Jdmse vol 2 no 1 jan 2012 by Vivekananda University, Coimbatore Campus

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 2

Number 1

January 2012

CONTENTS Editorial board

Instruction to authors

iii

Editorial

Does Cognitive Processing Speed Predict Social Maturity? A Comparative Study between Persons With and Without Mental Retardation during Task Performance : Seshagiri Rao Joshi and Tarana Pervaiz

01-10

General Self-efficacy and Depression among Women Teacher Students : Mohammad Sheikhiani, Bindu P Nair and Zahra Fakouri

11-17

Determination of Balance in Lower Limb Amputees Using the Berg Balance Scale : Shobhalakshmi and S. Savita Ravindra

18-32

Anxiety profile in well siblings of children with Developmental disabilities: Prof. S. Venkatesan and Nimisha Ravindran

33-46

Suspicion to identification of hearing loss in Children: Parentâ&#x20AC;&#x2122;s perception about Contributing factors: Gayatri Subodh Sirur and Prof. R. Rangasayee

47-51

Developing Self Determination among Individuals with Mild Intellectual Disability through Audio Visuals: Wasim Ahmad and Prof. A.T. Thressiakutty

52-63

A Study of impact of Distance and Regular Education Modalities on Competencies of Special Educators of Children with Hearing Impairment: Dr. Kaushal Sharma and Dr. Amitav Misra

64-76

Phonological Awareness: A Comparison between Children with Learning Disability and Poor Academic Performance. Akshatha S., Deepthi M. and Narasimhan S.V.

77-86

Disability: Bane or Boon: Swami Anuragananda

87-96

Success Story : Sheila Rao

97-98

Book Reviews:

99-101

JOURNAL OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION Jo u rn a l o f D is a bil it y M a na ge me nt a nd S pe c i a l Ed uc a ti o n (JO DM S E) 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: ` 200/-

One year : ` 400/-

Three years: ` 1000/-

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 par culars about Journal of Disability Management and Special Educa on

1. Place of Publica on 2. Periodicity of Publica on 3. Printer’s Name Na onality Address

: : : : :

Coimbatore Bi-annual Vidyalaya Prin ng Press Indian Ramakrishna Vidyalaya Prin ng Press, SRKV Post, Periyanaickenpalayam, Coimbatore 641 020 4. Chief Editor’s and Publisher’s Name : Dr. A.T.Thressiaku y Na onality : Indian Address Ramakrishna Mission Vivekanada University, Faculty of Disability Management and Special Educa on, 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 Educa on, SRKV Post, Periyanaickenpalayam, Coimbatore 641 020 Tel: 0422 2697529 e-mail: jodmse@gmail.com, fdmedu@gmail.com I, Dr. A.T. Thressiaku y, hereby declare that the par culars given above are true to the best of my knowledge and belief. ii

JOURNAL OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION ISSN : 2229-5143 Volume 2

Number 1

January 2012

EDITORIAL BOARD CHIEF ADVISOR Swami Atmapriyananda Vice-chancellor, Ramakrishna Mission Vivekananda University

ADVISORS Swami Abhiramananda 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

Former Deputy Director, NIMH, Secunderabad

Principal, College of Education, Ramakrishna Mission Vidyalaya, Coimbatore

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 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 iv

an Abstract of not more than 150 words, stating 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 â&#x20AC;&#x201C; 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.

From the Desk of Chief Editor The members of the editorial board feel proud to place the vol.2. Book .1 before the esteemed subscribers and readers of JODMSE. In addition to book reviews and success story, it has 8 research articles authored by professionals from various categories of disability rehabilitation such as psychology, physiotherapy, speech therapy and audiology and special education (Hearing Impairment, Intellectual and Learning Disability). The readers would have noticed a change in the editorial board. I feel sad to intimate unexpected demise of Revered Swami Atmaramananda, the Administrative Head of RKMVU, the source of inspiration and guiding force behind initiating JODMSE. Concurrently, on behalf of all readers, I, as the chief editor, welcome Revered Swami Abhiramananda, the successor of Revered Swami Atmaramananda, as advisor of JODMSE and seek his constant guidance and support. I feel proud to introduce the variety of research articles appeared in this issue. It starts with an in-depth analysis of the relationship between cognitive processing speed and social maturity which has a wider impact on human functioning. Teaching profession has a high regard. The women population aspiring for teaching profession is on the increase. The second article, in this issue, conducted on 120 teacher educators of the Boushehr University in Iran, suggests the new aspirants to check their general self sufficiency before opting the profession in order to avoid adversity. Shobhalekshmi and Ravindra, the physiotherapists, recommend for further research to examine whether the type of prosthesis, level of functional independence or environmental factors contribute any changes in the Berg Balance Score in lower limb amputees preferably on a large sample. On the one hand where the researchers are in search of topics for investigations, on the other, Prof. S. Venktesan sets an example of how to produce a series of fruitful research

articles pivoting around a particular major topic specifically on siblings of children with developmental disabilities. For his previous research article, you can refer JODMSE Vol. 1, 2: 1-23. The article “suspicion to identification of hearing loss in children” intends to bring forth the current inadequate scenario of aural-oral rehabilitation professionals in India which hinders the early identification and intervention of children with hearing impairment. Akshata et.al, in their research pointed out the poor performance of children with learning disability comparatively with regards to phonological awareness. This makes the professionals on alert who are involved in education of children with learning disability to give second thought on the methods of teaching and remedial education. Self determination in persons with intellectual disability is a much researched area at international level; however apprehensions are much and concept itself faces a big question mark among concerned professionals and parents. Wasim makes an attempt to prove the possibility of practicing self determination by persons with intellectual disability with positive result. It is an eye opener for those who are responsible for providing training to persons with intellectual disability. The aforementioned concept is apparently confirmed in the success story of Sanjay penned down by Rao. By this time the readers would have got the hidden message unfolded through the article, “disability: bane or boon” by Swami Anuragananda, which is continued in this issue also. This message is expected to have an impact on many unanswered questions related to disability. With gratitude,

A.T. Thressiakutty, PhD Chief Editor, JODMSE

Vol. 2. No. 1 January 2012

Journal of Disability Management and Special Education ISSN: 2229-5143

Does Cognitive Processing Speed Predict Social Maturity? A Comparative Study Between Persons With and Without Mental Retardation During Task Performance *Seshagiri Rao Joshi & **Tarana Pervaiz,

Abstract: Studies on age-related rate of cognitive processing (RCP) across the life span are well documented. However, there is little research done to understand whether RCP can become an indicator to other developmental domains like intelligence, socialization, or language development. In this regard, this paper compares persons with mental retardation (MR, n=35) and without mental retardation (NR, n=35) on the basis of mental age (MA) matched design (MR-MA mean = 10 years, SD= 1.50 and NR-MA mean = 11 years, SD = 2). The objective of the study was to determine whether RCP can estimate social maturity in both groups. For this purpose, Alexander Pass-Along Test was used as task performance and the results were compared with results on social maturity (SA) scales on Vineland Social Maturity Scales. The results showed that the calculated RCP-MA from time taken within the said age range on the completion of performance task matched with the SA in the both groups approaching statistical significance RCP-MA and SA in MR group ( p = <0.001) and RCP-MA and SA in NR group ( p = < 0.0001). The results were also treated with regression analysis predicting SA on the basis of RCP-MA. Concluding that estimation of developmental domains is possible on RCP. Key terms: Cognitive Processing, Social Maturity, Mental Retardation, Task Performance

Introduction: Mental handicap ranks among the worldâ&#x20AC;&#x2122;s most complex and challenging problems. It is a multi-dimensional phenomenon involving bio-psycho-social factors (Arya, 1991). Mental retardation is not an etiological entity but is a condition characterized with developmental delay, sub average intelligence and difficulties in adaptive behavior. In some cases hereditary endowment and in some a multitude of environmental factors

seem to be influencing. A particular etiological process may affect the child at any stage of the life span i.e., at the time of conception, during birth or any other time after birth. Zigler (1969) argues that non-organically based retardation, essentially due to inadequate stimulation, a basis for deprivation, and inconsistent positive reinforcements rather than to anything intrinsically related to the state of the child. According to the concept of Non-Organic Failure to Thrive (NOFT)

Guest Faculty, Rehabilitation Psychologist, Department of Rehabilitation Psychology, National Institute for the Mentally Handicapped, Secunderabad, Andhra Pradesh, India. e-mail: rehabilitation. psychologist@gmail.com

Consultant Rehabilitation Psychologist, Department of Psychiatry, Regency Hospital Ltd., Amrita School for Special Children, Kanpur, India. e-mail: taranapervaiz@rediffmail.com

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child’s growth deficit is primarily influenced by environmental factors. NOFT is primarily attributed to parental competence, parental personal resources such as developmental history, personality and physical health; child characteristics like temperament, illness; and contextual influences, which would be family stress, support and social network. Deficient social responsiveness has been consistently identified in NOFT. Behavioral deficits that are serious enough to affect the parent’s response to children may increase the risk of subsequent psychological problems. From the psychological viewpoint, research concentrates with regard to the learning capacity; cognitive functions; emotional and social problems like destructiveness, aggressiveness, and parentchild relationship in children with mental retardation.

processing directly influence in people’s ability to think, reason, and remember. Hale (1999) categorizes cognitive speed by proposing three varieties of processing speed a) global, b) local, c) strategic. Kail supports the global view hypothesis that information processing components develop at similar rates across the age. Hence, the efficiency of all controlled processes should be similarly affected by age. In contrast, local view assumes that information processing changes with age and that the components develop at different rates. Strategic hypothesis focuses on differences in the selection and organization of components, so quantitative differences in children’s latencies reflect qualitative differences in cognitive strategies. A number of studies which measure cognition, specifically attention, memory and problem-solving skills, explain a significant proportion of the variance in social skill.

Persons with disabilities (PWD) Act of India, 1995; ICD-10, [F.70-79]; DSM-IV (TR); and AAMR definitions regarding cognitive deficits and social competence are major contributors for mental retardation which seems to be the core of adaptive skills. Social maturity involves cognitive competence to maintain social relationships through interactions and through problem-solving skills in ones dayto-day life through the ease of information processing with which a person can establish adaptive skills. Hence the rate of cognitive processing is the key element for social maturity (Meyer & Kurtz, 2009).

Nihira (1976) observed levels of retardation proportionate to adaptive behavior. Greenspan (1979) considered social intelligence as a measurable construct for investigation of mental retardation. Doll’s Vineland Social Maturity Scales (VSMS) (1940) is the first measure of social maturity. Christake (1969,1970) observed no systematic decline in social quotient with standard IQ but indicated limitations in advanced social skills which requires multiprocessing. Zigler (1969) proposed motivational and emotional component to influence IQ test results. Kishwar (1976) attributed broken homes, brutal discipline, low social economic status and faulty relationships with parents may contribute to mental retardation confirming Zigler’s view. Galambos (2005) suggested that cognitive abilities are related to psychosocial maturity.

According to evolutionary psychology, social competence for adaptive behavior is cause for cognitive processing speed. Kail (2000) demonstrates that rate of cognitive 2

Joshi & Pervaiz / Does Cognitive processing speed predict Social Maturity?

Cohn (2004) studied “ego” and intelligence and found that personality variables are independent of intelligence and concluded that social development could be better construct to understand personality indicating that personality can be measured through social development. Considering neurobiological viewpoint Weber (1981) showed maturation correlated positively with sequencing (left hemisphere) and negatively with visiospatial performance (right hemisphere). Gould (1977) work shows that cognition and social development are related. The slowness in mental retardation could be difficulty in perception for example Robert Fox and Stephen Oross (1992) show that individuals with mild mental retardation, do not process depth cues or movement cues with the same degree of accuracy as individuals without mental retardation. The findings of Fox and Oross raise the possibility that some aspect of neural functioning involved in preattentive processing are deficient. The second aspect of slowness in information processing in individuals with mental retardation is encoding, which refers to the initial aspects of making information meaningful depending on the context and this decision may be made with varying degrees of accuracy.

The participants were asked to recall the items in their order of presentation. The sequence of the items was controlled by the experimenter, but the exposure time was controlled by the participant. In this type of task, individuals without mental retardation increased their study time as they progressed through the list, an indication that they were using a cumulative rehearsal strategy in which they reviewed the earlier items as the later items were exposed. The study time patterns for the individuals with mental retardation, however, were flat; they used the same exposure time for each item in the sequence. The failure to use a rehearsal strategy to keep track of the order of the items resulted in poor recall. Similar types of strategy deficiencies have been observed in a variety of memory tasks and specific deficits have been found in memory-related processes such as in the inhibition of irrelevant information (Merrill & Taube, 1996) and in speed of processing (Kail, 1993). The most distinctive aspect of neurological maturation in humans is the gradual acquisition of extensive cognitive skills. Decreased rate of development has an uneven impact on cognitive systems resulting in a striking degree of ‘scatter’ among some mental processes, which seem relatively well developed for the child’s age, and others that are pathologically delayed in the evolution. These instances of selective cognitive delay may involve any subset of spectrum of mental disabilities. Impaired mental development results from neurodevelopmental lag. As the normal brain matures, different areas of the brain take control over specific aspects of behavior in a predictable sequence and timing when the child is deprived of novel experience then its

The most firmly established finding in the study of individuals with mental retardation is that they have deficiencies in the use of cognitive strategies. A strategy is a method consciously devised by an individual to reach some goal. For example at the University of Kansas in the 1970s, John Belmont and Earl Butterfield conducted a program of research on memory strategies used to remember a sequence of letters, words, and picture names. 3

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control over skill acquisition is impaired, and an acquired deficit results. When the individual is deprived of learning experience due to psychological trauma early in life gradually the impairment manifests as a delay in the evolution of the mental process due to poor mental schema or strategy.

without mental retardation. Hence, it proves appropriate to study the social maturity keeping the age constant. Procedure: Firstly, the procedure and purpose was explained to the teachers and parents and consent was taken, after which Alexander PassAlong test was administered. This is a speed test, consisting of grade level increment in and each candidate was credited according to the norms on the test. Following this, the children’s parents and teachers were interviewed to credit the social maturity scale. The total procedure was completed within 30 minutes time period.

Method: Participants: T he re su lt s d e sc ri be d he re w e re obtained after comparing two groups of sample containing 35 individuals with and without mental retardation respectively. The chronological age range of individuals with mental retardation was above 7 years with mean of 16 years (SD = 4.71) and with the mean mental age being 10 years (SD = 1.50). The sample of experimental group was taken from clearly defined population who were culturally and family-wise affected by mental retardation without any medical condition or sensory impairment. The sample was attending special schools. The control group included children attending regular schools. The age range for the control group was within 7 years to 15 years (mean = 11.37; SD = 2). However, mental age (MA) matched design is considered over the groups chronological age. Support to MA is not new (e.g., Evans, Hodapp and Zigler, 1995; Barnett, 1986; Cherkes, 1975; Jensen and Rohwer, 1968). In the studies of mental retardation, this approach demonstrates the firstly, the abilities of individuals with mental retardation. Secondly, the importance of MA over IQ (Barnett, 1986) for rehabilitation services in required domains of life. Finally, to see whether age-related cognitive processing can be attributable to mental age and whether it follows the same sequence as persons

Tools used: Alexander Pass-Along Test: It is a speed test, using passing the given blocks without lifting from the given frame, in which the blocks are placed. The blocks are painted blue and red. One wall of the frame is painted blue and the other wall is painted red. The task is to bring the red block to the red wall. The first box presents problem, which is simple for the average 5-year-old, while final task is sufficiently difficult to challenge adult’s RCP. The age limit starts from 7½ years until 20 years. Performance is recorded on the basis of time taken for the completion of the tasks (minimum time is within thirty seconds = 30” and maximum time is 120” to 300”) as raw scores and computed with standard scores (with minimum score being 11 and maximum being 45). This means, the minimum time taken will score maximum (score 45 = MA 20 years) and maximum time taken will get minimum score (score 11 = MA 7.6 years )and vise verse according to Norms table. 4

Joshi & Pervaiz / Does Cognitive processing speed predict Social Maturity?

Vineland Social Maturity Scale (VSMS): Doll’s scales on social maturity were adapted by Father Malin in 1965 (Binapani et.al, 2011). VSMS aggregates the differential social capacities of an individual. There are 117 items in the scale, calling on “increasing” social adequacy at successive developmental stages, and they are grouped in the following categories: self-help skills for daily living; selfdirection, communication skills, locomotor, and socialization skills.

task before two consecutive failures. Social age depicts Social Maturity (SA). This study limits itself by demonstrating that the age-related cognitive processing speed follows the normal pattern in MR as in the NR if MA is considered and is consistent with Zigler (1999). It was seen that in the NR sample the mean for RCP-MA was 12.30 with a SD of 2.49 while the mean for SA was 11.77 with a SD of 1.93. The MR sample shows the means for RCP-MA (9.65) and SA (10.12) with SDs of 1.44 for RCP and 1.28 for SA. The results of comparison needs some explanation in that the number of tasks performed by the control group was more than the experimental group and hence the depicted means. The correlation calculated between CP and SA in MR and NR were 0.80 and 0.84 respectively.

Results and Discussion Persons with mental retardation (MR) performed equally when compared to MAmatched normal group (NR) and showed appropriate social age (SA) for their mental age. Cognitive Processing (CP), in the present study, is aggregate of time taken to complete the

Table 1 : Means and SD for NR and MR samples in CP and SA Mean

SD for

Sample

for SA

size

2.4913

11.771

1.9336

1.441

10.12

1.288

Variable

Mean for RCP-MA

SD for RCP-MA

12.305

9.657

Whe n t he data was analyze d for correlations, the coefficients were significant

for both the samples of NR (r = 0.66) and MR (0.53) in CP and SA.

Table 2. Pearson’s correlation and p-value for NR and MA samples Variable

Pearson Correlation RCPMA and SA

Signiﬁcance (1-tailed)

0.659

0.0001

0.530

0.001

The data was further analyzed using regression analysis with RCP-MA being the predictor and SA as the predicted. The slopes were manually calculated to assist in the

computing of the data for regression analysis. Therefore, in the MR sample “y” was calculated for by using the formula: y = bx + a 5

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The computed values are:

Table 3 shows the regression coefficients values. It can be seen that the R2 for MR children is 00.28 while for NR children it is 0.43. The Standard Error of Estimate (Sxy of estimate) is 1.24 for MR children and 1.90 for NR children. Furthermore, Table 4 & 5 show the one-way ANOVAs for these regression coefficients and residues. The one-way ANOVA for MR children (Table 4) was significant (p = 0.001) and the F value was 12.8. Similarly, Table 5 shows the one-way ANOVA for the NR sample. Here, it was seen that p-value was 0.001 and the F value was 25.2.

y = –0.59x + 5.36 where y = RCP-MA x = SA b = slope (b = - 0.59) with r = 0.53 and R2 = 0.281 with Standard Error (SE) = 1.24. Similarly, slopes were calculated for the NR sample. y = 0.77x + 6.02 with r = 0.65 and R2 = 0.434 with SE = 1.90

Table 3 : Regression coefﬁcients with SA for MR and NR samples Sample

Sxy of estimate

MR NR

0.530 0.659

0.281 0.434

1.2412 1.90297

Table:4 One-way ANOVA for CP in MR sample Model

Sum of squares

Mean square

Regression

19.848

12.884

Residual

50.838

1.541

Total

70.686

Sig

0.001

Table:5 One-way ANOVA for CP in NR sample Model

Sum of squares

Mean square

Regression

91.537

25.277

Residual

119.502

3.621

Total

211.039

Discussion In the current study, the results show that we can positively predict speed of cognitive processing and social maturity in MR and NR, which allows us to accept that there is a positive correlation between the two variables.

Sig

0.0001

Thus, directing the study to approximate Zigler’s developmental model, which argues that if individuals with cultural-familial mental retardation are compared with individuals without mental retardation with MA-matched design show same level of social maturity 6

Joshi & Pervaiz / Does Cognitive processing speed predict Social Maturity?

(Zigler, 1969). This study is consistent with the studies performed earlier with MA-matched design where results found to show no difference with and without mental retardation.

lobes become functional between the ages of four and seven years. However, Cognitive processing (CP) speed would not approach adult levels even by the age 8-10 years and still has 5-6 standard deviation units than an young adult (Kail, 2000). Kail’s studies on linking processing speed with intelligence found that the age-related RCP with MR would follow the same order as observed in NR population but becomes slower as it reaches MA 12. Also, findings assume that CP may have stages of development and the basic one being trial and error and the advancement is forming a strategy in abstract (Piaget formal operations stage), such advancement is economic in evolutionary timeline. In MR group, it seems to be in the basic stage as observed during test administration. These participants started approaching the task immediately after the “start” signal. In contrast, NR participants had taken some time before appreciating the task. The study is based on theoretical framework for understanding identified patterns and the relationships of strengths and weaknesses, and the extent to which these patterns remain stable or are subject to change over the course of development. Insights of the child’s strengths and weaknesses can potentially be used to provide compensatory strategies or methods to circumvent difficulties. Unlike calculating IQ, the present study argues that it is better to understand cognitive processing, because the former takes chronological age into consideration and reflects the inability more grossly than it is. But, if we consider MA on the basis of CP, it would give us better understanding with regard to the stage of processing capacity on the basis of clinical evidence.

