganviTarebis Sefasebisas xdeba yvela sferos asakobrivi niSansvetisa da saSiSroebis niSnebis identificireba. TiToeuli unari garkveul asakSi yalibdeba, yvela Semdgomi unaris Camoyalibeba damokidebulia ganvlil asakobriv periodSi Camoyalibebul unarebze. mag.: bavSvi ver dadgeba, Tu ar dajda; ver gaivlis, Tu ar dadga da sxv. romelime erT sferoSi CamorCena SesaZlebelia sxva sferos ganviTarebis Seferxebis mizezi gaxdes. mag.: Tu bavSvi ver dadis, is ver ikvlevs garemos, rasac SeiZleba mohyves kognituri ganviTarebis Seferxeba. Tumca, Tu aseT SemTxvevaSi mSoblebi gauweven saTanado stimulacias, bavSvis gonebrivi ganviTareba Seuferxeblad warimarTeba. ase, rom SesaZlebelia bavSvs aReniSnebodes izolirebulad erTi sferos CamorCena. 1 wlamde asakSi motoruli ganviTarebis Seferxeba ufro advili amosacnobia vidre kognituri ganviTarebis Seferxeba. motoruli ganviTarebis Seferxeba SesaZloa warmoadgendes kognituri ganviTarebis Semdgomi Seferxebis sawyis markers. aucilebelia garkveuli klinikuri niSnebis identificireba motoruli ganviTarebis Seferxebis gamosavlenad. es niSnebi Semdegia: kunTovani tonusis cvlilebebi, motoruli unarebis Camoyalibebis atipuri mimdinareoba, atipuri moZraobebi, paTologiuri refleqsebis arseboba. aRsaniSnavia, rom bavSvis fsiqomotoruli ganviTareba yovelTvis ar mimdi nareobs sqemis mixedviT, calkeul SemTxvevebSi SeiZleba CamorCes an win gauswros asa kobriv periodebs. es damokidebulia bavSvis janmrTelobis mdgomareobaze, socialur garemoze, aRzrdisa

45

mikrodone

da movlis pirobebze da sxv. Sesabamisad, yovel cal keul SemTxvevaSi saWiroa dadgindes CamorCenis mizezi _ nervuli sistemis dazianeba, interkurentuli da ava deba Tu movlisa da aRzrdis defeqti.

kognituri ganviTarebis Sefaseba (1-12 Tve)

asaki/ Tve 1

sfero/grZnobaTa organoebi mxedveloba kognituri/smena

ganviTarebis niSansvetebi xanmokled afiqsirebs mzeras. krTeba Zlier xmaurze. Tvals ayolebs moZrav sagans. reagirebs xmaze. iwyebs RuRuns, warmoTqvams calkeul bgerebs. iRimeba lapa rakis an gaRi mebis sapasu xod. xangrZlivad afiqsirebs mzeras uZrav saganze. abrunebs Tavs sagnis mimarTulebiT, afiqsirebs mas da ayolebs Tvals srulad, yvela mimarTulebiT. aTvalierebs sakuTar xelebs, akvirdeba saxeebs.

Nnatifi motorika/ mxedveloba kognituri/smena kognituri/ metyveleba socialuri/emocia

mxedveloba mxedveloba

kognituri/natifi motorika

46

mikrodone

emocia/kognituri/ socialuri natifi motorika

rodesac elaparakebian, iRimeba da warmoTqvams calkeul bgerebs. swrafad eWideba xelSi Cadebul sagans. nacnobi pire bisa da sagnis danaxvaze gamoxatavs sixa ruls fexebis moZraobiT da bgerebiT. abrunebs Tavs xmauris sapasuxod. iwyebs garemos daTvalierebas. iwevs sagnisaken, iWers xelTan mitanil saTamaSos da miaqvs pirTan. xmamaRla ici nis. cnobs axloblebs, gamoxatavs dadebiT emociebs. xelidan xelSi gadaaqvs saTamaSo. nacnob adamianebs ucxoebisgan asxvavebs, `ucxoobs~. titinebs, gamoTqvams calkeul marcvlebs. reagirebs sakuTar saxelze.

