ISSN 2229-5143
JOURNAL OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION
FACULTY OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION
JOURNAL OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION ISSN : 2229-5143 Volume 1
Number 2
July 2011
CONTENTS Editorial board
ii
Instruction to authors
iii
Editorial
v
Attitudes in Well Siblings of Children with Developmental Disabilities: Prof. S. Venkatesan & Nimisha Ravindran
01-23
Effectiveness of Metronome Training In Children with Developmental Coordination Disorder : Sujata Missal, J.T. Jacob & Sugi
24-32
Current Practices of Special Educators for Students with Intellectual Disability and Hearing Impairment: Shilpa Manogna
33-42
Prevalence of Cognitive Impairment in Senior Citizens: Shakeeb A. Khan
43-52
Importance of Developmental Screening and Assessment: From a Rehabilitation Psychologist's perspective: Binapani M, Keertisudha R, Sunita Devi, & Roma Anand
53-60
Effect of Drama on Learning Social Skills among Children with Mild Intellectual Disability: T.V.Sunish & Dr. A.T.Thressiakutty
61-70
Rating Special Schools for Students with Hearing Impairment in Mumbai: A Study: G. Shivaraju & Prof. R. Rangasayee
71-80
Play Activities to Enhance Gross Motor Skills of Visually Impaired Children: A, Divyapriya & Dr. K.Sambath Rani
81-86
Success Story: A Light unto Oneself and a Lamp unto Others Dr. K.S.Shilpa
87-88
Disability – Bane or Boon: A Spiritual Perspective Swami Anuragananda
89-96
Reviews: Books & documentary film
97-98
JOURNAL OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION Journal of Disability Management and Special Education (JODMSE) is a bi-annual publication of the Ramakrishna Mission Vivekananda Univeristy (RKMVU). The journal publishes original articles in the area of Disability Management and Special Education. It includes research articles, book reviews, success stories of persons with disability, news about conferences, letters to the editors and forthcoming events. The purpose is to promote research in the area of disability rehabilitation. The subscription rates are given below: Single copy: ` 100/-
One year : ` 200/-
Three years: ` 500/-
Mode of payment: Payment should be made by cheque or Demand Draft drawn in favour of the “Ramakrishna Mission Vivekananda University” payable at Coimbatore FORM: IV Statement about ownership and other particulars about Journal of Disability Management and Special Education
1. Place of Publication 2. Periodicity of Publication 3. Printer’s Name Nationality Address
: : : : :
Coimbatore Bi-annual Vidyalaya Printing Press Indian Ramakrishna Vidyalaya Printing Press, SRKV Post, Periyanaickenpalayam, Coimbatore 641 020 4. Chief Editor’s and Publisher’s Name : Dr. A.T.Thressiakutty Nationality : Indian Address Ramakrishna Mission Vivekanada University, Faculty of Disability Management and Special Education, SRKV Post, Periyanaickenpalayam, Coimbatore 641 020 Tel: 0422 2697529, Mobile: 76392 66343 5. Name and addresses of Individuals & : Ramakrishna Mission Vivekananda University, shareholders holding morethan 1% of Faculty of Disability Management and the total capital Special Education, SRKV Post, Periyanaickenpalayam, Coimbatore 641 020 Tel: 0422 2697529 e-mail: jodmse@gmail.com, fdmedu@gmail.com I, Dr. A.T. Thressiakutty, hereby declare that the particulars given above are true to the best of my knowledge and belief. ii
JOURNAL OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION ISSN : 2229-5143 Volume 1
Number 2
July 2011
EDITORIAL BOARD CHIEF ADVISOR Swami Atmapriyananda Vice-chancellor, Ramakrishna Mission Vivekananda University
ADVISORS Swami Atmaramananda Administrative Head, FDMSE, RKMVU
Swami Anuragananda Asst. Administrative Head, FDMSE, RKMVU, Coimbatore
Dr. M. Chandramani Dean, FDMSE, RKMVU, Coimbatore
CHIEF EDITOR Dr. A.T. Thressiakutty Professor, FDMSE, RKMVU, Coimbatore
EDITOR Abhishek Kumar Srivastava Asst. Professor, RKMVU, FDMSE, Coimbatore
EXPERT MEMBERS Dr. Jayanthi Narayan
Dr. N. Muthaiah Principal, College of Education, Ramakrishna Mission Vidyalaya, Coimbatore
Former Deputy Director, NIMH, Secunderabad
Dr. Asmita Huddar Principal, Hashu Advani College of Special Education, Mumbai
Dr. S. Venkatesan
Sri N. Narendiran
Ms. M. Annakodi
Professor, Clinical Psychology, AIISH, Mysore
Asst. Professor, FDMSE, RKMVU, Coimbatore
Audiologist & Speech Pathologist
iii
Instructions for Author(s) The chief editor invites original, scholarly articles and research papers within the aim and scope of the journal, that have not been published previously or submitted elsewhere, and that are not under review for another publication in any medium (e.g. printed journal, conference proceedings, electronic or optical medium) should be submitted to the Chief Editor, Journal of Disability Management and Special Education (JODMSE). A declaration by the author(s) that the paper(s) has/have not been sent elsewhere for publication/presentation is also required. Copyright clearance for material used in the article should be obtained by the author(s). It will be assumed that submission of the article to this journal implies that all the foregoing conditions are applicable. All articles and correspondence related to contribution should be addressed to the Chief Editor, JODMSE on the following e-mail: jodmse@gmail.com
the purpose of the study, the methods followed, main findings (with specific data and their statistical significance if possible), and the major conclusions. Main body of the text: Articles must be concise and usually follow the following word limitations: 1 Research Papers (3000-5000 words normally, 6000-8000 words in exceptional cases) 2 Short communication (1000 – 3000 words) on new ideas/new areas work/ innovation/ action research/ ongoing investigations/ conference and seminar and work shop outcomes. 3 Book reviews (1000-2000 words) Organization of the text: The general organization of research papers should be as follows: 1. Introduction should include important review of relevant studies which leads to the need, scope and objectives of the study. 2. Methodology should include sampling techniques, tool(s)/tool development and details of validation, data collection procedure and scheme of data analysis. 3. Results and discussion. 4. Conclusion. 5. Appendices may be used to amplify details where appropriate. Tables: Tables/figures should be typed at their apt position in the text. There should not be duplication of information by giving tables as well as graphs. Footnotes: Footnotes to the text should be avoided. References: References should be indicated in the text by giving the name of author(s) with the year of publication in parentheses. References should be alphabetically listed at the end of the paper. References should also be in tune with APA style.
Copyright: The authors are responsible for copyright clearance for any part of the contents of their articles. The opinions expressed in the articles of this journal are those of the authors, and do not reflect the objectives or opinion of RKMVU, FDMSE. Peer review: All Contributions submitted will be subjected to peer review. Format: The whole text manuscript must be typed in double space on one side A4 paper (including references) and should have oneinch margin at three sides and wide margin to the left side of the text. Every page should be numbered correctly including the title page. The article should confirm to APA style. Soft copy of the article should be attached and submitted to the above-mentioned e-mail. Title page: This should contain the title of the manuscript, the name of the author and at the bottom the address for correspondence including email ID, the number of authors should not exceed three. Abstract: The second page should contain an Abstract of not more than 150 words, stating iv
From the Desk of Chief Editor JODMSE is taking second step by placing the issue: 2 before its readers with a variety of research articles contributed by various professionals from psychology, occupational therapy, physiotherapy and special education (hearing impairment, visual impairment and Intellectual Disability). While the authors, Bina Pani and team, highlight the importance of developmental screening and assessment for infants at risk, another data based article by Khan brings out the prevalence of intellectual disability among senior citizens. The readers may get enlightened and surprised by analyzing the mysterious facts and risks involved in the life span of a human being. Metronome training for children with Developmental Coordination Disorder, by an author, Sujata from Occupational Therapy, Drama therapy for Children with Intellectual Disability by another author, Sunish from special education, and Play Therapy by the third author, Divya, for motor development in Children with Visual Impairment represent 3 disciplines and three types of innovative intervention strategies. Let us invite you, the readers, to comment and continue further research as a result of your introspection and interest. The current research should not be stopped by itself. Practices in special education with respect to Hearing Impairment and Intellectual Disability, analyzed and interpreted by Shilpa, demand the special educators, not only to be more vigilant, and committed, but also to be more scientific and progressive to fit in to the needs of the 21st century. The rating of special schools for Hearing Impairment authored by Shivaraju, affirms the findings of the study related to practices in special education. These articles invite the management to look in to the quality aspect of rehabilitation services.
v
Another author, Venkatesan, a practicing senior psychologist, proves the role of attitudes of well siblings towards their disability affected siblings in the process of their rehabilitation. The highlight of this article is the extensive data analysis touches every aspect of the area researched. JODMSE calls the attention of readers to reflect on the findings proved by the far-reaching data analysis supporting with national and international references. The success story of an ordinary man, Ramachandran, with physical disability, affirms that every person can inevitably be successful if he/ she be determined from within. Last but not the least, in the continuation of the article, “Disability - Bane or Boon: A Spiritual Perspective”, Swami Anuragananda combines the in-depth analysis of spiritual, philosophical and psychological facts on the basis of past and present human experiences which pave the way to uncover the fundamental realities of disability. It is beyond one’s understanding; but the author has explained it with examples from scriptures as well as day to day life. It is worth to read, think, reflect and share with the parents and persons with disabilities which may transform their lives.... this valuable article is expected to be continued which seldom appears in other journals ...wait for the issue no. 3. The documentary film and book review extends a valuable bit of information which could be used by future researchers. JODMSE expresses its gratitude to all the contributors of issue: 2 and requests the authors of the remaining articles to wait till they appear in the forthcoming issues.
A.T. Thressiakutty, PhD Chief Editor, JODMSE
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Journal of Disability Management and Special Education ISSN: 2229-5143
Attitudes in Well Siblings of Children with Developmental Disabilities *S. Venkatesan & **Nimisha Ravindran
Abstract This cross sectional survey on attitudes in 40 well siblings of children with developmental disabilities uses a need based 'Socio-Demographic Data Sheet' and 'Sibling Attitude Scale' to uncover three key aspects: thought, feeling and action components of respondent attitudes. For overall sample, results indicate mean attitude score of 146.4 out of 180 (60 items; 81.33 %; SD: 10.2) with tilt on the positive side. In terms of well sibling characteristics, females and those with lower education ('class ten or below') and older age (equal/above 18 years) showed more favorable attitude to their affected siblings although the differences were statistically insignificant (p: > 0.05). Well siblings of parents in young age have more favorable attitudes (p: <0.001). Family size is not a significant variable in influencing well sibling attitudes towards their brothers or sisters with developmental disabilities (p: > 0.05). With respect to age of affected child, even though generally positive, trends show well sibling attitudes undergo transformation towards negative direction as their affected sib grow older. The affected children without schooling are the least favored by their well siblings. Irrespective of diagnostic condition in children with disabilities, well siblings report positive attitudes. With associated problems in the affected child, they are viewed less favorably. A domain-and-item analysis and a brief note on psychometric properties of the tool used in this study are given before drawing conclusions (contrary to popular opinion) that the attitudes of well siblings towards their disability affected siblings are not dysfunctional or pathological, but different. Successful adaptation and coping is possible if the focus is made on altering the systems or social milieu surrounding the affected child and the family. Key terms: Attitudes, Siblings, Developmental Disabilities
Introduction Living with a sibling having disability can be rewarding, bewildering, instructive, and stressful experience. Well siblings of a child with disability express a range of emotions and responses similar to siblings with no disability (Powell & Callagher, 1993; Bank and Kahn,
1982). Children react to their affected sibling with feelings of love, empathy, pride, guilt, anger and support. The predominance and prevalence of these reactions have great impact on felt stress and coping ability of the sibling with disability. The positive or negative nature of relationships between siblings and
*Professor & Head, Department of Clinical Psychology, Email: psyconindia@gmail.com or psyconindia@aiishmysore.in **Research Assistant, Department of Clinical Psychology, Email: nimsravi@gmail.com All India Institute of Speech and Hearing, Mysore: 570 006.
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family members are also shaped by factors like family resources, their lifestyle, child-rearing practices, nature and severity of the disability, number of children in the family, age differences between children in the family, other stress-producing conditions that exist in the family, kinds of coping mechanisms and interaction patterns in the family and quality of the support services available in the community (Meyer, Vadasy and Fewell, 1985; O' Connor and Stachowiak, 1971). Each child's reaction to the sibling with disability varies depending on their age and developmental level. Their responses and feelings are unlikely to be static. They change over time as they learn to cope with day-to-day realities. Preschool-aged well siblings, for example, may feel confused, afraid, anxious, and angry about their affected sib's condition (Lobato et al, 1987). All children are different. The intensity of a child's concerns, needs and experiences vary from sibling to sibling, as will a child's reaction to and interpretation of events. The younger children find it more difficult to understand the situation and to interpret events realistically. Well siblings may resent the time their parents give to the affected sib and perceive it as their rejection. They wonder what is wrong with them or that their parents love their affected sibling more. During early years, some well siblings even mimic the physical or behavioral actions of the child with disability, or they regress in behavioral development. Later, they may become prone to extremes of behavior such as "acting out" or becoming the "perfect" child (Cmic and Leconte, 1986; Lamb and Sutton-Smith, 1982; Gralicker, Fishier and Koch, 1962).
differences between their affected sibling and someone else's brother or sister. They may worry about "catching" or developing the problem. They feel guilt because they themselves do not have a disability. They feel protective and supportive of their sibling and this may trigger conflicts with peers. Young adults have future-oriented concerns. They wonder what will become of their affected sibling. They get concerned about how the people they socialize and later marry will accept the brother/sister with a disability. Additional issues faced by young adults include genetic counseling when planning their own families, and coping with anxiety about future responsibilities for the brother/sister with a disability (Damiani, 1999; Deveraux, 1979; Dunlap and Hollingworth, 1977; Gath, 1972). Attitude is a critical hypothetical construct to determine nature, quality, intensity or extensity of sibling relationships. It represents an individual's relatively enduring organization of beliefs, feeling actions, likes or dislikes for an idea, object, event, situation, behavior or person. Attitudes may be positive, negative or neutral. One can have a conflicted, ambivalent or undecided attitudinal stance-meaning that they can simultaneously have positive and negative attitudes toward an object at the same time. Attitudes typically cover three judgmental components: thought (cognition), feeling (affect) and action (behavior). Attitudes can be reformed through techniques like coercive persuasion, emotional appeals, role playing, debating, brainwashing, indoctrination, etc. (Eagly and Shelly, 1993). Review of Literature
Elementary school-aged children feel embarrassed or ashamed as they recognize
Well siblings of individuals with disability have been considered vulnerable to adjustment 2
Venkatesan & Nimisha / Sibling Attitude in Developmental Disabilities
difficulties, behavioral and mental health problems (Caldwell and Guze, 1960). This notion has been perpetuated despite research support for this position being equivocal. Lobato (1983) lamented the absence of wellcontrolled empirical investigations to support the popular view that, as a group, well siblings are adversely affected by their handicapped brothers or sisters. Only certain siblings appear vulnerable to negative reactions, depending on factors like sibling gender, birth order, family socioeconomic status, and parental response to handicapped child. Similar views were reiterated by Cuskelly (1999) after reviewing and discussing some of the methodological shortcomings of earlier sibling research.
Most research has gone into the role relationships, inter-personal behaviors (Brody et al, 1991; Brody and Stoneman, 1986; Borke, 1971), responsibilities (Harland and Cuskelly, 2000), warm th, c onta ct, involvements, interactions (Lobato et al, 1991), competence and adjustments (Hannah and Midlarsky, 1999), felt stress, reported burden or what is labeled as 'parentification' (Chase, 1999), rather than on sibling attitudes per se. 'Parentification' is defined as compelling children to perform the role of parent or teacher at the expense of their own developmentally appropriate needs and pursuits-a common feature of families with a disabled child (Cicirelli, 1976; Miller and Cantwell, 1976; Bennett, 1973).
Many studies have focused on sibling adjustments and cohesive or non-cohesive relationships (Mates, 1990; Atkins, 1989; Dyson, 1989; McHale, Sloan and Simeonson, 1986; Dunn, 1983; Dunn and Kendrick, 1982). Others have elicited knowledge or awareness levels of well siblings on or about the condition of chronic illness or disability (Williams et al, 2002; 2003; Carandang et al, 1979) or on impact of death of a sib with disability (Rodger and Tooth, 2004). Few studies have covered particular aspects of sibling adjustment like selfconcept, pro-social behavior and behavior problems (Lardieri, Blacher and Swanson, 2000) or on specific clinical conditions like Downs syndrome (Gath, 1974), mental retardation (Leanza, 1970), autism (De Myer, 1979), blind (Lavine, 1977), spina bifida (Be llin, Bent ley a nd Sa win, 2009) or phenylketonuria (Pho et al, 2004). There are some studies on enabling sibling attitude change programs (Wiliams et al, 2003; Lobato, 1985; Cash and Evans, 1975; Weinrott, 1974).
On the whole, sibling research shows that disability has a strong impact on the family unit. But, the specific impact on the well sibling is unclear. Some claim that they are adversely affected, others suggest that growing up with a sib having disability offers psychological benefits like increased understanding of others, compassionate tolerance, dedication and altruistic goals, self-concept, maturity, humanitarian concerns and careers, sense of closene ss in fam ily, self conf idence, independence, etc. (Lobato et al, 1987; Lobato, 1983; Cleveland and Miller, 1977; Grossman, 1972). On the darker side, risks identified include anxiety, depression, aggression, poor peer relationships, and school difficulties (Fisman et al, 2000; Breslau, 1982; Brerslau et al, 1981; Gayton et al, 1977; Mc Andrew, 1976; Gath, 1973). The factors found to influence sib relationships and well being are communication or information (Gold, 1993), family supports or connections (Judge, 3
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1998; Kornblatt and Heinrich, 1985; Byrne and Cunningham, 1984), family roles and balances (Bat-Chava and Martin, 2002; Siegel and Silverstein, 1994; Hannah and Midlarsky, 1985; Bresla u et al, 1981), fam ily characteristics like their size, socioeconomic status, gender, ordinal position of affected or unaffected sib, culture, etc. Evidently, sibling studies exclusively on their attitudes towards their affected brothers or sisters are meager even in the west (Cleveland and Miller, 1977; Senel and Akok, 1996; Wilson, Mc Gillivray and Zetlin, 1992), while such investigations are almost unheard of in the Indian scene (Peshawaria et al, 1995). In a recent review on the subject (Dew, Balandin and Llewellyn, 2008), argued vehemently that previous researc h studies suff ered seve ral methodological shortcomings, had few control groups, selection bias and/or made use of poorly standardized instruments.
hostile detachment, and physical cruelty; (b) companionship, active helpfulness, and teac hing; and, (c) possessiveness and dependency have been isolated. This 4-point rating is scored as 'very much like' (4 marks) to 'not at all' (scored 1). Sample items in the inventory are: 'doesn't want me around', 'helps me if s/he can', 'expects me to be always with him/her', etc. Reliability of SBI is not reported. Vignes et al (2008) reviewed instruments measuring at least one of the three components of children's attitudes (affective, behavioral, or cognitive) t owards pe ers/siblings with disabilities in t erms of their conte nt, administration and psychometric properties like appropriateness, acceptability, validity, reliability, internal consistency, and test-retest reliability. Of the 19 instruments matching the inclusion criteria, 16 measured only one att itude component (af fective, n=4; behavioral, n=5; cognitive, n=7); one measured cognitive and behavior components. Only two of them, namely, 'Acceptance Scale' (Voeltz, 1982; 1980) and 'Chedoke-McMaster Attitudes Towards Children with Handicaps Scale' [CATCH](Mc Doughall et al, 2004, Alderfer et al, 2001; Tirosh et al, 1997; King et al, 1989; Armstrong et al, 1987; Rosenbaum et al, 1986) measured all three components and had adequate psychometric properties. Many of these instruments were developed in 1970s or 80s and do not cover some aspects relevant to current culture, although they are still being used in research. Other available scales include: 'Adjective Checklist' (Siperstein, 2006), and 'Peer Attitudes towards the Handicapped Scale' (PATHS)(McGregor and Forlin, 2005). It must be also noted that most of these attitude scales do not focus on siblings
Among the few research tools available for measurement of attitudes towards sibs affected by a disability, the 'Sibling Behavior Inventory' (SBI) (Aaronson and Schaefer, 1973) measures school aged sib relationship with each other. It is standardized on a sample of 185 children in elementary school. This 115item Likert scale consists of 23 primary constructs like posit ive relationship, conscie ntiousness, ac tive helpf ulne ss, possessiveness, argumentativeness, trouble making, teaching dominance, withdrawal, respecting autonomy, rivalry, physical cruelty, confiding, submission, mental cruelty, negative relationship, companionship, leadership, hostile deta chment, de pendency and acceptance. Three primary dimensions determined by factor analysis: (a) detachment, 4
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of children with disabilities per se. They are more related to peers, friends, or other children. Against this background of rather unresolved issues, unanswered questions and unknown situation especially in our country, the present study seeks to explore the degree, extent, direction or types of attitudes in well siblings of children with disabilities in relation to certain associated variables like sibling, parent, family as well as the disability affected child characteristics.
identified disability was 15.73 years (SD: 7.07). This implies that the well sibs were on an average elder to their disability affected brothers and sisters. The sample of well siblings included 15 males (Mean Age: 16.07; SD: 4.56) and 25 females (Mean Age: 18.72; SD: 6.97); and affected sample had 26 males (Mean Age: 15.65; SD: 6.47) and 14 females (Mean Age: 15.86; SD: 8.33). In case of multiple unaffected sibship (wherein disability affected child has two or more well siblings), the individual pairings were taken as one unit sample for the purpose of this study. Siblings separated at a young age, those staying with relatives or in hostels as well as those merely on weekend home visits were excluded from the sample in this study.
METHOD Sample A cross sectional exploratory survey design combined with use of random sampling techniques was used in this investigation. The overall sample comprised of 40 sib pairings of well siblings along with their brothers/sisters diagnosed or identified as having one or more of the recognized primary disabilities including mental retardation, locomotion or sensory impairments, with or without associated problems. The operational definition for 'disability' as used in this study follows the official classification under the 'Persons with Disabilities (Equal) Opportunities, Protection of Rights & Full Participation Act' (1995) and/ or 'The National Trust for Welfare of Persons wit h Aut ism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act' (1999) in Indian context. All chosen siblings for this study were resident members of their natural home settings and had continually lived together under the same roof as one family along with their parents or extended family members as the case could be. The mean chronological age of well siblings was 17.73 years (SD: 6.25) and those of children with
Tools A socio-demographic sheet exclusively prepared for purpose of this study was used to gather information on age, gender, residence, education, and other parent, sibling or family details, along with another section on the affected child with disability including their age, gender, schooling, diagnosis, associated problems (if any), etc . Ba sed on a comprehensive review of the 'attitude scales' already mentioned; and also, by taking into account local cultural factors regarding gender and family relationships to assess sibling attitudes, a need-based 60-item individually administered paper-pencil 'Sibling Attitude Scale' (SAS) was exclusively developed for the purpose of this study. It covered a ten-point intensity rating visual analogue scale for each statement which corresponded as score of 'five' being the mid point (meaning 'sometimes'), 5
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'one' being lowest extreme (meaning 'almost never') and 'ten' being highest extreme of attitudinal valence (meaning 'almost always'). The ten-point intensity rating scale was rendered collapsible eventually into a three score scale as 'one', 'two' or 'three' in order to prevent contamination by extremes of the decile scale. The subjects were instructed to read or understand each statement before deciding on the direction of their rating either as 'never', 'sometimes' or 'always' respectively.
sib' (32F), 'I feel embarrassed to be in the company of my disabled sib especially in public places' (29F), etc. Some examples of 'action/ behavior' related items in the scale are: 'I have deliberately reduced interactions with my affected sib so that I do not develop such problems' (15A), 'I usually avoid inviting people home' (9A), 'I refuse to play with my affected sib because s/he does not understand the game' (6A), etc.
The 60-item SAS is further sub-divisible into three aspects of attitude measure: (i) Thought-Cognitive; (ii) Feeling-Conative; and, (iii) Action-Behavioral. There are 14 items each in these three domains totaling to 42 items. Additionally, the scale has 6 x 3: 18 items designated as 'Lie' scorers intended to spot repetitive socially desirable or faking answers (if any) given by respondents. Evidently, the maximum score possible for any subject on 'whole scale' (60 x 3: 180) including the 'main scale' (42 x 3: 126) and 'lie scale' (18 x 3: 54). Higher the scores, the more positive is respondent attitude towards the affected sibling with disability. Some sample items in the scale under 'thought' are: 'I get insecure thinking of the future guardianship of my affected sib' (13T), 'I am irritated at the thought of my affected sib being unable to do things which my cousins or the sibs of my friends can do' (22T), 'I shudder to think what would happen if my sib's problem is hereditary and that it might affect my future family and children too' (31T), etc. A few examples of 'feeling' related items under SAS are: 'I feel lonely at home since I do not have anybody to share my personal problems' (35F), 'I feel that some of my relatives avoid me because of my affected
Data on respondent choices to individual items on 'Sibling Attitude Scale' was collected along with their socio-demographic details individually. Wherever respondents had difficulty in comprehending the statements, expansions and explanations were given for clarification. The collected data as raw scores on respondent attitudes and their directional valence as well as intensity ratings were compiled and subjected to statistical analysis by using SPSS/PC (George and Mallery, 2003).