When MA-matched design is treated with regression analysis (Table 4, 5), the results depict that Rate of Cognitive Processing (RCP-MA) predicts social maturity in both the groups. Also, RCP is predicted fairly closely in the sample MR with standard error of estimate 1.24 than in normals where it is 1.90 (table-2). In the present study social maturity has been taken as overall component and was not treated domain wise and observations are that MR participants faired well in selfhelp and communication skills but poor in goal-directed behavior. This observation is consistent during task performance, as all subjects consumed all the stipulated time and have got the same credit as NR participants. It has previously been suggested that a piecewise linear regression analysis may reveal such an effect (Neter, Wasserman & Kutner, 1990). Due to ongoing developmental process in persons without mental retardation there is a chance of advancement as Kail (2000) points out that during childhood and adolescence important neural changes and age-related changes in the number of transient connections in the central nervous system occur which contributes to processing speed dramatically and stagnates in late adulthood and then gradually declines during old age. However, this might not be the case for persons with mental retardation which approximates stagnation until MA of 12 years and then slowly declines. To substantiate the evidence further from the present study demands to notice Luria’s (1961) observations that the frontal 7

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According to the processing theory, Denkla (1996) and Luria (1973) suggest that it is important how a person comes to a particular conclusion with regard to problem solving rather than the result that he achieves. In other words, the ability to blend appropriately all the cognitive and emotional elements to deal with the environment is better understood through models drawn from processing theory.

retardation. This study supports the arguments of Barnett (1986) and later on Zigler (1999) to consider the MA, which helps to formulate public policy. Finally, revisits Alexanderâ&#x20AC;&#x2122;s Pass-Along Test, later adapted by Bhatia Battery in India, to show evidence that it has potential to assess cognitive processing speed as it reflects the MA with accuracy in the present study, which was confirmed by the control group.

Summary and Conclusion: The current study observed RCP is directly proportional social maturity and are complementary to each other within two independent groups i.e., NR and MR group and observed against the studies in review of literature CP can be approximated with social maturity in both the groups with marginal difference. However, the limitations which make the difference between NR and MR can be understood by Keganâ&#x20AC;&#x2122;s model of social maturity (1994), which argues that social abilities are developed like cognitive abilities in layers at each developmental stage, and children at preliminary level just imitate some social skills without having much insight.

Limitations: 1. The tool assessing cognitive abilities does not provide bonus credit points allowing a person to be rewarded if he/she had performed before stipulated time. 2. The MR sample was collected from institutions, which are specialized in training the children and might have effected in performance and during interview. In contrast, the normal sample collected was too heterogeneous ranging from wide variety of geographical areas. 3. The tool used for social maturity was found to be inadequate in measuring social competence in normal group.

Secondly, the study postulates that as there is developmental phase in CP, and the basic stage is trial and error method and advanced stage being abstract strategic planning method, thereby consistent with Haleâ&#x20AC;&#x2122;s study on developmental trends observed in processing speed. Individuals without mental retardation will adapt to decline in speed of cognitive processing across their lifespan but have a kind of backup compensatory systems like perceptual experiences with almost precise estimates to understand the environment rather than to exercise cognitive strategies which are compromised in persons with mental

4. Regression analysis was not done on the basis of domains provided in the VSMS scales. References Arya S. (1991). Screening of Pre-school children for early identification of developmental disabilities in rural area, Indian Journal of Clinical Psychology, 18, 65-70 Barnett, WS. (1986).Definition and classification of mental retardation: a reply to Zigler, Balla, and Hodapp. American Journal of Mental Deficits: 91(2), 111-9. (PMID: 3766611) 8

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Butterfield, E.C. & Belmont, J.M. (1977). Assessing and improving the retarded. In N.R. Ellis (eds). International review of research in mental retardation: Vol. 7, N.Y. Academic

in mentally retarded adults. In N.W. Bray (Ed.), International review of research in mental retardation: 18, 1-27. New York Academic Press. Galambos, N.L (2005). Cognitive performance diffe rentiat es se lect ed aspects of psychosocial maturity in adolescence. Developmental Neuropsychology: 28(1) 473-92.

Cherkes, MG. (1975). Effect of chronological age and mental age on the understanding of rules of logic. American Journal of Mental Deficits: 80(2), 208-16. (PMID: 1163568)

Gould, J. (1977). The use of the Vineland Social Maturity Scale, the Merrill-Palmer Scale of mental tests (non-verbal items) and the Reynell Developmental Language Scales with children in contact with the services for severe mental retardation. Journal of Mental Deficiency Research: 21(3) 213-26.

Cohn LD, Westenberg PM, (2004). Intelligence and maturity: meta-analytic evidence for the incremental and discriminant validity of Loevinger’s measure of ego development. Journal of Personality and Social Psychology: 86(5), 760-72. Doll, E. A. (1940). Annotated bibliography on the Vineland Social Maturity Scale. Journal of Consulting Psychology, 4(4): 123-132. Retrieved from: http:// psychology.wikia.com/wiki/Vineland_ Social_Maturity_Scale

Greenspan,S. (1979) Social intelligence in the retarded. In N.R. Ellis (Ed.) : Handbook of mental deficiency: Psychological theory and Research (2nd ed). New Jersy: Lawrence Erlbaum.

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Kishwar, I. (1976). Sociological aspects of mental retardation: In Anima Sen, Psycho-social integration of the handicapped: a challenge to the society. Mittal Publications. (pp.219-220)

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General Self-efﬁcacy and Depression among Women Teacher Students *Mohammad Sheikhiani, **Bindu P Nair & ***Zahra Fakouri

Abstract This study sought to determine the relationship between general self-efficacy and depression among women teacher students’ of the Bentolhoda Teacher Education Center of Boushehr, Iran. The correlation research design was used to conduct the study. Stratified random sampling technique was used to select 120 participants from the women teacher students on the basis of their training fields into five groups: Mathematics, Primary School, Experimental Sciences, Religion and Arabic and Social Studies Teaching. The age range of the participants was between 18 and 21years. Two validated instruments (General Self-efficacy Scale & Beck Depression Inventory) were used in collecting data. Pearson product moment correlation coefficient was utilized to analyze data. The results from this study showed that a moderate negative but significant association exists between general self-efficacy and depression (r =- .32, p < 0.01). The moderate negative relationship between general self-efficacy and depression indicates that general self-efficacy might be a resource for decreasing the depression among women teacher students. Based on this finding, it can be concluded that high generalized self-efficacy in students may serve as a protective factor against depression, whereas, low self-efficacy can lead them to depression. Keywords: General Self – efficacy, Depression, Teacher Students.

Education is vital for every country in the world, and Iran is not an exception. Higher education and universities are considered as scientifically innovative and intellectual production centers for mankind. Moreover, the universities are mainly concerned with education, training, and knowledge and science transition for students serves as future labour force anywhere. From organizational perspective, higher education aims to help students to develop their talents and potentials and succeed in educational endeavors throughout their lives (Akhavan & Dehghan, 2006).

Evidence suggests that teacher students are vulnerable to mental health problems. It has been generated increased public concern in societies (Bayram & Bilgel, 2008). Previous studies suggest high rates of psychological morbidity, especially depression and anxiety, among teacher students all over the world (Nerdrum, Rustoen, & Ronnestad, 2006; Ovuga, Boardman, & Wasserman, 2006; Voelker, 2003; Wong, Cheung, Chan, Ma, & Tang, 2006). Mohammadi et al (2006) showed that the lifetime prevalence of Major Depressive Disorder (MDD) in Iran was 3.1 %, which was

Ph. D Research scholar, Department of Psychology, University of Kerala, Trivandrum 8189195707, Email: mztf6509@yahoo.com or sheikhiani1970@gmail.com

Assistant Professor, Department of Psychology, University of Kerala, Trivandrum 695581.

*** M.A (educational planning) Organization of Education, Boushehr city, Iran.

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lower than in the United States (5.10% range). Results of Shojaei Zadeh and RasaFyani (2001) showed that 28.8% of students of university have mild depression, 9.6% have moderate depression, 3.3% have severe depression, and 1.3% have very severe depression.

mental health of an individual. High selfefficacy helps create feelings of serenity in approaching difficult tasks and activities. Conversely, people with low self-efficacy may believe that things are tougher than they really are, a belief that fosters anxiety, stress, depression, and a narrow vision of how best to solve a problem. Similarly, individual’s belief in his coping capabilities affect how much stress and depression a person experiences in threatening or difficult situations. Depression is believed to be cognitively generated by dejecting ruminative thoughts. A low sense of efficacy in order to exercise control over these ruminative thoughts tends to contribute to the development of depression (Bandura et al, 1999).

One area identified as influencing depression among students is the selfefficacy. Self-efficacy is the belief in one’s capabilities to organize and execute the courses of action required to produce given attainments (Bandura, 1997). These courses of action may include behavior, thoughts and emotions (Miller, 2002). Individuals form their self-efficacy beliefs, interpret information primarily from mastery of vicarious experience, learning or observation, social and verbal persuasions, and physical and affective states. Self-efficacy beliefs produce diverse effects on human functioning through four major psychological processes. These psychological processes include: (1) cognitive processes, (2) motivational processes, (3) selection processes, and (4) affective processes (Bandura, 1997). Researchers have also supported that mood affects people’s judgments of their personal efficacy. Positive mood enhances perceived self-efficacy; despondent mood diminishes it. Physiological indicators are considered as important sources of self-efficacy information. Similarly, the effects of self-efficacy on cognitive processes take a variety of forms as much of human behavior is purposive and regulated by forethought and goal setting, which is influenced by self-appraisal of capabilities (Bandura, Pastorelli, Barbaranelli & Caprara, 1999).

S u b st a n t i a l a m o u n t o f re s e a rc h (Adam, Remco, & Andrew, 2011; Baldwin, Baldwin, & Ewald, 2006; Bandura et al, 1999; Coleman & Karraker, 1998; Dieserud, Roysamb, Ekeberg, & Kraft, 2001; Ehrenberg, Cox, & Koopman, 1991; Fatima, & ALDarmaki, 2011; Jin, 2009; Kameda et al, 2001; Makaremi, 2000; McFarlance, Bellissimo & Norman, 1995; Tabassum & Rehman, 2005; Najafi, & Foladjang, 2011) have shown a significant inverse correlation between selfefficacy and depression. Relationship between self-efficacy and depression is explored among different samples, for instance on patients of different disorders (Kurlowicz, 1998; Robinson, Johnston, & Allen, 2000). The main question is: is there any relationship between the general self-efficacy and depression of teacher students? Variable under study General Self-efficacy: It refers to the global confidence in one’s coping ability across

Pajares (2002) argued that self-efficacy plays highly important role in physical and 12

Sheikhiani, Nair & Fakouri / General Self-efﬁcacy and Depression

a wide range of demanding or novel situations (Schwarzer, & Jerusalem, 1995).

demonstrated high internal consistencies with Cronbach alphas ranging from .75 and .90 (Schwarzer and Jerusalem, 1995). The scale is parsimonious, reliable and culturally fair. It has also proven valid in terms of convergent and discriminate validity. For example, it correlates positively with self-esteem and optimism and negatively with anxiety, depression and physical symptoms. Examples of items in the scale include “It is easy for me to stick to my aims and accomplish my goals” and “If I am in trouble, I can usually think of a solution.” Higher scores indicate high self-efficacy. Reliability of the GSES was estimated using two methods viz., the Spear-Brown split-half method and coefficient of Cronbach alpha. The split-half reliability of the GSES was 0.86 (N=100) and the Cronbach alpha reliability of the GSES was 0.90 (N=100). To find the validity of the scale, it was correlated with two external criteria, Beck Depression Inventory (BDI) (Beck & Steer, 1987) and State–Trait Anxiety Inventory (STAI) (Spielberger, 1983). The correlation using the Pearson product moment formula was found to be - 0.53 (N=100) with (BDI) and - 0.71 (N=100) with (STAI) which are significant at 0.00 level.

Depression: Depression may assume a variety of forms. In many instances, people experience the symptoms of depression only to a mild or moderate degree, so that they may continue their everyday activities. They may suffer from any number of the common symptoms of depression, including decreased energy, loss of interest in everyday activities such as eating, feelings of inadequacy, periods of crying, and a pessimistic attitude (Duffy & Atwater, 2008). Teacher students: Refer to female students that who are being trained to become school teachers in the age range of 18 to 21. Method Participants The population for the study comprised of teacher students of the Boushehr University, in Iran; out of which 120 participants were randomly selected through a stratified random sampling technique from the 5 training fields: Mathematics Teaching, Primary School Teaching, Experimental Sciences, Religion and Arabic Teaching, and Social Studies Teaching. The age range of participants was between 18 and 21 years. Measures General self-efficacy scale (GSES): It was developed by Schwarzer and Jerusalem (1995). It is a 10-item scale that assesses self-efficacy based on personality disposition. Participants responded by indicating their extent of agreement with each of the 10 statements using a four-point Likert scale of 1 (not at all true) to 4 (exactly true). The GSES has

1. Beck Depression Inventory (BDI): This self-reporting inventory consists of 21 items to assess the intensity of depression in clinical as well as normal patients. Each item in this inventory is a list of four statement arranged in increasing severity (neutral to maximum) about a particular symptom of depression. The objective of the BDI is to evaluate the severity of the cognitive, affective, 13

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behavioral, and physiological symptoms of depression (Beck & Steer, 1987). Each item has four possible response options ranging from 0 (depression absence) to 3 (maximum depression), with a total test score ranging between 0 and 63. The numerical values of 0 (low) to 3 (high), which are assigned to each statement, indicate the degree of severity. High score indicating greater depression. The splithalf reliability of the BDI was 0.84 (N = 100). To find out validity of the BDI, it was correlated with two external criteria General Health Questionnaire (GHQ-28; Goldberg, 1981) and State – Trait Anxiety Inventory (STAI; Spielberger,1983). The correlation using Pearson product moment formula was found to be 0.82 (N = 100) with GHQ, and 0.87 (N = 100) with State – Trait Anxiety which are significant at 0.00 level. This shows the test has concurrent validity.

between study variables: general self-efficacy and depression. Results The outcomes of the various statistical procedures mentioned above are reported below under different sections. Mean Score and Standard Deviations among Study Variables Initial analysis of data included mean and standard deviation for general self-efficacy and depression (Table 1). Table.1 Mean and SD for Self-efﬁcacy and Depression Variables Self-efﬁcacy Depression

Mean 27.85 13.38

SD 6.04 7.44

Table 1 displays the mean and standard deviation obtained by the subjects in the variables under study. The mean score of the General Self-efficacy was 27.85 (SD = 6.04), and Depression 13.38 (SD = 7.44).

Procedure The instruments were administered to the participants in the various fields. Before the administration of the instruments, participants were briefed about the aims and objectives of the exercise and the need for them to be as objective as possible in their responses to the items of the research instruments. The instruments were collected immediately and later scored. The data obtained from them were analyzed to answer the research questions using the Pearson product moment correlation coefficient. Results were tested for significance at the .05 level.

Correlation among Study Variables Beliefs may affect many aspects of thinking. Hence it was deemed important to evaluate correlation between general selfefficacy and Depression (Table 2). Table.2 Correlation Matrix for the Relationship between Selfefficacy and Depression

Statistical treatment of the data The data obtained from the sample were subjected to correlational analysis to find whether there is any significant relationship

Variable

Depression

Self-efﬁcacy

37**

Correlation is signicant at the 0.01 level (2-tailed)

In order to determine the linkages between general self-efficacy and depression, coefficient of correlations were computed (table-2). The 14

Sheikhiani, Nair & Fakouri / General Self-efﬁcacy and Depression

results of the correlation coefficient among the predictor variable (general self-efficacy) and the criterion variable (depression) are given in Table 2. It was found that teacher students’ general self-efficacy and their scores on depression were significantly negatively correlated. General Self-efficacy correlated negatively with depression (r =-.37; p<.01). Here it should be borne in mind that depression is scored in such a manner that higher scores of it indicates poorer mental health. Thus, the significant inverse relationship between self-efficacy and depression suggests that as general self-efficacy increases, psychological distress decreases, thereby enhancing the mental health of the individual.

mood enhances perceived self-efficacy and despondent mood diminishes it (Bandura, 1994). Conclusion Findings of this study indicate that there exists an inverse correlation between generalized self-efficacy and depression in women teacher students. It can thus be concluded from these findings that high generalized self-efficacy of these women teacher students may serve as a protective factor against depression, whereas, low selfefficacy can lead them to depression. The finding of the study may be of use to the developing intervention strategies, training and intervention programs for students, and be helpful for psychologists, teacher, and other mental health professionals. Efforts should be made to make these students learn to face the challenges of life with courage. The present research can serve as a preliminary study for future prospective researches in the area. Future researches should be focused on the investigate impact of self efficacy training on depression in a larger sample of women teacher students.

Discussion It was hypothesized that “self-efficacy will be inversely correlated with depression in women teacher students”. The results show that scores of GSES are inversely correlated with scores of BDI. These findings suggest that impact of low self efficacy is more upon of depression. These findings are in line with some earlier studies (Adam et al, 2011; Baldwin et al, 2006; Bandura et al, 1999; Coleman & Karraker, 1998; Dieserud et al, 2001; Ehrenberg et al, 1991; Fatima, & AL-Darmaki, 2011; Jin, 2009; Kameda et al, 2001; Makaremi, 2000; McFarlane et al, 1995; Najafi , & Foladjang, 2011) indicating an inverse correlation between self-efficacy and depression. Our findings is also supported by Bandura (1994) and Pajares (2002), who maintain that Physical and affective states such as anxiety, stress, arousal, and mood states provide information about efficacy beliefs. Mood has significant effect upon people’s judgments of their personal efficacy. Positive

Reference Adam R. N., Remco, P,. & Andrew R. L. (2011). Coping self-efficacy, pre-competitive anxiety, and subjective performance among athletes. March 5. 2011, Retrieved from: https://webspace.utexas.edu/neffk/ pubs/scandself-efficacy Akhavan, T.M., & Dehghan, N. (2006). A study of social skills, mental health and students’ academic success. Alzahra University, Iran. 15

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Baldwin, K. M., Baldwin, J. R., & Ewald, T. (2006). The relationship among shame, guilt, and self-efficacy. American Journal of Psychotherapy, 60(1), 1-21.

Ehrenberg, M. F., Cox, D.N., & Koopman, R.F. (1991). The relationship between selfefficacy and depression in adolescents: Journal of Adolescence, 26 (102), 361-7.

Bandura, A. (1994). Self-efficacy. [Online] a na i l a bl e : h t t : // ww w. e mo r y. e d u/ EDUCATION/ mfp/BanEncy.html.

Fatima, R., & AL-Darmaki. (2011). Counseling Self-Efficacy and its Relationship to Anxiety and Problem-Solving in United Arab Emirates: International Journal for the advancement of counseling. 27(2), 323-335.

Bandura, A. (1997). Self-efficacy “The exercise of control.” New York: Freeman. Bandura, A., Pastorelli, C., Barbaranelli, C., & Caprara, G.V. (1999). Self-efficacy pathways to childhood depression, Journal of Personal Social Psychology, 76 (2), 258-69

Goldberg, D. (1981). A user’s guide to the General health Questionnaire: Windsor: NFER- Nelson. Jin, X. (2009). Research on the relationship between general self-efficacy and mental health of the students at higher vocational college

Bayram, N. & Bilgel, N. (2008). The prevalence and socio-demographic correlations of depression, anxiety and stress among a group of university students, Soc. Psychiatry, Epidemiol. 43, 667-62.

Kameda, Y., Shimada, K., Tabuchi, N., S umit an i, M. , S ak ai , A. , K a to, M ., Mimura,A., Mura, A, & Kawamura, A. (2001).The relationship between childbirth self-efficacy and anxiety in pregnant women. Journal of Memoirs of School of Health Science, 24(2), 151-158.

Beck, A. T., & Steer, R. A. (1987). Beck Depression Inventory: Manual. New York: The Psychological Corporation. Coleman, P. K., & Karraker, K. H. (1998). Selfefficacy and parenting quality: findings and future applications. Developmental Review, 18, 47-85.

