Keterlambatan BIcara pada Anak

ZMCMZKP GMPMZIKEJKPKL JDNKZK RK@K KLKG

Rmejdejdlo8 `r. Ruiulo E. ^dikikfd, ^p.K

Rmlykhd8

Okjrdmik Nfrdsty

(:2;:-23;-2:6) (:2;:-23;-2:6)

Gmpkldtmrkkl Gmpkldtmrkkl Gidldg Jkodkl Dieu Gmsmfktkl Klkg Rmrda`m ;: Koustus „ ;= ;= ^mptmejmr :2;> Ckguitks Gmàgtmrkl Gmàgtmrkl ]ldgk Ktek Hkyk Dlàlmsdk Z^ Jfkyklogkrk Pg. D Zk`ml ^kd` ûgklta, Hkgkrtk :2;>

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GKPK RMLOKLPKZ

Ruhd `kl syugur pmluids fkturgkl gmpk`k Pufkl yklo Ekfk Msk gkrmlk ktks jmrgkt `kl rkfekt-Lyk rkfekt-L yk pmluids `kpkt emlymimskdgkl rmcmrkt dld tmpkt pk`k wkgtulyk. K`kpkul huùi rmcmrkt dld k`kikf ’Gmtmrikejktkl Jdnkrk pk`k Klkg― yklo `djukt pk`k juikl Koustus :2;>. Rmluids emlounkpgkl tmrdek gksdf yklo smjmskr-jmskrlyk gmpk`k `r. Ruiulo E. ^dikikfd, ^p.K smikgu pmejdejdlo rmcmrkt ktks wkgtu, ùgulokl `kl jdejdlokl yklo tmikf `djmrdgkl `kike prasms pmlyusulkl rmcmrkt dld fdlook smimskd. Rmluids jmrfkrkp rmcmrkt dld `kpkt emejmrd eklckkt jkod pkrk pmejknk, `kl pmluids emlyk`krd jkfwk rmcmrkt dld eksdf hkuf `krd smepurlk smfdlook grdtdg `kl skrkl yklo `djmrdgkl `kpkt emlhk`d eksugkl yklo emejkloul `med gmekhukl jmrskek.

Hkgkrtk, Koustus :2;>

Rmluids













@KCPKZ D^D GKPK RMLOKLPKZ………………………………………………………………. RMLOKLPKZ………………………………………………………………...d ..d @KCPKZ D^D…………………………………………………………………………dd JKJ D RML@KF]I]KL………………………………………………… RML@KF]I]KL……………………………………………………………; …………; ;.;. Iktkr Jmikgklo…………………………………………………………..; ;.:. Zueuskl Ekskikf……………………………………………………….> ;.>. Puhukl Rmluidskl………………………………………………………...> ;.0. Eklckkt Rmluidskl……………………………………………………….>

JKJ DD PDLHK]KL R]^PKGK……………………………………………………..0 :.;. @mcdldsd…………………………………………………………………..0 :.:. Jdnkrk `kl Jkfksk pk`k Klkg………...…………………………………= :.>. Mpd`medaiaod……………………………………..…...………… Mpd`medaiaod……………………………………..…...…………………3 ………3 :.0. Klktaed………………………………………………………………….? :.=. Rrasms Cdsdaiaod Jdnkrk…………………………………………………..4 :.3. Ckgtar Zmsdga Oklooukl Rmrgmejklokl Jdnkrk `kl Jkfksk…………..;; Jkfksk …………..;; :.?. Giksdcdgksd `kl Omhkik Oklooukl Jdnkrk……………………………….;= Jdnkrk ……………………………….;= :.6. @dkolasds Oklooukl Jdnkrk pk`k Klkg ………………………………..;6 ………………………………..;6 :.6.;. Klkelmsds……………………………………………………;6 :.6.:. Dlstrueml Rmlykrdlo………………………………………….;4 Rmlykrdlo ………………………………………….;4 :.6.>. Rmemrdgskkl Cdsdg…………………………………………….;4 :.6.0. Rmlokektkl ^kkt Jmrekdl……...…………………………….;4 :.6.=. Rmemrdgskkl Rmlulhklo…...………………………………….;4 :.6.3. Galsuitksd…………………………………………………….:; :.4. Rmlktkikgsklkkl………………………………………………………...:; :.;2. Rraolasds……………………………………………………………...:>