emocia/socialuri

kognituri /smena kognituri natifi motorika

emocia emocia/socialuri 6 natifi motorika kognituri

kognituri/ metyveleba socialuri

47

mikrodone

natifi motorika kognituri

saTamaSos sami TiTiT iRebs. kiTxvaze `sad aris~, irCevs saTanado sagans saTamaSoebidan. icis sakuTari saxeli, trialdeba daZaxebaze. Txovnaze ukravs taSs, uqnevs xels. sagnebs iRebs cerisa da saCvenebeli TiTis gamoyenebiT. aRebs da xuravs yuTs, usvams fanqars qaRaldze, cdilobs manqanis gagorebas. asrulebs martiv davalebebs. nacnob gmirebs da sagnebs wignSi TiTiT gviCvenebs. mizanmimarTulad ambobs 2-4 sityvas.

socialuri kognituri/ socialuri 12 natifi motorika

natifi motorika

kognituri kognituri kognituri/ metyveleba

48

mikrodone

ganviTarebis Sefaseba (15 Tve-3 weli)

asaki/ Tve 15

sfero/grZnobaTa organoebi kognituri/ metyveleba natifi motorika natifi motorika/ TviTmomsaxureba kognituri

ganviTarebis niSansvetebi ambobs ramdenime sityvas, zogjer maT Zalian amaxinjebs. xatavs uswormasworo figurebs. kovzi da Wiqa damoukideblad uWiravs. uTiTebs saganze, romelic unda. bevr sityvas ambobs gasagebad. arCevs formebs: burTi, kubi da sxv. SeuZlia tansacmlis gaxda. 3 kubiT agebs koSks. SeuZlia Wamos damoukideblad. gadaSlis saTiTao furcels. aSenebs 4-7-kubian koSks. ambobs 2-3-sityvian winadadebebs. saubrisas iyenebs nacvalsaxelebs: me, Sen, Cemi.

18

kognituri/ metyveleba kognituri natifi motorika/ TviTmomsaxureba natifi motorika natifi motorika/ TviTmomsaxureba

24

natifi motorika natifi motorika kognituri/ metyveleba kognituri/ metyveleba

49

mikrodone

36

kognituri/ metyveleba kognituri/ metyveleba kognituri kognituri/ metyveleba socialuri/ kognituri natifi motorika

metyvelebaSi iyenebs rTul winadadebebs. xSirad svams kiTxvebs : `ratom?~ `sad?~ `rodis?~ sworad da mizanmimarTulad iyenebs sagnebs TamaSSi. sworad aCvenebs da asaxelebs 4 ZiriTad fers. Cndeba roluri TamaSebis elementebi (mag.: deda-Svili). fanqriT xatavs wres, qmnis martiv, naZerw figurebs.

ganviTarebis Sefaseba (4-6 weli)

asaki/ weli 4

sfero/grZnobaTa organoebi kognituri

ganviTarebis niSansvetebi

icis da gvawvdis `wres~, `kvadrats~, `samkuTxeds~. figurebis Sedareba SeuZlia sigrZis, siganis da simaRlis mixedviT. cnobs 6 ZiriTad fers. icis cnebebis _ `axlos~, `gverdiT~, `ukan~ _ mniSvneloba. sagnebs cnobs SexebiT.

kognituri kognituri

50

mikrodone

kognituri

yuradRebiT ismens zRaprebs da Tavadac yveba; zRaparSi sworad xvdeba ZiriTad momentebs; asaxelebs suraTebis siuJets. metyvelebs sworad, winadadebebi gramatikulad gamarTulia. xatavs adamians SeuZlia samkuTxedis da sxva geometriuli figurebis gadmoxatva iTvlis xuTamde iyenebs 5-sityvian winadadebebs, yveba mcire ambavs. icis Tavisi gvari da misamarTi. emorCileba garkveul wesebs. sworad iyenebs saojaxo nivTebs. sruliad damoukideblad icvams tansacmels da fexsacmlis Tasmebsac ikravs.

kognituri/ metyveleba 5 natifi motorika/ kognituri natifi motorika/ kognituri kognituri kognituri/ metyveleba kognituri socialuri kognituri natifi motorika/ TviTmomsaxureba

51

mikrodone

kognituri

iTvlis aTamde, SeuZlia erTeulebis Sekreba. akeTebs Tanmimdevrul daskvnebs 2-4 suraTis mixedviT, msjelobs. gacnobierebulad emorCileba qcevis wesebs, esmis maTi mniSvneloba. yvelafris gakeTeba SeuZlia damoukideblad ibans, icvams, xmarobs dana-Cangals.