Procedure
RESULTS AND DISCUSSION Results of the present study on the profile of attitudes of well siblings of children with developmental disabilities are presented sequentially but separately under the following headings: (a) overall sample; (b) sibling, parent and family characteristics; (c) characteristics of affected children; (d) domain, content and item analysis; and, (e) psychometric properties of SAS. (a) Overall Sample For overall sample (N: 40), the mean attitude raw score of 146.4 out of 180 (60 items; 81.33 %; SD: 10.2) appears to be tilted on the positive side. When studied 6
Venkatesan & Nimisha / Sibling Attitude in Developmental Disabilities
separately for 'main items', the mean attitude raw score is 103.5 out of 126 (42 items; 82.14 %; SD: 8.0), which is also on a positive side. With regard to the repeated 'lie items', the mean attitude raw score is 43.8 out of 54 (18 items; 81. 11 %; SD: 6.7), whic h is again in congruence with the 'main items' (Table 1. See page 8 & 9). In a related study, Senel and Akok (1996) examined effects and attitudes on normal children of the presence in the family of siblings with disabilities by using 'Attitude towards Disabled Person Scale'. They found no significant differences in attitudes between well siblings of children with disabilities and siblings of normal children even in relation to associated variables like gender, family size and educational levels. (b) Sibling, Parent Characteristics
and
When regard to level of education for well sibling, those in 'class ten or below' (N: 18; Mean Score: 149.6; SD: 6.6) show more favorable attitudes than those in 'above class ten' (N: 22; Mean Score: 143.6; SD: 12.0) towards their brothers or siste rs with developmental disabilities although these differences are again not statistically significant (F: 1.236; p: 0.273). Nevertheless, within group differences are found for education variable on 'main items' in the group of well siblings for, both, 'above class ten' (F: 3.338; p: 0.042) and on 'lie items' for 'class ten or below' (F: 16.336; p: 0.001) as well as 'above class ten' (F: 12.575; p: 0.001) respectively (Table 2 See page 11). Lobato et al (1987) examined psychosocial characteristics of preschool-aged siblings of handicapped children against matched control group of siblings of nonhandicapped children to find no statistically significant differences on measures of perceived self-competence and acceptance, understanding of developmental disabilities, empathy, and child care responsibility. In another related study, Lobato et al (1991) found siblings of handicapped children engaged in more parallel and social play and were more nurturing with their siblings than were control children. Rossiter and Sharpe (2001) attempted to quantitatively integrate 25 studies and 79 effect sizes from the literature on siblings of individuals with mental retardation. A small negative effect for having a sib with mental retardation was attributed to a publication bias or some other artifact. This negative effect was greatest for direct observa tion measures, measures of psychologica l functioning, especia lly
Family
In relation to gender of well sibling, females in this sample (N: 25; Mean Score: 147.2; SD: 11.0) show slightly more favorable attitudes than males (N: 15; Mean Score: 144.8; SD: 8.7) even though these differences are not statistically significant (F: 0.518; p: 0.476). However, within the males, there are significant differences for scores on, both, the 'main items' (F: 5.170; p: 0.010) as well as the 'lie items' (F: 11.509; p: 0.001) (Table 2). With regard to age of well sibling, older sibs (equal or above 18 years) (N: 19; Mean Score: 144.4; SD: 10.1) show less favorable attitude than younger sibs (below 18 years) (N: 21; Mean Score: 148.0; SD: 10.3) of children with developmental disabilities although the differences are statistically insignificant (F: 1.241; p: 0.272). Within the older unaffected sibs, statistically significant differences are seen only for scores on 'main items' (F: 4.900; p: 0.011). 7
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depression, and for children. Limitations to this meta-analysis and directions for future research were discussed. In the present study, younger age of parents, particularly, within group statistically significant differences are noticed as more favorable attitudes in well siblings of, both, paternal (above 50 years) (F: 4.980; p: 0.011 and F: 14.571; p: 0.001) and maternal (above 50 years) (F: 5.655; p: 0.007 and F: 12.195; p: 0.001) groups of respondents. Family size does not emerge as significant variable in influencing well sibling attitude towards their brothers or sisters with developmental disabilities (p: > 0.05) (Table 2 See page 11). Thus, unaffected females, younger (below 18 years) and those in 'class ten or below' well siblings show in general more favorable attitudes than their male, older (above 18 years) and those 'above class ten' counterparts. Lobato et al (1991) report mothers are more likely to deliver commands, directives, and reprimands to siblings of handicapped children than to other children. (c) Characteristics of Affected Children The analysis of well sibling attitudes in relation to characteristics of the affected child, shows that there are within group statistically significant differences in the former only with regard to 'core items' on their affected males (F: 3.052; p: 0.053) and 'lie items' on their affected females (F: 11.970; p: 0.001). This implies that well siblings of affected males are a heterogeneous group with some having more positive attitudes and others less. With respect to age variable of affected child, it is seen that although the attitudes of well siblings are generally positive, there are statistically 10
significant within group differences in their attitudes as the affected child grows older (equal or above 18 years) (F: 4.899; p: 0.013 and F: 11.790; p: 0.001). The same trend is also reflected upon a closer look at the attitudinal 'raw scores' of well siblings showing a graded decrement from affected children below 12 years (N: 11; Mean: 105.4; SD: 6.5) to affected children between 13-17 years (N: 16; Mean: 103.1; SD: 9.8) and finally to lowest scores for affected persons above 18 years (N: 13; Mean: 102.1; SD: 6.7). Probably, sibling attitudes undergo changes as their affected sibs grow older (Tables 3 & 4 See Page 12, 13 & 14). In relation to education variable of affected sib, although no statistically significant differences are noted for the overall positive attitude scores of well siblings, it is seen that those affected children who attend 'special schools' are taken more favorably (N: 11; Mean: 143.4; SD: 10.0) than children who are in 'regular school' (N: 26; Mean: 147.2; SD: 10.8) and/or those who do not go to any school (N: 3; Mean: 148.7; SD: 3.1). Evidently, affected children who attend 'special schools' show statistically significant within group differences (F: 3.539; p: 0.042; and F: 10.604; p: 0.001) as compared to no such trends in the other educational groups of the affected children with developmental disabilities. The analysis of trends for sibling attitudes in relation to diagnostic condition of the affected child shows almost similar or stable picture across 'mild mental retardation' (N: 10; Mean: 148.7; SD: 8.0), 'moderate-severe mental retardation' (N: 16; Mean: 146.5; SD: 12.4) and 'others' (N: 14; Mean: 144.7; SD: 9.1). The type of disability does not appear to emerge as a
0.863 0.374
Within Females Between Groups
11
Family Size
Mother’s Age
Father’s Age
Education
Age
5.170
Within Males
Gender
4.900 0.816
=>18 Between Groups
0.881 5.390 0.148
Five & Above Five Between Groups
0.515
Between Groups Below Five
5.655
50+
1.384
Between Groups 1.008
4.980
50+ <=50
0.740
0.015
Between Groups <=50
3.338
Above Class Ten
0.477
0.726
<18
Class Ten or Below
Raw Score F Value
Parameter
Variable
0.702
0.008
0.419
0.477
0.007
0.370
0.247
0.011
0.481
0.903
0.042
0.623
0.372
0.011
0.488
0.545
0.426
0.010
P
0.873
14.563
2.546
0.670
12.195
2.744
1.542
14.571
2.412
0.119
12.575
16.366
0.137
1.540
2171
1.045
2.781
11.509
F Value
Lie Score
0.356
0.000
0.086
0.418
0.000
0.071
0.222
0.000
0.098
0.732
0.000
0.000
0.713
0.224
0.123
0.313
0.069
0.000
P
Table 2. Inferential Statistics for Distribution of Mean & SD Attitude Scores in relation to various Sibling, Parent and Family Characteristics
0.232
0.232
0.541
1.602
1.236
1.241
0.518
F Value
0.633
0.633
0.466
0.213
0.273
0.272
0.476
P
Grand Totals Venkatesan & Nimisha / Sibling Attitude in Developmental Disabilities
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12
Venkatesan & Nimisha / Sibling Attitude in Developmental Disabilities
13
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Table 4. Inferential Statistics for Distribution of Mean & SD Attitude Scores in relation to various Child Characteristics Variable
Gender:
Parameter
Within Males Within Females Between Groups Age: <12 years 13-17 years 18+ years Between Groups Education: No School Regular School Special School Between Groups Diagnosis: Mild MR ModerateSevere MR Others Between Groups Associated Absent Physical Problem: Present Between Groups Associated Absent Speech Problem: Present Between Groups Associated Absent Hearing Problem: Present Between Groups Associated V Absent isual Problem: Present Between Groups Associated Absent Behavior Problem: Present Between Groups On Medication Absent Present Between Groups
Raw Score F Value P 3.052 0.053 0.253 0.777 1.652 0.206 0.187 0.830 1.045 0.360 4.899 0.013 0.519 0.599 1.878 0.233 1.350 0.265 3.539 0.042 0.505 0.607 0.129 0.880
1.042 5.655 0.326 0.257 4.938 0.222 1.878 2.250 0.015 2.605 1.485 2.492 2.621 2.776 3.332 0.187 2.976 0.903 1.008 5.655 0.570
0.361 0.007 0.724 0.774 0.010 0.640 0.233 0.110 0.903 0.079 0.277 0.123 0.078 0.102 0.076 0.830 0.056 0.348 0.370 0.007 0.455 14
Lie Score F Value P 2.146 0.124 11.970 0.000 0.018 0.895 6.640 0.004 1.610 0.211 11.790 0.000 0.506 0.607 1.098 0.392 3.105 0.051 10.604 0.000 0.523 0.597 5.774 0.008
1.474 11.339 0.337 12.700 1.527 0.034 1.098 4.432 0.061 4.408 1.568 0.883 4.070 3.093 1.100 6.640 3.041 0.015 2.849 11.732 0.670
0.240 0.000 0.716 0.000 0.225 0.854 0.392 0.014 0.806 0.015 0.260 0.353 0.020 0.083 0.301 0.004 0.053 0.902 0.064 0.000 0.418
Grand Totals F Value P
2.247
0.142
0.747
0.481
0.615
0.546
0.436
0.650
0.548
0.464
0.162
0.689
3.424
0.072
3.876
0.056
1.353
0.252
0.541
0.466
Venkatesan & Nimisha / Sibling Attitude in Developmental Disabilities
significant variable in influencing well sibling attitudes (p: > 0.05). On the other hand, affected children with associated problems, such as, physical impairments (N: 21; Mean: 145.2; SD: 9.8), speech (N: 37; Mean: 146.2; SD: 10.6), hearing (N: 4; Mean: 137.3; SD: 10.6), visual (N: 5; Mean: 138.0; SD: 8.8) and/ or behavior problems (N: 29; Mean: 145.2; SD: 10.9) as well as those on regular medication (N: 14; Mean: 144.7; SD: 9.1), consistently receive lower attitudinal scores in terms of their sibling responses compared to children with handicap without such added problems. Thus, it can be inferred that attitudes of well siblings are slightly on less favorable side towards their brothers rather than their sisters with disabilities, as also their attitudes gradually appear to shade into disfavor from an earlier stance of being in favor as the age of affected sibs increase and enter into adulthood. Likewise, affected children in special schools are more favored by their well siblings than those in regular schools. The affected children without schooling are least favored. Irrespective of and across diagnostic condition of the children with disabilities, all their well siblings are equally positive in their attitudes although affected children with additional problems are viewed less favorably than those with no such problems. (d) Domain, Content and Item Analysis The next level analysis covered scores obtained on the three individual domains of SAS: (i) Thought-Cognitive; (ii) FeelingConative; and, (iii) Action-Behavioral. As mentioned earlier, there are 14 items under each of these three domains totaling to 42 items. The maximum possible attitude 'core' score on each domain is 42. For overall sample
(N: 40), the mean attitude raw score under 'action-behavior' domain (N: 40; Mean: 35.5; SD: 3.6) appears close to scores obtained on 'thought' domain (N: 40; Mean: 35.4; SD: 3.0) and 'feeling-conative' domain (N: 40; Mean: 33.5; SD: 3.4) (F: 4.547; p: 0.013). This implies that the respondents differ in their domain wise distribution of attitudes by scoring less on 'feeling' than on 'thought' and/or 'action' components. Likewise, even for 'lie score', the mean under 'action-behavior' domain (N: 40; Mean: 14.8; SD: 6.3) are different from scores obtained on 'thought' domain (N: 40; Mean: 13.1; SD: 1.5) and 'feeling-conative' domain (N: 40; Mean: 15.9; SD: 1.9) (F: 5.243; p: 0.007). Further, note that the total 'lie score' (43.8 out of 54; 81.1 %) or its domain range (between 13.1-15.9 for maximum 18 under each domain) reveals that the respondents in this sample have indeed given a high proportion of 'inconsistent', 'incongruent' or 'social desirable' responses on the SAS in revealing their attitudes towards their affected siblings with disabilities. Content and item wise analysis of high score SA S sta tements in well sibling respondents show their greatest concerns on how they 'shudder to think what would happen if (their) sib's problem is hereditary or that it might affect (their) future family and children too' (Item #36T; Score: 117/120; 97.5 %), or that they 'feel less cared and noticed at home and among (their) relatives' (Item #20F; Score: 117/120; 97.5 %), or that they 'envy (their) affected sib who does not have to do any routine family chores' (Item #12F; Score: 117/ 120; 97.5%), or that they 'feel jealous of (their) affected sib not called upon to perform household chores' (Item #50F; Score: 116/ 15
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120; 96.67 %), or that they 'have deliberately reduced interactions with the affected sib so that (they) do not develop such problems' (Item #16A; Score: 116/120; 96.67 %), or that they 'feel jealous that parents take care of (their) affected sib more' than themselves (Item #11F; Score: 116/120; 96.67 %), or that 'when they think of (their) responsibilities', they feel 'it is better to be born as disabled than normal' (Item #28T; Score: 115/120; 95.83 %) or that they 'get thoughts on why god has not taken away (the) affected sib or why s/he is alive' (Item #32T; Score: 115/120; 95.83 %). Content and item wise analysis of low score attitudinal statements in well sibling respondents include their concerns about their 'affected sib being much better off than their other unaffected sib/s (in case they have one)(Item #29F; Score: 37/120; 30.83 %), that they are 'doing a reversal of expected roles, like caring for older brother/sister' (Item # 56A; Score: 53/120; 44.17 %), or that when they think about their affected sib, they 'get a fear of losing him/her' (Item #1TL; Score: 55/120; 45.83 %), or that whenever they think of their affected sib, they are 'afraid of loosing him/ her' (Item # 42TL; Score: 59/120; 49.17 %), or that when away from home, they 'feel anxious thinking that something may happen to my affected sib' (Item #2F; Score: 66/120; 55 %), etc. (e) Psychometric Properties of SAS A unique feature of the 'SAS' developed in this study is its experimentation on a 'lie scale'. Out of the 60-items in the scale, there were 9 pairs of test statements with 6 from each of the three domains (6 x 3: 18 items) designated for detection of a respondent's 'Lie' scores. These pairs of test statements were 16
semantically similar although structurally dissimilar, worded differently by even changing their direction or valence and even locating them at varying unsuspecting points along the scale. The idea and intention was essentially to spot different responses by the same individual subject to the same statements. Similar responses have to be expected from a given respondent for these items if they are to be belie ved a s consist ent. Response inconsistency found in this study to the order of 43.8 out of 54 (81.1 %) need not be necessarily interpreted as 'true' responses of the subject or as 'faking' and 'socially desirable' answers. Rather, they could also be interpreted as ambivalent attitudes of the well siblings towards their brothers or siste rs with developmental disabilities. The frequency distribution of scores for overall sample (N: 40) on the identified pairs of test statements categorized under 'lie items' reveal overall mean of 2.7 and SD of.1.5 respectively. This implies that lie scores of plus one SD above the mean (which is in this case is 2.7 + 1.5: 4.2 or approximately more than 4) for any given individual subject must be treated as indicative of such attitudinal ambivalence. (See Table 5 on Page 17) For various logistic reasons, in the present study, the reliability estimates for 'SAS' is given in terms of Cronbach's alpha as a measure of internal consistency reliability in preference for test re-test reliability and/or equivalent or parallel forms reliability. Internal consistency reliability estimates come in several flavors. The most familiar are: (a) split-half adjusted (i.e., adjusted using the Spearman-Brown prophecy formula (Brown, 1961), (b) Kuder-Richardson formulas 20 and 21 (also known as K-R20 and
0.464 8.064 8.225
Kuder-Richardson 21
Kuder-Richardson 20
0.302
Split-Half (Odd-Even) Correlation
Spearman-Brown Prophecy
0.341
17
10.497
9.429
-0.742
-0.271
0.108
5.967
5.575
0.466
0.304
0.427
11.066
10.917
0.413
0.260
0.511
Concealed
Core
Core
Concealed
Feeling-Conative
Thought-Cognitive
Cronbachâ&#x20AC;&#x2122;s Alpha
Variable
5.670
5.455
0.696
0.535
0.411
Core
Overall
6.416
6.213
0.692
0.529
0.443
3.289
3.168
0.842
0.726
0.743
1.251
1.185
0.849
0.738
0.841
Concealed Extensity Intensity
Action-Behavioral
Table 5. Overall and Domain Wise Reliability Coefficients of Sibling Attitude Scale
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K-R21) (Kuder and Richardson, 1937), and (c) Cronbach's alpha (Cronbach, 1970) (Table 5). Since the 'SAS' is Likert type requiring more than dichotomous responses (right- wrong or agree-disagree), Cronbach's alpha is more preferred estimate than K-R20 and K-R21. The estimate of Cronbach's alpha (? ) for overall scale in terms of 'extensity' (3-point rating: Never-Sometimes-Always) is 0.743 which is 'acceptable' and for 'intensity' (10-point rating) is 0.841which is interpreted as 'Good' as per the rules of thumb provided by George and Mallery (2003). Further, following the defense provided by Hirai (1999), upon application of Spearman-Brown prophecy formula, ? rises to 0.842 for 'extensity' and 0.849 for 'intensity' which is interpreted as 'good'. The rather 'acceptable' levels of ? maybe also attributed to the rather smaller number of test items in the scale as well as its sub-scales. In sum, it is observed that most previous studies are cross-sectional and not longitudinal as based on clinic samples. Hence, their conclusions almost always assume that well siblings of children with disabilities have negative attitudes. Wha t nee ds to be increasingly argued is that behaviors, attitudes, interactions or relationships of well siblings with their disability affected siblings are not dysfunctional but different when compared to matched control groups. Further, the newer paradigms on this subject must view that care giving families of children with disabilities are dif fere nt not pat hological. Suc cessful adaptation and coping is possible if the focus is made on altering the systems or social milieu surrounding the affected child and the family. 18
Acknowledgements The authors seek to place on record the gratitude and credit due to Dr. Vijayalakshmi Basavaraj, Director, All India Institute of Speech and Hearing, Mysore, for financial grant received through 'AIISH Research Fund' for completion of the project titled 'Enabling and Empowering Siblings of Children with Communication Disorders' (2010-11). The present work is part of the series of research papers being brought out in the project. Reference Aaronson, M.R., and Schaefer, E.S. (1973). Schaefer-Aaronso Systems. In E.G. Boyes, A. Simon and G.R. Karafin. (Eds.). Measures of Maturation: An Anthology of Early Childhood Observation Instruments. Philadelphia: Research for Better Schools. Alderfer, M., Wieber, D., and Hartmann, D. (2001). Social behavior and illness information interact to influence the peer acceptance of children with chronic illness. British Journal of Hea lth Psychology, 6, 243-255. Armstrong, R., Rosenbaum, P., and King, S. (1987). A randomized controlled trial of a ‘buddy’ programme to improve children’s attitude toward the disabled. Developmental Medicine and Child Neurology, 29, 327-336. Atkins, S.P. (1989). Siblings of Handicapped Children. Child and Adolescent Social Work Journal. 6, 4, 271-282. Bank, S.P. and Kahn, M.D. (1982). The Sibling Bond. New York: Basic Books, Inc.
Venkatesan & Nimisha / Sibling Attitude in Developmental Disabilities
Bat-Chava, Y. and Martin, D. (2002). Sibling relationships of deaf children: the impact of child and family characteristics. Rehabilitation Psychology, 1, 73-91. Bellin MH, Bentley KJ, and Sawin KJ. (2009). Factors associated with the psychological and behavioral adjustment of siblings of youths with spina bifida. Families, Systems & Health, 27, 1, 1-15. Bennett, C. W. (1973). A four-and-a-half year old as a teacher of her hearing-impaired sister: A ca se study. Journal of Communication Disorders, 6, 67-75. Borke, H. (1971). Interpersonal perception of young children: Egocentrism or empathy. Developmental Psychology, 5, 263-269. Breslau, N. (1982). Siblings of disabled children: Birth order and age spacing effects. Journal of Abnormal Child Psychology, 10, 85-96. Breslau, N., Weitzman, M., and Messenger, K. (1981). Psychologic functioning of siblings of disabled children. Pediatrics, 67, 344-353. Brody, G.H. and Stoneman, Z. (1986). Contextual Issues in the Study of Sibling Socialization. In Gallagher, J.J. and Vie tze, P.M. (Eds. ) Families of Handicapped Persons: Research, Programs, and Policy Issues. Baltimore: Paul H. Brookes. Brody, G.H., Stoneman, Z., Davis, C.H., and Crapps, J.M. (1991). Observations of the Role Relations and Behavior between Older Children with Mental Retardation and Their Younger Siblings. American Journal on Mental Retardation, 95, 5, 527-36.
Byrne, E.A. and Cunningham, C.C. (1984). The effects of mentally handicapped children on families – a conceptual review. Journal of Child Psychology and Psychiatry, 26, 6, 847-864. Caldwell, B. M., and Guze, G. B. (1960). A study of the adjustment of parents and siblings institutionalized and noninstitutionalized retarded children. American Journal of Mental Deficiency, 64, 849-861. Carandang, M.L.A., Folkins, C.H., Hines, P. A. and Steward M.S. (1979). The Role of Cognitive Level and Sibling Illness in Children’s Conceptualizations of Illness. American Journal of Orthopsychiatry, 49, 474-481. Cash, W. M., and Evans, I. M. (1975). Training preschool children to modify their retarded siblings’ behavior. Journal of Behavior Therapy and Experimental Psychiatry, 6, 13-16. Chase, N.D. (Ed.). (1999). Burdened Children: Theory, Research, and Treatment of Parentifica tion. New York: Sage Publications Cicirelli, V. G. (1976). Siblings teaching siblings. In V. L. Allen (Ed.). Children as Teachers: Theory and Research in Tutoring. New York: Academic Press. Cleveland, D. W., and Miller, N. B. (1977). Attitudes and life commitments of older siblings of mentally retarded adults: An exploratory study. Mental Retardation, 15, 38-41. 19
Vol. 1 No. 2 July 2011
Journal of Disability Management and Special Education
Crnic, K. A., and Leconte, J. M. (1986). Understa nding sibling needs and influences. In R. R. Fewell and P.F. Vadasy (Eds.). Familie s of Handicapped Children: Needs and Supports Across the Life Span. (pp. 75-98). Austin: Pro-Ed. Cronbach, L. J. (1970). Essentials of Psychological Testing (3rd ed.). New York: Harper and Row. Cuskelly, M. (1999). Adjustment of siblings of children with a disability: Methodological Issues. International Journal for the Advancement of Counseling, 21, 2, 111124. Damiani, V.B. (1999). Responsibility and adjustment in siblings of children with disabilities: Update and review. Families in Society, 80, 34-40. DeMyer, M. K. (1979). Comments on Siblings of Autistic Children. Journal of Autism and Developmental Disorders, 9, 296298. Deveraux, R. (1979). The psychological effects of a handicapped child on parents and siblings. Spina Bifida Therapy, 1, 146155. Dew, A., Balandin, S., and Llewellyn, G. (2008). The Psychosocial Impact on Siblings of People with Lifelong Physical Disability: A Review of the Literature. Journal of Developmental and Physical Disabilities, 20, 5, 485-507. Dunlap, W. R., and Hollingsworth, J. S. (1977). How does a handicapped child affect the family. Implications for practitioners. Family Coordinator, 26, 286-293. 20
Dunn, J., and Kendrick, C. (1982). Siblings: Lov e, Envy a nd Understanding. Cambridge Massachusetts: Harvard University Press. Dyson, L.L. (1989). Adjustment of siblings of handicapped children: A comparison. Journal of Pediatric Psychology, 14, 215229. Eagly, A., and Shelly, C. (1993). The Psychology of Attitudes. Forth Worth, TX: Harcourt Brace Jovanovich College Publishers. Fisman, S., Wolf, L., Ellison, D., and Freeman T. (2000). A longitudinal study of siblings of children with chronic disabilities. Canadian Journal of Psychiatry, 45, 369375. Gath, A. (1972). The school age siblings of Mongol children. British Journal of Psychiatry, 123, 161-167. Gath, A. (1973). The mental health of siblings of congenitally abnormal children. Journal of Child Psychology and Psychiatry, 13, 211-218. Gath, A. (1974). Sibling reactions to mental handicap: A comparison of brothers and sisters of Mongol children. Journal of Child Psychology and Psychiatry, 15, 187-198. Gayton, W.F., Friedman, S.B., Tavormina, J.F., and Tucker, F. (1977). Children with cystic fibrosis: I. Psychological test findings on patients, siblings and parents. Pediatrics, 59, 888-894. George, D., and Mallery, P. (2003). SPSS for Windows Step by Step: A Simple Guide
Venkatesan & Nimisha / Sibling Attitude in Developmental Disabilities
and Reference. 11.0 Update (4th ed.). Boston: Allyn and Bacon Gold, N. (1993). Depression and social adjustment in siblings of boys with autism. Journal of Autism and Developmental Disorders, 23, 147-163. Gralicker, B., Fishier, K., and Koch, R. (1962). Teenage reactions to a mentally retarded sibling. American Journal of Mental Deficiency, 66, 838-843. Grossman, F. K. (1972). Brothers and Sisters of Retarded Children. Syracuse, New York: Syracuse University Press. Hannah, M.E., and Midlarsky, E. (1985). Siblings of the handicapped: A literature review for school psychologists. School Psychology Review, 14, 510-520. Hannah, M.E., and Midlarsky, E. (1999). Competence and Adjustment of Siblings of Children with Mental Retardation. American Journal on Mental Retardation, 104, 1, 22-37. Harland, P., and Cuskelly, M. (2000). The Responsibilities of Adult Siblings of Adults wit h Dua l Sensory Impa irments. International Journal of Disability, Development and Education, 47,3, 293307. Hirai, A. (1999). The relationship between listening and reading rates of Japanese EFL lear ners. Modern Language Journal, 83, 367-384. Judge, S.L. (1998). Parental coping strategies and strengths in families of young children wit h disabilities. Family Relations, 17, 263-268.