JKJ DDD GM^DER]IKL……………………………………………………………:=













JKJ D RML@KF]I]KL

;.;. Iktkr Jmikgklo

Rmrgmejklokl k`kikf jmrtkejkflyk gmekepukl `kike strugtur `kl culosd tujuf yklo imjdf gaepimgs `kike paik yklo tmrktur `kl `kpkt `drkekigkl, smjkokd fksdi `krd prasms pmektklokl. @dsdld emlyklogut k`klyk prasms `dcmrmlsdksd `krd smismi tujuf, hkrdlokl tujuf, arokl-arokl `kl sdstme arokl yklo jmrgmejklo sm`medgdkl rupk smfdlook eksdlo-eksdlo `kpkt ememlufd culosdlyk. Pmreksug huok pmrgmejklokl measd, dltmimgtuki `kl tdlogkf ikgu smjkokd fksdi dltmrkgsd `mlokl idlogulokllyk. ; Oklooukl jdnkrk `kl jkfksk k`kikf skikf sktu pmlymjkj oklooukl pmrgmejklokl yklo pkidlo smrdlo `dtmeugkl pk`k klkg. Gmtmrikejktkl jdnkrk k`kikf gmiufkl utkek yklo smrdlo `dnmeksgkl `kl `dgmiufgkl arklo tuk gmpk`k àgtmr Oklooukl dld smekgdl fkrd tkepkg smekgdl emldlogkt pmskt. Jmjmrkpk ikparkl emlymjutgkl klogk gmhk`dkl oklooukl jdnkrk `kl jkfksk jmrgdskr = „ ;2% ;2% pk`k klkg smgaikf. Gmekepukl eatardg `kl gaoldsd jmrgmejklo smsukd tdlogkt usdk klkg, `medgdkl huok pmemraimfkl jkfksk jmrtkejkf emikiud prasms pmrgmejklokl euikd `krd jkfksk pmrtkek, usdk prk smgaikf `kl usdk smgaikf `d eklk jkfksk jmrpmrkl sklokt pmltdlo `kike pmlnkpkdkl kgk`medg klkg.:,> Rmrgmejklokl jkfksk, pk`k usdk jkwkf idek tkful (jkidtk) kgkl jmrgmejklo sklokt kgtdc `kl pmskt. Gmtmrikejktkl jkfksk pk`k pmrda`m dld, `kpkt emldejuigkl jmrjkokd ekskikf `kike prasms jmikhkr `d usdk smgaikf. Klkg yklo emlokiked gmtmrikejktkl jdnkrk `kl jkfksk jmrmsdga emlokiked gmsuidtkl jmikhkr, gmsuidtkl emejknk `kl emluids `kl kgkl emlymjkjgkl pmlnkpkdkl kgk`medg yklo gurklo smnkrk emlymiuruf, fki dld `kpkt jmriklhut skepkd usdk `mwksk eu`k. ^miklhutlyk arklo `mwksk `mlokl pmlnkpkdkl kgk`medg yklo rml`kf kgdjkt gmtmrikejktkl jdnkrk `kl jkfksk, kgkl emlokiked ekskikf pmrdikgu `kl pmlymsukdkl psdgasasdki. ;,: Emidfkt sm`medgdkl jmskr `kepkg yklo tdejui kgdjkt gmtmrikejktkl jkfksk pk`k klkg usdk prk smgaikf ekgk skloktikf pmltdlo ultug emloaptdekigkl prasms













jmikhkr klkg tmrsmjut skkt emeksugd usdk smgaikf. Jmjmrkpk kfid emlydepuigkl pmrgmejklokl jdnkrk `kl jkfksk `kpkt `dpkgkd smjkokd dl`dgktar pmrgmejklokl klkg smnkrk gmsmiurufkl, tmreksug gmekepukl gaoldsd `kl gmsugsmskl `kike prasms

jmikhkr

`d

smgaikf.

Fksdi

stu`d

ialodtu`dlki

emlulhuggkl

jkfwk

gmtmrikejktkl pmrgmejklokl jkfksk jmrgkdtkl `mlokl dltmimomlsd `kl emejknk `d gmeu`dkl fkrd.:,> Oklooukl jdnkrk pk`k usdk prksmgaikf, `dpmrgdrkgkl tmrhk`d pk`k =% `krd papuiksd lareki `kl ?2% `krd gksus tmrsmjut `dtklokld aimf tmrkpds (_mdss mt ki. ;46?). Oklooukl pmrgmejklokl jdnkrk sklokt jmrvkrdksd `kl eksdf jklykg tmr`kpkt galtravmrsd gfususlyk emlomlkd pmlmltukl giksdcdgksd smsukd `mlokl mtdaiaod ktku ekldcmstksd gidldslyk. Fki pmltdlo yklo emlhk`d pmrfktdkl pkrk gidldsd k`kikf emlomlkd ckgtar rmsdga yklo emepmlokrufd pmrgmejklokl jdnkrk `kl jkfksk. Ckgtar rmsdga yklo pkidlo smrdlo `dikpargkl k`kikf rdwkykt gmiukrok, oklooukl pml`mlokrkl, ekskikf prmlktki `kl pmrdlktki emidputd gmikfdrkl prmtmre `kl jmrkt jk`kl ikfdr rml`kf, smrtk ckgtar psdgasasdki. :,> Ckgtar rmsdga yklo `dpmlokrufd aimf gal`dsd jdaiaod `kl idlogulokl dld emldlogktgkl gmeulogdlkl tmrhk`dlyk oklooukl pmrgmejklokl (Jraags-Oull, ;442). Emlomlkid jmrjkokd ckgtar rmsdga yklo jmrgkdtkl `mlokl `dskjdidtks pmrgmejklokl emlhk`d pmrfktdkl utkek, tmrutkek ckgtar-ckgtar yklo `dykgdld `dpmlokrufd aimf gal`dsd jdaiaods `kl idlogulokl pk`k cksm kwki `krd suktu prasms pmrgmejklokl. Ckgtar jdaiaods yklo jmrmsdga lmoktdc pk`k pmrgmejklokl k`kikf prmekturdtks, jmrkt jk`kl ikfdr rml`kf, gaepidgksd pmrdlktki. ^m`klogkl ckgtar rmsdga `krd idlogulokl emidputd stktus sasdamgalaed yklo rml`kf, fujulokl tmtklook yklo jurug, `kl psdgapktaiaod arklo tuk. Emlomlkid imjdf `dld ckgtar rmsdga pk`k klkg emrupkgkl ckgtar pmltdlo ultug emlhkedl jkfwk emrmgk `dtmepktgkl `kike jmltug praorke rmem`dki yklo tmpkt ultug emedldekigkl ktku emlourklod `kepkg `krd ckgtar rmsdga tmrsmjut. Rmrkl utkek pmlmidtdkl tmrsmjut k`kikf emikgugkl dltmrvmlsd `dld `kl pml`d`dgkl gfusus yklo emepmridfktgkl jkokdeklk pml`mgktkl suktu mpd`medaiaod pmrgmejklokl smfdlook `kpkt emejmrdgkl dlcareksd jkod upkyk pmlnmokfkl. ;,:,> @mtmgsd `dld `kl pmlkloklkl kwki tmrfk`kp measd, gaoldtdc ktku ekskikf













skepkd ekskikf pmrgmejklokl dtu emlhk`d smsuktu yklo td`kg `kpkt `dtklokld ktku jmr`kepkg smnkrk sdoldcdgkl tmrfk`kp fki-fki ikdl. :

;.:. Zueuskl Ekskikf

Kpk skhk fki yklo pmltdlo `dgmtkfud emlomlkd gmtmrikejktkl jdnkrk pk`k k lkg1

;.>. Puhukl Rmluidskl

Emlomtkfud tmltklo gmtmrikejktkl jdnkrk pk`k klkg, gfususlyk emlomlkd `mtmgsd `dld smrtk tktkikgsklk gmtmrikejktkl jdnkrk pk`k klkg.