kognituri

socialuri

TviTmomsaxureba

52

mikrodone

ganviTarebis Seferxebis saSiSroebis niSnebi

kognituri ganviTareba 2 Tvis 3 Tvis 9 Tvis 12 Tvis 15 Tvis 2 wlis 3 wlis 4 wlis 5 wlis ar iRimeba. ar reagirebs dedis gamoCenaze, ar iCens misadmi interess. ar iCens interess TamaSze `Wita~. ar eZebs damalul sagans. ar icis ZiriTadi saojaxo nivTebis daniSnuleba (cocxi, telefoni, Cangali, kovzi). ver ajgufebs sagnebs (mag.: cxovelebs, transports). ar esmis martivi wesebi, ver asaxelebs saxels srulad. saTanadod ver iyenebs sityvebs _ me da Sen. iolad efanteba yuradReba da ver axdens koncentrirebas raime saqmianobaze 5 wuTze met xans, ar icis ferebi da romelime aso. ar icis sakuTari misamarTi an dabadebis dRe.

6 wlis

53

mikrodone

0-3 wlamde asakis bavSvis emociuri da socialuri ganviTareba da misi Sefaseba bavSvis socialur da emociur ganviTarebaze dakvirveba aris bavSvis janmrTelobis Sefasebis erT-erTi mniSvnelovani momenti. emociuri ganviTareba bavSvis unari gamoxatos adekvaturi emociebi. socialuri ganviTareba _ bavSvis unari daamyaros mWidro kontaqti garSemomyofebTan da garemosTan. ganviTarebis Sefaseba bavSvze dakvirvebis Tanmimdevruli procesia, romlis drosac profesionali afasebs bavSvis asakis Sesabamis miRwevebs, unar-Cvevebs da axdens `saSiSroebis niSnebis~ droul identificirebas. garemo mniSvnelovan zegavlenas axdens bavSvis socialur da emociur ganviTarebaze.

emociuri ganviTarebis Tavisebureba bavSvebSi centraluri nervuli sistemis ganviTarebis mniSvnelovani maxasiaTebelia bavSvis emociuri statusi da socialuri ganviTarebis parametrebi. rac ufro mcire asa ki saa bavSvi, miT ufro naklebi emociebi aqvs da isic TiTqmis yo velTvis uaryofiTi xasiaTis (yvirili, tirili), aseve nakleb reagirebs garSemomyof pirbezec. dadebiTi emo c ebi ufro mogvianebiT, 1-1,5 Tvis asakSi vlindeba RimiliTa da bge riTi intonaciebiT. erTi Tvidan bavSvi interess
54

mikrodone

iCens dedis Zu Zu sadmi, pirvelad iRimeba, me-9-me-12 kviras iwyebs sicils, xe le bisa da fexebis moZraobas, me-4-me-5 Tves ufrosis miax loebisas aRebs pirs da farTod axels Tvalebs (saorientacio moZraoba), ra sac sixaruli an, piriqiT, SiSi, an negativizmi mos devs. me-4-me-5 Tves bavSvi kargad cnobs dedasa da axloblebs. dadebiT emo ciebs da socialur urTierTobebs mniSvnelovani roli ekuTvnis pirovnebis misi nebiTi da socialuri xasiaTis CamoyalibebaSi.

emociur da socialur ganviTarebaze moqmedi faqtorebi adekvaturi kveba (vitaminebiTa da mikroelementebiT mdidari sakvebi). Tandayolili (genetikuri daavadebebi, samSobiaro travma) Tu SeZenili (cns-infeqcia, sisxlCaqceva) daavadebebi. bavSvTan urTierToba da TamaSi (holdingi, mofereba, saubari, simRera, asakis Sesabamisi TamaSebi, asakis matebasTan erTad sxva bavSvebTan TamaSi da sxv.); Sesatyvisi stimulacia

55

mikrodone

bavSvis emociuri da socialuri ganviTarebis maCveneblebi

asaki emociuri ganviTareba 0-1 weli 2-3 Tvis _ iRimeba laparakis an gaRimebis sapasuxod. 3 Tvis RuRunebs, usmens bgerebs. 3-4 Tvis _ imeorebs ufrosebis saxis gamometyvelebas da emocias. 4 Tvis _ xmamaRla icinis ufrosebis Rimlisa da TamaSis sapasuxod. socialuri ganviTareba 1-2 Tvis kvebis dros akvirdeba dedis saxes. 3 Tvis _ nacnobi pirebisa da sagnis danaxvaze gamoxatavs sixaruls fexebis moZraobiT da bgerebiT. 4 Tvis _ iwyebs garemos daTvalierebas. 5-6 Tvis _ ucxo pirebs asxvavebs nacnobebisgan. 9 Tvis _ Txovnaze ukravs taSs, iqnevs xels. 10-11 Tvis _ gulisyuriT ikvlevs garemos, TamaSobs mSoblebTan.

