Amasu Okuhlola Ukukhula Nokuthuthukiswa Kwengane
Ukukhula kwengane kuyinqubo eqhubekayo ehlanganisa ukukhula (izinguquko ngobukhulu obungokomzimba njengesisindo, ukuphakama, kanye nobubanzi bekhanda) kanye nokukhula (ukuvuthwa kokusebenza, amakhono okunyakaza, ulimi, ukuthuthukiswa kwengqondo, ukuthuthukiswa komphakathi ngokomzwelo, kanye nokuzimela). Ukuhlolwa kokukhula nokuthuthukiswa kubalulekile kusukela ebuntwaneni kuze kube sebusheni ngoba kungabona izinkinga kusenesikhathi, kunqume izidingo zokukhuthaza, futhi kusize abazali kanye nochwepheshe bezempilo ukuthi bathathe isinyathelo esifanele. Lesi sihloko sixoxa ngamasu ayinhloko okuhlola ukukhula nokuthuthukiswa kwengane okuvame ukusetshenziswa ezinkonzweni zokunakekelwa kwempilo kanye nasemisebenzini yansuku zonke.
1. Izimiso Eziyisisekelo Zokuhlola Ukukhula Nokuthuthukiswa
Ukuhlolwa okuhle kufanele kube okuphelele, okwenziwa ngezikhathi ezithile, futhi okujwayelekile. Okuphelele kusho hhayi nje ukulinganisa isisindo nobude, kodwa futhi nokuhlola intuthuko yolimi lwengane, ukunyakaza, ukuziphatha, kanye nezimo zemvelo. Okujwayelekile kusho ukukwenza njalo ngokwezikhathi zokuvakasha ezihleliwe (isibonelo, ngesikhathi sokugonywa, ukuhlolwa kwe-post post (Posyandu), noma ukuvakasha kukadokotela). Izindlela ezijwayelekile zisebenzisa amathuluzi okulinganisa asebenzayo nathembekile ukuze imiphumela iqhathaniswe nezigaba zokukhula ezihambisana neminyaka kanye nentuthuko.
Ngaphezu kwalokho, ukuhlolwa kudinga ukucabangela izici ezithonya ukukhula nentuthuko, njengezakhi zofuzo, ukudla okunomsoco, umlando wokukhulelwa nokubeletha, izifo ezingamahlalakhona, ikhwalithi yokunakekelwa, kanye nokukhuthazwa. Ingane ebonakala "iphilile" ayinazo izinselele; ngokuphambene nalokho, ingane ebambezeleka endaweni ethile ayisho ukuthi inokukhubazeka okukhulu, njengoba kukhona ukwehluka kokukhula phakathi kwezingane. Ngakho-ke, ukuchazwa kwemiphumela kufanele kwenziwe ngokucophelela futhi, uma kudingeka, kuhilele ochwepheshe.
2. Indlela Yokuhlola Ukukhula Okubonakalayo (Ukuhlolwa Kokukhula)
a. Izilinganiso ze-Anthropometric
I-anthropometry iyindlela eyisisekelo yokuhlola ukukhula. Amapharamitha ajwayelekile ahlolwayo afaka:
1. Isisindo somzimba (BW): silinganiswa kusetshenziswa isikali somntwana noma isikali sedijithali ngokunemba okwanele. Ezinsaneni, isisindo senziwa ngaphandle kwezingubo ezisindayo kanye namanabukeni ambalwa ngangokunokwenzeka.
2. Ubude/ukuphakama komzimba (PB/TB): ubude bomzimba wengane bulinganiswa nge-infantasymeter isesimweni sokulala phansi, kuyilapho izingane esezikwazi ukuma ukuphakama kwazo kulinganiswa nge-stadiometer.
3. Ukujikeleza kwekhanda (HCM): Lokhu kubaluleke kakhulu ezinganeni ezineminyaka engu-0-2 ukuze kuqashwe ukukhula kobuchopho. Ukulinganisa kuthathwa ezindaweni ezivelele ebunzini nasemuva kwekhanda.
4. Umjikelezo wengalo engenhla (i-MUAC): ivame ukusetshenziswa ekuhlolweni kwesimo sokudla okunempilo, ikakhulukazi ezimweni zasensimini.
5. Inkomba yesisindo somzimba (BMI): ezinganeni ezindala, i-BMI ngokweminyaka ingasiza ekuhloleni ingozi yokungondleki kahle noma ukukhuluphala ngokweqile.
b. Ukudweba Ijika Lokukhula
Imiphumela ye-anthropometric kufanele iqoshwe futhi idwetshwe eshadini lokukhula elijwayelekile (isb., i-WHO noma amashadi kazwelonke asebenzayo). Ukuqapha izitayela kubaluleke kakhulu kunezinombolo ezilodwa. Ingane ehlala isezingeni eliphansi le-percentile ingaba evamile, kuyilapho ingane ewela imigqa eminingana ye-percentile idinga ukunakwa ngoba kungabonisa izinkinga zokudla okunempilo, izifo, noma ukungamuncwa kahle.
c. Ukuhunyushwa Kwesimo Sokudla Okunempilo
Ezinye izinkomba ezivamile ezisetshenzisiwe:
– I-BB yobudala (BB/U) ukuhlola isisindo esingaphansi.