;.0. Eklckkt Rmluidskl

Zmcmrkt dld `dfkrkpgkl jmreklckkt `kike emlkejkf pmomtkfukl emlomlkd gmtmrikejktkl jdnkrk.















JKJ DD PDLHK]KL R]^PKGK

:.;. @mcdldsd

Gktk jkfksk jmrkski `krd jkfksk iktdl ’idlouk― yklo jmrkrtd id`kf. Kwkilyk pmlomrtdkllyk fklyk emruhug pk`k jdnkrk, lkeul smiklhutlyk `doulkgkl smjkokd jmltug sdstme galvmlsdalki `krd sdejai-sdejai yklo `dpkgkd `kike gaeuldgksd. 0 Kemrdnkl ^pmmnf-Ikloukom Fmkrdlo Kssandktdal Naeedttmm al Ikloukom eml`mcdldsdgkl jkfksk smjkokd 8 suktu sdstme ikejklo galvmlsdalki yklo gaepimgs `kl `dlkeds yklo `dpkgkd `kike jmrjkokd nkrk jmrpdgdr `kl jmrgaeuldgksd. @kike Gkeus Jkfksk Dlàlmsdk, jkfksk `d`mcdldsdgkl smjkokd 8 suktu sdstme ikejklo julyd yklo yklo krjdtrmr, yklo `doulkgkl aimf suktu klooatk eksykrkgkt eksykrkgkt ultug jmgmrhk jmrskek, jmrdltmrkgsd `kl emlod`mltdcdgksdgkl `drd. Gkeus jkfksk Dloords huok emejmrd `mcdldsd yklo skek tmltklo jkfksk.0 Pmr`kpkt pmrjm`kkl eml`kskr kltkrk jdnkrk `kl jkfksk. Jdnkrk k`kikf pmlounkpkl yklo emlulhuggkl gmtrkepdikl smsmarklo emlounkpgkl sukrk `kike suktu gktk. Jkfksk jmrkrtd emlyktkgkl `kl emlmrdek dlcareksd `kike suktu nkrk tmrtmltu. Jkfksk emrupkgkl skikf sktu nkrk jmrgaeuldgksd. Jkfksk rmsmptdc k`kikf gmekepukl ultug emlomrtd kpk yklo `didfkt `kl kpk yklo `d`mlokr. Jkfksk mgsprmsdc k`kikf gmekepukl ultug jmrgaeuldgksd smnkrk sdejaids jkdg vdsuki (emluids, emejmrd tkl`k) ktku ku`dtardg.= ^marklo klkg yklo emlokiked oklooukl jmrjkfksk eulogdl skhk dk `kpkt emlounkpgkl sktu gktk `mlokl hmiks tmtkpd td`kg `kpkt emlyusul ùk gktk `mlokl jkdg, ktku smjkidglyk smarklo klkg eulogdl skhk `kpkt emlounkpgkl smjukf gktk













atat euiut `kl culosd pml`mlokrkl. Gmtmrikejktkl `kl oklooukl jdsk euikd `krd jmltug yklo sm`mrfklk smpmrtd julyd sukrk yklo ’td`kg lareki― (smloku, smrkg) skepkd `mlokl gmtd`kgekepukl ultug emlomrtd ktku emlooulkgkl jkfksk, ktku gmtd`kgekepukl emgkldsem eatardg arki `kike culosdlyk ultug jdnkrk `kl ekgkl.3 Oklooukl pmrgmejklokl krtdguiksd emidputd gmokokikl emlounkpgkl sktu furuc skepkd jmjmrkpk furuc, smrdlo tmrhk`d pmlofdiklokl ktku pmlookltdkl julyd furuc tmrsmjut smfdlook emldejuigkl gmskl nkrk jdnkrklyk smpmrtd klkg gmndi. ^mikdl dtu huok `kpkt jmrupk oklooukl `kike pdtnf, `kike pdtnf, vaiuem ktku gukidtks sukrk. > Kcksdk ykdtu gmfdiklokl gmekepukl ultug emejmltug gktk-gktk ktku gmfdiklokl gmekepukl ultug emlklogkp krtd gktk-gktk smfdlook pmejdnkrkkl td`kg `kpkt jmriklosulo `mlokl jkdg. Klkg-klkg `mlokl kcksdk `d`kpkt emedidgd rdwkykt pmrgmejklokl jkfksk kwki yklo lareki, `kl emedidgd e medidgd alsmt smtmikf trkuek gmpkik ktku oklooukl lmuraiaods ikdl (naltaflyk gmhklo). 0,= Okokp k`kikf oklooukl gmiklnkrkl ktku kjlarekidtks `kike gmnmpktkl ktku drkek jdnkrk. Pmr`kpkt pmlouiklokl sukrk, sugu gktk ktku gktk ktku suktu jiagdlo yklo spksea`dg, jdsk tmrhk`d spksem taldg `krd atat-atat jdnkrk smpmrtd id`kf, jdjdr `kl ikrdlo. Pmr`kpkt gmnml`mrulokl k`klyk rdwkykt okokp `kike gmiukrok. ^mikdl dtu, okokp huok `kpkt `dsmjkjgkl aimf tmgklkl `krd arklo tuk kokr klkg jdnkrk `mlokl hmiks, oklooukl iktmrkidsksd, rksk td`kg t d`kg kekl, `kl gmprdjk`dkl klkg. 0,=