Kurlowicz, L.H. (1998). Perceived selfefficacy, functional ability, and depressive symptoms in older elective surgery patients, Nursing Research, 47 (4), 21926.

Dieserud, G., Roysamb, E., Ekeberg, O., & Kraft, P. (2001).Toward an integrated model of suicidal attempt: a cognitive psychological approach. Pakistan Scientific and Technological Information Center.

Makaremi, A. (2000). Self-efficacy and depression among Iranian college students, Psychology Rep, 86 (2), 386-8.

Duffy, K.G., & Atwater, E. (2008).Psychology for living: Adjustment, Growth, and Behavior Today. Dorling Kindersley (India) Pvt. Ltd.

McFarlane, A.H., Bellissimo, A., & Norman, G.R. (1995).The role of family and peers in social self-efficacy: links to depression 16

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in adolescence. American Journal of Orthopsychiatry, 65 (3), 402-10.

life, and depression after stroke. Arch Phys Med Rehabilitation, 81 (4), 460-4

Miller, P.H. (2002). Theories of developmental psychology. USA: Worth publishers.

Schwarzer, R., & Jerusalem, M. (1995). Generalized Self-Efficacy scale, In J. Weinman, S. Wright, & M. Johnston, Measures in health psychology: A userâ&#x20AC;&#x2122;s portfolio. Causal and control beliefs (pp. 35-37). Windsor, UK: NFER-NELSON.

Mohammadi, M., Ghanizadeh, H., Noorbala, A., Davidian, H., Malek-Afzali, A., & Naghavi, H. (2006). Prevalence of mood disorders in Iran. Iran Journal of Psychiatry, 1, 59- 64.

Shojaei Zdeh, D. & Rasafiyani, H. R. (2001). A study on depression among preuniversity students, Kazeron city. Journal of Rehabilitation, 7, 32-39.

Najafi, M. Foladjang, M. (2011). The Relationship between Self- Efficacy and Mental Health Among High School Students. March 5, 2011. Retrieved from: www.ma giran.com/magtoc. asp?mgID=3681...22

Spielberger, C. D. (1983). Manual for the Stat-Trait Anxiety Inventory. Palo Atto, California: Consulting Psychologists press.

Nerdrum, P., Rustoen,T., & Ronnestad, M.H.(2006). Student psychological distress: A psychometric study of 1750 Norwegian 1st-year undergraduate students. Scand. J. Educ. Res, 50, 95109.

Tabassum, U., & Rehman, G. (2005). The Relationship between Self-Efficacy and Depression in Physically Handicapped Children. Journal of Pakistan Psychiatric Society, V 2(1), 37.

Ovuga, E., Boardman, J., & Wasserman, D. (2006). Undergraduate student mental health at Makerere University, Uganda. World Psychiatry, 5: 51-52.

Voelker, R. (2003). Mounting student depression taxing campus mental health services. JAMA, 289, 2055-2056. Wong, J.G.W.S., Cheung, E.P.T., Chan, K.K.C., Ma, K.K.M., & Tang, S.W. (2006). Web-based survey of depression, anxiety and stress in first-year tertiary education students in Hong Kong. Aust. N. Z. J. Psychiat., 40: 777-782.

Pajares. (2002). Overview of social cognitive theory and of self-efficacy. [Online] available: http://www.e mory. edu/ EDUCATION/mfp/eff.html. Robinson, S.G., Johnston, M.V., & Allen, J. (2000). Self-care self-efficacy, quality of

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Determination of Balance in Lower Limb Amputees Using the Berg Balance Scale *Shobhalakshmi. S & **Savita Ravindra Abstract Berg Balance Scale (BBS) is a tool that is easy to administer and has a strong functional component. The purpose of the study is to determine if BBS can discriminate the balance between lower limb amputees ambulating with prosthesis and normals and to assess if BBS can discriminate the balance between transfemoral and transtibial amputees and vascular and nonvascular amputees. The BBS was administered to a sample of 30 lower limb amputees ambulating with prosthesis and 30 age matched normals. Mann Whitney U test was used to compare the Balance scores. A significant difference in BBS Scores was found between the amputee and control group (p < 0.01). No significant difference was observed in balance scores between above and below knee amputees and vascular and nonvascular amputees. BBS can be used as a clinical and functional tool to assess balance in lower limb amputees. Key terms: Amputee, Balance, Berg Balance Scale

Introduction Balance is defined as the ability to maintain the body’s center of mass over its base of support with minimal postural sway (Shumway – Cook A et al, 1988). Balance is not an isolated quality but underlies our capacity to undertake a wide range of activities such as sitting, standing, cleaning and walking. These activities require different and complex changes in muscle tone and activity that are within the balance control system (Huxham et al, 2001). Balance, therefore forms the foundation for all “voluntary motor skills” (Massion and Woolacott ,1996).

ability to maintain and control balance is a complex motor task, and as such, virtually all neuromusculoskeletal disorders result in some degeneration of this ability (Byl.N N, 1994). Fifty two percent of a sample of people with unilateral transfemoral (TF) and transtibial (TT) amputations reported that they experienced at least one fall in a year (Byl.N N, 2001). The risk factors of falling and fear of falling, given their specific impairments, can include altered gait pattern associated with their use of a prosthesis, increased energy expenditure, decrease in sensory feedback associated with the loss of a lower limb and previous falls (Miller , 2003) .

The normal control of balance is known to emerge as a result of integration of inputs from the vestibular, visual and somatosensory system (Shumway Cook & woollacott). The

Falling and fear of falling have interesting implications for the rehabilitation of the

Assistant Professor, Department of Physiotherapy, shobha@msrpt.com

Professor & head, Department of Physiotherapy, M.S.Ramaiah medical college, MSRIT Post, Bangalore – 560054.

Shobhalakshmi & Ravindra / Determination of Balance in Lower Limb Amputees

prosthetic amputee population because they suggest a decline in function as a result of loss of confidence, decreased mobility, and self-imposed restrictions in activity (Tinetti ME et al, 1984), all of which is potentially modifiable. This can ultimately lead to deterioration in balance (Maki BE et al,1991), muscle endurance, strength, flexibility, and coordination( Myers and Gonda 1991).

of locus of postural sway in the amputee group than for control subjects (p < 0.001) . Vittas, Larsen and Jansen (1986) investigated the standing stability of amputees using the quantified Romberg test and found that all amputees below 59 years and all women above 59 years had a decreased sway compared to matched control groups. Isakov et al (1992) compared the standing stability and body sway in people with below-knee amputations and able-bodied controls on a set of two Kistler force plates and found that people with below knee amputation were significantly less stable when they stood with either closed or open eyes . Buckley, Oâ&#x20AC;&#x2122;Driscoll, and Bennett (2002) measured the postural sway and active balance performance using a single axis stabilimeter during quiet standing and under dynamic conditions and found that amputees had poorer static and dynamic balance than able-bodied controls. Postural sway in below - knee amputees was found to be significantly greater than above - knee amputees in a study conducted by Fernie and Holliday (1978). Hermodsson et al (1994) measured the standing balance as sway and standing time using a stable force platform (Kistler) in unilateral trans-tibial amputees and age matched healthy subjects and showed that the vascular group had a significantly increased sway in the lateral direction compared with the healthy group.

Successful rehabilitation therefore, extends beyond the acquisition of endurance, strength and range of motion, or learning about a new strategy (William & Miller, 2003). Recognizing and treating balance problems needs to be given specific interest by physical therapists (Berg et al 1997). Therefore ways to assess patients, to measure the outcome of treatment, and to predict who are at risk of falling and understanding this problem of balance need to be given special importance in order to provide meaningful treatment. Researchers have used various methods to assess balance and postural control in healthy able bodied controls, as well as in lower limb amputees. (a) In a laboratory set up, the center of pressure excursions during quiet standing have been determined using a force platform or single axis stabilimeter. (b) In a clinical set up the various tests performed in geriatric population and hemiplegics include: The Berg Balance Scale (BBS), Step test, Functional Reach Test, 10 m walk test, Timed Up and Go, Dynamic Gait index and functional obstacle.

All the studies identified in the literature to assess balance in lower limb amputees have been performed in a laboratory setup either by using a single axis stabilimeter or force platform (Kistler) where the postural sway and center of pressure excursions assess only the physiologic measures and not the functional mobility of the individual.

Dornan, Fernie and Holliday (1978) studied the comparison of the eyes open/eyes closed ratio between amputee and control group and found a significantly greater increase 19

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Given that the ultimate goal of rehabilitation is functional independence and return to participation in social activities among individuals with lower limb amputees, the need for this study is to find an effective clinical tool to assess balance in lower-limb amputees ambulating with prosthesis.

to correlate the BBS scores of the subjects who have undergone amputation and the age of the amputees.

to correlate the BBS scores of individuals who have undergone amputation and the duration of ambulation with prosthesis.

Method of data collection A cross sectional study was undertaken. A convenient sample of 30 community dwelling above and below knee amputees ambulating with prosthesis was taken from M.S.Ramaiah Hospital, Mobility India and Mahaveer Jain hospital, Bangalore. Duration of wearing the prosthesis varied. The control group consisted of 30 age matched able bodied individuals from Department of Physiotherapy, M.S. Ramaiah Medical College.

The Berg Balance Scale is a clinical tool that has been extensively used to assess balance and to predict falls in patients with hip fracture, geriatric population and stroke individuals. The intra - rater and inter - rater reliability of Berg Balance Scale was found to be excellent (ICC = 0.98 & ICC = 0.97) in elderly residents and patients with an acute stroke (Berg. K. Wood et al, 1995). However the validity and reliability of BBS in the amputee population has not been studied.

Inclusion criteria for control group • Age group 21 -70 years

Studies reveal that measures using the BBS are strongly linked with independence in daily and social activities while global measures of traits such as absence or presence of fear are relatively poor predictors of balance (Tinetti M.E., et al 1984, Miller W.C., et al, 2001) . Since the BBS is also a quick and easy to administer clinical tool this study is undertaken to determine if the Berg Balance Scale can be used as an effective functional tool to assess balance in lower limb amputees.

•

Subjects of either sexes

•

Asymptomatic individuals

Exclusion criteria for control group •

Visual disturbances

•

Vestibular dysfunction

•

Neurological disorders affecting the lower limb

•

Orthopedic problems of lower limbs

•

Recent fractures of the lower limbs

Objectives of the study were: 1. to compare the Berg Balance Scores between lower limb amputees ambulating with prosthesis and age matched normal population.

Inclusion criteria for subjects who underwent an amputation •

All above knee (Transfemoral) amputees ambulating with appropriately fitted prosthesis

to compare the BBS scores between above knee and below knee amputees.

•

to compare the BBS scores between vascular and nonvascular amputees.

All below knee (Transtibial) amputees ambulating with appropriately fitted prosthesis

•

Age group 21 – 70 years.

Shobhalakshmi & Ravindra / Determination of Balance in Lower Limb Amputees

Exclusion criteria for subjects who underwent an amputation • Bilateral amputees.

were then given instructions to perform the tests and each item was graded according to the scores in the scale.

•

Pain due to infections and ulcers of the stump.

•

Recent fractures of the unaffected limb and residual limb

•

Visual disturbances

•

Vestibular dysfunction

•

Neurological disorders affecting the lower limb

•

Orthopedic problems of lower limbs.

For item number 8, the subject was asked to reach forward with his /her dominant arm. For item number 9, the subjects were asked to pick any object from the floor. For item number 13, where the subject required performing tandem stance, the amputee group was scored with the amputated leg behind. For item number 14, the amputees were made to stand on their prosthetic limb and were scored accordingly. All the items of BBS were performed thrice and the best of three was considered. The subjects were asked to report any discomfort during the administration of the test. Rest was given if the subjects complained of fatigue.

The materials used • Assessment format of patient and control group created for the study •

The Berg Balance Scale

•

A stopwatch

•

A ruler or indicator of 2, 5 and 10 inches

•

A chair of 15 inches height

•

A step or stool of 7 inches

•

Procedure

Data Analysis The data was analyzed and tabulated using the SPSS package (version 10.0). The level of significance (p) was kept at 0.05. A nonparametric analysis was done for comparison of Berg Balance Scores between the subjects with amputation and control group using the Mann Whitney U test. The BBS scores were also compared between subjects who had an amputation due to vascular and nonvascular causes, and also between subjects with an above knee and a below knee amputation.A correlation using Spearman’s correlation coefficient was done between Berg Balance scores and age of the subjects who had undergone amputation

Ethical clearance was obtained from the ethical clearance committee of M.S. Ramaiah Teaching Hospital and Institute prior to the study. Occupational history, medical history, details about the prostheses was obtained and prosthetic assessment was performed. All the subjects were evaluated as per the assessment format. Those who fulfilled the inclusion criteria were taken up for the study. The procedure was explained to all the subjects. A written informed consent from both the groups was taken. The Berg Balance Scale was administered to both subjects with amputation and the control groups (Appendix 1). Each task was demonstrated to both the groups. They

A correlation using Spearman’s correlation coefficient was done between • 21

Berg Balance scores and age of the subjects who had undergone amputation

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â&#x20AC;˘

Journal of Disability Management and Special Education

Berg balance scores and duration of ambulation with prosthesis

at the stump site and recent fracture of the

Results Demographic data The total sample of amputees obtained was 33, of which 3 were excluded due to pain

control group was 30.The demographic data

residual limb. The number of subjects in the of both the groups is presented in Table I.

Table I: Sample design Experimental Group (1)

Control Group (2)

Number (Total)

Mean duration of ambulation with prothesis

45.97

Cause Vascular Non vascular

11 19

Level Above Knee Below Knee

9 21

Figure. I: Comparison of BBS scores between the amputee and control Group

Amputee Control Group

Amputee

Control Group

Figure.1 shows comparison of BBS scores between the amputee and the control group which was done using the Mann Whitney U test. The comparison shows that there is significant difference in the mean Balance Scores between amputee group and control

group (p < 0 .00001). This indicates that the BBS is able to detect the decreased balance in subjects who have had lower limb amputation when they were compared with the normal group. 22

Shobhalakshmi & Ravindra / Determination of Balance in Lower Limb Amputees

Figure.2: Comparison of BBS between vascular and nonvascular amputees

Figure 2 depicts the comparison of BBS scores between subjects who have had amputation due to vascular and nonvascular cause .There was difference in the mean BBS scores between the two groups but it was

not statistically significant (p < 0.123). This indicates that BBS is unable to differentiate the balance between vascular and nonvascular amputees.

Figure 3: Comparison of BBS between above and below knee amputees

Figure 3 Shows the comparison of BBS scores between subjects who had above knee and below knee amputation. It shows the difference in the mean BBS scores between the

two groups but it was not statistically significant (p < 0.063). This indicates that BBS is unable to differentiate the balance between above knee and below knee amputees 23

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Journal of Disability Management and Special Education

Figure 4: Correlation between BBS and age of two groups of subjects 60

BBS Score

20 10

Age

AGEPT

Figure. 4 shows the correlation between

amputee population. Spearman’s correlation coefficient was r = -0.0490, p < 0.006.This indicates that as the age of the subjects who have undergone amputation increases, the BBS scores increases.

the BBS score and the age of the subjects who have undergone amputation. There is negative correlation between age and BBS score in the

Figure.5 Correlation between BBS and duration of ambulation with prosthesis 60

BBS Score

20 -100

Rsq = 0.1140 0

100

200

Duration

The result of correlation between the BBS score and the duration and ambulation with prosthesis is depicted on figure.5. It shows that positive correlation exists between the duration of ambulation with prosthesis and

BBS scores. Spearman’s correlation coefficient was r =0.372, p < 0.043. This indicates that as the subject’s duration of ambulation with the prosthesis increases the BBS scores reduces. 24

Shobhalakshmi & Ravindra / Determination of Balance in Lower Limb Amputees

Discussion The results of this study revealed that there was statistically significant decrease in balance in subjects with lower limb amputation when compared to able bodied controls and the Berg Balance Scale was sensitive to detect these changes.

on the cause or level of amputees (Figures 2 & 3). This indicates that the BBS is unable to differentiate the balance between subjects who had amputation due to vascular cause and nonvascular cause. The result also showed that the BBS is unable to differentiate between above knee and below knee amputees.

This decrease in balance in lower limb amputees can be attributed to the following factors:

The possible explanations for these findings are:

•

The unavoidable prolonged disuse during convalescence, leading to weakening and loss of endurance of the residual (proximal) leg muscles.

•

Altered biomechanics of the lower limb, resulting in the necessity of modifying the existing control strategies that were used for postural control (Czerniecki J.M et al1991).

•

The elimination of a part of the neural input from pro-prioceptive efferents, causing changes in the spinal reflex circuitry (Cohen L.G et al, 1991).

•

Adaptive central reorganization in systems that is likely to take part in control of voluntary movements and posture. This reorganization is reflected particularly by the increase in the role of visual control as compared to proprioceptive control (Fuhr P et al.1992).

•

The Berg Balance Scale may not be sufficiently sensitive to detect clinically important differences between people with Above Knee -Below Knee and vascular and nonvascular amputees. A more sensitive tool may be required to detect these changes.

•

Skewed distribution of sample in the 2 groups i.e. the groups did not fall into the normal distribution curve.

•

The mean ages of the Above Knee - Below Knee and vascular -nonvascular amputees was not equal.

•

The sample size of the amputee population was too small.

However a study done by Fernie G.R., Holliday P.J., (1978) showed a greater postural sway in above knee amputees than below knee amputees. Also the study by Hermodsson et al (1994) showed that the vascular group had a significantly increased sway in the lateral direction compared with the healthy group.

In general, these findings corroborates with the previous work done by, Fernie GR et al, Vittas D, Isakov E et al, Hermodsson et al, which highlights increased body sway in people with lower limb amputation thus reflecting decreased balance.

The results also showed a significant negative correlation between BBS scores and age of the amputees (figure 4) which indicates that as the age of the subjects who have undergone amputation increases the BBS scores decreases. This decline in BBS score with ageing can be explained by the decline

The results however did not show any significant differences in BBS scores based 25

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Journal of Disability Management and Special Education

With regard to the limitations, the type and material of prostheses and duration of ambulation with the prosthesis could not be kept constant during the study

in visual acuity, under use of proprioception, decreased righting responses, decreased muscle strength and range of motion (Shumway Cook & Woolacott ) and decreased confidence that occurs with ageing.

In future studies there is a need to examine if the type of prosthesis, level of functional independence or environmental factors contributes to changes in the Berg Balance Score in lower limb amputees preferably on a large sample.

This is in accordance with the work done by Hermodsson et al(1994) which explains the decrease in balance as the age increases above 60 years. Also the results of experiments done by Berg et al (1995) and Chiu Ay et al (2003) showed that the Berg Balance scores decreased in the geriatric population.

Conclusion The study could be concluded that there is an observable difference in the Berg Balance Scores between subjects with amputation and the control group. The Berg Balance Scale thus, is able to detect changes in balance in lower limb amputees ambulating with prosthesis and therefore can be used as an effective clinical and functional tool to assess balance in lower limb amputees as its components also involve

The results of our study also showed a significant positive correlation between duration of ambulation with prosthesis and BBS scores (figure 5) i.e. as the duration of ambulation with prosthesis increased the BBS scores also increased. This can be explained by Gentileâ&#x20AC;&#x2122;s theory of practice wherein practice affects motor learning .i.e. if each trial is practiced in the same way, the resulting skill, probably with its underlying balance adjustments will be fine tuned to a single skilled production and motor learning of a reproductive nature will occur (Frances E Huxham et al 2001).

activities of daily living. References Berg. K.W., Dauphinee, S., Williams J. (1995). The balance scale and reliability assessment with elderly residents and patients with an acute stroke. Scan J Rehabil Med, 25(1), 27-36.

Hence it implies that the BBS might be able to detect the overall balance in lower limb amputees, but not specific changes based on cause and level of amputation. A more sensitive instrument is required to detect physiologic changes like postural sways. Since there was a significant difference in the BBS scores between the amputee and control group it indicates that there is a decrease in stability in the amputees which can be detected by BBS as most of the items of the Berg Balance Scale assess static stability

Buckley, J.G., Oâ&#x20AC;&#x2122;Driscoll z., Bennett, S.J. (2002). Postural sway and active balance performance in highly active lower limb amputees. Am J Phys Med Rehabil, 81 (1)13-20. Byl, N.N. (1992). Spatial orientation to gravity and implications for balance training, Orthop Phy.Ther Clin Nort 1,207- 42. Cohen, L.G et al. (1991). Motor reorganization after upper limb amputation in humans: 26

Shobhalakshmi & Ravindra / Determination of Balance in Lower Limb Amputees

a study with focal magnetic stimulation. Brain 1991,114, 615 – 627.