5 Tvis _ xangrZlivad RuRunebs, cnobs dedis xmas, asxvaebs moferebiT da mkacr tonebs. 7 Tvis _ gamoxatavs sixaruls, rodesac eTamaSebian.

8 Tvis ucxoobs. 9 Tvis _ icis Tavisi saxeli, kiTxvaze _ `sad aris~ _ irCevs saTanado sagans saTamaSoebidan.

56

mikrodone

11-12 Tvis _ asrulebs mozrdilTa elementarul Txovnebs, ba Zavs mozrdi lebs. 2 wlis gamoxatavs damoukideblobas, ukmayofilobas, brazdeba mSoblebTan ganSorebisas.

12 Tvis _ asrulebs mozrdilTa elementarul Txovnebs. 15 Tvis baZavs ufrosis saqmianobas. 24 Tvis iwyebs TamaSs sxva bavSvebTan. 3 wlis TamaSis dros icavs Tavis rigs, esmis Ggansxvaveba `Cemi~/`sxvisi~. 4 wlis ainteresebs axali saqmianobebi, interesiT TamaSobs bavSvebTan, `roluri~ TamaSebi. 5 wlis survili aqvs megobrebs asiamovnos, eTanxmeba wesebs, unda, rom moswondeT.

1-6 weli

3 wlis gamoxatavs sxvadasxva emocias (sixaruls, gabrazebas, SiSs da sxv); SedarebiT advilad Sordeba mSoblebs. 4 wlis _ aRiqvams Tavis Tavs mTlianobaSi, xSirad ver asxvavebs fantazias da realobas, xSiria monstrebis, Ramis SiSebi. 5 wlis _ axvavebs fantazias realobisagan.

57

mikrodone

emociuri da socialuri ganviTarebis Sefasebis meTodebi

emociuri da socialuri sferos ganviTarebis Sesafaseblad saWiroa dakvirveba bavSvis aqtivobebze, dedasTan, ojaxis wevrebsa da bavSvebTan urTierTobaze. eqimma unda icodes, rom mxolod erTjeradad Sefasebisas bavSvis warumatebloba ar niSnavs ganviTarebis Seferxebas. bavSvsac iseve, rogorc mozrdils, SesaZlebelia `cudi dRe~ hqondes. amitom Tu Sefasebisas bavSvi ver asrulebs misi asakis Sesabamis qmedebebs, mizanSewonilia misi ganmeorebiTi Sefaseba 2 kviris Semdeg. bavSvis emociuri da socialuri sferos Sesafaseblad gamoiyeneba mravali sxvadasxva sakvlevi instrumenti (testi). maT Soris erT-erTi metad mniSvnelovania denver-II-is testi, romelic afasebs bavSvSi ganviTarebis sxvadasxva sferos 0-6 wlamde asakSi.

denveris testis Sefaseba

25

50

75

90

testi moicavs 4 kategorias. TiToeuli maTgani warmodgenilia sxvadasxva moqmedebis aRmniSvneli mcire SkaliT, romelic asakobriv farglebSia moqceuli, roca bavSvTa populaciis 25-dan 90 %-s SeuZlia mocemuli moqmedebis ganxorcieleba. Skalis marcxena sazRvari gviCvenebs asaks, rodesac mocemuli asakis bavSvTa populaciis 25 %-s SeuZlia misi Sesruleba, patara xaziT aris aRniSnuli is asaki, rodesac mo-

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mikrodone

qmdebas asrulebs bavSvTa 50%, daCrdiluli nawilis marcena kideSi mocemulia 75%, xolo marjvniv aris 90 %-is aRniSvna, rodesac am asakis bavSvTa 90 %-s SeuZlia testis gavla. marcxad iTvleba, Tu bavSvi ver axorcielebs im moqmedebas, romelsac asrulebs am asakis bavSvTa 90 %, Tumca es yovelTvis ar niSnavs CamorCenas. ganviTarebis Sefasebis dros metad mniSvnelovania ganviTarebis Seferxebis saSiSroebis niSnebis (e.w. RED Flags) Sefaseba.