:.:. Jdnkrk `kl Jkfksk pk`k Klkg

Gaeuldgksd k`kikf suktu kikt yklo `doulkgkl aimf eklusdk ultug jmrdltmrkgsd sktu `mlokl yklo ikdllyk `kike jmltug jkfksk. Gaeuldgksd tmrsmjut tmrhk`d jkdg smnkrk vmrjki ekupul lal vmrjki ykdtu `mlokl tuidskl, jknkkl `kl tkl`k













tuidskl, tkl`k omsturki `kl eusdg. Jkfksk huok `kpkt emlnkgup kspmg gaeuldgksd lalvmrjki smpmrtd omstdguiksd, omsturki ktku pkltaede. Omstdguiksd k`kikf mgsprmsd omrkgkl tklokl `kl imlokl ultug emlmgklgkl ekglk wdnkrk. Rkltaede k`kikf smjukf nkrk gaeuldgksd yklo emloujkf gaeuldgksd vmrjki `mlokl kgsd yklo emlnkgup jmjmrkpk omsturki (mgsprmsd omrkgkl yklo emlooulkgkl smtdkp jkodkl tujuf) `mlokl ekglk yklo jmrjm`k jm`k. ; Oklooukl jdnkrk `kl jkfksk k`kikf skikf sktu pmlymjkj oklooukl pmrgmejklokl yklo pkidlo smrdlo `dtmeugkl pk`k klkg. Gmtmrikejktkl jdnkrk k`kikf gmiufkl utkek yklo smrdlo `dnmeksgkl `kl `dgmiufgkl arklo tuk gmpk`k àgtmr. Oklooukl dld smekgdl fkrd tkepkg smekgdl emldlogkt pmskt. Jmjmrkpk ikparkl emlymjutgkl klogk gmhk`dkl oklooukl jdnkrk `kl jkfksk jmrgdskr = „ ;2% ;2% pk`k klkg smgaikf.;,: Rmlymjkj gmtmrikejktkl jdnkrk sklokt jklykg `kl iuks, iuks, oklooukl tmrsmjut k`k yklo rdlokl skepkd yklo jmrkt, euikd `krd yklo jdsk emejkdg fdlook yklo suidt ultug emejkdg. Gmtmrikejktkl jdnkrk culosdalki emrupkgkl pmlymjkj yklo smrdlo `dkiked aimf smjkodkl klkg. Gmtmrikejktkl jdnkrk oaialokl dld jdksklyk rdlokl `kl fklyk emrupkgkl gmtd`kgektklokl culosd jdnkrk pk`k klkg. Rk`k usdk tmrtmltu tmrutkek smtmikf usdk : tkful kgkl emejkdg. Jdik gmtmrikejktkl jdnkrk tmrsmjut jugkl gkrmlk prasms culosdalki ekgk oklooukl tmrsmjut fkrus imjdf `dwkspk`kd gkrmlk jugkl smsuktu yklo rdlokl. ;,> ^mekgdl `dld eml`mtmgsd gmtmrikejktkl jdnkrk, ekgk smekgdl jkdg gmeulogdlkl pmeuidfkl oklooukl tmrsmjut. Jdik gmtmrikejktkl jdnkrk tmrsmjut lalculosdalki ekgk fkrus nmpkt `dikgugkl stdeuiksd `kl dltmrvmlsd pk`k klkg tmrsmjut. @mtmgsd `dld gmtmrikejktkl jdnkrk fkrus `dikgugkl aimf smeuk dl`dvdù yklo tmridjkt `kike pmlkloklkl klkg. Gmodktkl `mtmgsd `dld dld emidjktgkl arklo tuk,













`kl 3% gmtmrikejktkl jkfksk). Okokp tmrhk`d 0-=% pk`k usdk >-= tkful `kl ;% pk`k usdk rmekhk. Ikgd-ikgd `dd`mltdcdgksd emedidgd oklooukl jdnkrk `kl jkfksk fkepdr ùk gkid imjdf jklykg `krdpk`k wkldtk. ^mgdtkr >-3% klkg usdk smgaikf emedidgd oklooukl jdnkrk `kl jkfksk tklpk omhkik lmuraiaod, sm`klogkl pk`k usdk prksmgaikf prmvkimlsdlyk imjdf tdlood ykdtu smgdtkr ;=%. Emlurut pmlmidtdkl klkg `mlokl rdwkykt sasdki mgalaed yklo imekf emedidgd dlsd`ml oklooukl jdnkrk `kl jkfksk yklo imjdf tdlood `krdpk`k klkg `mlokl rdwkykt sasdki mgalaed emlmlokf gm ktks. ;,> Emlurut Lktdalki Emlurut Lktdalki Nmltmr car Fmkitf ^tktdstdns, ^tktdstdns , jmr`kskrgkl ikparkl arklo tuk (`diukr oklooukl pml`mlokrkl `kl nmikf pkiktue), klogk gmhk`dkl oklooukl jdnkrk k`kikf 2.4% pk`k klkg `djkwkf usdk = tkful `kl ;.40% pk`k klkg usdk =-;0 tkful. @krd fksdi mvkiuksd iklosulo tmrfk`kp klkg usdk smgaikf, klogk gmhk`dkllyk >.6 gkid imjdf tdlood `krd yklo jmr`kskrgkl fksdi wkwklnkrk. Jmr`kskrgkl fki dld, `dpmrgdrkgkl oklooukl jdnkrk `kl jkfksk pk`k klkg k`kikf smgdtkr 0-=%. :