King, S., Rosenbaum, P., Armstrong, R., and Milner, R. (1989). An epidemiological study of children’s attitudes toward disability. Developmental Medicine and Child Neurology, 31, 237-245. Kornblatt, E., and Heinrich, J. (1985). Needs and coping abilities in families of children with developmental disabilities. Mental Retardation, 23, 13-19. Kuder, G. F., and Richardson, M. W. (1937). The theory of estimation of test reliability. Psychome trica . 2. 151-160. reliability. Psychometrika. 2, 151-160. Lamb, M. E., and Sutton-Smith, B. (Eds.). (1982). Sibling Relationships: Their Nature and Significance across the Lifespan. Hillsdale, New Jersey: Erlbaum. Lardieri, L.A., Blacher, J., Swanson, H. L. (2000). Sibling Relationships and Parent Stress in Families of Children with and without Learning Disabilities. Learning Disability Quarterly, 23, 2, 105-16. Lavine, M. B. (1977). An exploratory study of the siblings of blind children. Journal of Visual Impairment and Blindness, 71, 102-197. Leanza, V. F. (1970). Tension in the adjustment of normal siblings of mildly retarded children. Disserta tion A bstra cts International, 2739-A. Lobato, D. (1983). Siblings of handicapped children: A review. Journal of Autism and Dev elopmental Disorders, 13, 4, 347-364. Lobato, D. (1985). Brief report: Preschool siblings of handicapped children — Impact of peer support and training. 21
Vol. 1 No. 2 July 2011
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Journal of Autism and Developmental Disorders, 15, 345-350. Lobato, D., Barbour, L., Hall, L.J., and Miller, C.T. (1987). Psychosocial characteristics of preschool siblings of handicapped and non handicapped children. Journal of Abnormal Child Psychology, 15,3, 329338. Lobato, D.J., Miller, C.T., Barbour, L., Hall, L.J., and Pezzullo, J.C. (1991). Preschool Siblings of Handicapped Children: Interactions with Mothers, Brothers, and Sisters. Research in Developmental Disabilities, 12, 4, 387-99. Mates, T.E. (1990). Siblings of autistic children: Their adjustment and performance at home and in school. Journal of Autism and Developmental Disorders. 20, 4, 545-553. Mc Andrew, I. (1976). Children with a handicap and their families. Child: Care, Health and Development, 2, 213-237. Mc Doughall, J., De Witt, D., King, G., Miller, L., Killip, S. (2004). High school aged youths attitudes toward their peers with disabilities: The role of school and student interpersonal factors. International Journal of Disabilities and Developmental Education, 51, 287-13. Mc Hale, S.M., Sloan, J., and Simeonson, R.J. (1986). Sibling relationships or children with autistic, mentally retarded, and nonhandicapped brothers and sisters. Journal of Autism and Developmental Disorders, 16, 4, 399-413. McGregor, S., and Forlin, C. (2005). Attitudes of students towards peers with disabilities: 22
Relocating students from and Education Support Center to an inclusive middle school setting. International Journal of Whole Schooling, 1, 18-30. Meyer, D. J., Vadasy, P. F., and Fewell, R. R. (1985). Living with a Brother or Sister with Special Needs: A Book for Sibs. Seattle: University of Washington Press. Miller, N., and Cantwell, D. P. (1976). Siblings as therapists: A behavioral approach. American Journal of Psychiatry, 133, 447-450. O’Connor, W., and Stachowiak, J. (1971). Patterns of interaction in families with low adjusted, high adjusted, and mentally retarded family members. Family Process, 10, 229-241. Peshawaria, R., Menon, D.K., Ganguly, R., Roy, S., Pillay, R.P.R.S., and Gupta, A. (1995). Understanding Indian Families having Persons with Mental Retardation. Secunderabad: National Institute for the Mentally Handicapped. Pho, L.T., Zinberg, R.E., Hopkins-Boomer, T.A., Wallenstein, S., and McGovern, M. (2004). Attitudes and psychological adjustment of unaffected siblings of patients with phenylketonuria. American Journal of Medical Genetics, 126A, 156160. Powell, T., a nd Ga llagher, P.A. (1993). Brothers and Sisters: A Special Part of Exceptional Families (2nd ed.). Baltimore, MD: Paul H. Brookes. Rodger, S., and Tooth, L. (2004). Adult siblings Perceptions of Family Life and Loss: A
Venkatesan & Nimisha / Sibling Attitude in Developmental Disabilities
pilot study. Journal of Developmental and Physical Disabilities, 16, 1, 53-71. Rosenbaum, P., Armstrong, R., and King, S. (1986). Improving attitude toward the disabled: A randomized controlled trial of direct contact versus kids-on-the-block. Journal of Developmental Behavioral Pediatrics, 7, 302-307. Rossiter, L., and Sharpe, D. (2001). The siblings of individuals with mental retardation: A quantitative integration of the literature. Journal of Child and Family Studies, 10. Senel, H.G., and Akok, F. (1996). Stress levels and attitudes of normal siblings of children with disabilities. International Journal for the A dvancement of Counseling, 18, 6, 61-68. Siegel, B., and Silverstein, S. (1994). What about me ? Growing up with a Developmentally Disabled Sibling. New York: Insight Books. Siperstein, G. (2006). Adjective Checklist (ACL). I n Sa lkind, N., (Ed.). Encyclopedia of Measurement and Statistics. Thousand Oaks, CA: Sage Publications. 12-13. Tirosh, E., Schanin, M., and Reiter, S. (1997). Children’s attitudes towards peers with disabilities: The Isreal perspective. Developmental Medicine and Child Neurology. 39, 811-814. Vignes, C., Coley, N. , Gra ndje an, H., Godeau, E., and Arnaud, C. (2008). Measuring children’s attitudes towards peers with disabilities: A review of instruments. Developmental Medical Child Neurology, 50, 3, 182-189.
Voeltz, L.M. (1980). Children’s attitude toward handicapped peers. American Journal of Mental Deficiency, 84, 455-464. Voeltz, L.M. (1982). Effects of structure interactions with severely handicapped peers on children’s attitudes. American Journal of Mental Deficiency, 86, 380390. Weinrott, M. R. (1974). A training program in behavior modification for siblings of the ret arded. Ame rica n Journal of Orthopsychiatry, 44, 362-375. Wiliams, P.D., Williams, A.R., Graff, J.C., Hanson, S., Stanton, A., Hafeman, C., Liebergen, A., Leuenberg, K., Setter, R.K., Ridder, L., Curry, H., Barnard, M., and Sanders, S. (2003). A community based intervention for siblings and parents of children with chronic illness or disability: The ISEE study. Journal of Pediatrics, 143, 3, 386-393. Wiliams, P.D., Williams, A.R., Graff, J.C., Hanson, S., Stanton, A., Hafeman, C., Liebergen, A., Leuenberg, K., Setter, R.K., a nd Ridder, L. (2002). Interrelationships among variables affecting well siblings and mothers in families of children with a chronic illness or disabilit y. Journal of B ehav ior Medicine, 25, 5, 411-424. Wilson, C.J., Mc Gillivray, J.A., and Zetlin, A.G. (1992). The relationship between attitude to disabled siblings and ratings of behavioral competency. Journal of Intellectual Deficiency Research, 36, 4, 325-336. 23
Vol. 1. No. 2 July 2011
Journal of Disability Management and Special Education ISSN: 2229-5143
Effectiveness of Metronome Training in Children with Developmental Coordination Disorder *Sujata Missal, **J.T. Jacob & ***Sugi
Abstract Children with developmental Coordination Disorder can benefit from Interactive metronome Training. Therefore this study investigated the Effectiveness of Metronome Training in children with Developmental Coordination Disorder. Ten clients with mean age of 6.5 years were taken for the study. DCD-Q (a 15 items questionnaire) was administered during pre and post intervention. It consists of 15 questions under 3 components - control during movement (questions 1-6), fine motor/handwriting (questions 7-10) and general coordination (questions 11-15). Fifteen sessions of intervention was done with Metronome developed by the investigator. Data were obtained and analyzed. Result showed a statistically significant improvement (p<0.0001) in coordination in children with DCD, control during movement, fine motor/hand writing. The study reveals that Metronome Training is effective in improving coordination specifically in control during movement in children with DCD. Key terms: Metronome Training, Developmental Coordination Disorder
Effect of Metronome Training Motor skills are typically acquired in a continuous, progressive, orderly process. Nor mal m otor func tion requires the coordination of neurologic, physiologic, and biologic processes including proprioception, vestibular integration, strength, balance, coordination, dexterity, visual-motor ability, and visual ability. Individual and environmental factors, such as motivation, perseverance, opportunity for practice and encouragement, also play a role. Problems in any of these areas can result in lack of motor skills or clumsiness. Approximately 6 percent of otherwise healthy school-age children have problems with motor coordination that interfere with
academic performance and social integration, sometimes termed "clumsy child syndrome" or Developmental Coordination Disorder (DCD). These motor problems typically present in the early school years with difficulty performing simple motor tasks (e.g. running, buttoning) Developmental Coordination Disorder encompasses a complex presentation of sensory and motor impairments in children that can result in significant restrictions of daily activities and participation in life roles. This significant disorder of childhood has an impact on motor skills and commonly leads to impairments in manual, locomotor and sporting act ivities. Developmental Coordination Disorder is the term used to
* Principal, KMCH College of Occupational Therapy, E-mail: sujatamissal@gmail.com **Occupational Therapist, St. John's Hospital, Bangalore ***Vice Principal, KMCH College of Occupational Therapy-mail: otsugi@yahoo.co.in
24
Missal, Jacob & Sugi / Effect of Metronome Training
describe difficulties in the development of movement skills. It becomes apparent in early childhood as a difficulty in learning or carrying out skills that require motor coordination. This condition affects a child's performance of everyday tasks in the home, play and school environments. Childre n exhibit ing Developmental Coordination Disorder struggle with motor activities such as jumping, hopping or running and agonize to perform fine motor skills such as writing letters, tying their shoe laces or using utensils, children with any of these difficulties are often referred as clumsy. A comparative study conducted on "Activities of daily living in children with DCD" showed that children with DCD had more difficulty with dressing, personal hygiene and eating skills when compared to children of the same age group. Difficulties of postural control and fine motor skills reported to contribute to poorer performance of activities of daily living. (Summers, 2008). A study on "Planning and Execution of action in children with and without DCD" showed that children with DCD performed less well in majority of the proprioceptive tasks but did not differ in controls in planning of grip selection. (Smyth, 1997). The problems experienced by children with DCD are believed to emanate from abnormalities in neurotransmitter or receptor systems rather than from damage to specific groups of neurons or brain regions. Several theories speculate that the etiology of DCD is secondary to prenatal, perinatal, or neonatal insult; or is secondary to neuronal damage at the cellular level in the neurotransmitter or receptor systems.
Difficulties with coordination can result from a combination of one or m ore impairme nts in proprioc eption, motor programming, timing, or sequencing of muscle activity. However new studies have found that children with DCD exhibit right hemisphere insufficiency (lesion/disconnection), frequently accompanied by a dysfunctional corpus callosum. A study conducted on" Motor problems in children with developmental coordination disorder", focused on the physiological explanation and origin of motor coordination problems in children with DCD, and showed that the current literature required more empirical evidence to substantiate either multisensory or unisensory theories of motor dysfunction in children with DCD (Willoughby, 1995). Although motor coordination difficulties can occur in the absence of any other disorders, they often do emerge with learning disability, attention deficit hyperactivity disorder, communication disorder and disorder of written expression. Children with Developmental Coordination Disorder have been treated with multisensory modalities, including visual, auditory and tactile materials with a goal of perceptual motor training for a variety of specific motor tasks like hopping, skipping, climbing and moving through hoops, climbing ladders and jumping on a trampoline. Sensory integration programs are often delivered as a related service to children with DCD; activities are designed to target the tactile, vestibular and proprioceptive systems. Advanced motor 25
Vol. 1 No. 2 June 2011
Journal of Disability Management and Special Education
imagery training and computer games are also the techniques being used for clumsiness in children.
timing. As Interactive Metronome is the only program that uses a patent auditory guidance
Int erac tive Metronom e (IM ) is an
IM training a trainee wears stereo headphones
advanced brain based treatment program designed to promote and enhance brain per form ance and recovery. This is
and listens to special sounds that the IM computer software program generates to guide
accomplished through the process of brain neuroplasticity. A double-blind, placebo controlled study published in the March 2001
and foot exercises are performed while
issue of American Journal of Occupational Therapy showed that individuals with ADHD experienced remarkable improvements in
to focus all their attention on the steady
motor coordination, control, attention, and better control of impulsivity, aggression,
system plus interactive exercises. During the
the training process. Thirteen different hand auditory guide tones direct the individual to match the metronome beat. The trainee learns metronome beat sound in their headphones, without being interrupted by thoughts around them. In this study the investigator has made
language processing and reading after use of
an attempt to use Metronome Training for
Interactive Metronome. Preliminary studies have shown that the level of a person's
children with DCD, to find its effectiveness on
performance on the IM that involves planning,
was to screen out children with Developmental
timing, and rhythmicity of motor regulation correlates with the severity of developmental, learning, attention problems, improvements in
Coordination Disorder using DCD-Q
academic performance and age expected performance changes during the school years
Metronome training in these children.
(Kuhlman & Schweinhart, 1999). Children with a range of developmental and learning problems in special education classes who trained on the IM have demonstrated gains in
motor skills and coordination. The objective
(Developmental Coordination DisorderQuestionnaire) and to find the effectiveness of Methodology The study design is a single group Quasiexperimental pre and post test design. The subjects were drawn from a
motor performance in comparison to a similar group without such training who demonstrated no gains over the same period of time.
population of school going children at risk for
(Stemmer, 1996)
Coimbatore and a special school in Kerala. The
Interactive Metronome combines the concept of musical metronome with patent technology computerized program that accurately improves a person's rhythm and 26
DCD as identified by special school teachers or occupational therapist, from the city of DCD Questionnaire was administered to 30 children .Ten out of 30 children between 5-9 years who fulfilled the selection criteria were chosen for the study. The sample consisted of
Missal, Jacob & Sugi / Effect of Metronome Training
nine children between 5-7years of age with scores between 15-46 on DCD-Q and one child
was done with Metronome developed by the investigator. 15 sessions of training were
in age range of 8-9 years with scores between
conducted. After completion of 15 sessions
15-55 on DCD-Q. Children having co-morbid
post-test scores were taken.
ADHD and LD were not ruled out from the study. Out of the ten children, three children
Intervention
had co morbid ADHD, five had associated LD and rest of the two were DCD. Whereas children with neurological disorders, deafness, PDD, and mental retardation were excluded from the study.
The intervention consists of 15 sessions which includes 13 tasks that require the trainee to perform a variety of upper and lower body movements in time with the metronome tone. Development of Metronome Metronome is an instrument for marking
Instrumentation Developmental Coordination Disorder Questionnaire (DCD-Q)
time in music that produces a regular ticking sound for a variety of rhythmic settings. The basic idea is to hit the metronome beat which
The questionnaire is designed for clients
comes in various rhythms. It was developed
with DCD, LD and ADHD. It consists of 15
base d on the principles of Interac tive
questions fewer than 3 components: control
Metronome.
during movement (questions 1-6), fine motor/ handwriting (questions 7-10) and general
Software Used
coordination (questions 11-15).The DCD-Q is
i.
Noteworthy Composer is a software for music composition and notat ion processor. It allows creating record, edit and playing back musical scores in pure musical notation.
a parent report measure developed to assist in the identification of DCD in children. Parents are asked to compare their child's motor response to that of his /her peers using a 5 point Likert scale. It provides a standard method to measure a child's coordination in everyday functional skills. As reported in 2000,
Noteworthy Composer
ii. Cool Edit Pro 2.0 Recording the metronome beats and streaming the MIDI files to MP3 was done using Cool Edit Pro 2.0, which is a digital audio editor computer program allowing waveform editing. Four rhythmic timing beats and 5 songs with metronome as background along with an introductory metronome counting were selected. The notations were typed in Noteworthy Composer and the instrumental sound for the metronome chosen was of a cymbal
the internal consistency of the DCD-Q is high and the results from discriminant function analysis were appropriately strong for a screening tool. Procedure A written consent was obtained from parents by the investigator to screen and include the sample for the study. Intervention 27
Vol. 1 No. 2 July 2011
Journal of Disability Management and Special Education
and a bell sound. The files were then saved to MIDI Format. The MIDI files were then converted to MP3 format using a MIDI-MP3 converter. The MP3 files were
then opened in Cool Edit pro and voice over was given by the investigator. The amplitude of the songs was increased by 6db. The files were then saved to MP3 and audio CD format.
Beats and Songs Sl. No.
Beats & Songs
Timing/ Tempo
Duration
No. of Beats
No. of Beats Per Minute
Tempo120
0.31sec
40
-
1
Intro
2
Beat on 4th count
4/4-120
13:13min
400
30
3
Beat on 2nd & 4th count
4/4-120
13:36min
800
60
4
Beat on 3rd count
3/4-120
8:14min
300
38
5
Beat on 6th count
6/8-120
20:12min
400
20
6
Song1
Tempo110
4:10min
120
30
7
Song2
Tempo188
2:42min
120
50
8
Song3
Irregular
15:43min
200
13
9
Song4
Irregular
10:48min
200
20
10
Song5
Irregular
12:00min
200
16
Instructions to the trainee
2.
Correct timing tendencies, relax regularly.
The tone you will hear sound like a cow's bell. This is the metronome beat that you should hit.
3.
Timing should stay before or after the beat for at least 8 repetitions-Aims for 4 bursts during this session.
Hit should be on the beat and not in reaction to it.
4.
The last tasks will have other sounds but just focus on the bell sound.
5 bursts (Burst is the ability of the trainee to attend and execute task with respect to the metronome beat).
5.
Controlling heel movements-6 bursts.
Always keep to the 'rhythm'.
6.
12 bursts.
Stand comfortably.
7.
Describe the movements before starting.
Check whether the trainee has shown the ability to return to the beat quickly (within 2-3 beats), 16 bursts, and warm up (3 difficult tasks 200 repetitions each).
8.
Improve worst done task 18 bursts.
Sessions 1.
Help trainee understand the sound and learn the motions. 28
Missal, Jacob & Sugi / Effect of Metronome Training
9.
Getting back to beat within 1 tone 22 bursts.
15. Burst goal-40+ Data Analysis and Results
10. Burst goal-25
The pretest and post test scores were analyzed using Paired't' test in graph pad and the comparison between the three components of DCD-Q was analyzed using ANOVA.
11. Burst goal-30 12. Burst goal-30+ 13. Trainee's choice-Burst goal 30+
Ten children with mean age of 6.5 years were chosen for the study.
14. Burst goal-30+
Table-1: Demographic details of the Subjects No of Clients 10
Sex M
Diagnosis F
DCD
DCD
Mean age DCD
with ADHD with LD 10
0
3
5
DCD-Q score 15-46
15-55
9
1
6.5 2
Table-2: Comparisons of the pre & post test scores of DCD-Q Experimental
N
Mean
SD
't' value
'p' value
Pretest
10
40.60
4.38
15.3995
0.0001
Post test
10
48.70
4.90
The mean and S.D of total DCD-Q pretest & post test scores are presented in Table II which shows t = 15.3995 that is statistically significant at p < 0.0001 Table-3: Comparisons of the pre & post test scores of Control During Movement Experimental
N
Mean
SD
't' value
'p' value
Pretest
10
15.90
3.28
8.9134
0.0001
Post test
10
19.10
3.28
The results of the pre and post test scores of control during movement, a subcomponent of DCD-Q are shown on table 3 shows where t =8.9134 showing a statistically significant difference at p < 0.0001. Table-4: Comparisons of the pre & post test scores of Fine motor/Hand writing Experimental
N
Mean
SD
't' value
'p' value
Pretest
10
9.20
2.04
7.5707
0.0001
Post test
10
11.40
1.96
The above table 4 shows the mean and SD of fine motor/handwriting, t = 7.5707, which is statistically significant at p < 0.0001 29
Vol. 1 No. 2 July 2011
Journal of Disability Management and Special Education
Table-5: Comparisons of the pre & post test scores of general coordination Experimental
n
Mean
SD
't' value
'p' value
Pretest
10
15.50
1.96
5.2500
0.0005
Post test
10
18.30
3.06
Effect of Metronome Training Lastly the mean and SD of General Coordination, pretest and posttest scores presented on table 5 shows that t =5.2500 which is statistically significant at p < 0.0005. Table 6: Comparison of post test values of DCD-Q components SL NO
COMPONENTS
MEAN
'P' value
1
CDM-FM/HW
19.10
0.0001
F value
Sign
44.83
0.000
11.40 2
CDM-GC
19.10
0.05
18.30 3
GC-FM/HW
18.30
0.0001
11.40 Table 6 interprets an obvious difference among the DCD-Q components on comparing them using analysis of variance. The results show that control during movement has improved more than fine motor/handwriting and general coordination. Discussion The purpose of the study was to find the effectiveness of Metronome Training on children with DCD. A total of 10 clients with mean age of 6.5 years were taken for the study, DCD-Q (a 15 item questionnaire) was used to measure the outcome of the intervention. It consists of 3 components, control during movement, fine motor/handwriting and general coordination. The results indicated that there was an overall improvement in coordination after the IM training program This is supported by the 30
study conducted by Stemmer on "improving student motor integration by use of interactive metronome" which showed that the special education group c hildren improved significantly in motor control and motor coordination after IM training. The study further revealed that there was a significant improvement in control during movement (p < 0.0001), fine mot or/ handwriting (p < 0.0001), gene ral coordination (p < 0.0005). These findings are consistent with studies done on IM intervention in children with DCD and ADHD (Cosper and Sharon, 2009). However, Shaffer, 2001) has noted that IM training appears to facilitate a number of capacities including attention, coordination, motor control and selected academic skills in boys with ADHD.
Missal, Jacob & Sugi / Effect of Metronome Training
On comparing each of the post test values of control during movement, fine motor/ handwriting and general coordination, control during m ovem ent showed marked improvement and greater significance. This could be because all the 13 tasks of the Metronome are basically gross motor tasks. Meanwhile, on comparing fine motor/ handwriting and general coordination, general coordination showed greater significant change. Further the parents of the children with DCD also noted an improvement in strength, endurance, stamina and reaction time. This could be because each client has finished each task (13 tasks in all) up to 6 times in different rhythmic timings for 15 one hour sessions. The metronome training though revealed significant increase in coordination; the study did not ident ify t he im prove ments in rhythmicity patterns. Although the investigator had noted in few of the children a hypo/hyper anticipatory response to the beats, the rhythmicity deficiency patterns associated with Metronome Training could not be recorded objectively. The finding that Metronome Training inf luences m otor cont rol, fine mot or/ handwriting and general coordination in children with DCD leads us to assume that Music and Timing skills (Query, 2003) can be used to influence coordination. MRI study conducted by Dr Neal Alpiner (2004) showed that IM training increased the activity in posterior temporal gyrus and frontal gyrus. This could reveal the fact that the auditory area is linked to motor area, producing improvement in coordination following Metronome Training.
Methodical considerations and limitations of this study include that only males of a defined age range were included in the study, limiting generalizing the results to female. The variables assessed by the investigator were limited to selected aspects of motor control, fine mot or /handwriting, and gene ral coordination only. The results of the current study suggest directions for further research in replicating the current study on a larger population, on females, on a more socioeconomically diverse population. Further research could also investigate outcome of Metronome Training on academics, attention, and child's processing skills. Study design should include well known continuous performance test measures, acade mic achievement measures, and standardized motor movement measures such as Bruininks Oseretsky Motor Proficiency Test. In conclusion the present study suggests that Metronome Training can improve aspects of motor control and coordination and it can be used as an adjunct to existing interventions for children with Developmental Coordination Disorder. References: Books: Abhigel Marshel; The Everything Parentâ&#x20AC;&#x2122;s Guide to Children with dyslexia; Adams Media; 2nd edition, 52-54. Benjamin, S, Virginia, S; Kaplan & Sadockâ&#x20AC;&#x2122;s Comprehensive Textbook of Psychiatry; Lippincot William; 8th edition, 31303135. Maria Chivers; Dyslexia and Alternative Therapies; Jessica Kingsley; 1st edition, 34- 40 31
Vol. 1 No. 2 July 2011
Journal of Disability Management and Special Education
Martha Logigian; Pediatric Rehabilitation; 1st edition, 111-124
in children with and without developmental coordination disorder.
JOURNALS:
Journal of Child Psychology, 38 (8)
Cosper, S.M. (2009). Interactive Metronome Training in Children with Attention Deficit and Developmental Coordination Disorder; International Journal of Rehabilitation Research, 32; (4) 331-336
1023-1037.
Jongmans, M. et al (2007). Consequences of co morbidity of Developmental Coordination Disorders and Learning Disabilities for severity and pattern of perceptual-motor dysfunction; Journal of Learning Disabilities; 36 (1) 528-537 Klein, S. & Erickson, L. (2007). Effectiveness of a computer skills program to Improve written communication in children with Developmental Coordination Disorder. Physical and Occupational Therapy Pediatrics; 28 (1) 5-23 Marina. M. S. (2006). Evaluation of the Developmental Coordination Disorder Questionnaire as a screening instrument; Dev elopmental Medicine & Child Neurology; vol. 48 Overy, K, Nicolson R.I., Fawcett A.J., & Clarke EF. (2008) Dyslexia and music: measuring musical timing skills; Human Movement Science, 9 (1). Smyth. M.M., Mason, U.C., & Smyth, M.M., (1997). Planning and execution of action
32
Summers, J., Larkin, D.,& Dewey, D. (2008). Activities of daily living in children with Developmental Coordination Disorder: dressing, personal hygiene, and eating skills; Human Movement Science, 27 (2). Whitall, J., Chang, T.Y. & Horn, C.L. (2008). Auditory-motor coupling of bilateral finger tapping in children with and without DCD compared to adults, Physical Therapy and Rehabilitation Willoughby, Polatajko H.J., et al. (1995). Motor problems in children with developmental coordination disorder: Review of the lit erat ure. Ame rica n Journal of Occupational Therapy, 48,787-794 Wegner, L.M. (1999). Gross Motor Dysfunct ion, Its Evalua tion and Managem ent.