saSiSroebis niSnebi _ emociuri da socialuri sferos ganviTareba 4 Tvis _ ar aris adekvaturi (socialuri) Rimili an sicili. 6 Tvis ar icinis mSoblebTan TamaSis dros; ar aqvs kargi TvaliT kontaqti. 12 Tvis Zneli dasawynarebelia, taqtilur Sexebaze vlindeba spontanuri gaWimva-hipertonusi. ar avlens mijaWvulobas aRmzrdelis mimarT. 15 Tvis _ ar urTierTobs mSoblebTan. 18 Tvis ar gamoxatavs interess sxva bavSvebis mimarT. 2 wlis mizezis gareSe ikbineba, kivis, urtyams. 3 wlis Zalian uWirs dedasTan ganSoreba, ar TamaSobs sxva bavSvebTan.
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mikrodone

4 wlis _ isev tiris, roca mSoblebi toveben; ar erTveba TamaSSi; yuradRebas ar aqcevs sxva bavSvebs, ar ekontaqteba ojaxis wevrebis garda sxva adamianebs. 5 wlis _ avlens zedmet SiSs an Warb agresias; mSoblebs ver Sordeba protestis gareSe; ar TamaSobs sxva bavSvebTan, ar gamoxatavs emociebs, uWirs ufrosebTan da TanatolebTan urTierToba.

konsultaciis meTodebi
emociuri da socialuri sferos ganviTarebis xelSewyoba bavSvis mofereba, xelSi ayvana. taqtiluri Sexeba tvinis ganviTarebis mZlavri stimulia. bavSvTan xSiri saubari, leqsebis, zRaprebisa da moTxrobebis wakiTxva. bavSvis nebismieri warmatebis sapasuxod Seqeba da taSi (mag.: `maCvene Tojina~, `dauqnie xeli~ da sxv.) pataras Zalian uxaria, rodesac aqeben, saqciels uwoneben da cdilobs gaimeoros Tavisi miRwevebi, raTa kvlav moisminos saqebari sityvebi. 6 Tvidan sxva bavSvebTan, ojaxis wevrebis garda sxva ufrosebTan urTierTobis damyarebis SesaZlebloba. bavSvebi am asakSi erTad ver TamaSoben, mxolod aTvaliereben erTmaneTs da SeiZleba saTamaSosTvis Cxubic ki mouvideT, magram amiT isini urTierTobas swavloben. 2-3 wlis asakidan bavSvebisaTvis erTad TamaSis sa-

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mikrodone

Sualebis micema, martivi wesebis daweseba, Tu rogor unda iTamaSon erTad. patara imeorebs ufrosebis Jestebs, mimikas, ganwyobilebasac ki; mSoblebma bavSvs yovelTvis dadebiTi magaliTi unda miscen. patara qcevas ara SegonebiT, aramed imitaciiT swavlobs. Tanatolebis mimarT simpaTiis gaRviveba, xSirad TanagrZnobis gamoxatva mag.: `nino pataraa, codvaa, Sen ki masze ufrosi xar, daexmare, dauTme an aTxove~. zedmeti akrZlavebisagan Tavis Sekaveba.

ganviTarebis Seferxebis zogierTi problemebis SesaZlo mizezebi da rekomendaciebi

dabadebidan 3 Tvemde ar reagirebs gare stimulaciaze (xmauri, Zlieri Suqi) _ unda gamoiricxos sensoruli sferos paTologia.

4-dan 6 Tvemde ar iRimeba _ unda gamoiricxos: mxedvelobis problemebi; mijaWvulobis problemebi; dedis Rrma depresia; mZime SemTxvevebSi bavSvisadmi uxeSi mopyroba (Zaladoba) an bavSvis ugulvebelyofa.

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mikrodone

6-dan 12 Tvemde ar ucxoobs 7 Tvis asakisTvis _ SeiZleba gamowveuli iyos mravali mzrunvelis arsebobiT.

12-dan 24 Tvemde mimbaZvelobis deficiti 16 Tvis asakisaTvis _ unda gamoiricxos smenis daqveiTeba, kognitiuri problemebi an socializaciis deficiti. 18 Tvis asakisaTvis ar uTiTebs sagnebze _ unda gamoiricxos problemebi socialur sferoSi.