Isakov, E et al. (1992). Standing sway and

Chiu, AY et al. (2003). A comparison of functional tests in discriminating fallers in older people. Disabil Rehabil, 25(1), 45-50

below knee amputations. Arch Phys Med

weight bearing distribution in people with Rehabil , 73(2),174-8. Kegel, B et al.(1982). Effects of isometric muscle training on residual limb volume,

Cook, S.A et al. (1988). Postural Sway biofeedback: its effects in re- establishing

strength, and gait in below – knee

stance stability in hemiplegic patients. Arch. Phy. Med. Rehabil , 69, 395 – 400.

Klingenstierna, U. et al. (1990). Isokinetic

amputees. Phys Ther, 61, 1419 – 1426. strength training in below – knee

Cook, S & Woollacott. Motor control theory & practical applications. Pp 120-121.

amputees. Scand J Rehabil Med , 22, 39 – 43.

Czerniecki, J.M., et al. (1991). Joint moment muscle power output characteristics of below knee amputees during running: the influence of energy storing prosthetic feet. J. Biomech, 24 , 63 – 75.

Maki, BE, Holliday, PJ, Topper, AK. (1991). Fear of falling and postural performance in the elderly. J Gerontol, 46, M123-31 Miller, WC., Speechley, M., Deathe, AB.,

Dornan, J., Fernie, G.R., Holliday, P.J. (1978). Visual input: its importance in the control of postural sway. Arch Phys Med Rehabil. Dec, 59(12), 586-91.

Koval, J. (2001). The influence of falling, fear of falling, and balance confidence on prosthetic mobility and social activity among individuals with a lower extremity

Fernie, GR., Holliday PJ. (1978). Postural sway in amputees and normal subjects. J Bone Joint Surg Am , 60(7), 895 – 8.

amputation. Arch Phys Med Rehabil , 82, 1238-1244

Fuhr, P et al. (1978). Physiologcal analysis of motor organization following lower limb amputation .Electroencephalogr clin Neurophysiol , 85, 53 – 60.

Miller, W.C., Deathe, A.B., Speechley,

Hermodsson, Y et al. (1994). Standing balance in trans-tibial amputees following vascular disease or trauma: a comparative study with healthy subjects. Prosthet Orthot Int,18(3),150-8.

amputation. Arch Phys Med Rehabil, 82,

M.(2001).The prevalence and risk factors of falling and fear of falling among individuals with lower extremity 1031-1037 Miller, W.C., Interdesciplinary Journal of rehabilitation. Aug/sept 2003. Myers, A., Gonda G. (1991). Research on

Huxham F.E., et al. (2001). Theoretical considerations in Balance assessment. Australian Journal of Physiotherapy, 47, 89 - 100.

physical activity in the elderly: practical implications for program planning. Can J Aging, 5, 75-87 27

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Renstom, P et al. (1983).Thigh muscle strength below knee amputees .Scan J Rehabil Med, 15(9), 163 â&#x20AC;&#x201C; 173

Arch phys Med Rehabil , 69, 840 - 845. Tinetti, M.E., Mendes de Leon C.F., Doucette, J.T., Baker, DI. (1984). Fear of falling

Renstrom, P et al. (1983).Thigh muscle atrophy in below knee amputees. Scan J Rehabil Med, 15 (9), 150 â&#x20AC;&#x201C; 162.

and fall-related efficacy in relationship

Ryser, D.K et al. (1988). Isometric and isokinetic hip abductor strength in persons with above - knee amputation.

Vittas, D., Larsen,T.K., Jansen, E.C. (1986).

to functioning among community-living elders. J Gerontol , 49, M140-7. Body sway in below knee amputees. Prosthet Orthot Int ,10(3), 139-41

APPENDIX 1 Berg Balance Scale Name: _________________________________________

Date: ___________________

Location: _______________________________________

Rater: ___________________

Item description score (0-4) 1. Sitting to standing

______________________________________

2. Standing unsupported

______________________________________

3. Sitting unsupported

_______________________________________

4. Standing to sitting

_______________________________________

5. Transfers

_______________________________________

6. Standing with eyes closed

_______________________________________

7. Standing with feet together

_______________________________________

8. Reaching forward with outstretched arm

_______________________________________

9. Retrieving object from floor

_______________________________________

10. Turning to look behind

_______________________________________

11. Turning 360 degrees

_______________________________________

12. Placing alternate foot on stool

_______________________________________

13. Standing with one foot in front

_______________________________________

14. Standing on one foot

_______________________________________

Total

_______________________________________ 28

Shobhalakshmi & Ravindra / Determination of Balance in Lower Limb Amputees

General instructions •

Please document each task and/or give instructions as written. When scoring, please record the lowest response category that applies for each item.

•

In most items, the subject is asked to maintain a given position for a specific time. Progressively more points are deducted if:

•

The time or distance requirements are not met

•

The subject’s performance warrants supervision

•

The subject touches an external support or receives assistance from the examiner Subject should understand that they must maintain their balance while attempting the tasks.

The choices of which leg to stand on or how far to reach are left to the subject. Poor judgment will adversely influence the performance and the scoring. Equipment required for testing is a stopwatch or watch with a second hand, and a ruler or other indicator of 2, 5 and 10 inches. Chairs used during testing should be a reasonable height. Either a step or a stool of average step height may be used for item # 12. Berg Balance Scale 1.

Sitting to standing Instructions: Please stand up. Try not to use your hand for support.

( )

4 able to stand without using hands and stabilize independently

( )

3 able to stand independently using hands

( )

2 able to stand using hands after several tries

( )

1 needs minimal aid to stand or stabilize

( )

0 needs moderate or maximal assist to stand

Standing unsupported Instructions: Please stand for two minutes without holding on. ( )

4 able to stand safely for 2 minutes

( )

3 able to stand 2 minutes with supervision

( )

2 able to stand 30 seconds unsupported

( )

1 needs several tries to stand 30 seconds unsupported

( )

0 unable to stand 30 seconds unsupported

If a subject is able to stand 2 minutes unsupported, score full points for sitting unsupported. Proceed to item #4. 29

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Sitting with back unsupported but feet supported on floor or on a stool Instructions: Please sit with arms folded for 2 minutes.

( )

4 able to sit safely and securely for 2 minutes

( )

3 able to sit 2 minutes under supervision

( )

2 able to able to sit 30 seconds

( )

1 able to sit 10 seconds

( )

0 unable to sit without support 10 seconds

Standing to sitting Instructions: Please sit down.

( )

4 sits safely with minimal use of hands

( )

3 controls descent by using hands

( )

2 uses back of legs against chair to control descent

( )

1 sits independently but has uncontrolled descent

( )

0 needs assist to sit

Transfers Instructions: Arrange chair(s) for pivot transfer. Ask subject to transfer one way toward a seat with armrests and one way toward a seat without armrests. You may use two chairs (one with and one without armrests) or a bed and a chair.

( )

4 able to transfer safely with minor use of hands

( )

3 able to transfer safely definite need of hands

( )

2 able to transfer with verbal cuing and/or supervision

( )

1 needs one person to assist

( )

0 needs two people to assist or supervise to be safe

Standing unsupported with eyes closed Instructions: Please close your eyes and stand still for 10 seconds. ( )

4 able to stand 10 seconds safely

( )

3 able to stand 10 seconds with supervision

( )

2 able to stand 3 seconds

( )

1 unable to keep eyes closed 3 seconds but stays safely

( )

0 needs help to keep from falling 30

Shobhalakshmi & Ravindra / Determination of Balance in Lower Limb Amputees

Standing unsupported with feet together Instructions: Place your feet together and stand without holding on.

( )

4 able to place feet together independently and stand 1 minute safely

( )

3 able to place feet together independently and stand 1 minute with supervision

( )

2 able to place feet together independently but unable to hold for 30 seconds

( )

1 needs help to attain position but able to stand 15 seconds feet together

( )

0 needs help to attain position and unable to hold for 15 seconds

Reaching forward with outstretched arm while standing Instructions: Lift arm to 90 degrees. Stretch out your fingers and reach forward as far as you can. (Examiner places a ruler at the end of fingertips when arm is at 90 degrees. Fingers should not touch the ruler while reaching forward. The recorded measure is the distance forward that the fingers reach while the subject is in the most forward lean position. When possible, ask subject to use both arms when reaching to avoid rotation of the trunk.)

( )

4 can reach forward confidently 25 cm (10 inches)

( )

3 can reach forward 12 cm (5 inches)

( )

2 can reach forward 5 cm (2 inches)

( )

1 reaches forward but needs supervision

( )

0 loses balance while trying/requires external support

Pick up object from the floor from a standing position Instructions: Pick up the shoe/slipper, which is in front of your feet. ( )

4 able to pick up slipper safely and easily

( )

3 able to pick up slipper but needs supervision

( )

2 unable to pick up but reaches 2-5 cm (1-2 inches) from slipper and keeps balance independently

( )

1 unable to pick up and needs supervision while trying

( )

0 unable to try/needs assist to keep from losing balance or falling

10. Turning to look behind over left and right shoulders while standing Instructions: Turn to look directly behind you over toward the left shoulder. Repeat to the right. (Examiner may pick an object to look at directly behind the subject to encourage a better twist turn.) ( )

4 looks behind from both sides and weight shifts well

( )

3 looks behind one side only other side shows less weight shift

( )

2 turns sideways only but maintains balance

( )

1 needs supervision when turning

( )

0 needs assist to keep from losing balance or falling 31

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11. Turn 360 degrees Instructions: Turn completely around in a full circle. Pause. Then turn a full circle in the other direction. ( )

4 able to turn 360 degrees safely in 4 seconds or less

( )

3 able to turn 360 degrees safely one side only 4 seconds or less

( )

2 able to turn 360 degrees safely but slowly

( )

1 needs close supervision or verbal cuing

( )

0 needs assistance while turning

12. Place alternate foot on step or stool while standing unsupported Instructions: Place each foot alternately on the step/stool. Continue until each foot has touched the step/stool four times. ( )

4 able to stand independently and safely and complete 8 steps in 20 seconds

( )

3 able to stand independently and complete 8 steps in > 20 seconds

( )

2 able to complete 4 steps without aid with supervision

( )

1 able to complete > 2 steps needs minimal assist

( )

0 needs assistance to keep from falling/ unable to try

13. Standing unsupported one foot in front Instructions: (demonstrate to subject) Place one foot directly in front of the other. If you feel that you cannot place your foot directly in front, try to step far enough ahead that the heel of your forward foot is ahead of the toes of the other foot. (To score 3 points, the length of the step should exceed the length of the other foot and the width of the stance should approximate the subjectâ&#x20AC;&#x2122;s normal stride width.) ( )

4 able to place foot tandem independently and hold 30 seconds

( )

3 able to place foot ahead independently and hold 30 seconds

( )

2 able to take small step independently and hold 30 seconds

( )

1 needs help to step but can hold 15 seconds

( )

0 loses balance while stepping or standing

14. Standing on one leg Instructions: Stand on one leg as long as you can without holding on. ( )

4 able to lift leg independently and hold > 10 seconds

( )

3 able to lift leg independently and hold 5-10 seconds

( )

2 able to lift leg independently and hold L 3 seconds

( )

1 tries to lift leg unable to hold 3 seconds but remains standing independently.

( )

0 unable to try of needs assist to prevent fall

( ) TOTAL SCORE (Maximum = 56) 32

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Journal of Disability Management and Special Education ISSN: 2229-5143

Anxiety Proﬁle in Well Siblings of Children with Developmental Disabilities *S. Venkatesan & **Nimisha Ravindran

Abstract This cross sectional exploratory study elicits data from 30 well siblings of equal number clinical sample of persons with various types of developmental disabilities about their felt anxiety in relation to associated variables like age, gender, sibling size, school experience and diagnosis. The key variable was measured on IPAT Anxiety Scale. Results indicate specific profiles of subjective anxiety reported by well siblings characterized by a favorable (but definitely not pathological) concern chiefly if their affected siblings are males, older in age (16 years+), attend special schools or are identified as ‘mentally retarded’, than when the affected siblings are females, young in age, do not attend any school or belong to ‘others’ diagnostic category. In relation to gender of well sibling, results reveal relatively higher felt/ expressed anxiety scores for females than males. Likewise, younger well siblings (below 18 years) show higher anxiety than elder ones (above 18 years). Single well siblings appear more concerned compared to multiple well siblings. While it is heartening that well siblings have anxiety of low intensity or extensity and is not extreme or pathological, this does not absolve the need to devise or implement anxiety reduction strategies through well sibling betterment programs. Key Words: Anxiety, IPAT, Siblings, Developmental Disabilities

Reviews on anxiety research have appeared regularly in literature (Kessler, 2000; Bernatein, Borchardt, and Periwien, 1996). Anxiety studies exclusively on well siblings of children with development disabilities are almost non-existent. A frequently perpetuated notion is that well siblings of individuals with disabilities are vulnerable to adjustment difficulties (Lobato, 1983), or that they have behavioral and mental health problems (Caldwell and Guze, 1960). Only certain well siblings appear vulnerable to negative reactions, depending on factors like their gender, birth order, family socioeconomic status, and

parental response to handicapped child (Cuskelly, 1999). Indeed, there are studies on sibling adjustments (Mates, 1990; Atkins, 1989; Dyson, 1989; McHale, Sloan and Simeonson, 1986; Dunn and Kendrick, 1982), or on impact of death of a sib with disability (Rodger and Tooth, 2004). There are also studies on the differential impacts on well siblings of specific disabling conditions, such as, chronic illness (Sharpe and Rossiter, 2002), Downs’ syndrome (Gath, 1974), mental retardation (Leanza, 1970), autism (De Myer, 1979), blindness (Lavine, 1977), spina bifida (Bellin, Bentley and Sawin, 2009) or phenylketonuria

Professor in Clinical Psychology, All India Institute of Speech and Hearing, Mysore: 570 006 (Karnataka).Email: psyconindia@aiishmysore.in or psyconindia@gmail.com Phones: 08212514449/2515410/2515905/Cell: 098447 37884

Research Assistant,Department of Clinical Psychology, All India Institute of Speech and Hearing, Mysore: 570 006 (Karnataka).

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Journal of Disability Management and Special Education

(Pho et al, 2004). Unfortunately, there are hardly studies exclusively on anxiety in well siblings of children with development disabilities.

own families, the continued responsibilities of rearing/caring for their affected sibling, the covert handling of their own intermittently felt or unexpressed infantile anxieties and jealousies, etc. Based on such concerns, sibling intervention programs have been devised for children between 9-12 years. These interventions have recorded improvements in their socio-emotional functioning, decrements of felt sibling related stress, reduced depression/ anxiety, increased levels of self esteem and reporting of more social supports while there were no such changes found in the control group (Phillips, 1999). Similar decrements in anxiety levels for siblings of hospitalized children have been reported after their undergoing educational intervention programs focused on teaching them about hospitalization, illness or injury, and treatment for the patient, based on cognitive stages of development (Gursky, 2007).

In a related retrospective cohort study, Coleby (1995) reported that well siblings of children with severe learning disabilities show restricted contact with friends, have behavior difficulties, increased anxiety and acceptance towards disability compared to normal controls. Boys older than the disabled child had increased acceptance, whereas older girls demonstrated high rates of behavior difficulty. Younger siblings showed high anxiety, and those near in age demonstrated restricted contact with friends and behavior difficulties. The ‘burden of care’ experienced by the mother had a significant positive correlation with the adverse effect on siblings. In another recent study on minority group of Latinos in United States, children between 8-15 years with a brother or sister having developmental disabilities, Lobato et al (2011) reported significantly more symptoms of internalizing psychological disorders, such as, anxiety than comparison children. They also had more problems with adjustment and coping including difficulties in relationships with their parents. The children showed a greater reluctance to express any negative experiences or feelings that they had about the disability in their siblings. In school, they had more absences and lower academic performances compared to their peers. According to these researchers, the combination of greater anxiety, worse attendance and lower performance placed these siblings of children with developmental disabilities at risk for poor academic outcomes.

Sibling research on children with developmental disabilities in India is on a virgin plate. As part of a larger multi-centric project on ‘Strengthening Families’ of persons with mental retardation, the investigators focused a component of their research on identifying and meeting information needs as well as impact on siblings (Peshawaria et al, 1995). The impact on siblings were described under ten categories, such as, career restrictions, compromise on recreation, lowered parent attention, stigmatization by peers or community, added responsibilities, disturbing emotional reactions, worry about future, stress of handling problem behaviors, isolation, and increased positive tolerance or forbearance. The expressed needs of well siblings included their asking for more information on the

The contents of well sibling anxiety dwell on issues about planning the future of their 34

Venkatesan & Ravindran / Sibling Anxiety in Developmental Disabilities

affected child’s diagnostic condition, tips on their management, or about available facilities, benefits and concessions (Peshawaria and Menon, 1991).

METHOD Sample A cross sectional exploratory survey design combined with random sampling techniques was used in this study. The overall sample comprised of 30 sib pairings of well siblings and their brothers/sisters diagnosed 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 is the official classification under ‘Persons with Disabilities (Equal) Opportunities, Protection of Rights & Full Participation Act’ (1995) and/or ‘The National Trust for Welfare of Persons with Autism, 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 and had continually lived together under the same roof as one family along with their parents or extended family members. The mean chronological age of well siblings was 17.5 years (SD: 3.54) and those of children with identified disability was 15.23 years (SD: 3.61). This implies that the well sibs were on an average elder to their disability affected brothers and sisters. The sample of well siblings included 10 males (Mean Age: 16.9; SD: 2.88) and 20 females (Mean Age: 17.8; SD: 3.86); and affected sample had 22 males (Mean Age: 15.55; SD: 3.80) and 8 females (Mean Age: 14.38; SD: 3.07). 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

Another recent cross sectional well sibling attitude survey revealed scores with a tilt on the positive side. 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. Family size did not emerge as significant variable in influencing well sibling attitudes towards their brothers or sisters with developmental disabilities. The trends indicated that well sibling attitudes undergo transformation towards negative direction as their affected sibling grew older. The affected children without schooling were the least favored by their well siblings. This study concluded (contrary to popular opinion) that the attitudes of well siblings towards their affected siblings are not dysfunctional or pathological, but different (Venkatesan and Ravindran, 2011). From the foregoing, it is clear that research focus on sibling anxiety is wanting. There is potential for research on this topic to pave way for later developing counseling or intervention programs. Well siblings form the most proximate and yet neglected segment of persons in the lives of individuals with developmental disabilities. It is the aim of this study to profile the degree, intensity, extent, direction, types or content of anxiety in well siblings of persons with developmental disabilities in relation to associated variables like gender, age, schooling, type of disability and sibling size. 35

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relatives or in hostels as well as those merely on weekend home visits were excluded from the sample in this study.

their age, gender, schooling, diagnosis, associated problems (if any), etc. Based on the comprehensive review of the ‘anxiety scales’ already mentioned; and also, by taking into account local cultural factors into account to assess sibling anxiety, the 40-item individually administered paper-pencil ‘IPAT Anxiety Scale’ (Krug, Scheier and Cattell, 1976) was chosen for this study.

Tools Research studies on felt or reported anxiety in various populations have used different investigative techniques like case studies involving in depth interviews (Holt, 2003), clinical observation (Hudson and Rapee, 2001), focus groups (Haslam et al, 2005), surveys (Wittchen et al, 1994), or questionnaires (Bjelland et al, 2002; Gilbody, House and Sheldon, 2001). Among the well known standardized anxiety measures used in research are: IPAT Anxiety Scale (Krug, Scheier and Cattell, 1976), State-Trait Anxiety Inventory (Spielberger et al, 1983), Taylor Manifest Anxiety Scale (Taylor, 1953), Freeman’s Anxiety Scale (Freeman, 1953), Hamilton Anxiety Rating Scale (Hamilton, 1959; Bendig, 1956; Castaneda, McCandless and Palermo, 1956), Montgomery-Asberg Depression and the Clinical Anxiety Scales (Snaith et al, 1986), Endler Multidimensional Anxiety Scales (Endler and Kocovski, 2001), Rating Instrument for Anxiety Disorders (Zung, 1971), Scales for Measuring Depression and Anxiety (Costello and Comrey, 1967), Revised Children’s Manifest Anxiety Scale (Reynolds and Richmond, 1978), etc. Of course, each measuring instrument has a different purpose, structure, scheme of administration, scoring, and/or interpretation.