In Developmental
Behavioural Paediatrics, Levine, M.D., Carey, W.B (eds), WB. Saunders, Philadelphia, 452.15 He nderson,S.E., & Hall, D.(1982). Concomitants of Clumsiness in young school
c hildren
Neurology, 24:448
Dev.Me d.Child
Vol. 1. No. 2 July 2011
Journal of Disability Management and Special Education ISSN: 2229-5143
Current Practices of Special Educators for Students with Intellectual Disability and Hearing Impairment *Shilpa Manogna
Abstract The major aim of special education is to provide appropriate education to children with special needs. The quality of services which are being offered by these organizations is often determined by the practices and service aspects which special educators focus and which they perceive to be important. The study investigated various practices in special education for children with intellectual disability and hearing impairment. The sample comprised of 120 special educators teaching students with intellectual disability and hearing impairment in the twin cities of Hyderabad and Secunderabad. Rao's Special Education Practices Scale was used to collect information on various practices in use. Results indicate that special educators teaching children with intellectual disability are following better practices than their counterparts. Key terms: Current Practices, Hearing Impairment, Intellectual Impairment, Special Educators
Introduction A dynamic concept of exceptionality encompasses all children who need a specially tailored education program to achieve in accordance with their potential. They require special materials, special equipment, and special methods so that they realize their full potential (Hallahan, 1988). Apart from children with visual impairment, hearing impairment, mental retardation, physical impairm ent, lear ning disa bilit ies and behavioral and emotional disorders, gifted and talented are also included in the category of exceptional children. All children, irrespective of disability have the right to get appropriate education. The enactment of the Persons with Disabilities Act 1995 is considered to be a
milestone in the disability rehabilitation in India. It ensures equal opportunities, full participation and protection of rights. Apart from Persons with Disabilities Act, The National policy of Education also demands inclusive education for all the children below 14 years irrespec tive of t heir disabilit ies. The Rehabilitation Council of India ensures quality in teacher education with regard to special education. As per RCI A ct only a registe red professional/personnel is allowed to practice in rehabilitation field including special educators. All special educators who are responsible for the education of the exceptional children are to be qualified in order to teach these special children.
*Faculty, Department of Special Education, National institute for the Mentally Handicapped, Secunderabad - 500009
33
Vol. 1 No. 2 July 2011
Journal of Disability Management and Special Education
Over the last few years, there have been many changes in the delivery of special education services for persons with disabilities in the country. This includes the role of special educator, therapist, parents and community, and the management process of that takes into account academics and other interventions such as control of undesirable behaviour, regulating students' growth and achievement, interpersonal development through cocurricular activities, organizational activities and therapeutic interventions. The curriculum for teacher trainees in special education in the earlier years had emphasized skill development that is essential for the classroom transaction of learning experiences. The developments that occurred in the field of disability rehabilitation and especially special education have eventually changed the role, duties and functions of special educator. The role of a special educator has undergone major metamorphosis during the last decade (Rao, 2005). The special educator is not only the one who imparts skill training and teaches various curriculum content but also a facilitator of learning experiences, planner, classroom manager, therapist and most often a clinician trying to handle and deal with behaviour management and control. Special education aims at curricular activities that aim at overall development of the child with disability, be it a child with mental retardation or a child with hearing impairment or a child with visual impairment and loco motor impairment. Holistic development of the student with 34
disability is the main objective of the special educator. Special educators dealing with children with hearing impairment have prescribed syllabus or curriculum by state board of education of respective states. But it is not the case with children with intellectual disability. Due to t heir significa nt limita tions in intelligence and adaptive behaviour, they have various needs. Hence, special educators teaching children with intellectual disabilities have an additional responsibility of developing individualized curriculum for every child. In India there are over 1200 organizations offering special education services. The quality of services which are being offered by these organizations is often determined by the practices and service aspects which special educators focus and which they perceive to be important. In spite of the efforts taken by the Rehabilitation council of India to have uniform practices in special education it is often observed that practices in special education var y from region t o re gion and f rom organization to organization across the country. The main aim of special education is to provide appropriate education in least restrictive environment to children with special needs. Thus it is necessary to study the practices in special education for children with special nee ds with a focus on the various responsibilities undertaken by trained special educators, their individual characteristics that may have an impact on the current practices. After going thoroughly through the review of related studies in Indian and international
Manogna / Current Practices in Special Education
context it is evident that quite a lot of work related to practices in special education is done if not directly but indirectly. The study done by Greg Conderman and Theresa Pedersen (2005) gives an insight into special education practices in special schools under Northern Illinois University. The authors acknowledge some poor practices occurring in secondary special education. It provides suggestions for school a dministrat ors who desire to strategically address these issues such as individual education plan, provision of related services to students with disabilities, practices in assessment and evaluation procedures and due process in order to provide exemplary programs for students with exceptionalities who are entitled to receive special education.
The study named 'Evidence-based practice among speech-language pathologists: attitudes, utilization and barriers' investigated by Richard, P. Zipoli, Jr. and Kennedy (2005) consisted of views of speech-language pathologists on evidence based practices and traditional practices. Positive attitude was reported for evidence based research practice but at the same time lack of time was perceived as a barrier to evidence based practices. Other than evidence based practice, practices in general in special school setting was not the priority. The study on 'Special education teachers' views of research-based practices' by Boardman, Gould; Arguelles, Elena; Vaughn, Sharon; Hughes and Tejero (2005) also reported that most teachers were not pressed to use practices supported by educational
The study done by French, 2001 though
research. They were not using extensively the research findings and results to introduce new
done mainly for finding out the teacher
practices. The special teachers preferred to
practices in supervising paraprofessionals it tells
go with the old practices in teaching their
us a great deal of information about the practices which they felt are important to
students with special needs. Current practices were not focused.
handle such as IEP planning, parent meetings,
A study was conducted by Rao and Panda
IEP meetings and so on in general but not in
(2005) with an intention to examine different
particular with any disability. The practices
practices in special education and also to
consisted of directions about guiding students'
develop a questionnaire to assess special
skills practice and suggestions for behaviour management. Teachers maintained primary responsibility for determining goals and objectives of individualized education program, informing parents, attending IEP meetings and
education practices in institutions that provide int erve ntion for children with mental retardation. Rao's SEPS scale was developed to study various practices in special education can be made uniform throughout the country
planning lessons and no other responsibility
by using Rao's SEPS. The findings have implications for planning for expansion of
was taken care until it was assigned.
services and can be made as an integral part 35
Vol. 1 No. 2 July 2011
Journal of Disability Management and Special Education
of their special education practice such a process will ensure holistic development of children with mental retardation. The findings of the study show that there were no differences in practice between rural and urban samples. Another major finding was that professional qualifications may not be a major influence on special education practices. The related studies review tells us that though a considerable amount of work is done in this area in western countries, but it is not disability specific. It is also inferred that very few studies were done in Indian context to study the practices in special education and still there is lot to be done. Hence there is strong need to study the practices prevailing in the field of special education with respect to intellectual disabilities and hearing impairment. The major objectives of the study were to examine different practices in special education for students with intellectual disabilities and hearing impairment with special emphasis on the roles and responsibilities of special educators teaching students with intellectual disabilities and students with hearing impairment. Method Participants The sample for the present study consists of special teachers working in special schools for students with intellectual disabilities and hearing impairment. The sample was drawn from special schools situated in the twin cities of Hyderabad and Secunderabad. Special educators who do not possess the qualifications as prescribed by Rehabilitation Council of India were not included in the study. Therefore the 36
sample size for the present study was restricted to 120 trained special teachers, in which 60 special teachers are trained to teach students with intellectual disability and 60 special teachers who are trained to teach students with hearing impairment. Purposive sampling was used by the researcher. Out of 120 special teachers 38 were male special educators and 82 were female special educators. 13 were male special educators and 47 were female special educators teaching students with intellectual disabilities. 25 were male special educators and 35 were female special educators teaching students with hearing impairment. Tool Rao's Special Education Practices Scale (Rao's SEPS) was used for data collection. It was developed by Dr. L.Govinda Rao, Former Director of the National Institute for the Mentally Handicapped, Secunderabad and Prof. K.C. Panda. The Questionnaire has two parts. Part 1 deals with the profile of the special educator in terms of age, gender, academic qualifications (general and professional/ rehabilitation), years of experience and Income and so on. Part 2 deals with Special education practices performed by the special educator as per their perception of the importance and advantage of such practices. The reliability of the scale is found to be high which 0.96 is. Rao's Special education Practices Scale (Rao's SEPS) consists of total 132 items arranged in six domains. Rao's SEPS uses a five point rating scale with ' not at all', seldom, sometimes, mostly, and always to elicit the responses from the special educators. The maximum score which can be obtained on this scale is 660.
Manogna / Current Practices in Special Education
The following table shows the number of items arranged in each domain.
Domains Therapeutic
Table -1 Domain wise arrangement of items S. No Domain
No. of Items
1
Academic activities
52
2
Management of behaviour problems
12
3
Therapeutic activities
11
4
Co-curricular activities
29
5
Student performance
10
6
Organizational activities
18
TOTAL
132
Students performance
Procedure The researcher had taken permission from the principals of the special schools to collect data from the special educators working in their schools. Special teachers were informed about the purpose of the study and their consent was taken before giving the scale. The Rao's SEPS was given initially to 160 special teachers teaching children with intellectual disability and hearing impairment. After two weeks the researchers collected back the filled in scale and given another two weeks time to those who have not completed. After two weeks the researcher again collected back the filled in questionna ire. A total of 120 filled in questionnaires were collected. Results Table- 2 Comparison of Domain wise mean scores in practices in special education Domains Academic activities profile Management of behavior problems
Co curricular activities
Group
N
Mean
ID
60 211.75
HI
60 194.23
ID HI
60 60
45.2 35.3
Organizational activities Grand total
Group
N
Mean
ID
60
36.37
HI
60
30.07
ID
60
93.8
HI
60
69.48
ID
60
45.75
HI
60
42.72
ID
60
60.75
HI
60
52.48
ID
60 493.62
HI
60 424.28
Domain wise mean scores are presented in table â&#x20AC;&#x201C; 2. The overall mean obtained by special educators teaching students with ID is 493.62, where as the overall mean score obtained by the HI special educators is 424.28. From the above table it is observed that the lowest scores are seen in the therapeutics domain in both groups of students with intellectual disability (36.37) and students with hearing impairment (30.07). It is also observed that the highest scores are seen in the academic activity profile in both students with intellectual disability (211.75) and students with hearing impairment (194.23). It can also be inferred from the above table that special educators teaching students with intellectual disabilities have scored higher than that of the special educators teaching students with hearing impairment in all the domains. Apart from domain wise analysis, item wise analysis was also done. In the domain academic activities profile, more than 80% of HI and ID and special educators have reported regular practices related to preparation of annual plan, writing lesson plans, developing IEPs, monitoring and evaluating students 37
Vol. 1 No. 2 July 2011
Journal of Disability Management and Special Education
performance, discussing progress details with parents and maintain record of the student. The lowest percentages were reported for practices related to circulating abstracts of recent research articles in the field(4%,37%), rea ding resea rch a rtic les/books(7%, 41%),presenting papers in staff meetings(7%, 40% ),developing quiz program mes (34%,52%), arranging educational tours/visits (32%, 40%), observing the sanitary and hygiene conditions in the classroom and school(30%, 62%) by HI and ID special educators respectively.
of training their students in drawing, painting, craft, and pottery and encourage them to participate in sports and games music, drama. About 40% of special educators (ID) and less than 25% of the special educators (HI) reported the practice of training the students in dance, drama, mimicry, folk songs, maintain the inventory of audio-visual, musical equipments, getting repair of the equipments, organizing exhibition cum sales stalls, mainstreaming students by participating in NCC and scouts and maintain record and albums related to co curricular events.
Under M anage ment of behavior problems, less than 60% of the ID and less than 40% of the HI special educators reported the practice of consulting the psychologist regarding the behavior problems in their students, implementing the program given by the psychologist, maintaining records, indulging in case discussions and to train parents in dealing with behavior problems. Under Therapeutic domain, less than 50% of the Special educators(ID) have reported the practice of organizing physiotherapy, speech therapy and occupational therapy exercises regularly and maintain the therapeutic records and monitoring the progress of the student. Nonetheless, 30% of Special educators teaching students with Hearing impairment reported the above said practices.
Almost 70% of both special educators reporte d the pra ctice of continuously evaluating the student's performance, maintain records of their progress, organizing parent meetings, reporting and discussing the progress of the students with the parents. Only 29% of HI special educators organize functions to celebrate the achievements winning students whereas 52% of ID special educators reported the same practice.
Though co curricular activities play an important role in the all round development of children with special needs most of the special educators reported less practice under the co-curricular activities domain. About 60% of the special educators (ID) and 40% of Special educators (HI) reported the practice 38
Under organizational activities, more than 55% of the ID special educators regularly inspect cleanliness, hygiene of door and corridors, ensure safety measures, take responsibility of teaching equipment, entry into stock registers, take interest in admission procedures, and make efforts for creating public awareness materials and less than 40% of special educators prepare schedules for ayahs, monitor their work, ensure that all electrical equipments are in proper order. Whereas special educators teaching students with hearing impairment have reported still more less practices in the same domain.
Manogna / Current Practices in Special Education
Table - 3: Comparison of Mean scores of overall practices with regard to Gender N =120 Gender Male
Female
Special educator
n
Mean
ID
13
466.69
HI
25
415.08
Discussion
ID
47
501.06
HI
35
430.86
The present study aimed at finding out the practices followed by special educators teaching students with intellectual impairment as well as students with hearing impairment. The study revealed mixed results. Planning as per the needs of the students is the key feature of special education. Majority of special educators were developing IEPs, writing lesson plans, monitoring and evaluating the student performance as per the IEPs and were regularly conducting parent meetings to report the progress of the students. But, there were several problematic findings. Neither of the special educators was interested in keeping themselves updated regarding the latest developments in the field. It was observed that special educators are not reading research articles/books in their respective fields which is not a positive finding. It was also noted that only 60% of the special educators (ID) and 40% of Special educators (HI) were regularly consulting the psychologist regarding the behavior problems. This can be attributed to the prevalence of behavior problems in children with mental retardation and hearing impairment. It is considered to be more prevalent among children with mental retardation than children with hearing impairment.
Table-3 shows the mean scores in practices in special education for students with intellectual disability and hearing impairment with regard to the gender of the special educators. The mean score of female special educators teaching students with intellectual disability is high (501.06) than that of female special educators teaching students with hearing impairment which is 430.86. The mean score of male special educators teaching students with intellectual disability is high (466.69) than that of male special educators teaching students with hearing impairment which is 415.08. Female special educators have scored more than the male special educators, indicating that they are following better practices while teaching children with disabilities than their counterparts. Table-4 Comparison of Mean scores in overall practices with respect to income N = 120 Income group < 10,000/-
>10000 /-
Table-4, presents the mean scores obtained by both HI and ID special educators. There is little difference between the mean scores obtained by both the groups. Hence Income may not be variable that influences the practices of special educators.
Special educators
n
Mean
ID
53
484.43
HI
40
478.13
ID
7
454.20
HI
20
460.11
Providing necessary therapeutic support is very important in special education. It was 39
Vol. 1 No. 2 July 2011
Journal of Disability Management and Special Education
expected that special educators teaching children with hearing impairment would score higher in therapeutics domain as they would be competent enough to give required speech therapy at classroom level. But the results have shown that only 51% of the HI special educators have reported the practice of organizing speech therapy exercises whereas 47% of ID special educators have reported the practice. It was observed that special educators are hesitant to talk to therapists regarding the condition and improvement of their students. Although inputs regarding various therapeutic aspects are included in the curriculum of teacher educators in special education as suggested by the Rehabilitation Council of India, special educators of both the groups are not facilitating and organizing therapeutic training to students with therapeutic needs. It is recommended that special educators of both groups make take keen interest in this line, in the interest of the overall development of the student. Alt hough, the tea cher training programmes in special education have a minimum of ten to fifteen hours of inputs on co curricular activities, the low percentages in the co curricular activities domain among both the special educators raises the concern regarding the under emphasis of special teachers on cocurricular activities. Only 25% of HI special educators have reported that they train students in dance, drama and other co curricular activities. It is recommended that the importance of co curricular activities should not be overlooked and special educators of students with hearing impairment and mental retardation should ensure that the students get enough exposure in this regard, which will help in the overall development of the students. 40
It was also found that majority of special educators were regularly documenting the progress of the students and evaluating the performance in line with the IEP. This practice should be continued. at the same time special educators should also make an effort to recognize and acknowledge the achievements and progress of the students by organizing gatherings in the schools. Such a practice will not only increase the self esteem of children with HI and ID but also will encourage them to strive hard for future. Cleanliness and hygiene is very important for maintaining good health. It was found that special educators do not take a proactive role in seeing that proper hygiene and cleanliness is maint ained in t he c lassrooms and surroundings and school. Active role should be played by the special educators in planning programmes for creating awareness among general public regarding children with special needs. It was found that only 40% of the special educators make an effort to create an awareness. Women are generally believed to be better teachers and especially when it comes to teaching students with special needs. This study showed that women were more involved than men and followed better practices. It was expected that age would be a critical factor in determining the practices which are followed. We expected that young special educators would enthusiastically involve in following better practices. But the results showed that there is no difference in the practices followed by young i.e., below thirty five years and special educators in age group of thirty five and above among both the educators teaching students with hearing impairment as well as
Manogna / Current Practices in Special Education
educators teaching students with intellectual impairment.
reliability and validity of the respondents. The
Experience appears to be a significant
current practices in special education in India
variable influencing the overall practices in
as research in this line is still in infancy stage.
special education. It is inferred that, educators
The investigator acknowledges that Rao's
with less than 10 years of experience were
SEPS is indeed a scientific and holistic
following better practices when compared to
approach for imparting education to children
their counter parts with more experience.
with special needs. The findings suggest that
Among the two groups, educators with less
Special educators can make a self evaluation
than ten years of experience in teaching
of the practices which are being followed by
students with intellectual disability were
them with the help of Rao's SEPS. Further
following better practices overall, when
research may be extended at national level,
compared to educators with more than ten
for all disabilities and the results may become
years of teaching experience and it is also
basis for developing guidelines for standardized
observed that income differences did not
common practices in education of children with
significantly influence the practices in special
special needs. The results of the extended
education among teachers teaching both the
research can be used as a guideline for
groups of special needs children. The results
evaluating the performance of special
of the present study are not in line with the
educators in providing appropriate education
findings of the study conducted by Roa.and
for students with intellectual disabilities and
Panda. (2005) i.e., experienced and older
hearing impairment.
educators were more competent than less
References
experienced counterparts but the present
Boardman, Gould.A,, Maria. E,& Marie Tejero(2005). Special education teachers' views of research-based practices, The Journal of Special Education, 22,
findings give a different picture that young and less experienced educators were more competent than their counter parts. One of the possible reasons for this could be less sample size and this study has restricted its sample from Hyderabad and Secunderabad cities. Conclusion The study has certain limitations first; the sample was collected only from Hyderabad and Secunderabad cities and hence could not be generalized. Second, survey data always have to be interpreted taking into account the
investigation adds to the research literature on
Cipani, C.E, Spooner, F. (1994). Curricular and Instructional approaches for Persons with Severe disabilities. A llyn and Bacon.1994. Conderm an,G & Theresa, P. (2005). Promoting Positive Special Education Practices, NASSP Bulletin, 89 (644), 9098 Fre nch, N. K. (2001). Supe rvising paraprofessionals: A Survey of Teacher 41
Vol. 1 No. 2 July 2011
Journal of Disability Management and Special Education
Pra ctic es: The journa l of spec ial education 35(1), 41-53. Hallahan, D.P.T. & Kauffman, C.M. (1988) Exceptional children (fourth edition), Prentice Hall Handbook on disability rehabilitation (2001) New Delhi: Ministr y of Welfa re, Government of India
Rao, G.L. & Panda, K.C. (2005). Practices in special education for children with intellectual disabilities, The Asia-Pacific Disability Rehabilitation Journal, 16, (2). Richard, P., Zipoli, Jr. & Marianne, K (2005). Evidence - based practice among speechLanguage Pat hologists: Att itudes, Utilization and Barriers. The American Journal of Speech language Pathology 14, 208-220.
Down syndrome I know a special little boy,
Now they are "healed perfectly,"
Logan is his name.
So now more problems with that part
He was born with all his body parts,
He learned to walk at fifteen months.
But some were not the same.
Right on time for a child with D.S.
There was something about
But, he didn't master crawling first.
chromosomes,
To the questioning concern of othersyes.
Whatever they may be! Instead of having forty-six,
Logan had made wonderful strides.
He has an extra one, you see.
Doctors and nurses have helped him so.
You'd think that such a tiny thread
But even with loving parents and siblings,
Could never cause much trouble, But it can and may upset many things--
Progress may be slow.
Some problems are even doubled.
So today I tell his story to you, My retired teacher friends.
When he was very, very small,
The more who know and pray for him,
He had defects in his heart.
The better he will grow and mend. â&#x20AC;&#x201C; Author Unknown 42
Vol. 1. No. 2 July 2011
Journal of Disability Management and Special Education ISSN: 2229-5143
Prevalence of Cognitive Impairment in Senior Citizens *Shakeeb A Khan
Abstract Cognition refers to a process through which information coming from sense is transformed, reduced, elaborated, recovered and used. With increasing life expectancy and decreased death rates, there is rapid rise in number and population in elderly individuals. Cognitive changes with ageing are proved and affect broad range of functions. This study examines the prevalence of cognitive impairment in senior citizens in terms of age, gender, literacy status and associated conditions like diabetes, mellitus and hypertension. The subjects were 100 senior citizens both male and female between the age group 60-75 years admitted to Acharya Vinobhava Rural Hospital, (AVBRH) Wardha, Maharashtra for various other ailments. Subjects were administered on a validated tool titled 'Mini Mental Scale Examination (MMSE)'. Data for cognitive impairment was obtained and analyzed using descriptive statistics. It was found that 47% of people in the age group of 60-75 years, showed the signs of cognitive impairment. Increasing age, hypertension and illiteracy were found to be significant correlates of cognitive impairment. Hence, if this group of patients is judiciously identified, functional recovery of elderly individual can be maximized through cognitive rehabilitation. Key terms: Cognitive Impairment, Senior Citizens
Introduction Mostly the world’s population is ageing. Increased life expectancy and decreased death rate have contributed to rapid rise in the number and proportion of persons above 65 years. By the year 2050 approximately 20% of world population will be older than 65 years (U.S dept. of Health and Human services 1995). According to National Bureau of Statistics, in India people above 60 in 1985 was 4.3 % and in 2005 was 6.3% of total population and in 2025, it will be 14 % of total population. Old age is partly a matter of subjective perception. The boundary between middle and
old age is not clearly marked by any physical or intellectual transformation. ‘How old would you be if you didn’t know how old you were’ was stated by Statchel, a clinical psychologist. In India retirement occurs around age of 60 and is generally viewed as beginning of old age. Cognition refers to the processes through which information coming from sense is transformed, reduced, elaborated, recovered and used. Cognitive processes are thus mental processes involved and knowing about the world as such they are important in perception, attention, thinking, problem solving and memory. Cognition plays an important role in
*Masters in Disability Rehabilitation and Administration, National Institute for the Mentally Handicapped Secunderabad Email: shakeeb_akhan@yahoo.co.in
43
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Journal of Disability Management and Special Education
learning. As learning is relatively permanent change in behavior as a result of experience. Thus use of cognition in learning produces a change in the way information is processed as a result of experience one had. In other words due to past experiences, significance and meaning of the events be changed, new association have been stored in memory for future use. Cognitive Abilities in Later Life: Cognitive changes with ageing are proved and affect a broad range of functions. Some intellectual skills stay on a more or less smooth plateau year after year. Other skills decline som ewhat . In general there a re three fundamental cognitive processing resources which tend to decline speed at which information can be processed - working memory, sensory skills and perceptual skills (Park, 1999). According to Piaget, elderly do not do as well on many tests as do adolescent and young adults. Conclusion from the studies is that as people grow old they regress cognitively- slip back to earlier less adequate levels of this thinking. Hornbulm & Overton concluded that older people generally show marked improvement in their performance and true underlying ability of older people may often be more advanced than their initial performance in unfamiliar tasks. Blackburn in 1984 concluded that poor performance of elderly as compared to younger people with respect to cognitive test is generally due to generat ional dif ference in hea lth and education. Because of increasing life expectancy and breakdown of social support system like joint family, cognitive impairment in elderly 44
individual has become a wide spread medical and social problem. It can be defined clinically as acquired loss of cognitive and emotional abilities severe enough to interfere with daily functioning and quality of life (Morgan and King).In developing countries like India, cognitive impairment produces large burden on support system. It is known that persons with mild to moderate cognitive impairment have a high risk of developing dementia. Therefore early and accurate identification of cognitive impairment is necessary. Although musculoskeletal disorders and osteoporosis are well-recognized long-term sequel of ageing, some researchers suggest that impaired cognitive status is least studied aspect of ageing. Along with that still there is a lack if consensual agreement regarding determinants of cognitive impairment. Eg., people with high level of education appear to have some protection against cognitive decline in elderly according to some researchers but other believed that age is the most determinant factor of cognitive impairment and increasing age is certainly associated with deterioration of cognitive abilities. Knowledge about such baseline modifiable and non modifiable determinants in cognitive impairment would help multi disciplinary team involved in rehabilitative process to adopt an appropriate treatment which may help to maximize the functional recovery during their rehabilitation. The Mini- Mental Status Examination (MMSE) is currently the main method of screening. This instrument was originally
Khan / Cognitive Impairment in Senior Citizens
developed as a screening tool for dementia and delirium in a psychiatric setting and has shown to have good sensitivity and specificity (Zenore - Kurlowicz -1999, Folstein 1975). MMSE takes only 5-10 minutes to administer and is therefore practical to use repeatedly and on a routine basis. In addition when used repeatedly the instrument is able to measure changes in cognitive status that may benefit from intervention point of view. The aim of study was to a scert ain t he prevalence and determinant of cognitive impairment. Earlier Studies Some of the studies, done earlier in Indian population have attempted for prevalence, are mostly urban based studies that have been carried out so far reported incidence rate of 12- 15 per 1000 persons per year for 65 and older. For people 75 years and above an incidence rate of 54 per 1000 persons per year have been estimated. Comparison of incidence rate across studies is difficult because of difference in diagnostic criteria, sample com posit ion; follow up periods and neurophysiologic m easures. Study of epidemiology of cognitive disorder in rural population requires specialized instrument and personal, cultural and sub cultural difference among population are highly relevant to design of such instruments. Over and above the cultural issue, it is widely recognized that low education and illiteracy pose considerable challenge to reliable and valid cognitive screening. Literature Review The study conducted by Venkatraman and Narayan on cognitive decline in elderly states that mild cognitive impairment refers to
clinical condition between normal ageing, in which persons experience memory loss to a greater extent than one would expect for age and yet do not meet current accepted criteria for clinically probable Alzheimer's disease. Acc ording to Mathurnath (2002), education has most pot ent e ffect on performance on mini mental state in Indian context. Stratified scores in education will provide more appropriate m eans of establishing cognitive status of patient. Rochester Minn. at mayo clinic found that patients with mild cognitive impairment performed like normal elderly person on MMSE and test of general intelligence. However they performed much worse than normal subjects and scored only slightly better than patient with Alzheimer's disease on test of verbal and spatial memory. Etiological study of dementia in tertiary care centre of N-W India by Panagarunja stated that 89.3% persons with dementia had memory impairment. According to Gupta there is significant correlation of MMSE scores with performance on attention visuo spatial, verbal learning and planning. Mary (2001) concluded in her study on 'depressive symptoms and cognitive decline in late life' that patient with baseline depressive symptoms had significantly lower baseline scores on all composites than non depressed participants. A study conducted by Clark et.al on 'Rapid eye movement sleep behavior disorder' found that sleep behavior disorder and its potential interaction with depression and cognitive impairme nt ca n be mist aken as ea rly dementia. According to Venkatraman and Narayan, diet high in anti oxidant rich food, higher 45
Vol. 1 No. 2 July 2011
Journal of Disability Management and Special Education
vitamin C and beta carotene level and high intake of mono saturated fatty acids like olive oil has been associated with protection against cognitive decline. In the same paper they concluded that cigarette smokers and people with high level of education appear to have some protection against cognitive decline. Reasons are unknown and they have found association between hypertension and deterioration in mental function. Need for the study: India with its population more than a billion faces myriad health problem. The increase in per capita income along with changing health care availability, with control of nutritional and infectious disorder has resulted in greater life expectancy of people. The scenario has also drawn new challenges of behavior linked with man made life style related problem. In this evolving health care scenario, non-communicable diseases pose major problem due to lack of skilled health care man power, inadequate information and inability of the system to meet this challenge. The social, biological and psychological strength of past have been slowly replaced by fragile life pattern of people making them more vulnerable to social, mental and psychological problem at all ages. Patients from all disciplines of medicine or surgery may develop cognitive complication in elderly age at any point of time. Therefore there is an urgent need to sensitize and assess in detail for all physiotherapist so that they don't miss such symptoms in their patients and establish appropriate connection. Unless this is done important advances made in different field of medicines are likely to go in vain. 46
In the present study, suitable cognitive and activities assessment and screening instruments have been used which are ď ˇ
Culturally fair, psychometrically sound and valid for a population with little or no education
ď ˇ
Optimally sensitive and specific for dementia
ď ˇ
Allow not only identification but also the more detail characterization of dementia of normal and abnormal cognitive ageing.
