Meanings and definitions for rehabilitation/ abilitation service in adaptive physical education of children with health limitations

Dr.Hab., Professor N.A. Fomina1
Dr.Hab., Associate Professor S.Yu. Maksimova1
PhD, Associate Professor I.V. Fedotova1
PhD I.S. Tamozhnikova1
1Volgograd State Physical Education Academy, Volgograd


In recent decades, the disability level of the child population has been steadily increasing in Russia. From 2010 to 2017, the number of minor children with disabilities has increased several times. The number of small patients suffering from multiple organ dysfunctions, polymorphous and overlapping syndromes of different origins is growing every year. All this necessitates the habilitation, rehabilitation and correctional activities with handicapped children to be improved [2 and 4]. In pedagogical rehabilitation practice, these actions are often considered as only one type of activity, whereas these are completely different remedial and rehabilitation actions. The specification of the content of these concepts will ensure the separation of the targets of correctional and pedagogical types of assistance; their achievement will ensure a comprehensive recovery effect. Therefore, for today, it is necessary to form a clear understanding of the concepts of "rehabilitation" and "habilitation," taking into account the modern analysis of the semantic components and a unified rehabilitation system.

The conceptual system of kinesio corrective techniques for handicapped children includes habilitation and rehabilitation. Rehabilitation (the French word rehabilitation is derived from the Latin re meaning "again" and habilis meaning "adapted") is a complex of medical, psychological, pedagogical, professional and legal measures to restore the autonomy, ability to work and health of people with limited physical and mental abilities, resulting from prior diseases and injuries. The rehabilitation is aimed at helping people who have lost any functional capacity and need to re-learn the skills of daily activities in order to achieve the maximum level of functionality [1]. It is a system of therapeutic and pedagogical measures aimed at preventing and treating pathological conditions, causing temporary or permanent disability. The rehabilitation is applied in cases when a sick child has already had experience of any social life, and his motor, speech and other skills have already been formed [8]. The kinesio corrective techniques at the modern level should be of integrated nature. According to Makhov and Akhtimirov (2016), in rehabilitation, medical field is considered to be the main direction among others. This type of rehabilitation is based on therapeutic, diagnostic and restorative measures. The next field is a psychological direction that implies a system of measures to maximally restore the personality characteristics of the individual. In pedagogy, rehabilitation is understood as a system of measures aimed at restoring the skills of learning, self-education and self-improvement. Within the framework of vocational rehabilitation, the tools to restore the lost professional skills are used. Social rehabilitation is a complex of methods aimed at restoring the social experience necessary for entering a society or a cultural system [7]. The above stated actualizes the need to provide comprehensive rehabilitation.

If the disabling condition of the child emerged at an early age, then we deal with habilitation, since the child’s motor stereotypes, gnostic-practical and speech functions have not formed yet, and the child does not possess self-service skills and has no experience in social life. In this respect, habilitation is often applied to children of early and younger preschool age, while rehabilitation is used for older children and adults. The purpose of habilitation, as well as rehabilitation, is to restore the ability to live and work in the ordinary environment as quickly as possible [3]. Habilitation and rehabilitation provide for therapeutic and pedagogical correction of the motor, mental and speech processes of children [8].

Despite the similarity of the targets of habilitation and rehabilitation, their content components are different. In the modern literature, the term "habilitation" (the word is of Latin origin abilitatio, meaning "adaptive") has the most ambiguous interpretations and there is no single agreement among authors addressing this notion. The concept of habilitation is close in meaning to the concept of normalization used in Denmark and Sweden. In Latin, habilitation means literally "giving rights and opportunities, ensuring the formation of abilities" and is often used in child psychiatry. In the medical literature, the concept of habilitation is often given in comparison with the concept of rehabilitation. According to Badalyan, "habilitation is a system of therapeutic and pedagogical activities aimed at preventing and treating those pathological conditions in young children who have not yet adapted to the social environment, which can lead to a permanent loss of the opportunity to work, study and being a useful member of society [5 and 11]."

Gerasimenko and Dimenshtein’s point of view seems to be of great interest for our research. They consider habilitation as a step prior to the adaptation and integration of children in society. So, "habilitation (in this case, this term is more precise than the commonly used term "rehabilitation" that is restoring of once-lost abilities) is creating of new opportunities and building of a social potential, i.e. the ability of a person to be realized in a given community. This refers to the development of those child’s functions and abilities that normally appear without special efforts of others, while a small handicapped patient can get only as a result of directed work of specialists [6 and12]."

Chepuryshkin (2010) has a similar point of view and believes, that "the habilitation of children with mental retardation is a stimulation of the potential capabilities of the child's psyche and motor skills, correction of defects in his/her development, treatment of comorbid somato-neurological disorders and correction of deviations in the emotional-volitional sphere to form optimal adaptation skills [9 and10]."

Undoubtedly, in the education and upbringing of a disabled child, rehabilitation and habilitation should be applied in an integrated manner. This process is very clearly seen in adaptive physical education. This important educational area allows forming the locomotor base of a handicapped child and his/her vital motor skills. Within the framework of providing a corrective-recovery process, the rehabilitation and habilitation goal set will provide a varied content of pedagogical influence. The rehabilitation will be aimed at restoring the lost motor functions, and the full range of pedagogical tools (therapeutic physical education together with medical and biological means) will be focused on compensating for the lost locomotor capacity. The habilitation will be applied to teach the child how to use his/her motor potential to adapt to the real world. The tools of pedagogical influence in this process are characterized by diversity and vastness. Of great interest is the correlation between these concepts in the adaptive physical education of children who have pathological findings from birth, i.e., pupils with Down’s syndrome, autistic spectrum disorder, cerebral palsy, etc. Here, in fact, the entire pedagogical process will solve the problems of the pupils’ habilitation.

The analysis of the scientific and methodological literature performed and consideration of the opinions of various authors dealing with the problem of corrective and restorative activities allowed us to conclude that the concepts of "rehabilitation" and "habilitation" are different. The former is mostly aimed at restoring the previously lost functions and capabilities of a man, while the latter (habilitation) is focused on the formation of new functions and abilities that the person did not previously have, which is necessary for the successful socialization and adaptation of the individual in society. This understanding allowed us to see the prevalence of the pedagogical component of habilitation that implies a special process aimed at the development, education and upbringing of vital functions, skills and habits. In the field of adaptive physical education, these formations imply a difference between the aims and tools of pedagogical influence.



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The study analyzes the notions, meanings and definitions for the rehabilitation/ habilitation service to handicapped children, with a special attention to the key elements of the rehabilitation service to the underage individuals with disabilities; and benefits of the adaptive physical education methods for the group health correction initiatives. It was found that presently the terms and definitions for the rehabilitation technologies are rather inconsistent, with the research and analyses still focused on the notion and meanings of rehabilitation rather than habilitation. The situation is further complicated by the shortage of dependable theoretical and practical data on the disabled children’s adaptation-focused combined individualized physical education methods. We believe that a special priority shall be given to the cost-efficient and physically feasible range of modern rehabilitation/ habilitation service in the adaptive physical education of children with disabilities.