– I-TB ngokweminyaka (i-TB/U) ukuze kuhlolwe ukungakwazi ukuqina (ukungakwazi ukuqina okungapheli).
– Isisindo ngokuya ngobude (BW/BH) noma i-BMI ngokuya ngobudala ukuze kuhlolwe ukuncipha (ukuncipha okukhulu) noma ukukhuluphala ngokweqile/ukukhuluphala ngokweqile.
Ukuchazwa kuvame ukusekelwe ku-z-score. Uma imiphumela ibonisa ukuphambuka okukhulu, izinyathelo ezengeziwe zifaka phakathi ukuhlola ukudla okudliwayo, umlando wezokwelapha, kanye nezimo zemvelo.
3. Amasu Okuhlola Ukuthuthukiswa
Ukuthuthukiswa kwengane kuhlanganisa izizinda eziningana ezibalulekile: ukunyakaza komzimba, ukunyakaza komzimba okuhle, ulimi/ukuxhumana, ingqondo, kanye nokuxhumana nabantu ngokomzwelo. Ukuhlolwa kwenziwa kusetshenziswa inhlanganisela yezindlela ezilandelayo.
a. Umlando Wokuthuthukiswa (Ingxoxo Eqondisiwe)
Abazali bangumthombo obalulekile wolwazi. Izisebenzi zezempilo kudingeka zibuze:
– Ingane iqala nini ukugoba, ukuhlala, ukukhasa, ukuma, ukuhamba.
– Impendulo yengane ezwini, ekubhekaneni emehlweni, nasekubizweni ngamagama.
- Ukuthuthukiswa kwamagama okuqala, ikhono lokwakha imisho, kanye nokuqonda imiyalelo.
– Amaphethini okudlala, ukuxhumana nabantu, amakhono okulingisa, kanye nokuzimela (ukudla wedwa, ukuqeqeshwa endlini yangasese).
Umlando wezinto eziyingozi nawo wabuzwa mayelana: ukukhulelwa ngaphambi kwesikhathi, ukuzalwa unesisindo esiphansi, ukutheleleka okukhulu, ukuquleka, umlando womndeni, ukuchayeka entuthwini kagwayi, kanye nezinkinga zengqondo.
b. Ukubuka Okuqondile
Ukuqaphela kwenziwa ngesikhathi izingane zidlala noma zixhumana. Izinto ezihlolwayo zifaka:
– Ikhwalithi yokunyakaza kanye nokuxhumana.
– Indlela izingane ezibamba ngayo izinto, ezibeka amabhlogo ndawonye, nezibhala ngayo.
– Izimpendulo zomphakathi: ukumamatheka komphakathi, ukukhomba izinto ozithandayo, ukudlala sengathi uyadlala.
– Ukulawula ngokomzwelo: ukucasuka kalula, ukucasuka ngokweqile, noma ukungenzi lutho.
Ukuqaphela kuvame ukuveza izinkinga abazali abangazazi, njengokungaxhumani emehlweni noma ukulibaziseka kokuxhumana ngaphandle kokusebenzisa amazwi.
c. Ukuhlolwa Kokuhlungwa Kokuthuthukiswa
Ukuhlolwa kuhlose ukuhlonza izingane ezisengozini yokubambezeleka kokukhula ukuze zithunyelwe ngokushesha ukuze zihlolwe kabanzi. Amanye amathuluzi okuhlola asetshenziswa kakhulu ahlanganisa:
– I-Developmental Pre-Screening Questionnaire (KPSP) isetshenziswa kabanzi e-Indonesia.
– Ukuhlolwa Kokuthuthukiswa KweDenver (Denver II) ukuhlola izizinda eziningana zokuthuthukiswa ezifanele ubudala.
– I-ASQ (Umbuzo Weminyaka Nezigaba) osekelwe emibikweni yabazali futhi owusizo kakhulu.