The IPAT Anxiety Scale measures trait rather than state anxiety. This scale is shown to have a factorial structure representing five sub scales which roughly matches the five personality traits from the 16 Personality Factors Questionnaire (Cattell, Eber and Tatsuoka, 1988). The sub scales are: apprehension, tension, low self esteem, emotional instability and suspicion respectively. A high ‘apprehension’ score reflects an individual who is ‘unstable, has sleep disturbance, feels unequal to the challenges of daily life, and gets easily down hearted and remorseful. They may not feel accepted or free to participate in group situations. They are considered ineffective speakers, remain rigidly task oriented have few friends. They are poor leaders and do not perform well under emergency conditions’. Individuals high on ‘tension’ represent ‘low general frustration level, high clinical depression, anger and antagonistic attitude’. Those high on ‘low self esteem’ show ‘little regard for socially approved character responses, lack self-control and foresight’ and are inconsiderate of others’. The component on high ‘emotional instability’ shows ‘dynamic disintegration and immaturity or that such persons are easily annoyed by things or people and are dissatisfied with the world situation, their family restrictions of life, their own health

For the purpose of this study, a sociodemographic s heet was exclusively prepared 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 36

Venkatesan & Ravindran / Sibling Anxiety in Developmental Disabilities

and are unable to cope with life. They are more prone to phobias, psychosomatic disturbances, hysterical and obsessive behaviors’. The component on ‘suspicion’ indicates that such respondents come from a parental home where they were admired and have lively intellectual interests or that they are contemptuous of the average, are scrupulously correct in behavior and are annoyed by people putting on superior size’. Apart from these five factored scales, the authors have also demonstrated that the first 20 test items help identify ‘unrealized covert anxiety’ (A) and the remaining 20 items identify the ‘symptomatic conscious overt anxiety’ (B). The product of B/A will give the ratio of overt to covert anxiety in each subject.

of scores obtained on the IPAT Anxiety Scale. STEN are standard scores on a 10-point scale from 1-10. Cut off scores obtaining below 7 on IPAT indicates normal and above 7 means pathological anxiety. Procedure Data collection involved individualized test administration of the chosen tools on identified unaffected well sibling/s from clinical cases of persons diagnosed with one or the other developmental disabilities. Each respondent was explained the objectives of the study. After obtaining their informed consent and providing the assured anonymity or confidentiality, the testing situation was kept in complete privacy. Respondents were clarified on each item of the used tools before they rated on their own choice based on their felt experience. Wherein affected sample of persons with developmental disabilities had multiple siblings, only reports from one of them who volunteered to participate in the study was taken.

These sub scales have been shown to have high correlation to an objective test factor identified as ‘general anxiety’. Norms for the total scores are based on 482 men and 313 women of whom a large but unspecified number are college students. Approximate corrections for sex and age are stated. Evidently, the IPAT Anxiety Scale has been shown to have a sound conceptual base than other current instruments of its type. The scale is objective, reliable and valid assessment tool. It is easy to administer and score by using a standardized key that is fixed over the booklet. A forced choice technique is used for responding. There are three possible answers: Yes, No or Uncertain. The scale is most appropriate for ages 15 years and above. These scales are widely used in India for clinical diagnostic purposes. Reliability of the scale is reported as 0.60 for a sample of 170 medical students over a two year period and the validity is 0.90. Anxiety is defined as the level

RESULTS AND DISCUSSION The results of the study on felt, reported or expressed anxiety in well siblings of children with developmental disabilities are summarized with discussion under three sections in relation to characteristics of the affected child and their well sibling (Table 1); and later, also their domain-wise distribution of anxiety profiles (Table 2). A further analysis of results based on overt/covert anxiety ratios (Tables 3 & 4) is also attempted in this study. Appropriate descriptive and inferential statistical procedures like measures of central tendency, dispersion and ANOVA was used for interpretation of results (Soper, 2011; Scheffe, 1999). 37

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(a) Affected Child: On the whole, the anxiety score in the overall sample for well siblings of children with developmental disabilities (N: 30; Mean: 25.5; SD: 8.9; Sten: 5; Percentile: 40) reflects typical non-pathological anxiety. However, with respected to gender, there appears to be relatively more anxiety felt/expressed by the

Variable Overall

well siblings for the male affected child (N: 22; Mean: 19.0; SD: 7.2; Sten: 4; Percentile: 23) than the female affected child (N: 8; Mean: 6.5; SD: 3.3; Sten: 2; Percentile: 4)(t: 4.68; df: 28; SED: 2.66; p: 0.001). This is probably a reflection of the gender equations typical of most Indian families with or without members having disabilities.

Table 1. Distribution of Raw Scores & Sten Scores on IPAT in relation to Affected Child & Well Sibling Characteristics Sten N Mean SD Percentile Probability Score 30 25.5 8.9 5 40

Child Gender Male

19.0

7.2

Female

6.5

3.3

<12 12-16 16+ Child Education

7 9 14

5.9 8.0 11.6

2.8 2.9 4.7

1 2 2

1 4 4

F: 5.82 ; p: 0.008; VHS

No School

8.0

3.9

17.5

6.2

T: 4.28; df: 28; SED: 2.24; p: < 0.0002; VHS

20 10

16.3 9.2

6.2 3.6

3 2

11 4

T: 3.38; df: 28; SED: 2.12; p: < 0.0021; VHS

Male

8.3

Female Sibling Age (in years) <18

17.2

T: 3.92; df: 28; SED: 2.25; P: < 0.0005; VHS

15.9

9.6

Single

18.9

Multiple

6.6

T: 4.68; df: 28; SED: 2.66; p: < 0.0001; VHS

Child Age (in years)

Special School Child Diagnosis MR Others Sibling Gender

>18

T: 3.31; df: 28; SED: 1.91; p: <0.0026; VHS

Sibling Size

T: 5.01; df: 28; SED: 2.44; P: < 0.001; VHS

Venkatesan & Ravindran / Sibling Anxiety in Developmental Disabilities

The age of affected child appears to have directly proportional relationship for the extent of reported anxiety in well siblings. As the age of the affected child increases from below 12 years (N: 7; Mean: 5.9; SD: 2.8; Sten: 1; Percentile: 1), between 12-16 years (N: 9; Mean: 8.0; SD: 2.9; Sten: 2; Percentile: 4) to above 16 years (N: 14; Mean: 11.6; SD: 4.7; Sten: 2; Percentile: 4), the mean anxiety scores are on an ascendance. This reflects the possible trend of an increasing maturity or appreciation of the problems; and hence, a growing anxiety in the well sibling as their affected brother or sister grows older (F: 5.82; p: 0.008).

category and/or those who attend special schools, than as much being worried or feeling anxious concern about their affected sibling when they are females, young in age, do not attend any school or belong to ‘others’ diagnostic category. These findings are backed by the similar trends of the previous study wherein the affected children without schooling were the least favored by their well siblings (Venkatesan and Ravindran, 2011). (b) Well Sibling: In terms of gender variable of the well sibling, results reveal marked differences with relatively higher (though not pathological) felt/ expressed anxiety scores for females (N: 20; Mean: 17.2; SD: 6.8; Sten: 4; Percentile: 23) than males (N: 10; Mean: 8.3; SD: 2.9; Sten: 2; Percentile: 4) (t: 3.32; df: 28; SED: 2.25; p: 0.005). Likewise, younger well siblings (below 18 years) show higher anxiety scores (N: 18; Mean: 15.9; SD: 5.5; Sten: 3; Percentile: 11) than elder ones (above 18 years) (N: 12; Mean: 9.6; SD: 4.5; Sten: 2; Percentile: 4)( (t: 3.31; df: 28; SED: 1.91; p: 0.003). These trends are supported by the limited studies available on the subject older female well siblings also maintained a relatively more favorable attitude towards their affected sibling (Venkatesan and Ravindran, 2011; Breslau and Prabucki, 1987; Breslau, Weitzman and Messenger, 1981).

When the affected child with developmental disabilities are into special school (N: 21; Mean: 17.5; SD: 6.2; Sten: 4; Percentile: 23), there is evidently growing positive concern in the well sibling as reflected by their higher but average anxiety scores than when the affected sib is without any school exposure (N: 9; Mean: 8.0; SD: 3.9; Sten: 2; Percentile: 4) (t: 4.28; df: 28; SED: 2.24; p: 0.002). Likewise, there is greater optimistic concern for affected children with mental retardation (N: 20; Mean: 16.3; SD: 6.2; Sten: 3; Percentile: 11) from their well siblings than for affected children from ‘others’ category (N: 10; Mean: 9.2; SD: 3.6; Sten: 2; Percentile: 4) which included individuals with hearing impairment, autism, cerebral palsy, etc (t: 3.38; df: 28; SED: 2.12; p: 0.002).

The number of siblings also emerges in this study as a significant variable in this study to influence the felt/expressed anxiety scores of well siblings towards their brothers/ sisters with developmental disabilities. On an average, single well siblings appear to be more concerned (N: 22; Mean: 18.9; SD: 6.6; Sten: 4; Percentile: 23) compared to multiple

Thus, in terms of affected sibling characteristics, there are grounds to believe that well siblings show greater positive concern and favorable (but not pathological) anxiety towards their affected siblings who are males, older in age (16 years+), identified as ‘MR’ 39

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well siblings (N: 8; Mean: 6.6; SD: 3.1; Sten: 2; Percentile: 4)(t: 5.01; df: 28; SED: 2.44; p: 0.001).

contrasting anxiety profile is also seen as greater ‘apprehension’ (Mean: 10.2; SD: 4.1) in well siblings for their affected siblings attending special schools just as there is greater ‘tension’ (Mean: 10.3; SD: 4.4) on or about children with developmental disabilities not attending any schools. In the same way, there are slight differences in the content profile of anxiety in well siblings based on the diagnostic conditions of their affected siblings. (See Table 2 in next page)

(c) Domain Wise Distribution Analysis: Apart from the test factor identified as ‘general anxiety’, as assessed on the IPAT Anxiety Scale, since this tool has been shown to have a factorial structure representing five sub scales equivalent of the 16 PF Questionnaire, viz., apprehension, tension, low self esteem, emotional instability and suspicion; the results in this study were also analyzed for domain wise distribution of scores. For the overall group, ‘apprehension’ (Mean: 10.0; SD: 4.0) surfaces is most frequently reported form of anxiety followed by ‘tension’ (Mean: 9.3; SD: 3.6), ‘low self control’ (Mean: 5.5; SD: 2.6), ‘emotional instability’ (Mean: 5.0; SD: 2.1) and ‘suspicion’ (Mean: 4.1; SD: 1.4) (F: 25.92; p: 0.000). While this may be taken as overall benchmark for distribution of domain wise scores, analysis in terms of gender of affected child shows greater ‘apprehension’ scores (Mean: 10.9; SD: 4.7) for or about females with developmental disabilities as compared to lower anxiety scores in other domains. This implies that well siblings harbor more ‘apprehension’ type of anxiety for their affected female siblings (F: 9.38; p: 0.000) contrasting other forms of higher ‘tension’, ‘low self control’, ‘emotional instability’ and ‘suspicion’ for affected male siblings with developmental disabilities (F: 16.27; p: 0.000). Similarly, in relation to age of affected child with developmental disabilities, highest form of ‘tension’ based anxiety is seen for or about the youngest age group (below 12 years) (Mean: 10.4; SD: 5.5) contrasting lowest ‘suspicion’ scores (Mean: 3.9; SD: 1.7). Likewise, a

In terms of gender in the well sibling, the trends support a view that female well siblings on an average hold greater ‘apprehension’ (Mean: 10.5; SD: 4.3), and ‘suspicion’ (Mean: 4.4; SD: 1.5) forms of anxiety for or about their affected sibling with developmental disabilities just as male well siblings report greater ‘tension’ (Mean: 9.4; SD: 2.5) and ‘low self control’ (Mean: 6.2; SD: 2.5) forms of anxiety. All forms of anxiety, except in the ‘suspicion’ domain (Mean: 3.9; SD: 1.3) appear to be generally profiled higher in younger well siblings (below 18 years) than older ones (above 18 years). Except for greater ‘apprehension’ (Mean: 10.1; SD: 3.8) as form of anxiety in single siblings, they appear to share the same pattern in all other domains of anxiety as seen or reported by multiple well siblings in this study. (d) Overt/Covert Anxiety: As mentioned earlier, the IPAT Anxiety Scale also facilitates another two dimensional analysis of scores for respondents based on whether their felt/reported anxiety is ‘overt’ or ‘covert’. Overt anxiety represents an open show of the emotion as manifested through their outward manifestation in thought, behavior or action. Covert anxiety covers internal, unrealized or unexpressed emotions. 40

21 20 10 10 20 18 12 22 8

Child Education: Special School

Child Diagnosis: MR

Child Diagnosis: Others Sibling Gender: Male

Sibling Gender: Female

Sibling Age: <18 years

Sibling Age: >18 years

Sibling Size: Single

Sibling Size: Multiple

Child Age: 12-16 years

Child Age: <12 years

Child Education: No School

Child Gender: Female

Child Gender: Male

Child Age: 16 years+

Overall

Variables

41 9.8

10.1

9.6

10.3

10.5

11.5 9.1

9.3

10.2

9.7

9.9

10.7

9.4

10.9

9.7

10.0

Mean

4.7

3.8

4.3

3.9

4.3

3.2 3.3

4.2

4.1

3.9

3.5

2.9

6.2

4.7

3.8

4.0

10.0

9.1

8.2

10.1

9.3

10.5 9.4

8.8

8.9

10.3

8.5

9.8

10.4

8.9

9.5

9.3

Mean

5.3

2.9

4.9

2.3

4.1

2.4 2.5

4.0

3.3

4.4

3.3

2.3

5.5

2.9

3.9

3.6

4.9

5.7

5.2

5.7

5.2

2.2 6.2

5.7

5.6

5.2

5.7

4.9

4.5

5.9

5.5

Mean

2.2

2.7

2.9

2.4

2.6

2.7 2.5

2.6

2.7

2.6

2.3

1.9

2.6

4.5

5.2

4.6

5.3

5.0

5.2 5.0

4.9

4.8

5.6

4.8

5.4

4.9

4.8

5.1

5.0

Mean

2.1

2.6

2.4

1.8 1.6

2.3

1.9

2.5

2.1

2.3

2.1

2.4

2.1

4.0

4.1

4.4

3.9

4.4

4.2 3.6

4.1

3.9

4.6

4.3

4.0

3.9

3.5

4.5

4.1

Mean

1.3

1.5

1.3

1.5

1.3 1.2

1.5

1.4

1.5

1.7

1.5

1.4

Table 2. Domain Wise Distribution of Raw Scores on IPAT in relation to Affected Child and Well Sibling Characteristics Low Self Emotional Apprehension Tension Suspicion Control Instability (12 items) (10 items) (4 items) N (8 items) (6 items)

F: 5.79; p: 0.000

F: 20.24; p: 0.000

F: 5.58; p: 0.001

F: 23.20; p: 0.000

F: 16.00; p: 0.000

F:20.82; p: 0.000 F: 11.67; p: 0.000

F: 11.52; p: 0.000

F: 19.67; p: 0.000

F: 6.60; p: 0.000

F:11.40; p: 0.000

F:14.76; p: 0.000

F: 4.01; p: 0.010

F: 9.38; p: 0.000

F: 16.27; p: 0.000

F:25.92; p:0.000

Probability Venkatesan & Ravindran / Sibling Anxiety in Developmental Disabilities

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An analysis of results based on the ratios (Tables 3 & 4) does not bring out any statistically significant patterns (p: >0.05) although there is slightly more overt or expressed anxiety

for female affected siblings (Mean B/A Ratio: 1.25; SD: 0.38), between 12-16 years (Mean B/A Ratio: 1.16; SD: 0.36) and/or for those children who go to special schools (Mean B/A Ratio: 1.12; SD: 0.43).

Table 3. Distribution of Covert/Overt Raw Scores on IPAT in relation to Affected Child and Well Sibling Characteristics

Variables

Covert (20 items)

Overt (20 items)

Mean

Probability

Overall

16.6

5.2

17.4

6.1

T: 0.53; df: 58; SED: 1.46; p: 0. 60

Child Gender: Male

17.6

5.6

17.1

6.1

T: 0.28; df: 42; SED: 1.76; p: 0.78

Child Gender: Female

14.4

3.5

18.0

6.4

T: 1.41; df:14; SED: 2.58; p: 0.18

Child Age: <12 years

17.1

7.1

16.3

8.3

T: 0.21; df:12; SED: 4.14; p:0.84

Child Age: 12-16 years

16.8

3.4

18.8

4.8

T: 1.02; df:16; SED: 1.95; p: 0.32

Child Age: 16 years+

16.2

5.3

17.0

5.9

T: 0.37; df:26; SED: 2.12; p: 0.71

Child Education: No School

18.0

5.7

17.3

6.2

T: 0.24; df: 16; SED:2.81; p: 0.82

Child Education: Special School

16.0

4.9

17.4

6.2

T: 0.80; df:40; SED: 1.73; p: 0.43

Child Diagnosis: MR

16.1

5.5

16.5

6.8

T: 0.23; df:38; SED:1.96; p: 0.82

Child Diagnosis: Others

17.6

4.5

19.0

4.1

T: 0.74; df:18; SED:1.91; p: 0.47

Sibling Gender: Male

15.9

4.9

17.4

5.0

T: 0.68; df:18; SED:2.21; p: 0.51

Sibling Gender: Female

17.0

5.4

17.4

6.7

T: 0.21; df:38; SED:1.92; p: 0.84

Sibling Age: <18 years

17.5

4.2

17.8

4.3

T: 0.23; df:34; SED:1.42; p: 0.82

Sibling Age: >18 years

15.3

6.3

16.7

8.3

T: 0.47; df:22; SED: 2.99; p: 0.64

Sibling Size: Single

16.7

4.6

17.6

5.8

T: 0.52; df:42; SED: 1.57; p: 0.61

Sibling Size: Multiple

16.3

6.9

16.9

7.2

T: 0.18; df:14; SED: 3.53; p: 0.86

Venkatesan & Ravindran / Sibling Anxiety in Developmental Disabilities

Table 4. Distribution of Covert/Overt Anxiety Ratios on IPAT in relation to Affected Child and Well Sibling Characteristics Overt/Covert Ratio Variables

Mean

Overall

1.05

0.40

Child Gender: Male

1.01

0.40

Child Gender: Female

1.25

0.38

Child Age: <12 years

0.91

0.21

Child Age: 12-16 years

1.16

0.36

Child Age: 16 years+

1.10

0.49

Child Education: No School

0.98

0.19

Child Education: Special School

1.12

0.43

Child Diagnosis: MR

1.05

0.44

Child Diagnosis: Others

1.13

0.34

Sibling Gender: Male

1.15

0.36

Sibling Gender: Female

1.04

0.43

Sibling Age: <18 years

1.05

0.27

Sibling Age: >18 years

1.12

0.56

Sibling Size: Single

1.08

0.41

Sibling Size: Multiple

1.07

0.41

Probability T: 1.47, df: 28, SED: 0.16; p: 0.152 F: 0.807; p: 0.46 T: 0.93; df:28; SED: 0.15; p: 0.36 T: 0.50; df: 28; SED: 0.16; p: 0.62 T: 0.70; df: 28; SED: 0.16; p: 0.49 T: 0.46; df: 28; SED: 0.15; p: 0.65 T: 0.06; df: 28; SED: 0.17; p: 0.95

willing, cooperative and participating well siblings in this study. There were as many unwilling, non-respondent well siblings who did not wish to be part of this study despite assurance of anonymity and confidentiality. It remains an open question as to how future research should attempt to harness such well sibling respondents into the ambit of similar studies for the optimum benefit of affected children with developmental disabilities.

CONCLUSION In sum, there are specific patterns or profiles of subjective anxiety felt or reported by well siblings of children with developmental disabilities which requires to be explored deeply and intensely. While generally and on the whole, it is heartening to note that the trends in this study are indicative of no pathological/ extreme forms, intensity or extensity of reported anxiety in the well siblings, this does not absolve the need to devise or implement anxiety reduction strategies through well sibling betterment programs. Further, the investigators are also left with a lingering sense of skepticism that this favorable profile is indicative of only

ACKNOWLEDGEMENTS The authors seek to place on record the gratitude due to Dr. S R Savithri, Director, All India Institute of Speech and Hearing, Mysore, 43

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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 in the project.

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.

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Dunn, J., and Kendrick, C. (1982). Siblings: Lo ve, Envy an d Un derst a nding. Cambridge Massachusetts: Harvard University Press.

Breslau, N., Weitzman, M., and Messenger, K. (1981). Psychological functioning of siblings of disabled children. Pediatrics, 67, 344 -353.

Dyson, L.L. (1989). Adjustment of siblings of handicapped children: A comparison. Journal of Pediatric Psychology, 14, 215-229. 44

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Endler, N.S., and Kocovski, N.L. (2001), State and Trait Anxiety revisited. Journal of Anxiety Disorders, 15, 3, 231-245.