:.0. Klktaed

Rk`k smjkodkl jmskr eklusdk krmk jkfksk tmrimtkg pk`k fmedscmr smrmjrd gdrd. Pmr`kpkt mepkt krmk jkfksk smnkrk galvmlsdalki ykdtu ùk krmk jkfksk rmsmptdc `kl ùk ikdllyk k`kikf mgsmgutdc yklo emlofksdigkl jkfksk. @uk krmk rmsmptdc jmrfujulokl mrkt `mlokl zalk jkfksk smltrki. Krmk rmsmptdc jmrculosd emloktur pmrsmpsd jkfksk yklo `dunkpgkl, ykdtu krmk :: pastmrdar yklo `dsmjut krmk _mrldngm `kl odrus Fmsnfis (krmk 0; `kl 0:). Krmk yklo emloktur pmrsmpsd jkfksk tuidskl emlmepktd odrus klouius (krmk >4) pk`k iajus pkrdmtki dlcmrdar kltmrdar tmrfk`kp krmk rmsmptdc vdsuki. Odrus suprk ekrodlki yklo tmrimtkg `d kltkrk puskt jkfksk ku`dtard `kl vdsuki `kl krmk tmeparki dlcmrdar yklo tmrimtkg `d kltmrdar gartmgs ksasdksd vdsuki gmeulogdlkl k`kikf jkodkl `krd zalk jkfksk smltrki huok. Krmk-krmk dld tmrimtkg













Krmk pmlmrdekkl vdsuki `kl saektasmlsard tmrdltmorksd pk`k iajus pkrdmtki, sm`klogkl pmlmrdekkl ku`dtard tmrimtkg `d iajus tmeparki. ^mrkt pml`mg, emlofujulogkl krmk Jrank `mlokl gartmgs Zaikl`d jkwkf yklo emlodlmrvksd arokl jdnkrk, atat jdjdr, id`kf, ckrdlos `kl ikrdlos. Krmk emluids Mxlmr huok tmrdltmorksd `mlokl arokl eatar ultug atat tklokl. Krmk jkfksk pmrdsyivdkl huok tmrfujulogkl `mlokl strdktk `kl tfkikeus `kl krmk garmspal`mlsd pk`k fmedscmr lal àedlkl emikiud garpus gkiasue `kl gaedsurk kltmrdar.

Okejkr ;. Krmk Jrank `kl _mrldngm. ?

Pdok culosd `kskr atkg k`kikf culosd pmlokturkl, prasms `kl careuiksd.Culosd pmlokturkl jmrtklooulo-hkwkj ultug tdlogkt mlmrod `kl talus gartmgs smnkrk gmsmiurufkl. Culosd prasms jmriagksd `d jmikgklo gartmgs, emloaltrai klkidsk dlcareksd, pmloga`mkl `kl pmlydepklkl. Gartmgs yklo imjdf tdlood jmrtklooulo hkwkj ultug emeprasms rklosklokl smlsard smpmrtd rklosklokl aptdg, kgustdg `kl aickgtard. @ktk `krd tdkp suejmr `dokjulogkl `mlokl suejmr smlsard ikdllyk ultug `dklkidsk `kl `dcareuiksdgkl. Rrasms careuiksd jmriagksd pk`k iajus craltki, jmrtklooulo hkwkj ultug careksd dltmlsd `kl pmrdikgu. Culosd

k`kikf















fmedcmr gklkl. Jmikhkr huok emrupkgkl suktu ckgtar, tmrhk`d jklykg pmromsmrkl `krd gdrd gm gklkl (sfdctm` sdldstrki). sdldstrki). Rk`k smjkodkl klkg tmrhk`d pmromsmrkl gm gklkl fmedscmr `d usdk eu`k, `kl emlhk`d jmrtklokl gd`ki. 3

:.=. Rrasms Cdsdaiaod Jdnkrk

Emlurut jmjmrkpk kfid gaeuldgksd, jdnkrk k`kikf gmekepukl klkg ultug jmrgaeuldgksd `mlokl jkfksk arki (euiut) yklo emejutufgkl gaejdlksd yklo smrksd `krd sdstme lmuraeusguikr ultug emlomiukrgkl calksd `kl krtdguiksd sukrk. Rrasms jdnkrk emidjktgkl jmjmrkpk sdstme `kl culosd tujuf, emidjktgkl sdstme pmrlkpkskl, puskt gfusus pmloktur jdnkrk `d atkg `kike gartmgs smrmjrd, puskt rmspdrksd `d `kike jktklo atkg `kl strugtur krtdguiksd, rmsalklsd `krd euiut smrtk ralook fdùlo. >,4 Pmr`kpkt : fki prasms tmrhk`dlyk jdnkrk, ykdtu prasms smlsards `kl eatards. Kspmg smlsards emidputd pml`mlokrkl, pmloidfktkl, `kl rksk rkjk jmrculosd ultug emekfked kpk yklo `d`mlokr, `didfkt `kl `drksk. Kspmg eatardg ykdtu emloktur ikrdlo, kikt-kikt ultug krtdguiksd, tdl`kgkl krtdguiksd `kl ikrdlo yklo jmrtklooulo hkwkj ultug pmlomiukrkl sukrk.3,4 Rk`k fmedscmr àedlkl atkg ktku sdstme susulkl skrkc puskt tmr`kpkt puskt puskt yklo emloktur emgkldsem jmrjkfksk ykgld ùk puskt jkfksk rmsmptdc krmk 0;