`mijaWvulobis~ ganviTareba

`mijaWvulobis Teoria~ ganviTarebulia jon boulbi ainsvorsis mier. am Teoriis Tanaxmad, mijaWvuloba viTardeba bavSvsa da im adamians Soris, romelic masze zrunavs. bavSvi grZnobs, rom misi gadarCenisTvis am etapze saWiroa dacva. yvela qceva, romelic mimarTulia sasurvel adamianTan kavSiris miRwevis da am kavSiris SenarCunebisken, SeiZleba ganvixiloT mijaWvulobis xelSeywobad. axaldabadebuli bavSvebi, romlebic dawesebulebebSi gaaSviles an raime mizeziT moaciles dedebs, garkveuli drois Semdeg avlenen zrdaSi da ganviTarebaSi CamorCenas, ufro xSir avadobas da sikvdilianobas. Cvilebi, rogorc wesi, SfoTaven da Taviseburad aprotesteben dedebTan ganSorebas. isini cdiloben ipovon siaxlovis niSnebi iseT adamianebTan, romlebic maTTvis mniSvnelovania (mSoblebi, ojaxis sxva wevrebi da a.S.). mi62

mikrodone

jaWvoloba intensiurad viTardeba pirveli 7 Tvis ganmavlobaSi. pirveli ori weli gansakuTrebiT mniSvnelovania am TvalsazrisiT. am periodSi ganviTarebuli mijaWvuloba adamians cxovrebis mTel manZilze gasdevs. am Teoriis Tanaxmad mijaWvuloba viTardeba 4 stadiad: 1. sawyisi stadia (mijaWvulobis wina stadia) grZeldeba dabadebidan 12 kviramde. bavSvi mijaWvulobas gamoxatavs instiqtebis doneze (tiris, uyurebs dedas, iRimeba da xels hkidebs). 2. mijaWvulobis Camoyalibeba grZeldeba 12 kviridan 6 Tvemde. bavSvi iwyebs sxvadasxvanairad qcevas nacnob da ucnob adamianebTan. SfoTavs, roca marto rCeba. 3. gansazRvris faza grZeldeba 6 Tvidan 8 Tvemde. ucnobi adamianebis garemocvaSi Riziandeba da Taviseburad aprotestebs dedasTan ganSorebas. 4. mSoblebs Soris TviTkoreqciis faza grZeldeba 18 Tvemde. am dros bavSvma icis rom deda arsebobs miuxedavad imisa xedavs Tu ara mas. masTan ganSoreba, rogorc qesi naklebad amaRelvebelia misTvis vidre wina etapze. boulbi did mniSvnelobas aniWebda bavSvis da masze mzrunvelebis erTmaneTTan interaqcias. myari mijaWvulobis ganviTarebisTvis saWiroa bavSvTan mudmivi kavSiri: saubari, TamaSi, maSinac ki rodesac Tqven fiqrobT rom mas Tqveni saubari ar esmis, Tqveni xmis tembri SeiZleba gaxdes misi dadebiTi an/da uaryofiTi emociis mizezi.

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mikrodone

bavSvis sapasuxo qceva xangrZlivi ganSorebis pirobebSi:

protestis faza bavSvi aprotestebs dedasTan ganSorebas, tiris, eZebs dedas. sasowarkveTis faza bavSvi mowyenili da pasiuria. Tu deda am fazaSi miuaxlovdeba bavSvs, bavSvi aReldeba da gaiwevs dedisken, raTa misgan miiRos yuradReba da zrunva. adaptirebis faza (detachment phase) bavSvi egueba danakargs. Tu deda am fazaSi ubrundeba bavSvs, bavSvi gaurbis mas (damcvelobiTi eqskluzia). Tu bavSvs aqvs daucveli mijaWvuloba, anu Tu misi mijaWvuloba xSirad dgeboda kiTxvis niSnis qveS, SeiZleba ganviTardes araerTi fsiqosocialuri problema.

sarekomendacio literatura: 1. n. xerxeuliZe - bavSvTa daavadebaTa propedevtika 2004 2. Georgetown Bright Futures Provider Guidelines http://www.brightfutures.org/bf2/pdf/index.html 3. http://go.worldbank.org/Q0DFS2VJ40 4. http://www.gpnotebook.co.uk/simplepage.cfm 5. http://www.fpnotebook.com/ 6. http://www.zerotothree.org