Behavior Research and Therapy. 39, 12, 1411-1427. Journal of Pediatric Psychology, 27, 8, 699710.

Feeeman, R.J. (1953). Manifest Anxiety Test. In Alpert, R., and Haber, R.N. (1960). Anxiety in academic achievement situations. The Journal of Abnormal and Social Psychology. 61, 2, 207-215.

Kessler, R.C. (2000). The epidemiology of pure and co-morbid generalized anxiety disorder: A review and evaluation of recent research. Acta Psychiatrica Scandinavica. 102, s406, 7-13.

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.

Krug, S.E., Scheier, I.H., and Cattell, R.B. (1976). IPAT Anxiety Scale; Handbook for the IPAT Anxiety Scale. Chicago. Champaign, Illinois: Institute for Personality and Ability Testing

Gilbody, S.M., House, A.O. and Sheldon, T.A. (2001). Routinely administered questionnaires for depression and anxiety: systematic review. British Medical Journal. 322: 405.

Lavine, M. B. (1977). An exploratory study of the siblings of blind children. Journal of Visual Impairment and Blindness, 71, 102-197.

Gursky, B. (2007). The Effect of Educational Interventions with Siblings of Hospitalized Children. Journal of Developmental Pediatrics. 28, 5, 1-8.

Leanza, V. F. (1970). Tension in the adjustment of normal siblings of mildly retarded c h il d re n. Di s se r t a t i on A b st r a c t s International, 2739-A.

Hamilton, M. (1959). The Assessment of Anxiety States by Rating. British Journal of Medical Psychology. 32, 50-55.

Lobato, D. (1983). Siblings of handicapped children: A review. Journal of Autism and Developmental Disorders, 13, 4, 347-364

Haslam, C., Atkinson. S., Brown, S.S., and Haslam, R.A. (2005). Anxiety and Depression in the Workplace: Effects on the Individual and Organization (A Focus Group Investigation). Journal of Affective Disorders, 88, 2, 209-215.

Lobato, D., Kao, B., Plante, W., Seifer, R., Grullon, E., Cheas, L., and Canino, G. (2011). Psychological and school functioning of Latino siblings of children with intellectual disability. Journal of Child Psychology and Psychiatry, 52, 6, 696-703

Holt, N.L. (2003). Coping in Professional Sport: A Case Study of an Experienced Cricket Player. Athletic Insight: The Online Journal of Sport Psychology. 5, 1, 1-11.

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.

Hudson, J.L., and Rapee, R.M. (2001). Parent-Child Interactions and Anxiety Disorders: An Observational Study.

Mc Hale, S.M., Sloan, J., and Simeonson, R.J. (1986). Sibling relationships or children 45

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with autistic, mentally retarded, and nonhandicapped brothers and sisters. Journal of Autism and Developmental Disorders, 16, 4, 399-413. Peshawaria, R., and Menon, D.K. (1991). Working with the families of children with mental handicap in India: Various models. Counseling Psychology Quarterly. 4, 4. 345-356. 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. Phillips, R.S.C. (1999). Interventions with siblings of children with developmental disabilities. Families in Society. The Journal of Contemporary Human Services. 80, 6, 569-577. 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. Reynolds, C. R., & Richmond, B. O. (1985). Revised Childrenâ&#x20AC;&#x2122;s Manifest Anxiety Scale (RCMAS). Los Angeles: Western Psychological Services. Reynolds, C.R., and Richmond, B.O. (1978). Revised Childrenâ&#x20AC;&#x2122;s Manifest Anxiety Scale. Journal of Abnormal Child Psychology. 6. 271-280. Rodger, S., and Tooth, L. (2004). Adult siblings Perceptions of Family Life and Loss: A 46

pilot study. Journal of Developmental and Physical Disabilities, 16, 1, 53-71. Scheffe, H. (1999). The Analysis of Variance. New York: Wiley. Sharpe, D., and Rossiter, L. (2002). Siblings of Children With a Chronic Illness: A Meta-Analysis. Snaith, R.P., Harrop, F.M., Newby, D.A., and Teale, . (1986). Grade scores of the Montgomery-Asberg Depression and the Clinical Anxiety Scales. British Journal of Psychiatry, 148: 599-601. Soper, D.S. (2011). Analysis of Variance Calculator: One way ANOVA from Summary Data. (Online software). http:// ww.danielsoper.com.statcalc3 Spielberger, C.D., Gorsuch, R.L., Lushene, R.E., Vagg, P.R., and Jacobs, G.A. (1983). Manual for the State-Trait Anxiety Inventory. Palo Alto: Consulting Psychological Press. Taylor, J.A. (1953). A Personality scale of Manifest Anxiety. The Journal of Abnormal and Social Psychology, 48, 2, 285-290. Venkatesan, S., and Ravindran, N. (2011). Attitudes in Non-disabled Siblings of Children with Developmental Disabilities. Journal of Disability Management and Special Education. 1, 2, 1-23. Wittchen, H.U., Zhao, S., Kessler, R.C., and Eaton, W.W. (1994). DSM-III-R Generalized Anxiety Disorder in the National Co-morbidity Survey. Archives of General Psychiatry. 51, 5, 355-364 Zung, W.W.K. (1971). A Rating Instrument for Anxiety Disorders. Psychosomatics. 12.6. 371-379.

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Suspicion to Identication of Hearing Loss in Children: Parent’s Perception About Contributing Factors *Gayatri Subodh Sirur & **R. Rangasayee

Abstract Identification of hearing impairment in infancy followed by appropriate intervention by six months is the most effective strategy for development of normal speech and language development in children with hearing impairment (Downs & Yoshinaga – Itano, 1999). In absence of universal newborn hearing screening in India, identification of hearing impairment largely depends on how early parents suspect it and how early they seek professional help. The objective of this study is to measure the gap in identification of hearing loss from the time of suspicion, in children with hearing impairment (CWHI) and to identify the factors that contribute to delay. 122 parents of children with hearing impairment (CWHI) studying in special preschools were asked to list the factors which contributed to delay of identification of hearing impairment in their child. Age of suspicion was noted as per the information given by the parent of CWHI to the researcher and age of identification was obtained from first audiological report of the child. The average gap from suspicion to identification of hearing loss was observed to be almost 12 months. As per the perception of the parents “delay in getting appointments for audiological testing” was the most prominent factor which contributed to delay of identification of the hearing impairment. Strategic planning is, therefore, necessary not only to lower the age of suspicion and the age of identification of hearing impairment but also to curtail the wastage of time from suspicion to identification of hearing impairment. Key Words- age of suspicion, age of identification, hearing impairment

Introduction In the absence of early detection and intervention, the lifetime effects of congenital hearing loss cascade from delayed language development into (i) poor literacy skills, (ii) decreased academic success, (iii) limited job opportunities, (iv) social emotional problems,(v) lowered lifetime economic

success, and ultimately (vi) reduced quality of life. (Hayes, 2008). It is unnecessary for a child to suffer these consequences. To maximize the outcome for infants who are deaf or hard of hearing, Joint Committee on Infant Hearing (2007) advocates “all infants should be screened no later than one month of age. Infants with confirmed hearing loss should

Hashu Advani College Of Special Education, 64/65 Collector Colony, Chembur , 400074, Email- gsirur@yahoo.com

Director, Ali Yavar Jung National Institute for the Hearing Handicapped, Bandra West, Mumbai 400 050, India, tel: 91-22 2642 2638 fax:91-22 2640 4170 Mobile:91-9869205945, Web site: ayjnihh.nic.in

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receive appropriate intervention no later than 6 months of ageâ&#x20AC;?.

was confirmed with first audiological report of the child. Interview schedule was used to pin down the factors causing delay in identification of hearing impairment. Only parents of preschool children were selected primarily for two reasons. Considering the limitations of human memory it was thought that parents of younger CWHI would be in a much better position to enlist the difficulties faced by them in identification of hearing impairment. It was also expected that the information provided by these parents would be more relevant for the present day situation.

As per NSSO 2002 reports, it is estimated that in India there are over 3 lacks children with hearing impairment in the age range of 0-6 years alone. In a developing country like India where universal newborn hearing screening is yet to be implemented, the early identification of hearing impairment in children largely depends on how early it is suspected by the parents and how accessible the testing facilities are. In the Indian context there are only few studies which have focused on age of suspicion and identification of hearing loss. Therefore, there is a dire need not only to get the baseline information about age of suspicion and identification but also to measure the gap between the two. It is also necessary to identify factors causing the delay in identification. This information will help to spot the lacunae in the system and consequently efforts will have to be directed towards evidence based action.

A structured interview schedule was developed for this particular part of the study. A set of predetermined questions were formulated which covered the following areas, namely: awareness about hearing impairment, acceptance of the hearing impairment, professional support, time/money constraints, and the adequacy of services. This questionnaire was sent for validity to 10 professionals working in the field of hearing impairment .The validity experts consisted of 3 special educators, 5 audiologists and speech pathologists, one psychologist and one social worker. The final version of the interview schedule in English contained 10 items. Parents (invariably it was the mother who appeared for the interview) of the CWHI were interviewed in the language they were conversant with. They were asked to indicate the factor /factors which caused the gap in identification of hearing impairment. Each â&#x20AC;&#x2DC;yesâ&#x20AC;&#x2122; response to a factor was given a score of 1; the cumulative score of each factor indicated by all the mothers was calculated. Multiple response analysis was applied to find out the main causes for delay in identification of hearing impairment.

Objectives of the study were: 1. To measure the gap between age of suspicion and age of identification of CWHI studying in special preschool in Mumbai and born between the years 2004 to 2008. 2. To study the factors contributing to delay in identification of hearing loss. Methodology: Research design used for this study was survey. 122 parents of CWHI studying in special preschools were selected with purposive sampling. Age of suspicion and identification was noted as informed by the parents. Further, the age of identification 48

Sirur & Rangasayee / Suspicion to identiﬁcation of hearing loss

Results and Discussion: Table 1 – Age of suspicion, identification and the gap of CWHI born in the year 2004 to 2008 Year

AOS

AOI

Gap in AOI & AOS

2004

17.28

29.1

11.82

2005

15.93

24.21

8.28

2006

11.47

27.08

15.61

2007

13.8

27.03

13.23

2008

12.12

22.54

10.42

Mean

14.1

25.9

11.8

Fig.1 Graph showing age of suspicion, age of identification and gap in the two

finding certainly is very disturbing for all those rehabilitation professionals who vouch for the benefits of early identification and intervention. In simple terms, it demonstrates the mismatch between demand and supply. In this context demand refers to audiological testing and supply refers to manpower and/or availability of such facilities. Pediatric audiological assessment is undoubtedly specialized and time consuming. Not every audiological centre

Mean age of suspicion of CWHI born in the year 2004 to 2008 was 14.1 months and mean age of identification was 25.9 months (Table 1). The mean gap between age of identification and age of suspicion was 11.8 months. The factor numbered as ten above has got the highest response (18.65%) which is “In spite of approaching the clinic/institute we did not get dates for testing immediately”. This 49

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Fig. 2. Percentage of responses to each factor indicated by mothers

may be equipped to test very young children; consequently it puts the load on those clinics /hospitals/institutes which are well equipped to do so. Further, the parents especially from the lower socioeconomic status would prefer to take their children to institutes/clinics which offer services at subsidized rates. The resultant crowding for availing services in such institutes/clinic is a common sight. This could be the main reason for the delay in getting the appointments.

To cur tail the wastage of time in identification, one of the solutions could lie in improvement in the number of audiological assessment facilities. Networking of the hospitals for referrals could be another possible option. Counseling parents regarding the tedious and time consuming process of pediatric assessment could relieve their anxiety and in turn make things easier for the audiologist. The second important factor voiced by the parents for the delay in identification was â&#x20AC;&#x153;Elders/relatives/neighbors told us not to go to the doctor so early, as some children speak or hear lateâ&#x20AC;?. In India, families are closely connected and a system of joint family is in practice. Therefore, it is not uncommon that a person may reach out to the elders in the family or to the neighbors to seek guidance and help rather than consulting professionals. This particular factor shows ignorance on the part

Pediatric assessment in many instances depends on cooperativeness of the child itself. In cases where child is not giving reliable responses, the audiologist may be compelled to call the child repeatedly or ask the parents to condition the child at home first before the actual hearing assessment. This again may be perceived by lay persons as a delay but from a technical point of view it is an unavoidable situation. 50

Sirur & Rangasayee / Suspicion to identiﬁcation of hearing loss

of the advisor as well as on the part of parents seeking guidance. Lack of awareness among parents was also noted when they attributed (third most common reason) for the delay as “We suspected problem in hearing but thought that it will improve on its own after some time”.

As per the perception of parents, inadequate service delivery and lack of awareness about hearing impairment were the main contributing factors for the delay in identification of hearing impairment. Measures like increasing number of audiological services offering paediatric testing and spreading awareness about hearing loss among general public could possibly improve the current situation.

Increasing overall awareness about hearing impairment in general public is much needed and should be done on priority basis. The role of general physicians / child specialists, who will invariably be attending to the child from the first month onwards for vaccination, cannot be underestimated for creating awareness. Initially they will have to be sensitized to spread awareness among parents. Finally universal neonatal hearing screening could be a desirable solution; which obviously takes the responsibility of early detection of hearing impairment from parents /relatives.

References Downs, M.P, Yoshinaga-Itano, C. (1999). The efficacy of early identification and intervention for children with hearing impairment, Pediatr Clin North Am, 46(1), 79-87 Hayes, D. (2008). Improved Health and Development of Children who are Deaf and Hard of Hearing Following Early Intervention, Ann Acad Med Singapore, 37 (Suppl 3), 12

These f indings highlight parent’ s perspectives on factors contributing to delay in identification of hearing impairment. Policy makers should take cognizance of the situation and try to fill the gaps in the service delivery, make more avenues available for creating awareness and disseminating information. Only modification of the current practices will lead to optimum and desired improvement in the current weak system of service delivery.

Joint Committee on Infant Hearing. (2007) Position Statement: Principles and guidelines for early detection and intervention programs. Pediatrics 2007;120:898–921 NSSO(2002).Disabled persons in India. Report No.485:58th Round.New Delhi, Department of Statistics, Government of India

Conclusion Average gap in suspicion to identification of hearing impairment is considerably high.

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Developing Self Determination among Individuals with Mild Intellectual Disability through Audio Visuals *Wasim Ahmad **A.T. Thressiakutty

Abstract The purpose of the study was to find out the effect of audio visuals on developing self determination among individuals with intellectual disability. Single group, pre and post tests experimental method was used. The sample, consisting five individuals with mild intellectual disability (i.e. IQ 50-70), was selected by using purposive sampling method. Self Determination Scale for Adults with Mild Mental Retardation (SDSAMR), a 36 items tool grouped under 5 domains namely Personal Management (PM), Community Participation (CP), Recreation and Leisure Time (RLT), Choice Making (CM) and Problem Solving (PS) was engaged for data collection. An audio visual package based on the five domains was prepared, field tested and used for the intervention of 35 sessions, each 45 minutes duration. In order to check the effect of audio visuals in the development of self determination, statistical analysis,â&#x20AC;?tâ&#x20AC;? test was carried out. The mean scores of pre and post tests of self-determination as a whole were 158.80 and 226.20 and the t value was 10.28 at .00 percent level of significance. On Personal Management the mean scores of pre and post tests were 131.10 and 191.70 and the t value was 12.30 at .00 percent level of significance. On Community Participation the mean scores of pre and post tests were 169.80 and 277.30 and the t value was 17.37 at .00 percent level of significance. On Recreation and Leisure Time the mean scores of pre and post tests were 131.10 and 191.70 and the t value was 12.30 at .00 percent level of significance. On Choice Making the mean scores of pre and post tests were 131.10 and 191.70 and the t value was 12.30 at .02 percent level of significance and on Problem Solving the mean scores of pre and post tests were 131.10 and 191.70 and the t value was 12.30 at .00 percent level of significance. The result confirms the significant effect of audio visuals on developing self determination on the selected sample. Key terms: Mild Intellectual Disability, Self Determination, Audio Visuals.

Introduction During the past two decades, self determination has emerged as an important concept in special education, progress and services delivery for persons with disabilities. It has been felt that training in post school programmes will further help in transition

process and thus results in successful placement of persons with intellectual disability. There is growing mindfulness in the fields of disability services, rehabilitation and education of the need to promote self -determination for individuals with intellectual disability and developmental disabilities

Research Scholar, RKMVU, FDMSE, Coimbatore

Professor in Special Education, RKMVU, FDMSE, Coimbatore

Ahmad & Thressiakutty / Developing Self Determination through Audio Visuals

(Abery, 1994; Brown & Gothelf, 1996; Crimmins & Berroti, 1996; Sands & Wehmeyer, 1996; Wehmeyer & West, 1995).

goals and dreams, and what services they need to obtain them. In day-to-day life, self determination is something that most people take for granted. If you are a person with a developmental disability, dependent on medicaid and the people around you, self determination is significantly more challenging. Working with a system that is struggling to catch up with new ideas, while still balancing the financial cost to the state, and trying to find your own voice is something that is challenging and sometimes impossible. This is where full life comes in. Working with an agency that believes whole-heartedly in self determination, and will help the participant and the participantâ&#x20AC;&#x2122;s family navigate the system, can make all of the difference. Self determination is a concept reflecting the belief that individuals have the right to direct their own lives. Individuals with intellectual disability, who have self determination skills, have stronger chances of being successful in making the transition to adulthood including employment and independence (Wehmeyer & Schawartz, 1997). A self determined person sets goals, makes decisions, see options, solves problems, speaks up for himself, understand what supports are needed for success and knows how to evaluate outcomes (Martin & Marshal, 1996).

It is important to focus on this topic because: 1) People with disabilities continue to stress the need for more control and choice in their lives to improve their quality of life (Kennedy, 1996; Gagne, 1994; Ward, 1996), 2) People with intellectual disability experience limited self- determination and few opportunities to make choices and decisions (Kishi, Teelucksingh, Zollers, Park-Lee, & Meyer, 1988; Stancliffe, 1994; Stancliffe & Wehmeyer, 1995; Wehmeyer, Kelchner, & Richards, 1995; Wehmeyer & Metzler, 1995), and 3) There is emerging evidence that selfdetermination skills are important for more successful adult and educational outcomes for individuals with disabilities (Sowers & Powers, 1995; Wehmeyer & Schwartz, 1997). T he in c re a se d a t t e n ti o n t o se l f determination has also contributed to the continuing emergence of quality of life as to an â&#x20AC;&#x153;overarching principle that is applicable to the betterment of society as a whole (Schalock, 1996, p. 123), and, specifically, for significant improvements in the lives of people with intellectual disability. Schalock stated: the current paradigm shift in mental retardation and closely related disabilities, with its emphasis on self-determination, inclusion, equity, empowerment, community-based supports and quality outcome has forced service providers to focus on an enhanced quality of life for persons with disabilities

Review of Literature Kishi, Teelucksingh, Zollers, Park-Lee and Meyer (1988) conducted a study on the extent to which individuals experience personal autonomy and may provide a crucial measure of the attainment of a more normalized lifestyle. Everyday choices and choice-making opportunities of 24 persons with intellectual disability living in community

It is the belief that people with disabilities have the right and ability to choose and control their own quality of life, their own 53

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group homes were compared to choices of 42 non retarded adults. The adults with intellectual disability had significantly fewer opportunities to make decisions on such matters as what to eat or wear, how to spend free time, and with whom to live. Results were discussed in terms of the need to operationalize meaningful improvements in the lives of persons with intellectual disability that go beyond the appearance of the physical environment.

that self-determination refers to acting as the primary causal agent in one’s life and making choices and decisions regarding one’s quality of life free from undue external influence or interference. Self-determined behavior is autonomous, self-regulated, based on psychological empowerment, and self-realizing. They evaluated this definition by asking participants with intellectual disability to complete various instruments that measured self-determined behavior and these essential characteristics. Discriminant function analysis indicated that measures of essential characteristics predicted differences between groups based on exhibition of self-determined behavior.

Krais (1989) investigated developmentally dis able d, sp ec ifi ca lly t hose me nta ll y incompetent from birth, are entitled to full constitutional rights and protections. These rights include the right to terminate lifesustaining treatment, the right of procreative integrity and the right not to be involuntarily institutionalized. However, the mentally incompetent developmentally disabled are generally unable to exercise these rights. This asserts first that proper procedural safeguards are necessary to guarantee the exercise of these constitutional rights by the incompetent disabled individual. Second, it focuses upon how best to preserve the disabled person’s autonomy and subsequently rejects the substituted judgment standard as a legal fiction, and endorses the best interest test which necessarily confirms with the evidence, and properly accounts for the disabled person’s incompetency.