Imiphumela yokuhlola ivame ukuhlukaniswa ngokuthi “ifanelekile,” “iyangabazeka,” noma “engavamile.” Uma imiphumela ingabazeka, ukuhlolwa kungaphindwa ngezikhathi ezithile ngokukhuthazwa okukhulu; uma kukhona ukukhubazeka, kudingeka ukudluliselwa.
d. Ukuhlolwa Kokuthuthukiswa Okujulile
Uma ukuhlolwa kubonisa ingozi noma ukukhathazeka ngokwezokwelapha, ukuhlolwa okujulile kungenziwa udokotela wezingane, isazi sokusebenza kwengqondo, isazi sezokwelapha emsebenzini, isazi sokukhuluma, noma isazi sezokwelapha ngokomzimba. Lokhu kuhlolwa okujulile kuvame ukufaka ukuhlolwa kwengqondo, ukuhlolwa kolimi, ukuhlolwa kokuziphatha, kanye nokuhlolwa kwezinzwa. Umgomo ukuqinisekisa ukuxilongwa nokuthuthukisa uhlelo lokungenelela oluqondene nomuntu ngamunye.
4. Ukuhlolwa Kwemisebenzi Yezinzwa: Ukuzwa Nokubona
Ukukhubazeka kokuzwa nokubona ngokuvamile kuyimbangela yokubambezeleka kolimi kanye nobunzima bokufunda. Ngakho-ke, ukuhlolwa kwezinzwa kuyingxenye ebalulekile yokuhlola.
– Ukuzwa: kungahlolwa ngokuhlolwa kwezinsana ezisanda kuzalwa (OAE/ABR) uma kutholakala, kanye nokubuka izimpendulo zomsindo. Ezinganeni ezindala, kungenziwa i-audiometry ehambisana nobudala.
– Ukubona: Ukuhlola kuhlanganisa ukuhlola i-red reflex, ukubona kahle, nokubheka ukuthi ingane ivame ukukhinyabeza amehlo, ukutshekisa ikhanda, noma ukuthi inobunzima bokulandela izinto. Ukudluliselwa kudokotela wamehlo kuyadingeka uma kukhona okusolakalayo.
5. Ukuhlolwa Kwezici Zengqondo Nezenhlalo
Ukukhula nentuthuko kuthonywa kakhulu yizindlela zokukhulisa izingane kanye nendawo ezikuyo. Amasu okuhlola ahlanganisa:
– Hlola ikhwalithi yokuxhumana komzali nomntwana: ukuthi kukhona yini ukuzibandakanya ngokomzwelo, ukuxhumana okubili, kanye nemikhuba ephephile.
– Hlola ukuchayeka ekucindezelekeni: izingxabano zomndeni, ubudlova, ukuntuleka kokusekelwa komphakathi, noma ukucindezeleka kwabanakekeli.
– Hlola ukufinyelela kokudla okunomsoco kanye nokuhlanzeka: ukutholakala kokudla okunomsoco, ukuhlanzeka kwemvelo, kanye nezindlela zokulala.
Izici eziyinkinga zengqondo zinganciphisa ukukhula ngisho noma isimo somzimba sengane sibonakala sihle.
6. Imibhalo, Ukuqapha, kanye Nokulandelela
Ukuhlolwa okuphumelelayo kumele kuhambisane nemibhalo enembile, isibonelo encwadini ye-KIA, amarekhodi e-Posyandu, noma amarekhodi ezokwelapha asemtholampilo. Izinto ezibalulekile okufanele uziqaphele:
- Amanani e-anthropometric kanye namashadi okukhula.
- Imiphumela yokuhlola intuthuko ngesizinda ngasinye.
- Okutholakele kokubuka kokuziphatha kanye nokuxhumana nabantu.
– Uhlelo lokukhuthaza kanye nesimiso sokulawula kabusha.
Ukulandelela kubalulekile. Uma kutholakala ukubambezeleka, ukungenelela kusenesikhathi njengokukhuthaza okuqondiwe, ukuthuthukiswa kokudla okunempilo, ukwelashwa kokukhuluma, noma i-physiotherapy kungathuthukisa kakhulu imiphumela. Abazali kufanele bafundiswe ngemisebenzi yokukhuthaza efanele iminyaka, njengokukhuluma, ukufunda izincwadi, imidlalo yezimoto, kanye nokunciphisa isikhathi esiningi sokubuka isikrini.
Isiphetho
Amasu okuhlola ukukhula kwengane kanye nokukhula kwayo afaka phakathi izilinganiso zokukhula ngokomzimba (i-anthropometry kanye ne-growth curves), ukuhlolwa kokukhula (ukuthatha umlando, ukubuka, ukuhlola, kanye nokuhlola okujulile), ukuhlolwa kwezinzwa (ukuzwa nokubona), kanye nokuhlolwa kwezici zengqondo nezendawo ezungezile. Ukuhlolwa okuvamile kwenza kube lula ukuthola izinkinga kusenesikhathi, okuvumela ukungenelela okufika ngesikhathi nangokufanele. Ngokubambisana phakathi kwabazali, ochwepheshe bezempilo, kanye nendawo yemfundo, izingane zinethuba elikhulu lokukhula kahle futhi zithuthuke kahle ngokwamandla azo.