`djkltu aimf kidrkl u`krk `krd pkru-pkru, sm`klogkl julyd `djmltug aimf omrkgkl jdjdr, id`kf `kl pkiktue (iklodt-iklodt). Hk`d ultug prasms jdnkrk `dpmriugkl gaar`dlksd sdstme skrkc eatards `kl smlsards `deklk arokl pml`mlokrkl sklokt pmltdlo.6,4

]eur

Jkfksk rmsmptdc (jkfksk pksdc)

Jkfksk mgsprmsdc (jkfksk kgtdc)

(juikl) ;

Gmodktkl tmrfmltd kgdjkt sukrk

Sagkidsksd yklo eksdf smejkrklo, tmrutkek furuc fdùp

:

Pkepkg

eml`mlokr

unkpkl

Pkl`k-tkl`k vagki yklo emlulhuggkl

pmejdnkrk, `kpkt tmrsmlyue pk`k pmrkskkl smlklo, smlyue sasdki pmejdnkrkkl >

Emidfkt gmkrkf pmejdnkrk

Pmrsmlyue smjkokd hkwkjkl tmrfk`kp pmejdnkrk

0

Emejmrd tklookpkl yklo jmrjm`k tmrfk`kp

sukrk

Hkwkjkl vagki tmrfk`kp rklosklo

jmrlk`k sasdki

ekrkf/smlklo =

Jmrmkgsd lkeklyk

tmrfk`kp

pkloodikl Euikd emldru sukrk













;=

pmrtklykkl vmrjki

lkeklyk

Emlomtkfud `kl emlomlkid lkek-

Gktk-gktk

lkek jkodkl tujuf

`dkltkrk gktk-gktk yklo gknku, smrdlo

yklo

jmlkr

tmr`mlokr

`mlokl `dsmrtkd omrkgkl tujuflyk ;6

@kpkt emlomtkfud `kl emlomlkid

Imjdf jklykg emlooulkgkl gktk-gktk

okejkr-okejkr ajhmg yklo su`kf

`krdpk`k

kgrkj

emloulogkpgkl gmdlodlkllyk

`mlokllyk,

hdgk

ajhmg

omrkgkl,

ultug

tmrsmjut `dsmjut lkeklyk :;

Kgkl emlodgutd pmtulhug yklo

Euikd emlogaejdlksdgkl gktk-gktk

jmrurutkl

(eajdi pkpk, ekek jmr`drd)

(kejdi

tapdeu

`kl

imtkggkl `dktks emhk) :0

Emlomtkfud imjdf jklykg gkidekt

Emlymjut lkek sml`drd

yklo imjdf ruedt Pkjmi ;. Rmrgmejklokl Jdnkrk `kl Jkfksk pk`k Klkg Lareki

:

:.3. Ckgtar Zmsdga Oklooukl Rmrgmejklokl Jdnkrk `kl Jkfksk J kfksk

Rmlymjkj oklooukl pmrgmejklokl jkfksk sklokt jklykg `kl iuks, smeuk oklooukl euikd `krd prasms pml`mlokrkl, pmlmruskl depuis gm atkg, atkg, atat ktku













Pmr`kpkt tdok pmlymjkj gmtmrikejktkl jdnkrk tmrjklykg `dkltkrklyk k`kikf rmtkr`ksd emltki, oklooukl pml`mlokrkl `kl gmtmrikejktkl ekturksd. Gmtmrikejktkl ekturksd dld smrdlo huok `dsmjut gmtmrikejktkl jdnkrk culosdalki. Gmtmrikejktkl jdnkrk culosdalki emrupkgkl pmlymjkj yklo nugup smrdlo `dkiked aimf smjkodkl klkg. Gmtmrikejktkl jdnkrk culosdalki smrdlo huok `ddstdikfgkl gmtmrikejktkl ekturksd ktku gmtmrikejktkl pmrgmejklokl jkfksk. Gmtmrikejktkl jdnkrk oaialokl dld `dsmjkjgkl gkrmlk gmtmrikejktkl ekturdtks (gmektklokl) `krd prasms skrkc puskt yklo `djutufgkl ultug emepraùgsd gmekepukl jdnkrk pk`k klkg. Oklooukl smpmrtd dld smrdlo `dkiked aimf ikgd-ikgd `kl smrdlo tmr`kpkt rdwkykt gmtmrikejktkl jdnkrk pk`k gmiukrok. Jdksklyk fki dld emrupkgkl gmtmrikejktkl jdnkrk yklo rdlokl `kl praolasdslyk jkdg. Rk`k ueuelyk gmekepukl jdnkrk kgkl tkepkg emejkdg smtmikf emeksugd usdk : tkful. Pmr`kpkt pmlmidtdkl yklo emikpargkl pml`mrdtk `mlokl gmtmrikejktkl dld, gmekepukl jdnkrk skkt eksug usdk smgaikf kgkl lareki smpmrtd klkg ikdllyk. @kike gmk`kkl dld jdksklyk culosd rmsmptdc sklokt jkdg `kl gmekepukl pmemnkfkl ekskikf vdsua-eatar klkg `kike gmk`kkl lareki. Klkg fklyk emlokiked oklooukl pmrgmejklokl rdlokl `kike culosd mgsprmsdc. Ndrd gfks ikdl k`kikf klkg td`kg emlulhuggkl gmikdlkl lmuraiaods, oklooukl pml`mlokrkl, oklooukl gmnmr`kskl `kl oklooukl psdgaiaods ikdllyk. ;,:,;2













Ekskikf pml`mlokrkl

Rmrgmejklokl tmrikejkt

klkg

pmrgmejklokl jkfksk

Galomldtki

Pmrikejkt/oklooukl pmreklml

jdnkrk

yklo

@d`kpkt

Pmrikejkt/oklooukl pmreklml

jdnkrk

yklo

Rmrgmejklokl ikejkt

Pmrikejkt jdnkrk

Rmrgmejklokl ikejkt, Pmrikejkt jdnkrk tmtkpd eksdf `kike jktks rktk-rktk Zmtkr`ksd emltki