We hme ye r a nd S ch wa r t z (199 8) investigated the relationship between selfdetermination and quality of life for adults with intellectual disability. In this study data were collected on the quality of life and self determination of 50 individuals with intellectual disability, and data were analyzed, using discriminant function analysis and correlational analyses, to determine the contribution of self-determination to quality of life and examine the relationship between these constructs. People who reported a higher quality of life were also identified as more selfdetermined. The results support the continued effort to promote self determination for people with intellectual disability and developmental disabilities.

Wehmeyer, Kelchner and Richards (1996) conducted a study on despite increased emphasis on self-determination for individuals with intellectual disability; only a few theoretical models have been formulated that specify measurable characteristics for the promotion and evaluation of this outcome. They propose

Wood, Kelly, Test and Fowler (2010) studied, with increasing numbers of students with disabilities entering postsecondary e duca tio n. This st udy c omp ared t he effects of audio-supported text and explicit instruction on students’ knowledge of their 54

Ahmad & Thressiakutty / Developing Self Determination through Audio Visuals

rights, responsibilities, and accommodations in postsecondary education. Participants included four high school seniors with mild disabilities from an urban school district. Using a simultaneous-treatments design with an initial baseline and final best treatment phase, results indicated explicit instruction produced higher scores compared to audio-supported text for all participants.

There are many strategies to teach self determination to individuals with intellectual disability. Audio-visuals are one among them. Since individuals who have problem in self determination they need to be taught through various strategies. Here is an attempt to use audio visuals to make it easier through visual and audio presentation to learn self determination, thereby improving these skills they will be much more independent. They will be accepted by peers, family members and others thus making normalization process easier. The self determination is very important in our day to day life. In general, individuals learn these skills through opportunities, exposure, intuition and imitation but for the individuals with intellectual disability it is difficult to perform the same due to sub average intelligence. Audio visuals are used to develop various skills among individuals with intellectual disability. Hence the investigator planned to take up a study in this area so as to contribute to the additional knowledge on self determination through audio visuals.

Pilnick, Clegg, Murphy and Almack (2010) conducted a study on for young people with intellectual disabilities. The transition from children to adult services has long been recognized as a challenging move. The study reveals that an attempt to allow self-determination in the context of transitions can paradoxically result in undermining user choice and control. The authors also argued that, while a rule-based approach to practice may offer moral clarity for professionals, it can result in interactional and practical difficulties which cannot be easily reconciled. Numerous research studies have been conducted on self determination by persons with intellectual disabilities at international level. The possibility of exercising self advocacy also has been proved by data based studies. But in India, still the concept remains new and the attitude of professionals and parents are not much on positive side. Due to the under estimation of the ability level of individuals with intellectual disability, parents and professionals have apprehensions in introducing new concept such as self determination and self advocacy. Therefore a need has been felt to study on this aspect to create a positive attitude towards the abilities of individuals with intellectual disability.

Objectives of the study were:

to find out the overall effect of audio visuals on developing self determination among individuals with mild intellectual disability.

to analyze the effect of audio visuals on the various aspects of self determination such as personal management, community participation, recreation and leisure time, choice making and problem solving skills among individuals with mild intellectual disability.

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Methodology

Pictures were collected in such a way so that it should not have any sort of ambiguity.

The research design was single group, pre and post test design without control group. 5 individuals with mild intellectual disability

Visuals (Hard Copy) intervention p ac kage: Pre parat ion of t he visuals intervention package was made prior to selecting suitable pictures and pilot testing.

above 18 years of age were selected from the book binding unit, Ramakrishna Mission Vidyalaya, Coimbatore, as sample through non probability sampling technique in which

Validation: In order to validate the visuals intervention package (hard copy) it was given to the professionals to check whether it

purposive/convenient method of sampling was used. It has been checked whether all

matches the objectives, the clarity of language, the suitability of pictures and other remarks.

individuals selected as sample were able to follow instructions, comprehend simple

According to their comments modification was done especially in the pictures and the script. The package also was tested on another set of persons with intellectual disability to find out the suitability of using for the selected sample for the research.

concepts when heard/read out to him and understand when pictures were seen them as inclusion criteria. Tool The tool â&#x20AC;&#x153;Self Determination Scale for Adult with Mental Retardationâ&#x20AC;? (SDSAMR)

Preparation of frames: To achieve

developed by Keshwal & Thressiakutty (2010)

the objectives of the study, considering the recommendations and suggestions by the

was used. The SDSAMR has 36 items grouped under 5 domains namely Personal Management (12 items), Community Participation (6 items),

professionals, finally frames were prepared on computer. After making the frames on

Recreation and Leisure Time (6 items),

computer, audio was given according to the script. It was made sure that the audio should be presented in such a way so that the subjects should not feel bored; audio was recorded with the help of a person who has good command over the language. Opinions were sought from the professionals on suitability, appropriateness of the language used and pictures selected are matching the content

Choice Making (6 items) and Problem Solving (6 items). It is a self administrated tool by the individuals with mild intellectual disability. Preparation of Audio Visuals Intervention Package Script writing: Script was written for all the 36 items. The script was written in such a way so that individuals with intellectual disability easily can understand about the written script.

Suitability While preparing audio visuals intervention package, professionals opinion was taken. The expert group consisted of guide, research

Picture selection: As soon as script was written, pictures were sorted out accordingly. 56

Ahmad & Thressiakutty / Developing Self Determination through Audio Visuals

subject experts, lecturers in special education

intervention package was translated into Tamil language.

and special educators. The audio visuals intervention package was circulated among

Deciding the final Audio Visuals intervention package The final form of the audio visuals intervention package was decided after the refinement of irrelevant, vague and difficult items in it. Finally 36 items were selected for the intervention.

the above mentioned members for their suggestions and requested to comment for further modification. As per their comments modification was done to meet the actual objectives of the research study. Appropriateness of language

Procedure The investigator conducted pre test on the selected samples using the Self Determination Assessment Scale. After finding the base line, the frames were arranged based on the objectives set for each subject. The individualized self intervention arranged for 45 days using individualized intervention and package which has 10 items from the 5 domains of the SDSMR. Periodical assessment data was entered on the master sheet. At the end of the intervention, post test was conducted and entered on the master sheet. For the present study the investigator used both qualitative and quantitative analysis to draw the conclusion based on the objectives set.

Before introducing the audio visuals intervention package to the selected sample for the present study, appropriateness of language was also taken in to consideration. In order to check, it was given to the language expert who has knowledge of both the languages i.e. English and Tamil. According to their suggestions modification was done. Pictures and the content matching It was made sure that the pictures which are going to be used in the audio visuals intervention package are appropriate according to the comprehension level of the individuals with mild intellectual disability to see if they could understand the correct meaning of the pictures used in the audio visuals intervention

Intervention After finding the base line of all the 5 subjects, each one was asked individually to listen and select the items. The items in which they scored less were selected for intervention. Each one of them selected 10 activities for their own self learning through audio-visuals. The AV intervention package was prepared for the self learning of all 5 subjects. For example, items which are selected by subject: 1, from SDSMR are given below.

package and whether there is any ambiguity in thought or in the presentation of the pictures. Translation into regional language i.e. Tamil As the researcher is not familiar with regional language i.e. Tamil, previously he made the audio visuals intervention package in English, Later with the help of a person who has good knowledge of both the languages i.e. Tamil and English the audio visuals 57

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Domains

SDSMR: Item nos.

I go to shop and buy items of my use

I can keep my bank account

I take part in festivals

I greet friends and elders on birthday and festivals

2) I play with my friends

I spend time in hobbies

I select TV/ Radio channels or movies

While travelling in a bus if a normal person is sitting on a seat for the disabled ..........................................

RLT

CM 3) PS

I choose gifts for my friends

3) If my friends makes fun of another ......................................................

The audio visuals intervention package was made in such a way that assessment, learning, evaluation and reinforcement should be mentioned by the subject himself. Self determination has 36 items to learn which are broadly spread out in five major areas such as Personal Management, Community

Participation, Recreation and Leisure Time, Choice Making and Problem Solving. In each domain 12 frames were made for learning. Based on the assessment and interest subjects can choose any two items out of 12 activities for their learning. It is explained in figure 1.

Figure: 1

Ahmad & Thressiakutty / Developing Self Determination through Audio Visuals

Results and discussion Based on the two main objectives of the study, two major hypotheses with 5 minor hypotheses of the second objective related to the 5 components of self determination were formulated to find out the effect of audio visuals on developing self determination among individuals with mild intellectual disability.

After the intervention, the pre and post tests scores were analyzed using “t” test to accept or reject the hypothesis: 1 “There will be significant difference in the pre and post tests mean scores of self determination developed through audio visuals by the group of individuals with mild intellectual disability”.

Table: 1 Comparison of Pre and Post Test Means Scores, Standard Deviation of Self Determination and “t” value Variable Self Determination

Test

Mean

Pre-Test

76.00

13.87

Post-Test

108.20

t-value

Sig.

10.23

.00

8.52

development was observed in the post test and the hypothesis 1 is accepted.

Table-1 shows the mean scores of pre and post tests of self-determination among

The second hypothesis had 5 minor hypotheses based on the 5 components of self determination.

individuals with intellectual disability. The pre and post tests mean scores were 76.00 and 108.20 respectively, the t value was 10.23 and

The first minor hypothesis was to find out whether there is any significant effect of audio visuals on the personal management, one of the 5 components of self determination.

the difference was significant at .01 level. It was found that audio visuals have significant effect on developing self determination. Remarkable

Table: 2 Comparison of Pre and Post Test Means Scores, Standard Deviation of Personal Management and “t” value

Variable

Test

Mean

Pre-Test

24.00

5.52

PM Post-Test

33.60

5.12

t-value

Sig.

8.91

.00

Vol. 2 No. 1 January 2012

Journal of Disability Management and Special Education

Table-2 shows the mean scores of personal management after the intervention (pre and post tests) it was 24.00 and 33.60 and the t value was 8.91. It was found that audio visuals have significant effect on developing personal

management, one of the components of self determination. The second minor hypothesis of objective 2 was to find out the effect of audio visuals on developing community participation.

Table: 3 Comparison of Pre and Post Test Mean Scores, Standard Deviation of Community Participation and “t” value Variable CP

Test

Mean

Pre-Test

13.80

3.11

Post-Test

19.40

1.140

Table-3 shows the mean scores of community participation after the intervention (pre and post test) it was 13.80 and 19.40 and the t value was 5.43. It was found that audio visuals have significant effect on developing community participation.

t-value

Sig.

5.43

.00

The third minor hypothesis was to find out whether there is any effect of audio visuals on developing recreation and leisure time among individuals with mild intellectual disability.

Table: 4 Comparison of Pre and Post Test Means Scores, Standard Deviation of Recreation and Leisure Time and “t” value Variable RLT

Test

Mean

Pre-Test

9.60

1.67

Post-Test

17.60

2.07

Table-4 depicts the pre and post tests mean scores (9.60 and 17.60) and the t value 6.53. It was found that audio visuals have significant effect on developing recreation and leisure time. Remarkable development was observed in the post test.

t-value

Sig.

6.53

.00

The fourth minor hypothesis was to find out the significant difference in the pre and post tests mean scores of choice making developed through audio visuals by the group of individuals with mild intellectual disability.

Table: 5 Comparison of Pre and Post Test Mean Scores, Standard Deviation of Choice Making and “t” value Variable

Test

Mean

Pre-Test

14.00

.70

Post-Test

17.60

2.96

t-value

Sig.

2.98

.02

Ahmad & Thressiakutty / Developing Self Determination through Audio Visuals

Table-5 shows the result of statistical analysis and significant difference in the mean scores of choice making after the intervention (pre and post test). It was 14.00 and 17.60 and the t value was 2.98. It was found that audio visuals have significant effect on developing choice making.

The fifth minor hypothesis was to find out the significant difference in the pre and post tests mean scores of problem solving developed through audio visuals by the group of individuals with mild intellectual disability.

Table: 6 Comparison of Pre and Post Test Means Scores, Standard Deviation of Problem Solving and â&#x20AC;&#x153;tâ&#x20AC;? value Variable

Test

Mean

Pre-Test

14.60

2.54

Post-Test

20.00

4.33

The mean scores of problem solving after the intervention (pre and post test) were 14.60 and 20.00 and the t value was 4.46. It reveals that audio visuals have significant effect on developing problem solving. Remarkable development was observed in the post test.

t-value

Sig.

4.46

.00

visuals on developing all the above mentioned 5 components of self determination among the selected samples. Conclusion This study is the first of its kind in India. It throws light on developing self-determination among the individuals with mild intellectual disability through audio visuals. The research focuses on how self-determination can be enhanced among individuals with mild intellectual disability in order to achieve their livelihood.

Major Findings The first objective was to analyze the effect of audio visuals on developing self determination among individuals with mild intellectual disability. It was found that audio visuals have significant effect on developing self determination. Remarkable development was observed in the post test.

Data analysis shows significant difference in the pre and post tests mean scores on self determination i.e. personal management, community participation, recreation and leisure time, choice making and problem solving skills of individuals with mild intellectual disability.

Second objective was to analyze the effect of audio visuals on developing the components of self determination namely, personal management, community participation, improving recreation and leisure time, choice making and problem solving among individuals with mild intellectual disability. The statistical analysis proved the significant effect of audio

Review of literature shows that there is a wide scope of research in this area in India as there is no data based studies found by the researcher. It is the need of 61

Vol. 2 No. 1 January 2012

Journal of Disability Management and Special Education

the hour, so developing self determination has to be an integral part of the curriculum. Individuals with mild intellectual disability, who have self-determination skills, have stronger chances of being successful in making transition to adulthood including employment, independence and right to live with dignity and self-esteem.

disabilities: A mandate for change at many levels. Baltimore, MD: Paul H. Brookes. 362.1968 BRA â&#x20AC;&#x201C; Book) Kennedy, M. (1996). Self-determination and trust: My experiences and thoughts. In D.J. Sands & M.L. Wehmeyer (Eds.), Self-determination across the life span: Independence and choice for people with disabilities (pp. 37-49). Baltimore: Paul H. Brookes.

References: Abery, B. (1994). A conceptual framework for enhancing self-determination. In M.F. Hayden and B.H. (Eds.), Challenges for a service system in transition: Ensuring quality community experiences for persons with developmental disabilities (pp. 345-380).

Keshwal, H. & Thressiakutty, A.T. (2011). Effect of self-directed IEP on development of Self-Determination in special employees with mild mental retardation, Journal of Disability Management and Special Education 1, 56-69.

Brown, F., & Gothelf, C. R. (1996). Selfdetermination for all individuals. In D. H. Lehr & F. Brown (Eds.), People with disabilities who challenge the system (pp. 335-353). Baltimore: Paul H. Brookes publishers.

Kishi, G., Teelucksingh, B., Zollers, N., Park-Lee, S. & Meyer, L. (1988). Daily DecisionMaking in Community Residences: A Social Comparison of Adults with and Without Mental Retardation. 1988 Mar; 92(5):430-5. PMID: 3358867 [PubMed - indexed for MEDLINE]

Chandra, S. (2011) Developing SelfDe ter minat ion Among Persons With Mild Mental Retardation - An Intervention Study Involving Parents and Teachers, RKMVU, Coimbatore.

Krais, W. A. (1989). The Incompetent Developmentally Disabled Personâ&#x20AC;&#x2122;s Right of Self-Determination: Right-ToDie, Sterilization and Institutionalization. 1989; 15(2-3):333-61. PMID: 2603868 [PubMed - indexed for MEDLINE]

Crimmins, D. B., & Berotti, D. (1996). Supporting increased self-determination for individuals with challenging behaviors. In D. H. Lehr & F. Brown (Eds.), People with disabilities who challenge the system (pp. 379-402). Baltimore: Paul H. Brookes Publishers.

Pilnick, A., Clegg, J., Murphy, E. & Almack, K. (2010). Questioning the Answer: Questioning Style, Choice and SelfDetermination in Interactions with Young People with Intellectual Disabilities. 2010 Mar; 32(3):415-36. PMID: 20415789 [PubMed - indexed for MEDLINE]

Gagne, R.J. (1994). A self-made man. In Bradley, V.J., Ashbaugh, J.W., & Blaney, B.C. (Eds.). Creating individual supports for people with developmental

Schalock, R. L. (1996). Reconsidering the conceptualization and measurement 62

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of quality of life. In R. Schalock (Ed.), Quality of life: Conceptualization and measurement (Vol. I; pp. 123-139). Washington, DC: American Association on Mental Retardation.

factors related to the self-determination of adults with mental retardation. Journal of Vocational Rehabilitation, 5,291-305. Wehmeyer, M.L & Schwartz, M.L (1998). The Relationship between Self-Determination and Quality of Life for Adults with Mental Retardation. Education and Training in Mental Retardation and Developmental Disabilities, 1998, 33(1), 3-12

Sowers, J. A., & Powers, L. (1995). The participation and independence of students with severe physical and multiple disabilities in performing community activities. Mental Retardation, 33, 209220. Stancliffe, R (1994). Assessing opportunities for choice-making: A comparison of self- and staff reports. American Journal on Mental Retardation, 99, 418-429.

Wehmeyer, M.L. & Schwartz, M.L. (1997). Self-Determination and Positive Adult Outcomes: A Follow-Up Study of Youth with Mental Retardation or Learning Disabilities. Exceptional Children, Vol. 63, No. 2, pp. 245-255.

Stancliffe, R., & Wehmeyer, M.L. (1995). Variability in the availability of choice to adults with mental retardation. Journal of Vocational Rehabilitation, 5, 319-328.

Wehmeyer, M.L., & Meltzer, C.A. (1995). How self-determined are people with mental retardation? The national consumer survey. Mental Retardation, 33, 111-119.

Ward, M. J. (1996). Coming of age in the age self-determination: A historical and personal perspective. In D. J. Sands & M. L. Wehmeyer (Eds.), Self-determination across the life span: Independence and choice for people with disabilities (p p. 3-16). Baltimore, MD: Paul H. Brookes.

Wehmeyer, M.L., Kelchner, K., & Richards, S. (1996). Essential characteristics of selfdetermined behavior of individuals with mental retardation. American Journal on Mental Retardation, 100, 632-642. Wood, C. L., Kelly, K. R., Test, D. W. & Fowler, C. H. (2010). Comparing Audio-Supported Text and Explicit Instruction on Studentsâ&#x20AC;&#x2122; Knowledge of Accommodations, Rights, and Responsibilities. Career Development for Exceptional Individuals August 1, 2010 33: 115-124.

Wehmeyer, M. L., & West, M. D. (Eds.). (1995). Theme issue: Self- determination. Journal of Vocational Rehabilitation, 5(4). Wehmeyer, M. L., Kelchner, K., & Richards, S. (1995). Individual and environmental

Vol. 2. No. 1 January 2012

Journal of Disability Management and Special Education ISSN: 2229-5143

A Study of Impact of Distance and Regular Education Modality on Competency of the Special Teachers of Children with Hearing Impairment * Kaushal Sharma & ** Amitav Mishra

Abstract The main objective of the present study was to compare the impact of teacher training either gained through regular mode or distance mode on the competency of special education teachers (Hearing Impairment). It was primarily a survey type of evaluative research involving systematic observations of variables by the use of standardized tools and systematic procedure. The sample of the study, 100 Special Education teachers, were selected through randomization techniques from the short listed 4 regular universities and 10 study centers of an open university where the target samples had passed out B.Ed. Special Education course during 2004-07. It included all those variables which may influence the competency of special teachers (HI) including their age, sex and marks obtained in the qualifying examinations of the professional special education degree. The tools developed by the researchers namely ‘Teaching Competency Scale for the Special teachers (HI) (TCSST)’ and ‘Teachers’ Perception Questionnaire on Quality of Special Education Teacher Training Institute (TPQ2-SETTI)’were used for data collection. On comparing teaching competency skills of the special education teachers studied through regular education and distance education learning modes on the basis of modality, sex, age and professional qualification, there was no significant difference found. Key terms: Distance and Regular Education Modality, Competency of the Special teachers, Hearing Impairment

Introduction In the recent age, ‘Distance Learning’ is not a future possibility for which higher education must prepare; but it is a current reality creating new opportunities and challenges for educational institutions. Distance Education Mode is becoming a more vital part of the higher education since it reaches a broader

student audience, better addresses student needs, saves money, and more importantly uses the principles of modern learning pedagogy (Fitzpatrick, 2001). Public as well as political interest in ‘Distance Education’ is especially high in geographic regions where the student population is widely distributed (Sherry, & Morse 1995).