The study was very simple and used an accessible scale like MMSE and judge patient's orientation, attention, memory (immediate and delayed), verbal fluency, confrontation, naming items, repetition and writing executive function. Objectives of the study were to evaluate prevalence of cognitive impairment in senior citizens and to find out correlation of cognitive impairment with respect to age, gender, diabetes, hypertension and literacy status Methodology Simple random sampling technique was used to select 100 persons from AVBRH, Department of physiotherapy, Sawangi (M) Wardha, both male and female, age group 60-75 years. Subjects with any known nervous system dysfunction and communication problem such as language barrier or severe visual or hearing loss were excluded from the study. Mini Mental Scale Examination was used as a tool. The study comprised of 100 subjects in the age group of 60-75 yrs. The data for cognitive impairment was obtained from the subjects and was analyzed for descriptive statistics. On subjects, with age group of 60-75 years from each ward, assessments were made on admission to hospital which includes
Khan / Cognitive Impairment in Senior Citizens
inf orma tion on c linic al diagnosis and secondary diagnosis like hypertension and diabetes. Variables like socio demographic and educational status were also collected.
functions- orientation, registration, attention, calculation, recall and language. Patients whose MMSE score was more than or equal to 27 were classified as cognitively normal and patients with MMSE score was less than 27 were classified as cognitively impaired.
A validated tool of assessment MMSE, was used for cognitive impairment comprising 18 questions that test five areas of cognitive Data Analysis
Figure:1
No. of Patients
Graph 1:Agewise and gender wise distribution of patients. 40 35 30 25 20 15 10 5 0
male female
60-65
66-70
71-75
Age Group (Yrs)
Figure: 1 depicts the age and gender wise distribution of sample. In the age group of 60-65 years there were 35 males and 26 females, while in the age group of 66-70, there were 15 males and 10 females and in age group of 71-75 there were 11 males and 03 females Figure: 2 Prevalence of Cognitive Impairment
N o rm a l 53%
47%
Im p a ire d
Figure: 2 depicts prevalence of cognitive impairment in the selected sample. 53% was found normal and 47% were found having impaired cognitive function. 47
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Journal of Disability Management and Special Education
Figure: 3: Correlation between age and Mini Mental State Examination
No. of Patients
60
53 47
50 40 30
37
Cognitively Impaired
24 15 10
20 10
Normal Cognition 8 6
0 60-65 66-70 71-75 Total Age Group (Years)
Figure 3 shows the correlation between age and MMSE. There was non-significant correlation between age and Mini-Mental State Examination where P value is 0.054 (P>0.05) Figure: 4: Correlation between Gender and Mini Mental State Examination Score 60 53 47
50
No. of Patients
st n e it a p f o . o N
40 30
34
cognitively Impa ired
27 Normal Cognitio n
20 19
20 10 0 Male
Female
Total
Gender
Figure 4 shows the correlation between gender & MMSE. Out of 61 males selected for the study, 34 males and 19 females had cognitive impairment. There is non significant correlation between gender and cognitive impairment. 48
Khan / Cognitive Impairment in Senior Citizens
Figure: 5 Correlation between diabetes and
No. of Patients
Mini Mental State Examination Score
60 50 40 30 20 10 0
47
44
53
Cognitively
35
Impaired Normal Cognition
12 9
Present
Absent
Total
Diabetes
Figure: 5 depicts correlation between subjects having diabetics and MMSE. Out of the 21 diabetic subjects 12 had cognitive impairment while 35 non-diabetic subjects also had cognitive impairment; significant relation was found between diabetes and cognitive impairment.
Figure: 6 Correlation between hypertension and Mini Mental State Examination Score
60
53 47
No. of Patients
50
47 Cognitively
40 30
Impaired
26
21
Normal Cognition
20 10
6
0 Present
Absent
Total
Hypertension
Figure: 6 shows that out of 27 hypertensive patients 21 had cognitive impairment. Thus there is significant correlation between cognitive impairment and hypertension (P<0.05)
49
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Journal of Disability Management and Special Education
Figure: 7: Correlation between literacy status and Mini- Mental State Examination score
60
53 47
No. of Patients
50
39
Cognitively
34
40
Impaired
30 20
Normal cognition
14
13
10 0 Present
Absent
Total
Literate
Figure 7 shows correlation between literacy status and MMSE. Out of 48 uneducated subjects 34 of them had cognitive impairment. Fisher's exact test established extremely significant correlation between cognitive impairment and literacy status (P=0.0001)
No . o f P atien ts
Figure: 8 Age wise distribution of severity of impairment.
20
17
15 10
60-65
9 5
5
7
66-70 3
3
3 0
71-75 0
0 M ild(21-26)
M oderate(11- S evere(0-10 20) S e ve rity
Figure 8 depicts the age wise distribution of severity of impairment. 31 out of 47 subjects had mild, 13 had moderate and 3 had severe cognitive impairment, 50
Khan / Cognitive Impairment in Senior Citizens
Findings: The study comprised of 100 subjects. The data for cognitive impairment was obtained from subjects and analyzed using descriptive statistics. Prevalence ratio was used to evaluate cognitive impairment. Out of 100 subjects, 47 patients had cognitive impairment. Their score was less than 27 out of 30 and 53 were normal. Researcher also found out the correlation between cognitive impairment with respect to age, gender, and score of MMSE, hypertension, diabetes, mellitus and literacy status of patient. The result of correlation between literacy status and cognitive impairment, calculated using Fisher's exact test were highly significant with value 0.0001 P < 0.05. There was significant correlation between cognitive impairment and hypertension with value 0.0002 P < 0.05. Study showed non significant correlation bet ween age and M ini Menta l St ate Exa minat ion, where P value is 0. 054 P > 0.05.The reason for such result was due to less number of patients having hypertension in the age group of 66-70 as compared to the other group as well as this particular age group which had higher number of literate patients. Investigator found non significant result for correlation between gender and cognitive impairment where P value is 0.5416 P > 0.05. Same relation was found in diabetes and cognitive impairment with P value 0.332 P > 0.05 that is non significant. Discussion In the study investigator was able to assess the prevalence of cognitive impairment in elderly individual who upon their admission to rehabilitation settings had significant
cognitive impairment ranging from mild to severe and baseline correlates. Study comprised of 100 patients and data was obtained from the subjects for cognitive impairment using MMSE and it demonstrates significant result (47 out of 100 patient had cognitive impairment) In earlier study by Venkatraman and Narayan 'Cognitive decline in the elderly' reported an average incidence rate of 12-15 per 1000 persons per year has been reported for people 65 years and older. In the same study it was concluded like life style changes like cigarette smoking and adequate amount of vitamin B6 (pyridoxine) in the diet have some protection against cognitive decline. According to Mathuranath & Cherian in their article MMSE - effect of education and norms for multi cultural population, education has most potent effect on performance of MMSE in Indian context. Education stratified scores MMSE will provide a more appropriate means of establishing cognitive status of patient. The pre sent study shows t hat hypertension and increasing age are significant determinants of cognitive impairment. Investigator evaluated their sta tistical correlation in that and got significant results in hypertension and cognitive impairment. (p < 0.05) The present study is similar to most of other studies on cognitive impairment in elderly individual e.g. Venkatraman & Narayan (2004) concluded age, education and other diseases like hypertension are strongly associated with cognitive impairment. Reasons for this association remain unknown. 51
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The result of present study matches with the above mentioned studies. The present study suggests that there is significant prevalence of cognitive impairment in senior citizens and educated and non hypertensive patient are benefited and gender has no role in cognitive impairment.
Folstein (2001). Users Guide Mini Mental Sta te Examination. Psychological Assessment Resources
Conclusion
Morgan & King Introduction to Psychology 7th Edition
From the above study it is concluded that 47% of elderly individual in the age group of 60-75, present with cognitive impairment in rehabilitation settings. Along with increasing age, hypertension and illiteracy were found to be significant correlate of cognitive impairment. Hence by judiciously identifying their group of patients functional recovery of elderly individual can be minimized specially that visiting rehabilitation setup. Another study can be conducted based on neurological c ondit ion, chronic musculoskeletal conditions, gender related problems and other geriatric related problems comprised of large sample with broader range of age group References: Ahuja N. Brief Text Book of Psychiatry - 2nd Edition. Banks, W.A.( 2003). Recent Advances in Understanding Cognitive Impairments and Dementia. Journal of Gerontology; 58 (3) 114-121
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Mathurnath, P.S. Cherian (2007). Effect of education and norms for a multicultural population. Neurology India AprilJune;55(2)97-126.
Mary, G. ( 2001). Depressive symptoms and cognitive decline in late life. Arch Neurology; 58:517 National Bureau of Statistics. Population Growth in India - A Perspective Study (2005). (www.populationcommission. nic.in) Park K. Text Book of Preventive and Social Medicine -15th Edition. Paykel, ES. (1998). Incidence of dementia in a population older than 75 years, Arch. Gen. Psychiatry; 51:325-328 Panagarjuna, A. (2004) Etiological Study if Dementia in a Tertiary Care Center of North West India. Neurosciences Today; 8: 84-87 Stahelin, (1997). Relation between antioxidants and memory performance in old and very old. Journal American Geriatric Society; 45.718-24 Venkatraman S, Narayana C.S. (2004). Cognitive De cline in Elderly. Neurosciences Today; 8:120-24.
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Importance of Developmental Screening and Assessment: From a Rehabilitation Psychologist's perspective *Binapani Mohapatra, **Keerti Sudha Rajput ***Sunita Devi, ****Roma Anand
Abstract Developmental screening is a procedure designed to identify children who should receive more intensive assessment or diagnosis, for potential developmental delays. It can allow for earlier detection of delays and improve child health and well-being for identified children. Many children with behavioral or developmental disabilities are missing vital opportunities for early detection and intervention. Assessment is generally used for diagnosis or classification, however, Rehabilitation Psychology, which has emerged from Evidence Based Practice (EBP) uses assessment for early intervention and rehabilitation following the guidelines of Rehabilitation Council of India (RCI). The present article is the convergence of experimental studies that indicate EBP, Rehabilitation Psychology and Developmental screening and Assessment are contemporary. Also, discusses how a diagnostic algorithm can be used for interventional purposes and how best practices improve the life of children with developmental disabilities.
Background Evidence Based Practice (EBP) has expanded from its origins in medical sciences to rehabilitation sciences to encompass care for chronic health conditions and mental disorders. Developmental screening and assessment is one such advancement in clinical prac tice. Such quality pra ctice during developmental phase promotes direction for research. Advent of contemporary education emphasized the importance of early child care and demonstrated the impor tance of environmental stimulation. Chances of brain
insult during prenatal and perinatal stage, infections in post natal stage or failure to thrive without organicity due to deprivation of novel external stimulus have high risk for global developmental delay which may lead to intellectual disability along with impairment in adaptive behavior in early life of a child. Keeping above points in view early 60s have witnessed the emergence of pediatric screening and assessment for recognizing children's unmet psychological needs, thus professionals from various fields endorsed screening and assessment as a viable approach
*Head of the Department, Department of Rehabilitation Psychology National Institute for the Mentally Handicapped, Secunderabad. **M.Phil, Rehabilitation Psychology Scholar ***M.Phil, Rehabilitation Psychology Scholar ****M.Phil, Rehabilitation Psychology Scholar
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to provide overall pediatric services on a large scale. These services emerged in providing spe cial services for c hildren with developmental disabilities through preschool screening programs. Gesell (1925) argued that it is important to become knowledgeable and effective in the development diagnosis of behavior; also that behavior develops in a patterned, more or less, predictable manner. Another way to observe this phenomenon of quality practice is evolution of Rehabilitation Psychology. The field of Psychology has wit nesse d Rehabilit ation Scie nce a s a consequence of EBP. A Rehabilitation Psychologist is concerned with management and science of disabling and chronic health conditions (Frank and Elliot, 2002). Hence, she/he understands the importance of systema tic docume ntat ion of human development in physical and mental areas, which helps her/him for valid diagnosis and formulating appropriate intervention strategies. Development and Maturity: Development is to unroll and eventually grow over a period of time and maturity is the term used when such development attains full purpose. According to Gesell, development is an organic process which yields to scientific and to diagnostic appraisal. He further argues that the most fundamental function of an infant is development. Development of child is defined as the emergence and expansion, in scope of living, of its capacities to provide great facility in functioning. This is achieved through the process of growth, maturation and learning, which has two aspects of change in terms of 54
quantity and quality. The maturity is usually designated as qualitative changes in the complexicity of structure, which makes it possible to begin functioning. Maturation determines development and maturation occurs regardless of practice or training. Hence maturity is not an endpoint but a characteristic that can be attained relative to any state in the life span. According to Gesell, to evaluate maturational behavior symptoms is the most cost effective, reliable and easy process. Rationale: Best practic es in Re habilitat ion Psychology in clinical setup and systematic documentation of developmental process has made the world of diagnostic tests highly dynamic. A sensitive and specific screening and assessment tests not only reduce the number of unwanted clinical consequences related to misleading estimates of test accuracy, but also limit health care costs by preventing unnecessary testing. Screening provides the key to the door of a wide range of professional services available to children with disabilities and their families; help developing a reliable database for the incidence of developmental disorde rs in children. Provide tim ely intervention for children who are at high risk and therefore facilitate program planning to meet the service need of these children. Definitions: Screening is to plan a therapeutic management, referring to a professional when and whom to refer for further diagnostic evaluation/ observation/monitoring. Screening
Mohapatra, et. al / Importance of Developmental Screening
is a critical process that aids early detection and facilitates early referral for evaluation and subsequent intervention. Assessment on the other hand, according to Achenbach (1988); Tryon (1976); and Weaver (1984) is to dist inguish the spec ific features of an individual's problems or disorder as well as to determine causality. Hence Developmental Assessment is a process through which clinical information is obtained in order to provide answers to developmentally related questions and to generate appropriate intervention. So Assessment is advancement of screening in dia gnost ic continuum, which involves continuous or ongoing process. It indicates the planning intervention strategies and their efficacy. Developmental assessment is done during the process of development and has very specific purposes regarding development.
Screening procedures must be culturally sensitive;
Extensive and comprehensive training is required by those who screen.
The major goal of Deve lopmental Assessment is firstly, deriving a diagnosis; secondly, planning for intervention and evaluating progress and finally for research and policy making
Conceptual Framework:
Factors determining the Screening and Assessment are their sensitivity, specificity, reliability, validity, Rate of false positives and rate of false negatives and co-positivity. Guidelines for Screening:
Screening is specific to the area and should not be generalized;
Screening tools needs to be reliable and valid;
Family members should be integral part of the screening process
Guidelines for Assessment:
Assessment need to be holistic;
As assessment is ongoing and continuous process, development needs to be assessed at periodic inter vals for understanding indivualistic formulation of brain processing and its capacities and limitations
Assessment needs to be domain specific and need to be balanced
It should be confidential.
Flow chart for diagnostic purpose: (Flow chart 1)
The deve lopme ntal scree ning and assessments have been evolved through valuable contributions from: a) biopsychosocial model (Engel, 1980); b) ecobehavioral model (Bonker, 1972) in psychology; bioecological model (Bronfenbrenner, 1999) in child development. By integration of all models, an integrated framework evolved in screening and assessment of development. This integrative framework is used in different areas in different set tings the y include : de velopment of cognition; language development; social and emotiona l developm ent; personal development. Framework for Assessment: (Flow chart 2) 55
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Flow chart - 1
Flow chart for diagnostic purpose:
Negative results: development normal
screening
Referral issue
Positive results: confirmation of development problem
Further assessment (e.g., observation, interviewing, testing
Assessment results and decision making
Confirm diagnostic Confirm entity diagnostic
Document developmental developmental Document
Efficacy of intervention through assessment
Interventio Intervention
status
Methods of Assessments:
into a container, respond to simple verbal
Babies can do very little when they are first born. But, gradually, over the first few years of life, they learn to walk and run (gross motor skills), they learn to manipulate objects with their hands (fine motor skills), they learn to
requests, and enjoy imitating people during pla y. Every child att ains the various
communicate with words and gestures (language skills), and they learn how to interact with other people (social skills). For each of these skill "domains," experts have identified "developmental milestones," skills that are acquired by a specific age if development is proceeding normally. So, for example, by one year, a child should be able to crawl, put objects 56
developmental milestones at a slightly different age but their overall development can be monitored using a series of simple tests (items) covering each of the developmental domains. Clinicians and teac hers can use these "developmental assessment tools" to identify children whose development devia tes significantly from the norm. It is important to identify these children as young as possible because early intervention can help them reach their full developmental potential.
Mohapatra, et. al / Importance of Developmental Screening
Flow chart - 2
Framework for Assessment:
Referral Question
Define Assessment goals
Define Characteristics Derive information for intervention planning Efficacy of intervention
Select strategies and domains to address assessment goals
Ecobehavioral
Psychometeric
Cognitive domain
Qualitative development
Communication domain
Personal/social domain
Behavior domain
As illustrated in the above flowchart, Psychological Screening and Assessments involve cognition, emotion, connation during developmental period of an individual. Table-1 : Popular Developmental screening and Assessments used in India. Sl Screening Tests No.
1 Developmental Screening Test (DST) By Bharat Raj, 1977 (Arya, 1987)
Age range 0 month to 15 years
Areas covered Sl No.
Motor, speech, self-help skills; concept formation
Assessment tests
1 Developmental Assessment scales for Indian Infants (DASII) (Patak, 1987) 57
Age range
Areas covered
1 month to 30 months
Motor and Cognitive
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Age range
Areas covered Sl
2 Denver Developmental Screening Test (DDST) (Frankenburg, 1990, 1992)
1 month to 6 years
Developmental sequence
3 Vineland Social Maturity Scales (VSMS) (Nagpur adaptation, Malin, 1965)
1 month to 15 years
Motor, Self-help 3 Binet-Kamat skills, social Test of intelligence Intelligence (BKT) (V.V.Kamat, 1934)
No.
No.
Assessments tests
2 Early childhood Inventory (Ringwalt,2008)
Age range
Areas covered
3-5 years
Emotional and behavioral disorders, language liabilities, gross and fine motor, and social skills
Memory, language, reasoning, concept formation, attention, social intelligence 4 Malin's scales 7 years Comprehension, of Intelligence to Information, for Indian Arithmetic, Children vocabulary, (MISIC) memory, (Malin, 1966,1968) attention, problem solving, visio-perceptual abilities, visioconstructional abilities
4 Gessell Drawing Test (Gessell, 1949)
18 months Motor to coordination, 8 years spatial abilities,
5 Developmental screening schedule, I,II,III (NIMH, Saroj Arya, 1987)
I - (below Motor 3 years) development, II - (3-6 years) self-help skills III - (7 years Socialization and above) skills
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5 Bhatia Battery of Intelligence (Bhatia, 1955) 11 years to 16 years
3 years to 22 years
11 years memory, to attention, 26 years problem solving, visio-perceptual abilities, visioconstructional abilities
Mohapatra, et. al / Importance of Developmental Screening
Conclusion: As a rule, prevention is more effective and economical than rehabilitation; however, perinatal stress and its outcomes are such factors which are difficult to control, hence early identification of high risk of intellectual disability is essential for developing appropriate intervention strategies. The main purpose of screening and asse ssme nt is to plan intervention program. After initial screening, a battery of assessment tools are used to approximate the a bilities of the child contrasting limitations; as stated above, this is a continuous process. There are several scales of measurement, selecting an appropriate measure is a crucial part, because diagnosis saves the time of professional from intervening a child on "trial-and-error" basis. Without measurement scales, there will be no evidence as to whether interventions to improve outcomes in early childhood are effective in the context of individuals with developmental disability. The authors agree with Pinto-Martin (2004) who stated that the science of developmental screening and assessment has dramatically matured over years. It is now possible per form standard low-c ost developmental screenings in community-based settings as well as in Institute-based setting like hospitals. However, current practice lags far behind the research. Integration of routine developmental screening into pediatric primary care is still an unrealized goal. It has now become necessity that all professionals work in synchrony to implement effective changes from grass root level to policy making. The
compelling rationale for change is clear: promising and effective approaches are available to ensure that all young children receive high-quality, first-level screening and assessment. References Ames, Louise Bates (1989). Arnold Gesell: Themes of his work, New York, Human Science Press. Arya, S. (1987). Developmental Screening of Preschool Children: An overview, Indian Journal of Disability and Rehabilitation, December, Bhatia, C.M. (1955). Performance Tests of Intelligence, under Indian conditions; Oxford University Press, London Culbertson, J.L. and Willis J.D; (Edt) 1993; Testing young Children-A reference guide for Developmental, Psychological, educational and Psychosoc ial Assessments; Pro. Ed, Austin, Texas, USA. Pinto-Martin J.A., Dunkle, M., Earls, M., Dane Fliedner, D., and Landes, C. (2005). Developmental Stages of Developmental Screening: Steps to Implementation of a Successful Program, American Journal of Public Health, 95, 1928-32 (http:// www.ncbi.nlm.nih.gov/pmc/articles/ PMC1449461/pdf 0951928.pdf?tool =pmcentrez) Levine M.D., Carey W.B. and Crocker A.C. (1992); Developmental-Behavioural Paediatrics; W.B. Saunders Co.; 2nd edition; Sydney, Tokyo, Philadelphia, London, Toronto, Montreal. 59
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Malin, A.J. (1976). Malin's intelligence scale for Indian children (MISIC), Indian Journal for Mental Retardation; 4:15-25. Phatak, P (1987). Developmental Assessment Scales for Indian Infants: Manual, Anand Agencies, Pune. Ringwalt, S. (2008). Developmental screening and assessment instruments with an emphasis on social and emotional development for young children ages birth through five. Chapel Hill: The University of North Carolina, FPG Child Development Institute, National Early Childhood Technical Assistance Center. (http://www.nectac.org/~pdfs/pubs/ screening.pdf) Sheehan, R. (1998); Assessment of young developmentally disabled children; Plaenum press, New York. Simeonsson, R.J. & Rosenthal S.L. (2001); Psychological and Developmental Assessment- children with disabilities and chronic conditions; The Guilf ord Press,New York, London.