Nknkt jkwkkl

Gmruskgkl atkg

Rkstd tmrikejkt jdnkrk

Rkiktasnfdzds

Pmrikejkt `kl oklooukl gmekepukl jdnkrklyk

^dl`rae @awl

Gmekepukl jdnkrkyk imjdf rml`kf

Gmikdlkl lmuraeusguikr

Emepmlokrufd gmekepukl emlodskp, emlmikl, emloulykf, `kl kgfdrlyk tdejui oklooukl jdnkrk `kl krtdguiksd smpmrtd `dskrtrdk















Rmrgmejklokl jkfksk yklo ikejkt `kpkt jmrsdckt ckedidki. Aimf gkrmlk dtu fkrus `dnkrd `kike gmiukroklyk kpkgkf k`k yklo emlokiked gmtmrikejktkl jdnkrk huok. @dskepdlo dtu gmikdlkl jdnkrk huok imjdf jklykg pk`k klkg ikgd-ikgd `krdpk`k pmrmepukl. Fki dld gkrmlk pk`k pmrmepukl, ekturksd `kl `kl pmrgmejklokl culosd vmrjki fmedscmr gdrd imjdf jkdg. ^m`klogkl pk`k ikgd-ikgd pmrgmejklokl fmedscmr gklkl yklo imjdf jkdg, ykdtu ultug tuoks yklo kjstrkg `kl ememriugkl gmtmrkepdikl.: ^m`klogkl K`ke @E, emloktkgkl jkfwk oklooukl jdnkrk pk`k klkg `kpkt `dsmjkjgkl aimf gmikdlkl `djkwkf dld8 : ;. Idlogulokl sasdki klkg. Dltmrkgsd kltkr pmrsalki emrupkgkl `kskr `krd smeuk gaeuldgksd `kl pmrgmejklokl

jkfksk.

Idlogulokl

yklo

td`kg

emlymjkjgkl oklooukl jdnkrk `kl jkfksk pk`k k lkg.

emlùgulo

kgkl













ultug jmrjdnkrk, julyd ikrdlo, pmejmltugkl julyd ultug krtdguiksd jdnkrk emikiud kidrkl u`krk imwkt ikrdlo, ckrdlo `kl ralook euiut.

:.?. Giksdcdgksd `kl Omhkik Oklooukl Jdnkrk

Pmr`kpkt jmreknke-eknke giksdcdgksd `dscksdk, tmrokltulo `krd nkrk emrmgk emekl`klo. Gmjklykgkl sdstme giksdcdgksd jmr`kskrgkl ktks ea`mi dlput-autput. Jmjmrkpk tmikf `d`mcdldsdgkl `mlokl emlooulkgkl tms yklo tmikf `dstkl`krdsksd. K`k yklo emlooulkgkl ea`mi yklo `d`kskrd pml`mlokrkl k`k k`k puik yklo jmr`kskrgkl pktacdsdaiaod tmrhk`dlyk `dscksdk.:

Zdlokl

Gmtmrikejktkl kgudsdsd `krd julyd @dsikidk gktk-gktk, jkfksk lareki













>. : `mcdsdt jkfksk yklo imjdf jmrkt -

oklooukl imgsdgki-sdltkgsds

-

oklooukl smekltdg-prkoektdg

Klkg `mlokl `dscrkgsdk vmrjki (kcrkgsdk vmrjki ktku oklooukl pmrgmejklokl jdnkrk mgsprmsdc) emlomrtd smokik smsuktu yklo `dgktkgkl pk`klyk, emrmgk imjdf smrdlo emlulhug `krdpk`k jdnkrk. Jklykg yklo emepulykd rdwkykt prmektur, jmjmrkpk eml`mrdtk `dscrkgsdk araeatar (klkg dld emlomiukrgkl kdr idur `kl emepulykd gmsuidtkl emlodgutd omrkgkl euiut). Hdg emrmgk jdnkrk, imjdf jklykg emlomiukrgkl sukrk vagki `mlokl oklooukl pmlounkpkl galsalkl. Klkg-klkg dld smtmikf `mwksk emlhk`d kcmedk. Klkg `mlokl `dscrkgsd vmrjki gk`klo-gk`klo `dsmrtkd `mlokl oklooukl tdlogkf ikgu (kutdsem). Zmfkjdidtksd pk`k klkg dld imjdf ememriugkl tmrkpd wdnkrk yklo dltmlsdc. : Jmjmrkpk klkg jdnkrk `mlokl gktk-gktk `kl crksm yklo suidt `demlomrtd,













`kl td`kg emlofdl`kr ultug jmrjdnkrk. Omhkiklyk smpmrtd arklo `mwksk `mlokl kcksdk galùgsd, `deklk emrmgk kgkl jmrfmltd jdnkrk smjmltkr ultug emlmeugkl gktk-gktk yklo tmpkt. Jdksklyk arklo tuklyk kgkl emejkltu ultug emlmeugkl gktk-gktk yklo tmpkt. Klkg dld jdksklyk jdnkrk `mlokl emlooulkgkl gkidekt-gkidekt yklo pml`mg pk`k ueurlyk.tmrkpd jdnkrk kgkl emejkltu emiktdf klkg emlnkrd gktk-gktk yko tmpkt pk`k skkt jdnkrk, tmtkpd praolasds smiklhutlyk eksdf jmiue jklyk `dgmtkfud. : Jmjmrkpk klkg k`k yklo jdnkrklyk iklnkr `kl `kpkt emlooulkgkl gktk-gktk yklo tmpkt, tmtkpd emrmgk jdnkrk tklpk fmltd emlomlkd sktu tapdg. Emrmgk td`k gemlomrtd tktk jkfksk. Omhkiklyk edrdp oklooukl jdnkrk pk`k klkg `mlokl fd`rasmckius aimf Zkpdl `kl Kiiml dsmjut oklooukl smekltdg prmoektdg . Klkg dld pk`k ueuelyk eml`mrdtk oklooukl fujulokl sasdki `kl `d`dkolasds smjkokd oklooukl pmrgmejklokl pmrvksdc. Emrmgk pulyk sm`dgdt tmekl smjkyk `kl td`kg pmrlkf eku jmikhkr kturkl pmrekdlkl `kl `dpmriugkl psdgaiao `kl kfid tmrkpd tdlogkf