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mikrodone

bavSvebi maRali riskis qveS ojaxis Semosavlebis simcire erT-erTi yvelaze gavrcelebuli risk-faqtoria bavSvis ganviTarebis procesSi CamorCenis da paTologiebis ganviTarebisTvis. kvlevebma aCvena rom, siRaribe aseve moqmedebs kognitiur da qceviT doneebze. dabalSemosavlian ojaxebSi aRzrdil bavSvTa didi nawili ar aris mzad sazogadoebrivi ganaTlebis dawesebulebebisTvis. bevr maTgans uviTardeba qceviTi deviaciebi, romlebic SeiZleba sociumisTvis da gansakuTrebiT misi TanatolebisTvis iyos miuRebeli. aman SeiZleba momavalSi uaresi da ufro mZime problemebis winaSe daayenos bavSvi da misi ojaxi. maRali riskis mqone bavSvebis baRisTvis/skolisTvis mosamzadeblad saWiroa socialuri muSakis Careva. am intervenciis farglebSi unda moxdes im saWiroebebze zrunva, romelic yvelaze metad axdenen zegavlenas bavSvebis ganviTarebaze. am faqtorebSi Sedis: janmrTelobis mdgomareobaze zrunva da misi gaumjobeseba; fsiqosocialuri mdgomareobis gaumjobeseba; ganaTleba, momzadeba baRis/skolis programisTvis, klaselebTan interaqciisTvis.

unarebis ganviTarebaze zrunva SeiZleba individualuri muSaobiT, mSoblebTan muSaobiT, ojaxebTan konsultaciiT da a.S.

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mikrodone

Tu intervenciis SedegSi bolomde ar varT darwmunebuli, saWiroa misi gagrZeleba baRis/skolis periodSic, gansakuTrebiT maSin, Tu igi arRvevs dawesebulebaSi yofaqcevis wesebs, aqvs problemebi TanatolebTan da maswavleblebTan. aucilebelia am dros moxdes situaciis siRrmiseuli Seswavla, Sefaseba/diagnostireba da Sesabamisi intervenciis dagegmva/ganxorcieleba.

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makrodone

intervenciebi Temis doneze marTalia, adreuli asakis bavSvis ganviTarebis programebis mier SeTavazebuli servisebis pirdapiri momxmareblebi adreuli asakis bavSvebi arian, programis miznobrivi populacia SeiZleba maTi dedebi an maTze mzrunvelebi iyvnen. rogorc sxva TemTan muSaoba, adreuli asakis bavSvTa mSoblebTan muSaoba gulisxmobs Temis organizebas da mis ganviTarebas. es meTodi moicavs Temis mobilizebis da gaZlierebis process maTi instituciebis, organizaciebis, jgufebis, liderebis, advokatebis (interesTa damcvelebis) da moxaliseebis CarTvis gziT. TemSi muSaobisas yuradReba unda mieqces Semdeg komponentebs: gaZliereba (saSualebebiT aRWurva) socialuri qmedebis procesi, romelic Sedegad iZleva sakmaris Zalas marTon (mniSvnelovani wvlili Seitanon) sakuTari da Temis cxovreba (`bedis~ kontroli). Temis wevrebi intervenciis Sedegad iZenen axal Zalas an aviTareben arsebul Zalas, raTa moaxdinon sasurveli cvlileba.
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makrodone

kritikuli cnobiereba _ cnobiereba, romelic efuZneba cvlilebis procesSi misken mimarTuli qmedebis da misi Sedegebis urTierTqmedebas. kritikuli cnobiereba moicavs analitikur procesebs. am dros xdeba ZiriTadi problemebis da maTi gadaWrisken mimarTuli Temis qmedebis analizi. Temis warmomadgenlebi saubroben am urTierTqmedebis Sesaxeb da erToblivad midian daskvnamde, Tu ramdenad efeqturia esa Tu is intervencia erTi romelime problemis aRmosafxvrelad. Temis SesaZleblobebi _ Temis niSan-Tvisebebi/unar-Cvevebi, romlebic zegavlenas axdenen mis SesaZleblobaze gansazRvros/aRmoaCinos problema da gadaWras igi. Temis SesaZleblobebis gaZlierebis Sedegad Temis wevrebi aqtiurad monawileoben Temis cxovrebaSi liderobis, socialuri qselis da maTTvis xelmisawvdomi Zalauflebis saSualebiT. problemis SerCeva gulisxmobs cvlilebis specifikuri samizneebis SerCevas, romlebze muSaobac aZlierebs Tems. problemebi/samizneebi ganisazRvreba Temis uSualo monawileobiT, samizneebi irCeva imis mixedviT, Tu ramdenad uwyoben isini xels strategiuli gegmis ganxorcielebas. monawileoba da Sesabamisoba _ Temis organizeba iwyeba iq, sadac adamianebi arian (igulisxmeba Temis/adamianebis sxvadasxva maxasiaTebeli) da aZlevs maT Tanabar saSualebas, rom CaerTon intervenciaSi. Temis wevrebi maTive saWiroebebis (sakuTari Sexedulebebisamebr), saerTo Zalauflebisa da arsebuli resursebis (maTive azriT) safuZvelze TviTonve adgenen samoqmedo gegmas.
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makrodone