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Verma, S.K., Pershad, D., & Kaushal, P. (1972). Gessell Drawing Tests as a measure of intelligence in the mentally retarded children, Indian Journal of Mental Retardation, 5 : 64-68 Bibiliography: Dana S. Dunn & Timothy, R. Elliott, T. (2008). The Place and Promise of Theory in Rehabilitation Psychology, Rehabilitation Psychologist, 53(3): 254-267. Frank, RG.; Elliott, T., (Eds) (2000). Handbook of rehabilitation psychology. Washington, DC: American Psychological Association. Suzann, K. Campbell; Darl W Vander Linden; (Eds) (1994). Physical Therapy for Children. Philadelphia, Saunders. Tehal Kohli (1998).Family and community intervention services through self help groups (CBR) for enhancement of development of mental retardates, at The 7th. International Portage Conference Hiroshim a Proceedings (http:// www.port age project .org/7th_conf/ se_India2.htm)
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Effect of Drama on Learning Social Skills among Children with Mild Intellectual Disability T.V. Sunish & A.T. Thressiakutty
Abstract The present study was conducted to determine whether drama has a positive effect on learning social skills among children with mild intellectual disability. The sample included six students with mild intellectual disabilities studying in pre-vocational-I and National Institute of Open Schooling (NIOS) class at National Institute for the Mentally Handicapped, Sceunderabad. Social skills development of the students were assessed by using an advanced level social skills checklist prepared by the investigator. Pre-test post-test design without control group has been used for the present study. Intervention group was intervened for twenty sessions for twenty days. Statistical analysis revealed significant difference among students for pre and post-test scores (p < 0.01). In addition, the researcher observed that the attention, concentration, and interest of the students were improved. Key terms: Mild intellectual disability, Drama, Social skills
Introduction The social skill is an individual ability to express both positive and negative feelings in the interpersonal context without suffering consequent loss of social reinforcement in a large variety of interpersonal context, involving the co-ordinate delivery of appropriate verbal and non-verbal responses (Bellack, and Hersen,1997). The emphasis of sharing reciprocity and responsibility are important here. Children with intellectual disability like the normal children have the capacity to grow and develop. But they need an environment conducive for growth and development. The process and the means of growth and development depend on the degree of their
retardation, psychological and emotional capacities and the environment in which they live in. Their growth and development may be facilitated in a therapeutic environment providing opportunity f or functional programmes, which usually emphasis social skills with collaboration of professionals, parents, teachers, peers and relatives. The children with intellectual disability undergo the same maturation process as other children do, except some with delayed milestones. The extent of the difference between the pattern of social relations and social maturity of the children with intellectual disability and the normal is quite obvious. The socio-grams of the children with intellectual disability if drawn, will show a low
*Assistant Professor, FDMSE, RKMVU, Coimbatore sunishtv@gmail.com ** Professor in Special Education, FDMSE, RKMVU, Coimbatore Kutty1942@yahoo.com
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range of social relationship since their interaction is confined to limited persons in the se environments and their soc ial functioning, interpersonal relationship and real performances present the evidences that the persons with intellectual disability are not socially so matured as the persons without intellectual disabilities. Effective social skills programs are comprised of two essential elements: a teaching process that uses a behavioral or social learning approach and a universal language or a set of steps that facilitates the learning of new behavior. Interventions can be implemented at a school wide, specific setting, class room or individual level, but at all levels the emphasis is on teaching the desired skill, not punishing negative behaviors. The school or home environment can affect a child's ability to learn and perform good social skills. If a child is experiencing difficulty in demonstrating a particular skill, it is best to first evaluate the environment to determine wha t might inter fere with the child's appropriate acquisition of that skill (Lovett, and Harris, 1987). Some children need more intensive, personalized training because of individual factors, such as a disability. These interventions might be aimed at children experiencing a specific difficulty or those who have previously been identified as at risk for behavior problems. For example, studies (Carreira, 2005 and James, 2005) showed that children with mild disabilities tend to exhibit deficient social skills and excess problem behaviors more than students without such disabilities. Intervention programmes for the at-risk students are based on individual assessment of the particular child's skills and deficits. Selected interventions aim to prevent 62
existing behavior problems from developing into more serious ones. Drama One of the most basic skills that are encouraged by participating in drama is social skills (Bayhan, 2001). Children develop language skills and vocabulary as well as math and problem solving skills as they act out scenes from plays. When children act out scenes on stage, they learn to sort plot and character information by classifying and categorizing, develop a keen scene of timing and learn decision making skills by determining appropriate ways to portray character. The special benefits of this art form Participation in the performing arts is not appropriate or desirable for every student at every level of development. However, for exceptional learners who are open to the process of rehearsal and performance (and that in many experience, is the vast majority of them) there are numerous advantages, both obvious and subtle. Since pre-historic tribes first began to perform around the campfire. The impulse to act has reflected two supremely hum an needs: to understand and to communicate. A reflective actor is analytical. He/she strives to identify and anticipate both behavioral and narrative patterns, and eager to perceive the cause and effect relationship between the action of a character and the subsequent course of a story he/she seeks to understand. An effective actor should be a cooperative person. Rehearsal and performance constitute an extremely social process. A productive teacher will always seek to create an encouraging, supportive atmosphere in which each member of the class is free, indeed eager, to participate. There is conversation,
Sunish & Thressiakutty / Effect of Drama on Learning Social Skills
there is discussion, and most of all, there is laughter. Finally, there is an awareness that effective actor must work together, encouraging one another's effort and sharing one another triumphs (Smith, 2005). Review of Literature Lanny (1998) demonstrated through the study that children with learning disabilities can improve and mainta in social and oral expressive language (speaking) skills through a creative drama program with an emphasis on specific social and oral language usage. Bayhan (2001) conducted a study to investigate the effects of the drama in education on the social development of the children with intellectual disability. The study was performed on 17 children whose developmental levels were 3-4 year according to the Portage Early Childhood Period Educational Program. Social development skills of children were determined by using a pre- and post-test with Vineland Social Maturity Scale. During the study, an educational program prepared to support social development was used by means of the method of educational drama. As a result of the statistical analysis, a significant difference was found between and within groups for preand post-test scores (p<0.05). Johnson and Magid (2005) developed multimodal group counseling approach to enhance adolescent interpersonal skills through combining interpersonal cognitive problem solving (ICPS) dialoguing and a variation of drama therapy. Fifteen black foster care youth participated in a summer stock theatre experience. The Means-Ends-Problem-Solving Procedures was administered pre-and postgroup intervention, showing a significant difference in interpersonal cognitive problemsolving.
Walsh (2005) desc ribed a drama prevention program in a rural Grade 6-8 junior high school, designed to facilitate incoming students' transition to their new school environment by developing social skills. Extensive pilot work with a social skills curriculum based on creative drama in small groups suggested that it could be successful in strengthening peer relations. The results indicate that creative drama groups have some usefulness for individual-centered primary prevention. Laura (2006) conducted a study to explore the effects of the Social Competence Intervention Program, a unique intervention based on creative drama. The sample included children with diagnoses of Nonverbal Learning Disabilities (NVLD), Asperger Syndrome, High Functioning Autism (HFA) and Attention Deficit Highperactivity Disorder (ADHD). Qualitative data were also collected through child interview, parent interview and group leader journals. Quantitative results approached significance at 0.05 level. Post-intervention, the treatment group was observed to have significantly less solitary behaviors and significantly more positive interactions than the clinical control group. According to parent and child pa rticipant inter views, 75% of participants reported one or more positive effect in social competence as a result of participation Catterall (2006) conducted a study on lea rning through drama in light of conte mporary t heories of knowle dge acquisition. This experiment involved young adolescents over a span of 24 weeks in a drama program aimed at both teaching dramatic arts and also boosting peer-to-peer conflict 63
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resolution skills. To assess individual learning, the research enlisted a pre-post-treatment and com parison de sign with a rigorously established matched control group. The program goals included promoting general group skills, the ability to work with interpersonal differences, and problem resolution skills. Participants exhibited positive developments in 5 of 7 scales designed to measure group skills and motivation. Advances in the ability to work in groups and in selfefficacy stands out. Students also gained regard for acting and performing. Malm and Lofgren (2007) conducted a study aimed at improving conflict handling among adolescent school children through the use of educational drama. Interviews with students and their teachers as well as observations have been used; drama exercises have also been video recorded for further analysis. While students found it difficult to articulate their understanding of conflicts verbally, their engagement in the reconstruction of conflicts disclosed their grasp of the components of a conflict clearly enough. Peer teaching was found to be an effective method of teaching about conflict management Need and Significance of the study Every individual is expected to be independent in his/her life. He/she is expected to solve a problem and handle a situation tactfully when the need arises. Achievement of social skills, to a certain extent, is expected from the persons with intellectual disability. A person with intellectual disability has to learn social skills systematically and through different teaching methods and strategies to deal with the situation. Social skills areas are the most 64
important are as where a person with intellectual disability needs to be trained to get the social acceptance in the community. It can be taught by creating a simulated situation like drama or one act play. Drama is one of the methods to teach basic concepts and social skills to the children with intellectual disability. Professionals in the field of special education can meet the challenge of training difficult task to children with special needs in a better manner by the use of this method. If drama has been found effective for adolescents with mild intellectual disability to learn social skills, importance can be given to this method. It is a source of recreation and enjoyment. In this study the term 'drama' refers to the one act play developed by the investigator to teach social skills to children with mild intellectual disability. The term, 'social skills' refers to the necessary skills which are expected from the adolescents with intellectual disability, in order to become acceptable persons in the society. Social skills include communication, leisure time and skills needed to interact with others. Objectives of the study were to find out the effect of drama on learning social skills especially survival, interpersonal, problem solving and conflict resolution skills among children with mild intellectual disability. Methodology Single group pre t est post t est experimental design was used to measure the effect of drama on learning social skills among children with intellectual disability. Six adolescents with mild intellectual disability both male and female attending National Institute of Open Schooling and pre-vocational I at the
Sunish & Thressiakutty / Effect of Drama on Learning Social Skills
Nat ional Inst itute for the Menta lly Handicapped, Secundarabad were selected as per the requirements of the characters of the one-act-play developed for the study. Development of the tool The primary objective of the study was to find out the effect of drama on learning social skills among students with mild intellectual disability. Social skills checklist for pretest and post test and a one act play to teach social skills were developed exclusively for this study. Social skill checklist The main checklists, which were in use in special schools, were Madras Developmental Programm ing System , Behavioural Assessment Scale for Indian Children â&#x20AC;&#x201C; Mental Retardation (BASIC MR) and Functional Assessment Checklist for Programming. These checklists have a domain on social skills. The researcher went through all these checklists and items included in the social skills domain. Though, the items are arranged f rom dependence to independence level advanced social skill items necessary for adolescents with intellectual disability are not adequately given in these checklists. An advanced level social skills checklist exclusively for this purpose was not found in use in India. Therefore an advanced level social skills checklist has been developed. In order to develop the check list, initially thirty five items were listed related to social skills in the categories of survival, interpersonal, problem solving and conflict resolution. The items have been randomly arranged. The thirty five ite ms list was circula ted to eight professionals working in the field of special education. The items with 80% consensus were selected and rests of the items were excluded.
The revised version kept as the final checklist. The total of 20 items grouped into four categories. They are: survival (5 items), interpersonal (5 items), problem solving (5 items) and conflict resolution (5 items). The selected twenty items of advanced level social skills categorized under four subheadings has been used as the final tool for pre-test and posttest for the study. The responses were scored by assigning a value of '0' for 'Never', 1 for 'Rarely', 2 for 'Sometimes', 3 for 'Often', and a score of 4 for 'Always'. Drama (One-act play) Criteria for selection: The play included the social skills which are necessary to be taught to the adolescents with mild intellectual disability matching the level of the sample selected for the study. The one-act play (duration 10-15 minutes) also had a message suitable for the objective of the study. Selection: The researcher went through different children's story books and selected four stories which could be converted to oneact play. Selected stories had been circulated to five professionals requesting to give the rank order as per the suitability. As per the rank order, the story titled 'unity is strength' had been selected Script writing: After identifying the characters from the story the script has been prepared in simple words and sentences, which could be followed by the target group. Validation: The script of the one-act play had been circulated among three special educators and a professional drama script writer for suggestions. Accordingly it has been re-written. The drama (one-act play) had been audio-recorded and the audio cassette has been used for intervention. 65
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Procedure The base line of the social skills of the selected sample was collected before beginning the inte rvent ion a nd re corde d in the performance data sheet. The six students selected for the study were taught the drama during a period of twenty days. The following strategies were used:
day of National Institute for the Mentally Handicapped, before a packed auditorium. As per the research design and plan, the selected samples were taught the one-act play specially prepared for the study for a period of twenty days. The collected data had been analyzed based on the objectives set for the study.
ď ˇ
Results and discussion:
ď ˇ
ď ˇ
The selected sample of students were asked to watch when another group was acting when the audio recorder was played. The selected sample of students were explained the story while they were listening to the audio cassette. Modeling, verbal prompt and cues were used during the practice session. The promptings were reduced as they started to follow the rec orde r and act ing independently.
The researcher was always keen to inculcate the expected social skills to the samples showed as they improved in learning the drama, for example, following instruction, how to deal with other actors, waiting for turn, accepting corrections and so on. These observations were promptly recorded on every 5th day of the practice. Not only the students learned the drama, but also they acted the same on 22nd February 2007 on the annual
Table :1 Mean values, SDs, and t-value of pre test and post test social skill scores Pre-test Mean SD
Post test
Signifii-
Mean SD t-value
27.80 4.40 76.50 2.50 36.46
cance p < 0.01
Mean values, SDs, and t-value of pre test and post test social skill scores are depicted in the Table 1. As the obtained t-value is more than that of the table value at 0.01 level of significance, it can be inferred that, there is statistically significant difference between pre test and post test scores. A close observation of the mean values reveals that there is significant increase in the post test scores of the students than that of pre test scores. Hence it can be concluded that drama was highly effective in increasing the social skills of students with mild intellectual disability.
Table: 2 Mean values, SDs, and t-value of pre test and post test social skill scores of each domain Pre-test
Post test
Domain
t-value
Significance
Mean
SD
Mean
SD
Survival skills
8.20
2.04
19.50
0.55
7.50
p < 0.01
Interpersonal skills
7.30
0.82
19.50
0.55
39.76
p < 0.01
Problem solving
7.00
1.79
19.17
0.75
16.19
p < 0.01
Conflict resolution
5.30
1.21
18.30
1.03
28.95
p < 0.01
66
Sunish & Thressiakutty / Effect of Drama on Learning Social Skills
increasing interpersonal skills of children with mild intellectual disability.
Table:2 shows the difference between pretest and post-test mean scores in the area of survival, interpersonal, problem solving and conflict resolution skills. The pre-test mean is 8.20 and the post-test mean is 19.50 for survival skills area. The calculated t-value is more than that of the table value at 0.01 level of significance. It can be found that there is statistically significant difference between pre test and post test scores. Hence it can be inferred that drama was highly effective in increasing the survival skills of children with mild intellectual disability.
The pre-test and post-test mean scores in problem solving skills area is 7.00 and 9.17 respectively. The obtained 't' value is 16.19; it is more than that of the table value at 0.01 level of significance. It can be inferred that, there is statistically significant difference between pre test and post test scores. Hence it can be concluded that drama method was effective in increasing problem solving skills of children with mild intellectual disability. The mean scores of pre-test and post-test in conflict resolution domain is 5.30 and 18.30 respectively. As the obtained t-value 28.95 is more than that of the table value at 0.01 level of significance, it can be inferred that, there is statistically significant difference between pre test and post test scores. The result of the analysis shows that drama was effective in increasing conflict resolution skills of children with mild intellectual disability.
The pre and post-test mean scores in the area of interpersonal skills are 7.30 and 19.50 respectively. The t' value is 39.76 and it shows a significant difference at 0.01 level. A close observation of mean values reveals that there is significant increase in the post test scores of the students than that of pre test scores. It can be concluded that drama was effective in
Table:3 Subject wise performance stu dents
survival pre
interpersonal
problem solving
post gain pre post gain pre
conflict resolution
Total
post gain pre post gain Pre Post Gain
1
8
19
11
7
19
12
4
19
15
4
17
13
23
74
51
2
6
19
13
7
19
12
8
18
10
4
18
14
27
74
47
3
11
20
9
8
20
12
9
20
11
7
20
13
36
80
44
4
6
19
13
7
20
13
8
19
11
5
18
13
26
76
50
5
8
20
12
7
20
13
7
20
13
4
19
15
26
79
53
6
10
20
10
7
19
12
6
19
13
6
18
12
29
76
47
Domain wise performance of Sample 1 at Pre and Post-test The achievement of the social skills in survival, interpersonal, problem solving and
resolution skills areas of sample 1 is given in table 3. In the domain survival skills the improvement is from 8 to 19 (40% to 95%), the area of interpersonal skills improvement is 67
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7 to 19 (35% to 95%), improvement in the problem solving skills area is from 4 to 19 (20 to 95%), and in the area of conflict resolution improvement is from 4 to 17 (20% to 85%). The improvement was gradual from entry level to post-test level. In all the areas there is significant difference between pre-test and the post-test scores.
significant difference between pre-test and the
Domain wise performance of Sample 2 at Pre and Post-test
resolution skills areas of sample 4 is given in
The achievement of the social skills in survival, interpersonal, problem solving and resolution skills areas of sample 2 is given in table 3. In the domain survival skills the improvement is from 6 to 19 (30% to 95%), the area of interpersonal skills improvement is 7 to 19 (35% to 95%), improvement in the problem solving skills area is from 8 to 18 (40 to 90%), and in the area of conflict resolution improvement is from 4 to 18 (20% to 90%). The improvement was gradual from entry level to post-test level. In the all the areas there is significant difference between pre-test and the post-test.
improvement is from 6 to 19 (30% to 95%),
Domain wise performance of Sample 3 at Pre and Post-test The achievement of the social skills in survival, interpersonal, problem solving and resolution skills areas of sample 3 is given in table 3. In the domain, survival skills the improvement is from 11 to 20 (55% to 100%), the area of interpersonal skills improvement is 8 to 20 (40% to 100%), improvement in the problem solving skills area is from 9 to 20 (45 to 100%), and in the area of conflict resolution improvement is from 7 to 20 (35% to 100%). The improvement was gradual from entry level to post-test level. In the all the areas there is 68
post-test. The student 3 achieved 100% score at the post-test. Domain wise performance of Sample 4 at Pre and Post-test The achievement of the social skills in survival, interpersonal, problem solving and table 3. In the domain, survival skills, the the area of interpersonal skills improvement is 7 to 20 (35% to 100%), improvement in the problem solving skills area is from 8 to 19 (40 to 95%), and in the area of conflict resolution improvement is from 5 to 18 (25% to 90%). The improvement was gradual from entry level to post-test level. In all the areas there is significant difference between pre-test and the post-test. Domain wise performance of Sample 5 at Pre and Post-test The achievement of the social skills in survival, interpersonal, problem solving and resolution skills areas of sample 5 is given in table 3. In the domain, survival skills the improvement is from 8 to 20 (40% to 100%), the area of interpersonal skills improvement is 7 to 20 (35% to 100%), improvement in the problem solving skills area is from 7 to 20 (35 to 100%), and in the area of conflict resolution improvement is from 4 to 19 (20% to 95%). The improvement was gradual from entry level to post-test level. In all the areas there is significant difference between pre-test and the post-test.
Sunish & Thressiakutty / Effect of Drama on Learning Social Skills
Domain wise performance of Sample 6 at Pre and Post-test The achievement of the social skills in survival, interpersonal, problem solving and resolution skills areas of sample 6 is given in table 3. In the domain, survival skills the improvement is from 10 to 20 (50% to 100%), the area of interpersonal skills improvement is 7 to 19 (35% to 95%), improvement in the problem solving skills area is from 6 to 19 (30% to 95%), and in the area of conflict resolution improvement is from 6 to 18 (30% to 90%). The improvement was gradual from entry level to post-test level. In all the areas there is significant difference between pre-test and the post-test. Findings The re was a progress in subjec ts' performance in the survival social skills. At the entry level, group performance was 40% but at the final level performance was 97.5%. A significant change was noticed. In the area of interpersonal social skills, students showed a significant progress. At the entry level group performance was 36.6% and at the final level performance was 97.5%.Thus a significant effect of drama on learning social skills was noticed. A significant change was noticed in the area of problem solving. In this area subjects' performance at the entry level was 35% and at the final level the performance was 96%. The re was a progress in subjec ts' performance in the conflict resolution skills. At the entry level, group performance was 26.5% but at the final level, performance was 92%. A significant change was noticed.
The interest, motivation and involvement were observable in all the six subjects taken for the study. They were very attentive to follow the script which was recorded. It was also found that the attention and concentration of the subjects were improved. Their self-esteem has been improved when they got the chance to act on a stage before a packed audience. The researcher was also able to see that the subjects were correcting the inappropriate social behaviors among themselves. The study confirms that the social skills can be improved through the educational drama. Analysis of data supported the hypothesis, that the drama has a significant effect on learning social skills among children with mild intellectual disability. Conclusion The study shows that drama is also an effective way of teaching various concepts and skills as same as other methods of teaching. However this method of teaching for children with intellectual disability has not gained momentum in the special schools. The review of literature revealed that drama was effective in improving interpersonal, conflict resolution, and social development in the children with intellectual disability. Regarding research in the field of special education in India, none of the studies were focused on the effectiveness of drama on learning social skills for the children with intellectual disability. The results of the study support the fact that special educators can use the drama as a teaching method to teach various skills and concepts. It would help the students with intellectual disability to learn the concepts and skills, which they find difficult to learn due to low intelligence level. 69
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Journal of Disability Management and Special Education
Based on this result, it is suggested that skills, which can be taught through drama can be listed out and appropriate drama can be developed. This study can be conducted for different groups of children belong to various levels of intelligence, socio economic status and educational background. References: AAMR. (2002). Mental retardation: Definition, Classification and System of support (10th edn.). American Association on Mental Retardation, Washington. DC. Bayhan, A. (2001). The impact of Drama Education on the Social Evaluation of Mentally Retarded Children. Journal of Cognitive, Crier, Compartment, Vol. 5, pp. 137-144. Bellack, A. A., and Harsen, A. E. (1977). Social history and prospects. In E. L. Philips (Eds.), Handbook of social skills training. A wiley intersentence publication, New York. Catterall, J. S. (2006). Enhancing Peer Conflict Resolution Skills through Drama. An Experimental study. Research in Drama Education, Los Angels. Carreira, J. M. (2005). Discovering the magic of Harry Potter: Adapting the drama method in an EFL class for upper grade primary students. Keiai, Tokyo. Hallahan, D. P. & Kauffman, J. M. (1978). Exceptional children- introduction to
special education(4th edn.). Prentice Hall, New Jersey. James, N. (2005). 'Actup!' Theatre as education and its impact on Young People's Learning. Leicester, UK. Johnson, J. C. and Magid, D. T. (2005). A Multimodal group counseling approach to enhance adolescent interpersonal cognitive proble m solving (ICPS) dialoguing and variation of therapy. Philadelphia. Lanny, E. (1998). The effect of creative drama on social and oral language skills of children with learning disabilities. Journal of youth theatre, Vol. 12, pp. 89-95 Lovett, D. L., and Harris, M. B. (1987). Important skills for Adult with Mental Retardation: The client's point of view. Journal of mental retardation, Vol. 25 (5), pp. 351-356. Malm,B. and Lofgren, H. (2007). Empowering students to handle conflicts through the use of drama. Journal of peace education, Vol. 4 (1), pp. 1-20. Smith, S. L. (2005). The power or arts, creative strategies for teaching exceptional learners. PAULSH books publishing Co., Washington. Walsh, R. T. (2005). A creative drama prevention program for easing early adolescent's adjustment t o school transitions. Waterloo, Canada. .
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Vol. 1. No. 2 July 2011
Journal of Disability Management and Special Education ISSN: 2229-5143
Rating Special Schools for Students with Hearing Impairment in Mumbai: A Study *G. Shivaraju & **R. Rangasayee
Abstract Education is the innermost call of human kind to evolve, innovate and reach its pinnacle socially, culturally and spiritually. Special education means specially designed instruction, which meets the special educational and related needs of an exceptional child. The teaching of liberty, equality and fraternity should be the basic issue in all our education system. In order to have an objective understanding of functioning of special schools the present study was undertaken with the aim of rating special schools for students with hearing impairment to identify areas in which a special school has to improve in it's functioning, as required under the PWD Act (1995) and to select model special schools for teacher training institutions, as required under the RCI Act (1992). The results of the present study revealed that few special schools are at a higher level on all the areas and also better on the current concepts like early intervention and promotion of inclusive education. Key terms: Rating Special Schools, Students with Hearing Impairment
Introduction contribution to and participation in the complex and rapidly changing society.
Education plays a vital role in the development of any nation. Quality is the main issue of today's education. The drive for quality around the globe is becoming a matter of life and death for educational system. In the current context of globalization, scaling heights in pursuit of quality striving for excellence, and approaching of perfection is imperative for the educational system. The pursuit of quality education aims at developing the full potential of students in all aspects so as to prepare them for the challenges in life. Through quality education, students are better equipped with the knowledge and skills for making
Navaratnam (1997) says that only well managed schools could provide quality education. The perception of quality was represented by school facilities, teachers, principal, fellow students, learning materials, teaching methods, assessment and technology as well as the sur rounding economy, community and the political system. Besides indicat ing t he relative strengths and weaknesses of an institution, here and now, the assessment also provides the base line data on various aspects of the institution on which
*Assistant Professor, FDMSE, Ramakrishna Vivekananda University, Coimbatore **Director, Ali Yavar Jung National Institute for the Hearing Handicapped, Bandra West, Mumbai, 400 050, ayjnihh.nic.in
71
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development could be built up. There are two main objectives of an institutional assessment (Mukhopadhyay, 2001). Firstly, institutional assessment can be effectively used for organizational diagnosis. Secondly, this serves the purpose of benchmarking. Smith and Tomlinson's (1989) study of multi-racial comprehensive schools identified considerable differences between schools in terms of effectiveness and identified certain conditions as being typical of successful schools. Mc Curtain (1988) conducted a study on perception of elementary school teachers about their principal's competencies and school effectiveness in Alameda Country, California. The findings of the study revealed that in schools where teachers perceived their principal to be extremely competent, the school was also rated to be highly effective and viceversa, highly effective schools were due to principals' ability to establish a positive school climate and professional accountability. The effectiveness of the school depends on principal's competence and his higher level of communicative skill in demonstration and teaching in schools. Indu Garg & Niyaz Ahmad (2007) conducted a study in Greater Mumbai at the school level to find out the perception of tea chers and stude nts a bout the implementation of quality in schools. The teachers perceived that good teaching-learning and evaluation methods, training students, teachers and non-teaching staff, democratic environment and opportunities for students to try out new things without fear and ridicule help to improve the quality in schools. The 72
students also perceived that the collaboration and cooperation between departments and schools help to improve quality in schools. Luthar and Sunanda (1984) specified that the parents of hearing impaired children who were under observation appeared to take a fair amount of interest in their child's progress. Most of them regularly attended the parent teacher meetings and generally did what was recommended to aid their child's linguistic and academic progress. The National Policy for Persons with Disabilities (2006) emphasizes that the special schools shall be appropriately remodeled and reoriented based on t echnological development for preparing children with disabilities to join in mainstream education, becoming resource centers for inclusive education and quality in special schools. The fifth chapter of PWD Act (1995) envisages the integration of students with disabilities in the normal schools, setting up of special schools in government and private sectors to impart special education with vocational training, setting up of teachers' training institutions to develop trained manpower for schools for children with disabilities and quality education to all children with disabilities. RCI recommends that every teachertraining center should have a model school as approved through peer reviewing- a process which is more of a qualitative subjective feeling/ judgment than through an objective structured procedure. Need for the Study: Education empowers a person. Literacy and other skills achieved through education make the person a contributing citizen for the
Shivaraju & Rangasayee / Rating Special Schools
country. Hence 'Quality' of education plays a detrimental factor for achieving the same. To ensure quality in educational services and practices, researchers had aimed at developing tools for rating the institutions for non-disabled students. In the field of special education, Vijetha (2005) had developed a rating scale (comprising of a User Guide, Trend Data Sheet and Questionnaires for principals, teachers and parents) to grade the special schools for students with hearing impairment. However, no attempt was initiated yet to rate the special schools based on the developed tool. So, there is a need to rate the special schools for students wit h hea ring impairment to know the weaknesses and strengths. An exercise of this nature will in turn help to o
indicate to the consumers on the relative quality of educational service of the special schools for students with hearing impairment.
o
select model special schools for the purposes of teacher training institutions as required under RCI Act (1992).
o
identify areas in which a special school has to improve in its functioning as required under the PWD Act(1995) and the National Policy for Persons with Disabilities(2006).
o
select special schools which can be converted as resource centers for Sarva Shiksha Abhiyan(SSA).
o
enable funding the special schools by funding agencies.