;;. pk`k ;;. pk`k usdk >3 juikl td`kg jdsk jmrtklyk `mlokl emlooulkgkl gkidekt tklyk yklo sm`mrfklk ;:. pk`k ;:. pk`k usdk >3 juikl unkpkllyk td`kg `demlomrtd aimf arklo `d iukr gmiukroklyk ;>. pk`k ;>. pk`k usdk >,= tkful smikiu smik iu okoki ultug emlymjutgkl gktk kgfdr (nk ( nk ultg nkt, n kt, jk ultug jkl, `kl ikdl-ikdl) ;0. smtmikf usdk 0 tkful td`kg iklnkr jmrjdnkrk/okokp

:.6. @dkolasds Oklooukl Jdnkrk pk`k Klkg

^mpmrtd pk`k oklooukl pmrgmejklokl ikdllyk, gmsuidtkl utkek `kike `dkolasds k`kikf emejm`kgkllyk `krd vkrdksd pmrgmejklokl yklo lareki. Klkg lareki emepulykd vkrdksd jmskr pk`k usdk skkt emrmgk jmikhkr jmrjdnkrk `kl tmrkepdi jmrjkfksk. Gmtmrikejktkl jmrjkfksk smrdlo `ddgutd gmsuidtkl `kike















:.6.:. Dlstrueml Rmlykrdlo

^mikdl klkelmsds yklo tmidtd, `dskrklgkl `doulkgkl dlstrueml pmlykrdlo ultug emldikd oklooukl pmrgmejklokl jkfksk. Edskilyk Mkriy Edskilyk Mkriy Ikloukom Edimstalm ^nkim (Napikl `kl Oimksal), ktku @mlvmr @mvmiapemltki ^nrmmldlo Pmst ktku Zmnmptdvm-Mxprmssdvm Memromlt Ikloukom ^nkim. Mkriy Ikloukom Edimstalm ^nkim nugup smlsdtdc `kl spmsdcdg ultug emlod`mltdcdgksd oklooukl jdnkrk pk`k klkg













Zmspalsm Ku`daemtry) Ku`daemtry) emrupkgkl nkrk pmlougurkl mvagm` patmlsdki (kgtdvdtks idstrdg yklo `dfksdigkl skrkc SDDD, puskt-puskt lmurki `kl trkgtus `d `kike jktklo atkg) smjkokd rmspal tmrfk`kp stdeuius ku`dtardg. Rmemrdgskkl ku`daemtrdg `ddl`dgksdgkl ultug klkg-klkg yklo sklokt gmndi `kl ultug klkg-klkg yklo gmtkhkekl pml`mlokrkllyk tkepkg tmrokloou. K`k 0 gktmoard pmlougurkl `mlokl ku`daemtrdg8

k)

Ku`daemtrd tdlogkf ikgu, emrupkgkl pmemrdgskkl pk`k klkg yklo `dikgugkl













`dpmriugk. ^grdldlo tmrfk`kp pmlykgdt-pmlykgdt emtkjaidg jkru `dikgugkl gkiku tmr`kpkt gmnurdokkl gm krkf dtu, gkrmlk pmemrdgskkl dtu sklokt ekfki. :

:.6.3. Galsuitksd

Rmemrdgskkl `krd psdgaiao/lmurapsdgdktmr klkg `dpmriugkl hdgk k`k oklooukl jkfksk `kl tdlogkf ikgu. Rmemrdgskkl dld emidputd rdwkykt `kl tms jkfksk, gmekepukl gaoldtdc `kl tdlogkf ikgu. Pms dltmimomlsdk `kpkt `dpkgkd smjkokd













^mnkrk ueue, klkg kgkl jmruskfk ultug imjdf jkdg skkt arklo `mwksk emrmspal kpk yklo `dunkpgkllyk tklpk emlmgkl klkg ultug emlounkpgkl sukrk ktku gktk tmrtmltu. ^mjkokd eatdvksd gmtdgk smarklo klkg jmrjdnkrk sktu gktk smnkrk hmiks, pml`mlokl smjkdglyk emrmspal emr mspal tklpk pkgskkl `mlokl emepmriuks emepmr iuks fdlook ùk gktk. ;, : Pdl`kgkl gurktdc pmlktkikgsklkkl oklooukl jdnkrk `kl jkfksk pk`k klkg `dsmsukdgkl `mlokl pmlymjkj gmikdlkl tmrsmjut. Rmlktkikgsklkkl `kpkt emidjktgkl













Rmrgmejklokl tmrikejkt

@d`kpkt

Ealdtar `kl emeulogdlgkl

Rmrgmejklokl ikejkt

Pdlogktgkl stdeuiksd

Rmrgmejklokl ikejkt, Pdlogktgkl stdeuiksd tmtkpd eksdf `kike jktks rktk-rktk Zmtkr`ksd emltki

Ekgsdekigkl patmlsd

ajktd

gkiku















dltmimomlsdklyk lareki pmrgmejklokl jkfksklyk imjdf jkdg `krdpk`k klkg yklo













JKJ DDD













@KCPKZ R]^PKGK













IKERDZKL













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