socialurma muSakma SeiZleba am procesebis fasilitatoris roli aiRos Tavis Tavze. sawyis etapze es gansakuTrebiT mniSvnelovania manam, sanam ar moxdeba TviTon TemSi arsebuli resursebis gamovlena da maTi CarTva Temis ganviTarebisken mimarTul saqmianobebSi.

politika da media politikis donis intervenciis erT-erTi mizania Secvalos Sexeduleba da midgoma bavSvis winaSe pasuxismgeblobebis Sesaxeb. kerZod, bavSvis sicocxlis xarisxze sruli pasuxismgeblobis mxolod individualur ojaxebze dakisrebis nacvlad, pasuxismgebloba unda iqnes gaziarebuli da iqmnebodes politika, romelic xels uwyobs bavSvis interesebis saukeTesod dacvas. bavSvis aRzrdaze ZiriTadi pasuxismgebeli piri SeiZleba iyos sxvadasxva sazogadoebis normebidan, socialur-ekonomikuri mdgomareobidan da sazogadoebis sxva maxasiaTeblebidan gamomdinare. politikis donis intervenciam unda uzrunvelyos bavSvis ganviTarebisTvis saWiro politikuri situacia qveyanaSi. aucilebelia uwyvetobis principis dacva, rac xels Seuwyobs yvela asakobrivi kategoriis bavSvis saWiro servisebis miwodebas. qveynis politikuri da ekonomikuri mdgomareobidan gamomdinare, arsebobs bavSvTa servisebiT uzrunvelyofis universaluri da seleqciuri midgoma. universaluri midgoma gulisxmobs yvela bavSvis servisebis uzrunvelyofas ganurCevlad sxva kriteriumebisa. seleqciuri midgoma ki
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makrodone

moicavs mxolod da mxolod iseT bavSvebs, romlebic moxvdebian miznobrivi populaciis rigebSi. xSirad am kategoriaSi xvdebian e.w. `maRali riskis mqone bavSvebi~. riskSi moiazreba is faqtorebi, romlebic xels uSlian bavSvebs ganviTardnen normis farglebSi. politikis donis intervenciisas unda gvaxsovdes, rom bavSvis garemo ar Semoifargleba sabavSvo baRiT, ojaxiT an garemos sxva romelime komponentiT. bavSvze zegavlenas axdens mTeli rigi fizikuri da socialur-emociuri faqtorebi. swored am faqtorebis gaumjobeseba unda iyos saboloo politikis mizani, raTa moxdes bavSvTa normaluri ganviTarebis sruli xelSewyoba. qveyana gansazRvravs adreuli asakis bavSvTa mimarT politikas da misi regulirebis meqanizmebs. nebismier etapze mniSvnelovania socialuri muSakis roli, romelic politikis Seqmnisa da ganxorcielebis procesSi sxvadasxva dainteresebuli piris CarTulobas da interesebis gaTvaliswinebas exmareba. socialuri muSaki SeiZleba sxvadasxva meTodiT uwyobdes xels politikis Seqmnas da regulirebas, misi erT-erTi ZiriTadi funqcia ki unda iyos politikis Semqmnelebsa da politikis beneficiarebs Soris produqtiuli TanamSromlobis xelSewyoba. umniSvnelovanesia aseve mediis roli adreuli asakis bavSvTa ganviTarebis xelSewyobisTvis. medias SeuZlia iTamaSos ganmanaTleblis roli. saganmanaTleblo programebis, axali ambebis da socialuri reklamebis gziT medias SeuZlia aamaRlos sazogadoebis cnobierebis done
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makrodone

adreuli asakis bavSvTa ganviTarebis arsisa da misi mniSvnelovnebis Sesaxeb. amasTan, sazogadoebaSi cnobierebis amaRleba da problemebis Sesaxeb sazogadoebis sensitizacia iwvevs sazogadoebis mxridan moTxovnas servisebis gaumjobesebasa da efeqturi politikis Seqmnaze. politikosebs ki sazogadoebrivi azrisa da faseulobebis gaTvaliswineba momgebian poziciaSi ayenebs.

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