Objectives of the Study: 1.
To rate the practice teaching and nonpractice teaching special schools
2.
To compare practice teaching and nonpractice teaching special schools in terms of perception of principals, teachers and parents towards academics and school practices.
Methodology The methodology c hosen was to administer a rating scale on the selected sample of special schools and analyze the data based on the research questions and hypotheses formulated. The research method of the present study was survey type. Details regarding the proc edure followed are mentioned below. Selection of the special schools: 16 special schools for students with hearing impairment (8 practice teaching and 8 nonpractice teaching special schools) of Greater Mumbai were randomly selected on the basis of their willingness to participate in the study. Selection of Respondents: Total 16 principals, 106 teachers and 80 parents were selected randomly from each of the selected practice teaching and non-practice teaching special schools. It was seen that the selected teachers have been teaching in the school since 3 years. Tools for data collection: A rating scale to grade the special schools for students with hearing impairment developed by Vijetha (2005) was used for this purpose. The rating scale has two sections viz. a Trend data sheet and Questionnaires for respondents (principals, teachers and parents). This tool was developed based on Mukhopadhyay's Institutional Profile Questionnaire (MIPQ). The questionnaire for teachers was prepared to collect information on 12 areas such as Principal as leader, Teacher 73
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quality, Linkage and Interface, Students, Cocur ricular ac tivities, Teac hing, Off ice manageme nt, Relationships, Parental involvement, Material resources, Support Services and Job satisfaction. Data Collection: For collection of data from the teachers, principals and parents, the respective questionnaires were given and explained to them personally by the researcher. The trend data sheets were given to the office clerk of each practice teaching and nonpractice teaching special schools and requested them to fill the information for the last five years from the off icia l rec ords. The filled questionnaires and trend data sheets were collected personally after two days. Compilation of the d ata: The procedure used for compilation of the data obtained from the duly filled questionnaires and the scoring pattern followed for converting the qualitative data into quantitative data in each of the questionnaires was followed according to the guidelines given in the rating scale. Data Analysis: The data collected from the three questionnaires was analyzed using the t-test and Mann - Whitney test. Pearson's Correlation was also used for obtaining the test - retest reliability. Results and Discussion The analysis of the data was carried out to answer the research questions and to test null hypotheses. The details of the statistical tests used for the analysis of the data and the procedure followed for obtaining the results are given below: Research Question: In order to rate the special schools, the research question framed was: 74
What would be the rating of each of the practice teaching and non-practice teaching special schools as per the rating scale? Result Among practice teaching special schools only one school had obtained 'A' grade, two schools have obtained 'B+' grade and remaining five schools have obtained 'B' grade. Among non-practice teaching special schools, only one school had obtained 'A' grade, three schools have obtained 'B+' grade, one school obtained 'B' grade and remaining three schools have obtained 'C+' grade. Discussion The results revealed that the rating of practice teaching special schools shows that they are at a higher level on all the features compared to non-practice teaching special schools. Also, other factors like medium of instruction distance between training center and special school, willingness of the school authorities and teachers to support trainees play a crucial role in selecting the practice teaching schools. All the above might have influenced in selecting these special schools for practice teaching. Also from the trend data sheets, it was observed that the practice teaching special schools were better on the current concepts like early intervention and promotion of inclusive education. These could have been major factors for selecting these schools for practice teaching. Hypothesis 1: The first step undertaken to test the null hypothesis was to check the normality of the data obtained from the teachers of Group-A
Shivaraju & Rangasayee / Rating Special Schools
non-parametric Mann - Whitney 'U' test was administered.
(practice teaching special schools) and GroupB (non-practice teaching special schools), the Kolmogorov - Smirnov test was administered. From the test it can be observed that the data of Group-A was found normal and the data of Group-B was not falling under the normal distribution. Hence, to test the null hypothesis,
Ho framed for this purpose was "there is no significa nt difference between the perception of teachers of practice teaching and non-practice teaching special schools towards academics and school practices".
Table 1: Mann-Whitney 'U' test analysis: perception scores of teachers Type of school Group: A
N
P value (2 tailed)
Result
1347.50
0.719
Not significant
5 3
Group: B
(Mann Whitney) 'U' value
5 3
Result From the table it can be observed that the 'U' value is 1347.50 corresponding p-value is 0.719 which suggests that the obtained 'U' value is statistically not significant. Therefore the null hypothesis was retained that is there is no significa nt difference between the perception of teachers of practice teaching and non-practice teaching special schools towards academics and school practices. Since no significant difference was found in t he perc eption of teachers towards academics and school practices, it was decided to study and compare each of the areas covered under the perception of teachers. From the statistical analysis it can be observed that the obtained 'U' value of perception scores of teachers of Group-A and Group-B on six areas (Principal as a leader, Teacher quality, Linkage and int erfac e, Of fice mana geme nt, Relationships, Parental involvement) is statistically significant and on other six areas
(Students, Teaching, Support services, Job satisfaction, Co-curricular activities, Material resources) is statistically not significant. Discussion In the present study, it was found that there was a significant difference between the perception of teachers towards principal as a leader, teacher quality, linkage and interface, office management, relationships and parental involvement. Perception is a hypothetical concept abstracted from the totality of a person's feelings, beliefs and behavioral intentions regarding an object. According to some psychologists, a direct experience helps to form perceptions and attitudes stronger than that of indirect experiences. Fiazio et.al. (1983) found that prediction of subject's attitudes and perceptions through direct experience was better than those subjects with indirect experiences. In the parent study also, direct experience of teachers might have influenced them in developing perceptions 75
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Journal of Disability Management and Special Education
towards the above mentioned areas. Teachers are the building blocks of every school. Their experience with the principals and parents in the technical and administrative matters of the school might have influenced in developing appropriate perception. In this study, teachers working in practice teaching schools might have had more and wider direct experiences in schools as compared to their teachers of nonpractice teaching schools. On the other hand, no significant difference was found in the perception of teachers of practice teaching and non-practice teaching schools towards students, teaching, support services, job satisfaction, co-curricular activities and material resources. In the education of children with hearing / hearing impairment, teachers are in direct contact with the children all the time. They use teaching as a tool to reach them. Also supportive services are generally provided to the children with the consent and guidance of the teachers. Since all these are revolving round the teachers and are pertained to the classroom activities, it is obvious to have similar perceptions towards these areas. The curriculum of students with hearing impairment in special schools includes activities, which are planned inside and outside the classrooms. The concept of multiple intelligence has resulted in the inclusion of cocurricular activities. Irrespective of the nature of schools and the services provided to teacher
training institutions, teachers continue to explore the hidden talents in children with hearing impairment through co-curricular activities. The practice teaching and non-practice teaching special schools of Mumbai work under the Departme nt of Soc ial Welfa re, Maharashtra. Hence, every school has to maintain the guidelines of the social welfare department particularly the infrastructure and material resources. Hence, the teachers of practice teaching and non-practice teaching schools hold similar perceptions. Hypothesis 2: The first step undertaken to test the second null hypothesis was to check the normality of the data obtained by the principals of Group A (practice teaching special schools) and Group B (non-practice teaching special schools), Shapiro - Wilk test was administered. From the test it can be observed that the data of Group-A and Group-B was falling under the normal distribution. As the sample size was small, to test the null hypothesis, nonparametric Mann - Whitney 'U' test was administered. Ho framed for this purpose was "there is no significa nt difference between the perception of principals of practice teaching and non-practice teaching special schools towards academics and school practices".
Table 2: Mann-Whitney 'U' test analysis: perception scores of principals: Type of school
N
Group A
8
Group B
8
(Mann Whitney) 'U' value
P value (2 tailed)
Result
23.50
0.371
Not significant
76
Shivaraju & Rangasayee / Rating Special Schools
Result
teachers, parents and the society. Though they
From the table it can be observed that the
use different means, they are constantly striving
'U' value obtained was 23.50 corresponding p
to achieve the common goal of successful
(2-tailed) value was 0.371 which suggests that
'educational rehabilitation of students with
the obtained 'U' value was statistically not
hearing impairment'. Hence, it is obvious that
significant. Therefore the null hypothesis was
the perceptions of principals are more or less
retained that is there is no significant difference
the same.
between the medians of the perception scores
The following research studies are
of principals of practice teaching and non-
supporting / contradicting the obtained results.
practice teaching special schools towards
There are important differences between
academics and school practices.
elementary and secondary schools in school
To conform the same, area wise analysis
organization, teachers, and students that may
of the obtained scores of Group-A and Group-
affect variables claimed to improve school
B was carried out. From the statistical analysis,
effectiveness (Cuban,1983 & Van Der
it can be observed that the obtained 'U' value
Urg,1986). There is no significant difference
of perception scores of principals of Group-A
between the organizational climate of the
and Group-B on six areas was statistically not
Government and private schools (Anju
significant. This shows that there is no
Mehrotra, 2002). Most of the teachers have
significant difference between the perception
favorable perceptions on principal leadership
scores of principals of Group-A and Group-B
(Shwu - Yong L. Huang's, 2004). Government
on six areas viz. job satisfaction, quality of
and non-government high schools find that
education,
teacher morale is high in the government high
students'
achie veme nt,
involvement, linkage and relationships.
schools than the private schools (Panda, 1988).
Discussion
Hypothesis 3:
In the education of children with and
The perception scores of parents on the
without hearing impairment, principals play a
selected ten items were considered for testing
key role. They are the leaders, primarily
the null hypothesis. The test for homogeneity
responsible for providing quality education to
of variance was done and then the t-test was
their students. So they are always in a constant
applied to test the following null hypothesis.
drive to improve the academic achievement
Ho framed for this purpose was "there is
of students and teaching-learning process. The
no significa nt difference between the
schools are generally considered as a miniature
perception of parents of practice teaching and
society. So, they are also responsible to create
non-practice teaching special schools towards
a linkage and relationship between students,
academics and school practices". 77
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Journal of Disability Management and Special Education
Table 3: 't' test analysis: perception scores of parents: Type of school
N
Mean
S.D.
't' value
Group-A
40
35.2
3.6599
+2.49 at
Group-B
40
33.075
3.9768
df=78
Result From the table it can be observed that the calculated value of t=+2.49 is greater than the table value and was falling in the critical region. The corresponding 'p' value is 0.0149 which suggests that the null hypothesis was not retained that is there is a significant difference between the means of perception scores of parents of practice teaching and non-practice teaching special schools towards academics and school practices. Discussion Research generally supports the belief that parental involvement is productive of effective schools (Armor et al., 1976; Levne & Lerotte, 1990). The results of the present study indicate that parental involvement in practice teaching special schools is better than the non-practice teaching special schools. Parents select schools based on the quality of educational services extended to the children. They actively involved in the educational practices as the key to educational success is parent-professional partnership. Hence this partnership in practice teaching schools could be stronger than that of the non practice teaching schools. Hence, the perception of the parents of practice teaching special schools was found better than that of the non practice teaching special schools on the educational services. Test-Retest Reliability: Pearson's correlation was administered to obtain the correlation of the test-retest scores 78
p-value (2-tailed)
Result
0.0149
Significant
obtained on the perception of teachers and parents towards academics and school practices. From the statistical analysis, it can be observed that the Pearson correlation value of test scores and retest scores of teachers' perception was 0.947 and the parents' perception was 0.977. This shows that the responses of the subjects were highly reliable. Conclusion Interestingly, the results consistently shown that no significant difference between practice teaching and non-practice teaching special schools in terms of the perception of principals, and consistently shown significant difference in terms of perception of parents in all the areas studied. However, there was no significant difference between practice teaching and nonpractice teaching special schools in terms of the perception of teachers only in the six areas out of twelve areas studied. Thus, it is inferred that the difference between practice teaching and non-practice teaching special schools can best be established if one could study the six areas namely principal as a leader, teacher quality, linkage and interface, office management, relationships and parental involvement along with the ten items given in the questionnaire for parents. It was found that the rating of practice teaching special schools ranged from grade A to grade B, while non practice teaching special school grade A to grade C+. Every teachertraining center with a vision of 'quality training'
Shivaraju & Rangasayee / Rating Special Schools
tries to expose the trainees the best practices in e ducation of students wit h hearing impairment. Also the quality of services of the key features of special education of students with hearing impairment like objectives, infrastructure, manpower, curricular and cocurricular activities reflects their rating. Hence it is important to note that while selecting a practice teaching school, training institution tries to identify special schools having good infrastructure, adequate manpower and their efforts in achieving the special educational objectives through curricular and co-curricular activities. References: Armor, et al. (1976). Analysis of the School Pre ferre d Rea ding Programme in Selected Los Angeles Minority Schools. Santa Monica, CA: the Rand Corporation. Beirg, V. D. K. (1986). Effective School Characteristics- A Comparison of Expert and Parent Perspectives. Unpublished Doctoral Dissertation, University of Wisconsin, Madison. Cuban, L. (1983). Effective Schools: A friendly but Cautionary note. Phi Delta Kappan, 64, 695 - 696. Curtain, M & Busier. R. (1988). Elementary School Principals Competencies and School Effectiveness-Instructional Staff Perception. University of San Fransisco. Garg,l. & Ahmad,N. (2007). Perception of School Teachers and Students about Implementation of Quality Principals in Schools. Unpublished M.Ed. Dissertation, Mumbai University, Mumbai
Huang, S.Y. (2001). Teachersâ&#x20AC;&#x2122; Perceptions of High School Environments. Journal of Learning Environments Research, Vol. 4, No. 2, 2001. Levine, D.U. & l.ezotte. L.W. (1990). Unusually Effective Schools: A Review and Analysis of Research and Practice. Madison, WI: National Center for Effective Schools Research and Development. Luthar & Sunanda, (1984). All India Workshop for Teachers and Parents of Hearing Impaired children. Max Mueller Bhavan, New Delhi. Pp.145-162. Mehrotra, A. (2003). A Comparative Study of Leader ship Styles of Principals in Relation to Job satisfaction of teachers and organizational climate in government and private senior secondary school of Delhi. Ph.D. thesis, Jamia Millia Islamia, New Delhi. Mukhopadhyay, M.(2001). Total Quality Management in Education. NIEPA, New Delhi. National Policy for Persons with Disabilities (2006). Government of India, New Delhi. Navarat nam, K.K. (1997). Quality Management in Education Must Be a Never-ending Journey. In Watson, K., Modgal. C. & Modgal, S. (eds). Educational Dilemmas: Debate and Diversity. Vol- VI, Cassell, London. Persons with Disabilities Act (1995). Government of India, New Delhi Rehabilitation Council of India Act (1992) .Government of India, New Delhi Smith,D. & Tomlinson,S.( 1989). The School Eff ect - A Study of Multi-rac ial Comprehensives. Policy Studies Institute. 79
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Vic kers,B.(1988). A Comparison of Elementary Principal’s and Elementary Teachers’ Perceptions of their Principal’s Supervisory Behaviours. University of Mississippi State.
Vijetha, I. (2005). Developing a Rating Scale to Grade the Special Schools for Students with Hearing Impairment. Unpublished M.Ed. Dissertation, Mumbai University, Mumbai.
Heaven’s Very Special Child A meeting was held quite far from earth. “It’s time again for another birth,” Said the Angels to the Lord above, “This special child will need much love. His progress may seem very slow Accomplishments he may not show And he’ll require extra care From the folks he meets way down there. He may not run or laugh or play His thoughts may seem quite far away In many ways he won’t adapt, And he’ll be known as handicapped. So let’s be careful where he’s sent We want his life to be content. Please, Lord, find the parents who Will do a special job for You. They will not realize right away The leading role they’re asked to play But with this child sent from above Comes stronger faith and richer love. And soon they’ll know the privilege given In caring for this gift from Heaven Their precious charge, so meek and mild Is Heaven’s very special child.” -Author Unknown 80
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Play Activities to Enhance Gross Motor Skills in Children with Visual Impairment * A.Divyapriya, ** K.Sambath Rani
Abstract Play is recognized as an important part of a child's development. In the field of early childhood special education, play is valuable in assessing a child's level of development and in providing intervention. The present study has been under taken with the objective to develop gross motor skills through play which enhances better participation of children with visual impairment in all functional activities. The sample for the investigation included 30 visually impaired children in the age group of 6-11 years. The study was experimental in nature. A checklist was prepared to assess the gross motor skill development among samples. Based on the assessment a play activity kit was developed and implemented. Results reveal that Intervention programme was found to be effective in the development of gross motor skills. The play activity kit serves as a best tool for the special educators/resource teachers and parents in developing gross motor skills among their visually impaired children through play. Key terms: Play Activities, Gross Motor Skills, Children with Visual Impairment
Introduction Play is freely chosen, intrinsically motivated and personally directed. Play has been long recognized as a critical aspect of childhood and child development. Play is one of the ways children learn about themselves, the people around them, their environment and their community. It is an essential part of every child's life and important to their development. Only through play, children learn to explore the world around them, develop and practice skills that they will use throughout their lives. Visual impairment can limit the range of experiences and information available to a
child and thus, have a significant impact on child's emotional, neurological and physical development (Mervis etal., 2000). Motor skills that are important for daily motions are posture, balance, coordination, and the ability to move (Palazesi, 1986). These skills are also important for mobility. The independent variables that determine mobility are motor, sensory and conceptual skills ( Merbler & Wood, 1984). Most children who are born with low vision participate in gross motor activities like their sighted peers. Even though these children
* Resource Teacher, Sri Avinashilingam Trust Institutions, Coimbatore - 641 043, divyakannan05@gmail.com ** Assistant Professor, Department of Special Education, Avinashilingam Deemed Women, Coimbatore - 641 043, sampathrane@yahoo.co.in
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University for
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appear to be physically normal, their early physical development milestone are often delayed and out of sequence (Adelson and Fraiberg 1997). Blind children generally had low muscle tone, poor posture and motor skills and difficulty coping with activities in the prone position and they rarely initiated movements (Adelson and Fraiberg, 1976, Sykanda and Levitt, 1982). Magalhaes et al., (1989) noted that the ability to move about in and explore the environment must be considered essential to the global development and adaptation of children to their environment. According to Haywood (1986) the preteen and teenage years are an ideal time for overcoming learning impairments in the efficiency of motor patterns. Studies have documented the numerous beneficial effects of play for children (Berger, 1988; Johnson et al., 1987). During play, children practice interacting with others, which lea ds to social compet ence and t his competence, is reflected in the increasingly interactive characteristics of play as children grow older (Goncu, 1993; Herzka, 1986; Johnson, et al., 1987; Pellegrini, 1982). Similar scaffolding has been reported in the areas of cognitive, motor, creative, emotional, and language development (Herzka, 1986; Spodok & Saracho, 1988).
educational status and income of the Parents. Methodology In this study attempts have been made to enhance gross motor skills among visually impaired children through play which helps the child to attain gross motor skills easily. The sample for the investigation included 30 visually impaired children in the age group of 6-11 years. The investigator used purposive sampling technique to select the sample. The study was experimental in nature. The main independent variables were age, gender, type of schooling, type of visual problem, family income, educational status of parents and locality. The main dependent variable included in the study is gross motor skills of visually impaired children.
ď ˇ
To study the impact of play activities on the gross motor development of children with visual impairment.
Interview schedule prepared by the investigator elicited information on age, gender, nature of disability and background information of selected visually impaired children. A checklist was prepared to assess the gross motor skill development among them. It includes five main gross motor skills such as posture, walking, balancing, motor strength, sensory integration and motor planning and 25 sub components. Based on the assessment the investigator developed a play activity kit in such a way that each play covers variety of gross motor skills such as passing, clapping, walking and jumping. The play activity kit serves as the tool for the special educators/ resource teachers and parents in developing gross motor skills among their visually impaired children.
ď ˇ
To find out the impact of play activities on gross motor skills with respect to age, gender, locality, nature of disability,
Results and Discussion Pre and post test mean scores of motor skills
Objectives
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Table: 1 presents pre and post tests mean scores of gross motor skills Variable
Testing
N
df
Mean
S.D
t-Value
Gross Motor Skills
Pretest
30
29
13.47
4.09
11.587**
18.33
2.70
Posttest ** Significant at 0.01 level The table: 1 reveals that the t - value for
children with visual impairment. This result
gross motor skills (t = 11.587) was significantly
coincides with the results of Burlingham, 1975;
different between pre and post tests mean
Ervin, 1993; Ferrell, 1986; Skellenger & Hill,
scores at 0.01 level. Therefore, the null
1994, states that "Since children with visual
hypothesis stated as "There is no significant
impairments may benefit from active, age-
difference in the gross motor skills of visually
appropriate play activities. Information on their
impaired children before and after intervention"
levels of play is necessary for developing
is rejected stating that the play activities made
intervention studies to improve their play
a significant influence on gross motor skills of
behaviours".
Pre and post mean scores of gross motor skills with respect to Age Table:2 presents Pre and post tests mean scores on Gross motor skills with respect to Age. Variables Age
Levels
Testing
N
df
Mean
S.D
t- Value
6 - 8 years
Pretest
18
17
11.11
3.14
15.39**
16.89
2.27
17.00
2.49
20.50
1.62
(In years)
Posttest 9 - 11 years
Pretest
12
11
Posttest
4.70**
** Significant at 0.01 level The table: 2 reveals that the t - value of
is no significant difference in the gross motor
the children at the two age groups namely 6 -
skills of visually impaired children before and
8 years (t = 15.39); 9 - 11 years (t = 4.70)
after intervention with respect to age" is rejected
was significantly different between pre and post
stating that the play activities made a significant
mean scores of fine motor skills at 0.01 level.
influence on gross motor skills of children with
Therefore, the null hypothesis stated as "There
different age groups. 83
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Pre and post mean scores of gross motor skills with respect to gender Table: 3 presents pre and post tests mean scores of gross motor skills with respect to gender Variables
Levels
Testing
N
df
Mean
S.D
t- Value
Boys
Pretest
18
17
13.83
4.19
9.11**
18.83
2.85
12.92
4.06
17.58
2.35
Gender
Posttest Girls
Pretest
12
11
Posttest
6.88**
** Significant at 0.01 level While considering the pre and post mean scores of boys (t = 9.11) and girls (t = 6.88) the t - values differ significantly at 0.01 level. Therefore, the null hypothesis stated as "There is no significant difference in the gross motor
skills of visually impaired children before and after intervention with respect to gender" is rejected stating that the play activities made a significant influence on gross motor skills of boys and girls.
Pre and post mean scores of gross motor skills with respect to nature of disability Table: 4 presents Pre and post mean scores of Gross motor skills with respect to nature of disability Variables
Levels
Testing
N
df
Mean
S.D
t- Value
Totally Blind
Pretest
18
17
12.28
4.04
9.33**
17.39
2.45
15.25
3.62
19.75
2.49
Nature
Posttest
of disability Low Vision
Pretest
12
11
Posttest ** Significant at 0.01 level It is clear that there was significant difference in the pre and post mean scores of children with total blindness (t = 9.33) and low Vision (t = 6.73) at 0.01 level. Therefore, the null hypothesis stated as "There is no
6.73**
significant difference in the gross motor skills of visually impaired children before and after intervention with respect to nature of disability" is rejected stating that the play activities made a significant influence on gross motor skills of children with different nature of disability.
Pre and post tests mean scores of gross motor skills with respect to educational status of parents Table: 5 presents pre and post tests mean scores of gross motor skills with respect to educational status of parents Variables Levels Testing N df Mean S.D t- Value Educational Literate Pretest 17 16 14.71 4.33 6.73** Status of Posttest 18.71 2.71 parents Illiterate Pretest 13 12 11.85 3.24 14.16** Posttest 17.85 2.70 ** Significant at 0.01 level 84
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There was significant difference in the pre and post test scores with respect to educational status of parents i.e. Literate (t = 6.73) and Illiterate (t = 14.16) at 0.01 level. Therefore, the null hypothesis stated as "There is no significant difference in the gross motor skills
of visually impaired children before and after intervention with respect to educational status of parents" is rejected stating that the play activities made a significant influence on gross motor skills of children with visual impairment.
Pre and post tests mean scores of gross motor skills with respect to income of parents Table: 6 presents pre and post tests mean scores of gross motor skills with respect to income of parents Variables
Levels
Testing
N
df
Mean
S.D
t- Value
Low
Pretest
5
4
14.0
3.32
4.33*
18.20
2.68
12.38
4.41
18.00
3.38
13.82
4.28
18.53
2.50
Posttest Income of
Middle
parents
Pretest
8
7
Posttest High
Pretest
17
16
Posttest
8.61** 7.62**
* Significant at 0.05level ** Significant at 0.01 level The t - value of the samples indicate the significant difference between the pre and post tests mean scores of samples belong to various income status of parents namely low ( t = 4.33) at 0.05 level , middle (t = 8.61) and high (t =7.62) at 0.01 % level. Therefore, the null hypothesis stated as "There is no significant difference in the gross motor skills of visually impaired children before and after intervention with respect to income of parents" is rejected stating that the play activities made a significant influence on gross motor skills of children with different income status of parents. Conclusion Lack of vision affects the child's motor development. Basic motor skills are necessary for the visually impaired children for survival in everyday life. Gross motor skills are essential
to attain quality movement in mobility, concept, personal and social development. For children with visual impairment to move skillfully and independently it is necessary for them to develop gross motor skills. These children therefore require specific training to develop gross motor skills. Intervention programme implemented was found to be effective in the development of gross motor skills. The mean pretest score of selected samples in performing gross motor skills is being 13.47 whereas the posttest score increased to 18.33 after intervention. It was found that the intervention in gross motor skills helped in improving the performance of the sample with respect to age, gender, nature of disability, educational and income status of parents. The results reveal positive impact on 85
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the attainment of gross motor skills through play by the children with visual impairment.
Hurlock, E. (1988). Child Development, 6th edition, New Delhi- Mcgraw hill, pp. 13-48.
References Bouchard, D., and Tetreault, S. (2000). "The Motor Development of Sighted and Children with Mild Low Vision Aged 8-13", Journal of Visual Impairment and Blindness, 94: 564-573. Fra igberg, S. (1974). "Gross Motor Development in Infants from Birth, Child Development, 45: 114-126. Gallahul, D. (1982). Understanding Motor Development in Children, UK-Welsey Publishing Company, pp. 134-254, 37887,385-93. Goldberg, C. (1989). N orma l Motor Development, Philadelphia: B. B. Lippincott Company, pp. 1-15.
Murlidharan, R. (1983). Motor development of Indian Children Developmental norms for Indian Children 2 Years to 5 Years, New Delhi: Na tiona l Council for Educational Re- search and Training. Sandra, A. (2000). "Early Motor Development of Blind Children", Journal of Paediatrics and Child Health, 36: 226-238. www.eric.com www.nifplay.org/states_play.html. www.playfoundation.com www.wikipedia.com
Universal Lingua Franca Kindness is a language which blind can see and deaf can hear, Then why don’t you use this particular language my dear? Kindness is a language which LD can grasp and MR can understand, Then why don’t you use language lending them a helping hand? Kindness is a language which Autistic can recall and CP can tackle, Then why don’t you use language leaving entire lame shackle. Wow! Its matter for all of us of an utmost glee, That kindness is a language which deaf blind can see. I say abandon all the languages which are hollow, And use a language which everyone can easily follow. That language is the language of kindness………. Composed by Abhishek Kumar Srivastava Asst. Professor, RKMVU, FDMSE- Coimbatore 86
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A Light unto Oneself and a Lamp unto Others *K.S. Shilpa Take a stroll in the mellow warmth of the sun at the IHRDC campus and visit the Faculty of Disability Management and Special Education. The moment you enter, you will find yourself facing a man with a bright, warm and welcoming smile. Ever active, ever busy and yet spreading radiant joy everywhere he goes- this man will intrigue you. Writing down appointments, attending phone calls, guiding new comers and visitors and myriad other duties, all have become an inherent part of his daily routine. Come closer and it is then that you will see that he is no ordinary man. Mr. Ramachandran, the 40 years old receptionist is a bilateral upper limbs amputee. It was at the age of 20, when he was working as an accountant at Annur that he met with an electrical mishap. He was carrying a metal rod down the stairs when all of a sudden, the rod slipped from his hand and fell over a heavy tension wire, throwing him off his feet and smashing him unconscious to the ground far below. He was rushed to the hospital and admitted in the Intensive Care Unit. When he awoke days later, it was only to find that both his upper limbs had been amputated. He spent three gruelling months at the hospital, his mental agony far outweighing the physical pain. The world had come crashing around him. He wondered why he was still alive; apprehensions regarding his future taunted him. Every ray of hope in his life had been wiped out and he shrunk away from
friends and family. After his discharge, he stayed at home for a month sunk in despair, shutting himself away from the rest of the world. It was then that his life took a golden twist. His fiancĂŠ, a lady of tremendous faith and courage, stood by him and counselled him. Unperturbed by societal pressures, she gave Mr. Ramachandran incessant support and care. It was this selfless love that lent the magical healing touch to his wounds. From that day his life took a turn for the better and he has never turned back. With renewed strength he battled with every challenge.
* M.Ed in Special Education, Mental Retardation, FDMSE, RKMVU, Coimbatore
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He tried artificial limbs and many other therapies but when they failed to help him, he learnt to write with the help of his upper limb stumps itself. The next hurdle was getting a job again and it was here that he realized the tremendous need for attitudinal change in the society regarding persons with disabilities. He was told that there was no job that he was suited for and that persons like him are fit for nothing. Subtle refusals to outright insults- he faced them all boldly but he never gave up. Finally he got a job in Child Labour Abolition Society and contributed to the formation and sustenance of almost 10 self help groups of persons with disability. During his tenure, he also worked diligently towards the
88
rehabilitation of 24 children who were previously child labourers. He then joined the Faculty of Disability Management and Special Education at Ramakrishna Mission Vivekananda University in the year 2004. Today, he is a happy man, married to that gem of a lady who stood by him through the darkest phase of his life and enjoys playing with his two children. It is his ardent wish to be a role model to everyone he meets, to show them that life can be faced with courage and poise, no matter how tough the road becomes. He wants everyone to know that all the power to shine on is very much within them. He has found the light within himself and is now, a lamp unto all others.
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Disability – Bane or Boon: A Spiritual Perspective *Swami Anuragananda The theory of transmigration: This brings us back to the question as to how the microcosm is connected to the macrocosm; the individual to the universe, as per this theory. When the famous physicist Newton said that every action had equal and opposite reaction, he was stating an age-old psychological fact known to ancients.The theory of transmigration is the most feasible and rational explanation available to us. It provides consistent answers to seemingly irreconcilable facts of life, such as the inequality we are born with in terms of mental, moral, physical, social and environmental inheritance. The holistic view of life proposed by the protagonists of the transmigration theory has the support of a plethora of west ern philosophers, scientist, a nd sc hola rs, vouchsafing its soundness. Stated simply the theory states that: Death does not mean annihilation of an individual; it is a state of transition from one state of experience to another state. The experiencer (now onwards to be referred as ‘entity’) is immortal. The sum-total of pleasant and unpleasant experiences an entity undergoes during a life-cycle give rise to a resultant urge (desire/impulse) at the time of death. This plays a decisive role in determining the nature and quality of next cycle of experiences of the entity in the next birth. That is to say that we are the makers of our own destiny.
Consequently, no baby comes to this world with a blank slate. It brings in a bundle of experiences that are latent in the baby like a seed. The reincarnating entity is thus generally driven by a specific mental urge predisposing it to attain specific goals. These latent resolves start manifesting itself as soon as the entity attain to sufficient mental and physical maturity.
The matrix of circumst ances an inc arnat ing e ntit y inherits is commensurate with the deeds performed by it in the previous life. That is to say that there is a law of compensation in ope ration.The inexplaina ble circumstances we thing we inherit by accident in the present life is the ‘exact and opposite’ compensation of our own past deeds.
Law of Compensation: Man is a thinking animal. What you think will decide the quality of man. So all spiritual traditions caution us to be careful about cultivating right attitude whatever be our vocation or station in life. Regulated and controlled life based on principle of right thinking is the cornerstone of yoga psychology. Yogis state that people respond (conation: pratikriya- àiti³ya) to an object of knowledge (cognation: anubhava- Anu-v) in three broad basic modes; “Attraction, Repulsion or Fear ragÖe;ai-inveza> {Raga, Dveasa and Abhinivesa
* Asst. Administrative Head, FDMSE, RKMVU, Coimbatore
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(or Bhaya) - technically known as Klesas (¬ez>)}”. That is to say that the knowledge gets affected or coloured by the experiencer. The colouring, Klesas (¬ez >), yogi says, is due to inherite d response grounded on past experie nces whic h inc lude s past lives experiences. That is to say that we are prejudiced about what we perceive. The yogi further tell us that as long as we are perjudiced, i.e. we have klesas, eve ry act of cognition is an impalement of the psyche of the experiencer. This is tremed as samskara (s<Skar>) in yoga. These samskaras are produced because of klesas and in-turn, like a feedback mechanism, it reshapes the klesas. So samakaras can be termed as biasing current and klesas to the bias of human psyche. So every act of cognation sends a biasing current readjusting the bias status as per the nature and quality of stimulus.
Old people are generally said to be living in the memory of their youthful days. But yoga says that this is true of all human beings. Our ignorance of the past life events of a young man deludes us in thinking that he is original in his response. The yogi asserts that the only difference between the old man and the young man is that the former lives in the memory of the present life whereas the later is the product of memory of previous lives. In somewhat similar vein, the modern school of psychology speaks of Implicit and Explicit memory shaping our personality. The psychologist will tell you that that component of our memory which we can recall is the Explicit Memory and that which cannot is the Implicit. By whatever name we may call the effect, the fact remains that we are always controlled by our memories, whether Implicit or Explicit, is yogis’ point of view. The emphasis of Zen masters “To live in the present” is to live without any bias, Implicit or Explicit. It is a process of de-hypnotization of the psyche. Hypnotization, on the other hand, is conditioned prejudiced response. Let us take an example of a typical conation-cognation model in yoga psychology.
Fear (Abhinivesha, Ai-inveza>)
Repulsion (Devas, Öe;>)
Attraction (Raga, rag)
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Most people, including psychologists, will tell you that fear of snakes is a collective phenomenon irrespective of caste, creed, gender or nationality. People are scared of this reptile and they do not think twice to kill it even though it may have taken shelter in their house to lay eggs. Who will not give shelter to a woman who is in a family way? But not so when it comes to this dispised reptile. But there are few souls belonging to the family of Siva* who embrace this very creature. To them there is no more auspicious sign than a dangling cobra on a blue neck howsoever venomous it may be. To tell the truth both responses to snakes are not the natural outcome of an unbiased mind. Our responses are conditioned responses of our psyche. It is self-made not only in this case but in every case we can ima gine. Wit h proper c ulturing and conditioning, mode of response can be changed from one type to another. But the yogi strives to overcome the impulsive-response ingrained in our sensory system by our past associations. #iNÔySyeiNÔySyaweR ragÖe;aE VyviSwtaE, tyaenR vzmagCDeÄaE ýSy pirpiNwnaE.
3.34.
Attachment and aversion of the senses for their respective objects is natural. But these are (to be considered) as great foes under whose sway none should come - Gita, 3.34 Why should we be so fussy about not being biased? It is but natural that we feel repelled by snakes, may be because fear of snakes is drilled into our psyches either by our past experiences or by myths and lore of our culture. What is wrong in that? That is a
reasonable question. But the Yogi says that it would have been all-right if the matter ends there; your perception and your response. But it is not so. Firstly, with every response, the response gets impaled, so to say, deep into our psyche. If we do not temper our response with reason, we are sure to fall victim to its consequences in the long run. There is a great danger of becoming automat to our responses even when it is detrimental to our good. Most parents can predict the response of their children to a great extent because of this fact. We have become predictable because our responses are being conditioned by our previous responses. Automatic Response: To illustrate this we narrate the following parable. There was a person who was told that on the sea-shore there exist a “touch-stone” that can turn any metal to gold. Having ascertained the size, shape and color of the stone, this man ran to the shore to find it. His enthusiasm could not be dampened when he found that the shore was full with pebbles. He resolved to secure the pebble by examining each and every pebble, whatever time it took. To avoid picking-up same pebble, he would throw into the sea the pebble he had examined. Thus he set upon the task with firm resolve. Every day he used to pick-up a pebble, examine it, and throw it away. That became a routine with him. Day-in and day-out, he would rush to the shore in morning, pick-up a pebble, see it, and throw it in the sea. Days rolled into months but the routine continued; coming to the sea shore, pick-up a pebble, see it, and
*A great cult in India that worships the Lord as Siva, the auspicious one, who is adorned with snakes and is known to be the master of repulsive and fearsome spirits and animals. 91
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throw it away — pick-up, see, and throw …. pick-up, see, and throw. Then one sunny day, he came across the touch-stone. He picked it up, saw it and threw it!!! In spite of his intensions to the contrary, he just could not control the momentum of his habits - “pick up, see, and throw”. He was compelled, so to say, by the force of habit to react, before he could comprehend what he was doing. Similar is the fate of foolish person who thinks that he will not be affected by the habits he is forming. Chain smokers just cannot give up the habit even though they know the consequences of smoking. It is said that every smoker begins the habit of smoking cigarette and ends up by being smoked by the cigarette*. It is true of all habits, good or bad. Only Yoga asks you to consciously build good habits to counter-act bad habits. And both must be discarded in the ultimate analysis because both are habits. Sri Ramakrishan used to say that we need a thorn to extract another thorn from the flesh, but both are discarded once the job is done. A thorn is a thorn whatever is its utility. So, yogi is very careful of his mental associations. He knows that all interactions are unique and context specific. These should not be allowed to become our standard or generic response. Otherwise the day is not far off when that bias will dictate our response in spite of us not desiring so. It is not reasonable to brand everything good or bad on the basis of good and bad experiences of our past. Just because Mr. X, who happen to be tall, blonde with blue eyed had wronged me in some way, may be repeatedly, may be few such types have done
so, cannot be a justification to brand all tall, blonde and blue eyed people bad and then develop a feeling of hatred and fear towards them. The prejudice Hitler had towards few Jews became the seed of the worst holocaust hum an histor y ha s in its memory. Consequently, just because Hitler and few Germans were guilty of this crime, Jews or others have the license to hate every German is an equally erroneous view. Both victim and victimized have no legitimate claim to justify prejudice howsoever appealing it may be to our emotions. No one is ultimately good or bad in yogic worldview. Good and bad are contextual and cannot be treated as fixed and permanent. The context is intertwined, complex and many-layered. We generally understand that bad deeds will bring bad results. Accordingly, we categorize deeds as good and bad. But the law of compensation says that no act by itself is good or bad. It is the quality of associations with an object or experience that need to be taken care of. The great epic Mahabharatha contain the story of a butcher (vyadha-Vyad>) who attained enlightenment by performing butchery. He transmuted the base act of butchery by the touch-stone of his noble associations. Attitude can lend sanctity to any act. Killing is lauded as a great act of bravery when performed by a soldier in war, but that very act is most reprehensive in any civil society. Similarly, in the Epics we come across great ascetics who fall from their ideal (yogabhrashta- yaegæò>) because they lacked proper attitude even though pursuing a noble profession.
*In athletics, this concept is exploited by marathon runners to set-in a rhythmic pace. They say that a marathon runner can even doze off while maintaining his pace. May be sleep walkers also work on the similar principle.
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Swami Anuragananda / Bane or Boon: A Spiritual Perspective
Guru Nanak, the founder of Sikhism, once had to accompany a Nawab*, and his officer, Qazi*, during their prayers. The two Muslim dignitaries started performing their daily prayers as rules of their tenets but the Nanak just kept standing. The Nawab felt offended and he questioned Nanak about his conduct. Guru Nanak replied, it was I who actually prayed though apparently standing. While the Qazi was worried about a baby horse running loose in his courtyard and your thoughts were of how much money you will make by selling horses. On confronted with truth, the Nawab looked surprised and left Nanak.
*Nawab/Qazi are official designations used by medieval Islamic rulers in India Parable of Sri Ramakrishna: Once two friends were going along the street, when they saw some people listening to reading of the Bhagavata – a spiritual book of Hindus. ‘Come, friend’, said the one to the other. ‘Let us hear the sacred book.’ So saying he went in and sat down. The second man peeped in and went away. He entered a house of ill fame. But very soon he felt disgusted with the place. ‘Shame on me!’ he said to himself. ‘My friend has been listening to the sacred word of God; and see where I am!’ But the friend who had been listening to the Bhagavata also became disgusted. ‘What a fool I am!’ he said. ‘I have been listening to this fellow’s blah-blah, and my friend is having a grand time.’ In course of time they both died. The messenger of Death came for the soul of the one who had listened to the Bhagavata and dragged it off to hell. The messenger of God came for the soul of the one who had been to the house of prostitution and led it up to heaven.
The parable shows how vital is right association of ideas in determining the conduct of acts we perform. The Cosmic Factor: We discussed earlier that when cognition is affected due to a biased response (klesas), the experiencer suffers an impalement (samskara), so to say, of his psyche. This is, in principle, acceptable to modern psychologists. What is not palatable to them is the cosmic action attributed to our our actions under the impulse of these samakaras. This cosmic deposit of our deeds is known as karmaashya (kmaRzy>). This is so because yogi believes that all minds are part of a cosmic mind. This being so, all interactions are part and parcel of cosmic transactions. In whatever way we affect the cosmic field due to our ingained bias, in almost equal measure the living body of the universe reacts. So yoga psychology postulates two effects produced by a defective cognation or biased behaviour of an individual and his environment as stated below: 1.
Readjustment of mental bias known as samskara (s<Skar>) in the individual psyche of the experiencer
2.
Production of
a
c osmic
effe ct,
Karmaashya (kmaR z y>) due to actions performed under the influence of the biased mind. The se sa makaras a re the lat ent impressions that remain with us in our day-today interactions. And will be our inheritance when born in a new body. Whereas, the karamashaya will create, so to say, the environment needed for manifestation of our latent desires. So samskaras and karamasayas 93
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are the wrap and woof of microcosm and macrocosm. Because the the macrocosm is nothing but the sum total of all individual karmaashyas of entities being born in a given time. The worm builds a cocoon and, in the long run finds itself capsuled in the cocoon. Every act of an individual is, so to say, a hammer blow that shape his individual mind and, at the same time, defines the contours of world he must inhabit in next birth. It is, as if, the seed determines the environment to manifest its specific potential. By doing so, it unintentionally, inhibits the manifestation of its other potentialities. In what way karmaasaya affects the macrocosm? According to yogis, the effect of karmasaya can also be classified in three broad parameters as listed below: 1)
Type of Body-Mind Constitution (JatijaiTa) acquired by a new born entity
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2)
Life span of the inherited constitution (Ayu- Aayu)
3)
Environment, inter-personal, physical and mental, vital in influencing production of good and bad experiences in life (Bhogah-aeg>)
The theory of kar ma is wrongly understood as fatal mainly because of faulty understanding of Karmaashya. It is not that some unseen effect predetermines our destiny. The theory simply states that if you put your finger in fire, you cannot expect a cooling experience. You have the freedom to make choices but then you set in motion the wheel of cause and effect which is inevitable. We do have the freedom to make choices, but we can not run away from the effect of these choices. We cannot disowe them. Yoga psychology is a process of understanding the entaglement of individual entity in cycle of transmigration. It unravels
Swami Anuragananda / Bane or Boon: A Spiritual Perspective
how the worm like mind of ours gets enslaved in the self created cocoon world of its making. This understanding is vital in leading a rigrous and dedicated yogic way of life and chosing a specilised lifestyle appropriate to each individual. By doing so an individual can break the shakles in this very life need to be emphasished intead of fatalistc coloring given to this wonderful theory. Good and Bad Deeds: If the glass through which we see is coloured, we will only see a coloured picture. A defective instrument can only produce distorted output. Similarly, deeds performed with a prejudiced mind give rise to good-bad, vir tue-vice dichot omy. The affec ted environment reacts by produceing an equal and opposite response is the claim of the yogis. This does not mean â&#x20AC;&#x153;eye for an eye and ear for an earâ&#x20AC;? in literal sense. The statement is more metaphoric than factual. Equality and intensity of compensation is matched on psychological scale rather than being a replication in physical terms. To understand it
in a better way, we illustarte the story of Bhishma as given in the great Epic Mahabharatha. The story is very enlightening regarding the law of compensation as understood by the ancients. Bhishma the Great: Once upon a time, the eight Vasus (celestial beings) were wandering in the woods with their wives. They came upon a mythical cow named Nandini who could fullfill all the wishes of her owner. The wife of one of the Vasus, Prabhasa, pestered him to take away the cow so that she can give the cow to a friend of hers. Though unwilling, and aware of the wrongness of the act, Prabhasa could not refuse her wife and yielded to unlawful pleadings (rag>). This sets in motion the wheel of law of compensation for Prabhasa and his party. All the eight Vasus must pay the price for their deeds; seven Vasus for being the consenters of the crime (passive witness) and the eigth vasu, Prabhasa, for being its active agent.
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All the eight Vasus are cursed to an earthy life comusurate with their sins. The Vasu Prabhasa is born as Bhishma, son of king Santanu and Ganga. The Epic depicts him as a righteous man, a noble soul, who is a victim of self-imposed entanglements impelled by his impulsive and sensitive heart. This trait of his personality, his fixation with being good without consideration to its effect, was misused by evil Kauravas to sustain their kingdom of deceit. Virtuous and faithful Bhishma became the strongest pillar on which the sinful Kingdom of Kauravas was built. He becomes a helpless witness to sinful consequences of his apparently noble resolve and his inability to break away from it in spite of his love and preference for the Pandavas whose kingdom the Kauravas usurp by foul means. It is a case of good intentions, assisting bad deeds. He is, so to say, emotionally blackmailed by his “habit of goodness” and he is torn between an internal struggle to break this force of habit, as altered circumstances demanded, and his inability to do so. Finally, on the tenth day of the great battle of Kurkshetra, Bhishma, resolves to willingly pay the price for his fixation. He ends his lfe by a premeditated act of self-sacrifice on a bed of arrows. By doing so he broke his stubborn vow and signalled the dissolution of Kaurava kingdom. A careful study of history will show that all evil empires rests on folly of righteous people.
The Epic further shows how individual destinies of major players create a complex matrix of intertwined destinies. The original sin, in the above episode, is enticement of Prabhasa by his wife; softness of his heart being the culpable factor. The wife also put her skills of persuasion to wrong use. So in the new setting, she is born as as Amba*, the daughter of king of Kaashi. In this experience, she suffers the indignity of repeated failures in her attempts to influence Bhesshma, her former husband. She uses every mean under the sky to win him but fails. This becomes possible because by the law of compensation is in work. By providence, Bheeshma is protected from the beguiling influence of her former wife. It so happens that before she could m eet Bheeshma, he has come under the protection of his weakness in his earlier life as Prabhasa. In a fit of emotional outburst, in order to satisfy his father, Bheeshma has taken the terrible vows 1) not to marry and 2) not to rule 3) but to re main the protector of his fa thers dominions. This act earned him the name Bheeshma - one who took the terrible vows considering his young age at that time. Heavens have conspired to foil all attempts of Amba by the time she meets Bheeshma. Failing utterly in her resolve, the enraged Amba, metamorphoses into Shikhandi, daughter-turned-son of Drupad, the king of Panchaal and becomes the instrument of Bhishma’s death. …………………….. to be continued
*The epic does not specifically mention that female character Amba, being the wife of Prabhas, but the fact is implicit in the narration. 96
Vol. 1. No. 2 July 2011
Journal of Disability Management and Special Education ISSN: 2229-5143
ELEMENTARY EDUCATION IN INDIA Book review: 1. Flash statistics 2. State Report Cards: 2008-09 Published by: National University of Educational Planning and Administration (NUEPA) A. 17 B, Sri Arabindo Marg, New Delhi:110016 It is a very brief information in the form of book review for the benefit of the readers of JODMSE on the enormous work done by NUEPA so that the researchers in Disability Management and Special Education also could avail and make use of the data presented in the two books 'flash statistics' and 'State report cards'. The "Flash Statistics" of the Elementary Education in India brought out by NUEPA, in a 47 pages book form, is a wealth of information on the progress made in UEE in India. It is a readymade supporting data for researchers to go in-depth, especially in educational research, and policy makers to get in touch with the realities by analyzing, comparing and cross checking the factors reflected on each page of the book: Flash statistics.
A4 size page/card which includes information at all levels such as school, cluster, block, district and state with key information on number of schools with performance indicators and number of beneficiaries. This marvelous contribution of NUEPA, especially Dr. Arun C. Mehta, Professor and Head, Department of Educational Management Information System and his entire team, has been already applauded by winning the National and International awards. If the researchers in Disability Management and Special Education need copies of these books to make use of the analytical reports and tables related to Elementary Education in India, please contact the following address and websites:
The tables and figures on 47 pages present the quantified information on elementary education of 35 districts/ UTs in India with respect to school, facility, teacher related and enrolment based indicators with educational development index which could be easily understood and analyzed.
National University of Educational Planning and Administration (NUEPA) 17 B, Sri Arabindo Marg, New Delhi: 110016 arunmahta@nuepa.org http://www.dise.in http://www.schoolreportcards.in http://www.nuepa.org
The "State Report Cards", the 71 pages book begins with a summary of the major findings of the above mentioned factors. Any reader will be amazed to see the comprehensive data on an
Reviewed by: A.T. Thressiakutty, PhD Professor in Special Education FDMSE, RKMVU, Coimbatore
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Vol. 1. No. 2 July 2011
Journal of Disability Management and Special Education ISSN: 2229-5143
Video review Swapan se Hakikat : A Documentary Film on Inclusive Education Author: Mamata Mehrotra D.A.V. Public School, Patliputra Colony, Patna, Bihar, 800013 Price- Not Mentioned The documentary film entitled Swapan se Hakikat ( From dream to reality) under review vitally throws light on the significance of inclusive education that values all children together to devise classroom, and welcomes all children irrespective of their ability, disability, community and ethnic background. The documentary intends to bring forth the successful aspects of inclusive education trough a number of case vignettes which prove that as a result of inclusive education provided under D.A.V. Public School, Patliputra Colony, Patna; quite a lot of children with disabilities got success and achievement being independent in due course of time. The documentary sanguinely and frequently emphasizes that school should bring modifications in its system to respond to the varying competencies of children rather than children adapt as per the school system. The documentary is a result of a longitudinal research conducted by Mrs. Mamta Mehrotra. The core feature of the documentary is its case vignettes of Rajat, Vidya, Shubham, Aryan and many differently abled students who present live examples to the success of inclusive education. At the very outset Mrs. Mehrotra wants to bring forth how the dream can be translated into reality applying collective effort of Government, schools, teachers, peers, community and most importantly parents. The film affirms that the Government of Bihar through Bihar Education Project is instantly working not only for the education, rehabilitation and employment but also for providing respectful lives to children with disabilities. The Government is committed to provide equal opportunities and full participation to such children so that they can lead a quality life and entertain their rights on the basis of basic human rights.
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On the one hand the film projects the damn reality through two cases where it is shown that Rajat, a child with behavioural problem is tied for no rhyme and reason of his own. Still in n another case of Vidya, a child with hearing impairment, her mother was even advised not to beget the child; on the other hand the same children are shown to do better in their lives and education showing independency. The most touching scene in the film is the innocent aspirations of Shubham, a child with Autism which are laudable. In one scene, Shubham reveals his hearty wishes to have a Mercedes car and also one day he wants to be a player like Sunil Gawaskar, Mahendra Sing Dhoni and Scahin Tendulkar so that he can win name and fame for his nation India and state Bihar. The film comes to an end with legendary motivating song "We shall overcome, we shall overcome, we shall overcome one dayyyyy; deep in my heart, I do believe, we shall overcome one day â&#x20AC;Ś." collectively sung by children holding hand together bringing the rays of hope and expectation for them. Overall the film is a result of extensive research and painstaking effort by Mrs. Mehrotra and group which brings home the positive effects of inclusive education for children with disabilities. The documentary is available in Hindi language and for more information, the readers can contact on the following address: D.A.V. Public School, Patliputra Colony, Patna, Bihar, 800013 Reviewer Abhishek Kumar Srivastava Asst. Professor, FDMSE, RKMVU abhishekbhu2007@gmail.com
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