Special Education Professional, C-77, Minal Residency, J.K. Road, Govindpura, Bhopal- 462023 Ph. + 91 9893445048, e-mail: kaushalvnu06@hotmail.com

Assoc. Prof. in Special Education, M.J.P. Rohilkhand University, Bareilly, U.P. 243001

Sharma & Mishra / Impact of educational modality on competency of special teachers

According to Fox (1998), what is in dispute is not whether Distance Education Mode is ideal, but whether it is good enough to merit a university degree, and whether it is better than receiving no education at all. For distance mode ‘Teacher Education’ is not an exception; it is kept on increasing as the number of teachers required is not yet met.

education students versus traditional students (Freeman 1995; Mortensen 1995; McKissack 1997). The present study de alt with the competency of the school teachers who passed their degree in education from the traditional mode or distance mode. Whatever the mode may be, the concern is that we must prepare quality teachers. Since the distance mode special education teachers in India are going to cross the number of traditionally trained special education teachers, hence we must evaluate the stuff and ensure the quality.

A large portion of ‘Distance Education’ researches has been devoted to comparative studies of distance and traditional methods of education. In this type of research, the teaching modality (traditional or distance) is considered the independent variable and the study intends to find out how distance mode compares with traditional teaching with respect to promoting student success (e.g., course grades, test scores, attribution). Those researchers who conduct comparative research are often asking the same basic research question, “Is Distance Education Mode as good as, or better than, the traditional education? Results indicate that distance learners should not be viewed as disadvantaged in their learning experiences. Further, distance learners can perform as well as or better than traditional learners as measured by homework assignments, exams, and term papers. Equally important, as noted by researchers, is the fact that students in distance learning courses earned higher grades than those in the traditional classroom setting. Bartlett 1997; Bothun 1998; Heines & Hulse 1996; Kabat & Friedel 1990; Schutte 1996; Souder 1993). Gubernick and Ebeling (1997) stated that distance education students scored from five to ten percent higher on standardized achievement tests than did students in the traditional classroom setting. Conversely, as reported by other researchers, there are no significant differences in grades for distance

The term “Competency” describes something that has to do with an individual’s ability to perform a certain job or role within an organization. It is important to make a distinction between the knowledge and skills a child possesses, called competence. In this study it refers to the teaching competency of Special Teachers of Children with H.D. Objectives of the Study The main objective of the present study was to compare the impact of teacher training either gained through regular mode or distance mode on the competency of special education teachers (HI). Further the study aims: 1. to measure the level of the competency among the teachers of special education (HI), who have passed their examinations through distance education mode with specific reference to area of hearing impairment; 2. to measure the level of the competency among the teachers of special education (HI), who have passed their examinations through regular education mode with specific reference to area of hearing impairment; 65

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Journal of Disability Management and Special Education

3. to compare the impact of distance education and regular education modality on competency of the special teachers (HI) with specific reference to area of hearing impairment;

observations of variables by the use of standardized tools and systematic procedure. It was planned to include all those variables which may influence the competency of special teachers (HI) including their age, sex and marks obtained in the qualifying examinations of the professional special education degree. It was also planned to include the samples to the study having an inter-rater agreement more or equal to 80%. The average of both ratings was considered as the competency score of the individual samples. If inter-rater agreement happened to be less than 80%, both ratings were rejected and the samples/subjects were excluded from the study.

4. to analyze influence of other variables such as sex, age, basic qualification, experience in the field prior to training while comparing the impact of distance education and regular education modality on competency of special teachers (HI) with specific reference to area of the hearing impairment; 5. to study the perceptions of the special education teachers (HI) towards the resources and curricular transaction in regular and distance education mode;

Variables selected 1. Academic Qualifications: 2. Professional Qualifications:

6. to suggest recommendations to maintain the required level of the competency among special teachers (HI) passed their examinations through distance education mode.

3. Total length of experience of the field: 4. Marks obtained in the qualifying class i.e. B.Ed. (in percentage) 5. Age group

Design of the Study The selected study was primarily a survey type of evaluative research involving systematic

Based on the above variables the sample characteristics are described in following tables-

Table: 1.1 Academic Qualifications Sr. No.

Variable

Educational QualiďŹ cation

Regular Education Mode 1) Graduates 2) Post-Graduates

Distance Education Mode 1) Graduates 2) Post-Graduates

Table 1.2 Professional Qualifications Sr. No.

Variable

Professional QualiďŹ cation

Regular Education Mode

Distance Education Mode

None

1) Foundationcourse/BridgecourseinSpecial Education 2) Diploma in Special Education 3) PG Diploma in Special Education 66

Sharma & Mishra / Impact of educational modality on competency of special teachers

Table 1.3 Total length of Experience in the Field Sr.No.

Regular Education Mode

Variable Length of experience in the ďŹ eld

1) 0-2 years 2) 3-5 years

Distance Education Mode 1) 0-2 years 2) 3-5 years

Table 1.4 Marks Obtained in the Qualifying Examination (i.e B.Ed. Special Education/ B.Ed. SE-DE) Sr. No.

Regular Education Mode

Variable

Distance Education Mode

Percentage of marks in the qualifying examination i.e B.Ed. Special Education/

1) Below 55% 2) 56-65%

B.Ed.SE-DE

3) 66% and above

3) 66% & above

Table 1.5 Age Groups Sr. No.

Variable

Regular Education Mode

Distance Education Mode

1) 25-35 yrs

Length of experience in the

2) 36-45 yrs

field

3) 46-55 yrs

4) 56 + yrs

Population and Sample of the Study

competency, it was planned to select 100

Special Education teachers those who

samples from each of the learning modality (i.e

passed out B.Ed. Special Education degree

from regular/traditional education and distance/

between 2004-2007 sessions from any Indian

ODL education mode). Randomization

university, affiliated college or study centers

techniques was considered to shortlist 4 regular

(in case of distance education/ODL mode)

universities and 10 study centers of an open

were the population of the present study.

university where the target samples had passed

Considering the evaluative nature of the

out B.Ed. Special Education course in regular

study and systematic observations of teacher

mode during 2004-07 sessions. 67

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Journal of Disability Management and Special Education

Table 1.6 Sample, Sample Drop Outs and Equalization of Samples Selected Samples (A)

Sample dropouts (B)

Exclusion based on inter-rater disagreement (80%) (C)

Pre-ﬁnal sample (A)-(B+C)

Equalization by randomization

Regular Education Mode

120

101

100

Distance Education Mode

120

110

100

Sr. No.

Mode

Table 1.7 Population & Sample Selection

Sessions

2004-2005 2005-2006 2006-2007

Institutions

Indian university, afﬁliated colleges or study centers (in case of distance education/ODL mode).

Sample taken

100 from each modality

From Regular mode

04 Universities

From Distance mode

10 study centers

Population

Sample

Tools and Approach For the purpose of study the researcher himself developed tools titled ‘Teaching Competency Scale for the Special teachers (HI) (TCS-ST)’. Similarly, to evaluate teacher’s perception on availability of resources at teacher training institute, a questionnaire was developed namely ‘Teachers Perception Questionnaire on Quality of Special Education Teacher Training Institute (TPQ2-SETTI)’. Both the tools had undergone all essential stages of standardization before utilizing them for the present study.

developed for the present study to elicit systematic information on the status of teaching competency skills amongst special teachers those are involved in the education of students with hearing impairment. The following steps were taken to develop the tools as1.

The ‘Teaching Competency Scale for the Special Teachers (TCS-ST)’ has been 68

Formation of indicators (items) pool a) Selection of indicators for initial tryouts b) Preparation of teacher’s competency scale (Teaching Competency Scale for the Special Teachers (TCS-ST) c) Tryout of selected indicators d) Reliability e) Validity

Sharma & Mishra / Impact of educational modality on competency of special teachers

The scale was consists of 82 item grouped under the 09 dimensions asTable 2.1 Area of skills of Teaching Competency Scale for the Special Teachers (TCS-ST) Sr. No

Area of Skills

Items Standardized

Planning Skills

Introduction Skills

Content formation skills

Presentation skills

Reinforcement skills

Black Board Skills

Personal Skills

Class room Management Skills

Concluding skills

Total Items

The initial pool of 126 indicators (items) for ‘Teaching Competency Scale for the Special Teachers (TCS-ST)’ was formed by undertaking excessive review of the literature available on assessment of competency of special teachers in west (unfortunately no similar scale available to measure competency

of special teachers); obtaining comments from the experts, administrators and teacher trainers in the field of special education; observing and interviewing special teachers in relation to their competency. The ‘r’ values of the competency skill areas are as under-

Table 2.2 Reliability of TCS-ST Skills: Area of Skills

Correlation (r) Value

Planning Skills

0.3492

Introduction Skills

0.4894

Content formation skills

0.3987

Presentation skills

0.5274

Reinforcement skills

0.3616

Black Board Skills

0.4751

Personal Skills

0.3354

Class room Management Skills

0.3705

Concluding skills

0.4472 69

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Journal of Disability Management and Special Education

The ‘Teachers Perception Questionnaire on Quality of Special Education Teacher Training Institute (TPQ2-SETTI)’ has been developed for the present study to elicit systematic information on the status of special education institutes/study centers those are involved in the education of students with hearing impairment. The following steps were taken to develop the tools as1.

The initial pool of 56 indicators (items) for ‘Teachers Perception Questionnaire on Quality of Special Education Teacher Training Institute (TPQ2-SETTI)’ was formed by; 

a) Selection of questions for initial tryouts

undertaking excessive review of the literature available on assessment of competency of special teachers in west (unfortunately no similar scale available to measure teacher’s perception on the quality of special education institutes in our country);



b) Preparation of teacher’s Perception S c a l e ( Te a c h e r s Pe rc e p t i o n Questionnaire on Quality of Special Education Teacher Training Institute (TPQ2-SETTI))’

obtaining comments from the experts, administrators and teacher trainers in the field of special education;



observing and interviewing special teachers in relation to their perception. Out of 56 indicators 44 were selected those which enabled to expression clear observable and measurable terms. There were 11 indicators of ‘Teachers Perception Questionnaire on Quality of Special Education Teacher Training Institute (TPQ2-SETTI)’ rejected from the initial pool.

Formation of indicators (items) pool

Tryout of selected questions

d) Reliability e) Validity The scale was consists of 56 questions grouped under the 06 dimensions as given

Table 3.1 Formation of TPQ2-SETTI Indicators Pool: Sr. No.

Dimensions

Initial Indicators

Rejected

Selected Main pool

Infrastructure

Laboratory

Library

Technological advancement

Special school/Model school facility

Conduct of the course

Total

Sharma & Mishra / Impact of educational modality on competency of special teachers

The correlation was established for the items with the help of above mentioned

formula given under the table-

Table 3.2 Correlation between Items TPQ2-SETTI Area of Skills

Correlation (r) Value

Infrastructure

0.2085

Laboratory

0.1670

Library

0.3232

Technological advancements

0.1838

Special school/Model school facility

0.2584

Conduct of the course

0.0147 Analysis and Results:

Scheme of Data Analysis

Analysis of ‘Overall Competency Skills’ of ‘Special Education Teachers’

Data and information collected through scale and questionnaire had been analyzed in both qualitative and quantitative form. Analysis

To study the competency of teachers on Overall skills of those completed B.Ed. (Special Education) through different modes (i.e. Traditional/Regular and Open/ Distance Learning), the F and t-values were compared by the mean variance within and among the group(s).

of Variance (ANOVA) followed by ‘t’-test was applied to analyze the data for the TCS-ST and Chi-square techniques were applied to the TPQ2-SETTI of the questionnaire to analyze the data.

Table: 4.1 Summary of ANOVA for the Competency Skills of ‘Special Education Teachers (HI)’ Studied through Different Modes (i.e. Traditional/Regular and Distance/Open Learning) Groups

Sum of Squares

Mean Square

Between Groups

650.250

Within Groups

6516.378

198

32.746

Total

7166.628

199

Sig.

19.857

.01*

*Significant at 0.01 level The F- value (F= 19.857, df= 1/199) was found significant. It shows that, the mean square for the ‘Overall Competency Skills’ of ‘Special Education Teachers’ studied through

different modes (i.e. Traditional/Regular and Distance/Open Learning) modalities did significantly differ.

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Journal of Disability Management and Special Education

Table 4.2 Mean, SD and SEM of ‘Overall Skills’ of ‘‘Special Education Teachers (HI)’’ Studied through Different Modes (i.e. Traditional/Regular and Distance/Open Learning) Skills Overall Competency

Modality

Mean

Std. Deviation

Std. Error Mean

Regular Mode

100

25.86

5.89

.42

Distance Education Mode

100

23.31

5.55

.39

Table 4.3 t- value of the ‘Overall Skills’ of ‘Special Education Teachers’ Studied through Different Modes (i.e. Traditional/Regular and Distance/Open Learning) Levene’s Test for Equality of Variances Overall Competency

Sig.

t-test for Equality of Means ‘t’

Equal variances -4.456 198 assumed .824 .365 Equal variances not -4.456 198.269 assumed

On the basis of obtained scores of ‘Overall Teaching Competency’ there was a significant difference between the ‘Special Education Teachers’ those studied through the different modes (i.e. Traditional/Regular and Distance/Open Learning). This clarifies that the competency of ‘Special Education Teachers’, passed through regular mode was better than their Distance Education counterparts.

Sig. Mean Std. Error (2-tailed) Difference Difference .000

-2.55

.57

.000

-2.55

.57

of special education teachers studied through different modes (i.e. Traditional/ Regular and Distance/Open Learning). The competency of special education teachers who passed the B.Ed. (Special Education) course through regular mode was significantly higher than their counterparts who completed B.Ed. (Special Education) course through d i st a n c e mo d e ( M e a n = 2 5. 8 6, SD = 5.89, N = 100). On comparing the different competency skills individually with the modality of education, significant difference were found with reference to (i) planning skills; (ii) introduction skills; (iii) content formation skills; (iv) presentation skills; (v) reinforcement skills; (vi) black board skills; (vii) personal skills; (viii) classroom management skills

Fin din gs , Recom men datio ns an d Suggestions The findings of the study are briefly described below: a)

On Modality and Its Effect on Teaching Efficiency: The study revealed statistically significant difference in teaching competency skills 72

Sharma & Mishra / Impact of educational modality on competency of special teachers

and (ix) concluding skills. On comparing the competency skill differences, the teachers who passed through regular education mode showed higher level of competency in all the above areas. b)

age group had significant difference in their competency skills where distance education mode teachers were found having more strength on competency skills than that of the regular education mode teachers.

Influence of Sex and Age of Teachers on their Competency with reference to Modality

On comparing teaching competency skills of the special education teachers studied through regular education and distance Education learning modes on the basis of sex, there was no significant difference found. The study compared males and females independently for the regular education and distance education and vice-versa. Statistically the difference was not significantly seen between the competency skills of special education teachers on the basis of sex.

Inf luence of Acad emic and Professional Qualifications of Teachers on their Competency with reference to Modality: With reference to the basis of academic qualifications no significant difference was found between special education teachers of different modes i.e. traditional vs. distance. I n f l u e n c e s o f s u c h p r o f e s si o n a l qualifications on the competency skill of special education teachers of different modes of learning (i.e. Traditional / Regular and Open/ Distance Learning) was studied and found that previous professional training (i.e Foundation course or diploma course in special education) positively influences the future training.

Study compared different age groups of the special education teachers independently for the regular education and distance education modes as: (i) the special education teachers of 25-35 years age group from regular education modes are having more strength on competency skills than that of the distance education mode teachers; (ii) for the age group of teachers of 36-45 years there is significant difference between the competency skills. The mean scores of this group showed that the teachers from distance education mode was higher than their counterparts; (iii) on comparing the age group of 46-55 years, the significant difference was seen and the mean scores of regular education mode teachers was found higher than that of their counterparts; (iv) special education teachers of 56 years and above

Influence of Field Experience of Teachers on their Competency with reference to Modality: Influence of experience was studied on competency skills of special education teachers from different modes (i.e. Traditional/Regular and Open/ Distance Learning) but found no significant difference.

Influence of B.Ed. Special Education Results of Special Ed ucation Teachers on their Competency with reference to Modality: While comparing different percentage groups based on the results of the B.Ed.

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special education examination for both regular education and distance education mode it was found that the marks secured in B.Ed. (Special Education) have direct impact on the special education teachersâ&#x20AC;&#x2122; competency.

disability areas and recent publications at the study centers for both the modalities (i.e distance education/ODL and traditional/ regular education), were found satisfactory according to the teachersâ&#x20AC;&#x2122; responses; 8. The reading room facility provided by the centre, availability of lectures, books and lessons in the form of CD and Audio/Video cassettes were found inadequate by both modality groups;

4.3 Perception towards Resources and Curricular Transaction in Regular and Distance Education Mode Teachers were most concerned about the infrastructural and other facilities at the training centers. Both Distance education and Regular education mode teachers perceived that:

9. The allotment of the library time was found inadequate. teachers of both of the modalities responded that the number of issued books were sufficient;

1. The classrooms at the centers are adequate for theory and practical classes, rooms have properly lighting and ventilation with proper seating arrangements;

10. Teachers from distance education mode responded positive towards the use of technological advancements like teleconferencing, availability of Satellite Interface Terminals (SITs) and the facility of EDUSAT at their centers as compare to the regular mode teachersâ&#x20AC;&#x2122; training centres.

2. With regard to the facilities of internet, computer and multimedia, both of the groups responded that boards and displays are adequate in numbers and properly maintained at the centers of both modalities, but often used in distance education centers than that of regular mode centers;

11. The sufficient number of teaching staff at the model school as well as in the training centre was found insufficient by both of the groups, but the number of qualified and trained staff was found in-sufficient at distance education centers as compared to the regular education mode.

3. Hearing aid testing and audiometry room facilities with different types of aids were not available at distance mode centers but in regular mode centers these facilities were available to the practical purpose

12. Similarly, regular mode teachers responded that the guest faculty were available whenever needed as compared to the distance mode;

4. Ear mould lab/aid repair and fitting centre/ lab facilities were available in distance mode centers as compare to regular mode;

13. Both modes of teachers responded that the audiologist and the speech therapist of the model school help the students when needed frequently, and the number of the students and rooms at the model school are sufficient to conduct the practical;

5. Least restrictive environment in labs with ramps was a shortcoming of the centers of both modes centers; 6. Both types of the centers were having the facilities of power backup (UPS) and generators.

14. The counseling facilities to the parents at the model school were found at both types

7. The library facilities, books on different 74

Sharma & Mishra / Impact of educational modality on competency of special teachers

of centers;

experience. 3. Infra-structure: The government needs to facilitate some financial support to the study centers to establish well equipped labs. The financial input may be given as on lending basis for a defined time limit.

15. The time table adopted at the training centre was appropriate in regular mode centers as compared to the distance education mode. But on the other hand the inculcation of sufficient input of training part in the time table, teachers of both the modalities found un-satisfactory;

4. Library: Library must be updated and reading room facility should be provided for adequate time. Most of the centers are not aware of the new arrivals. The University and / or RCI must be given the list of the new arrivals to the study centers time to time.

16. The opportunity of self learning and the group discussions for the trainees at the study centers is the issue on which both the groups of the teachers equally perceived, but on the other hand disagreed with the numbers of lectures to complete the training components fully;

5. Tec hn olo gic al Ad van cem ent s : Internet, intranet, EDUSAT etc. should be used. RCI and Open Universities should provide the lease line to the centers at no profit-no loss basis and centers must have the audio-video/e-lessons. The regular mode training centers should procure these e-lessons through another center. Mutual sharing of resources will play an important role to empower the centers and trainees too.

17. Both of the groups responded that the teaching strategy of the faculty members at the study centers was not in a simple and easy way to understand but faculties were found cooperative and ready to help in assignments given to the trainees. Implications and Suggestions of the Study

6. Model Special / Inclusive School: The techno-savvy staff, with the knowledge of new methodologies and techniques of teaching-learning should be appointed at the centers. The problem of teaching learning material at the model school can be fulfilled by using the TLMs prepared by the trainees.

From the current study, some important recommendations have come up which may be considered to enhance the competency of special education teachers. 1. Eligibility Criteria: Previous training may be the preferential criteria for getting admission to the distance as well as in regular/traditional mode B.Ed. Special Education course.

7. The time table for the training center must be clear cut and full of field experiences. Besides this, it should extend the opportunity to provide the group discussions to the trainees for better understanding of the content.

2. Experience: In selection process for admission to B.Ed. (Special Education) course, the experience must receive adequate weightage. The guidelines must be evolved how to access the quality of

8. The oppor tunity of seminars and workshops would also be provided to the trainees for discussions of the chapters 75

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and to improve their self learning habits.

school instruction. Journal of Education for Business, 71(2), 74-76.

9. It is obviously true that sufficient numbers of experts in special education are not available at a time in a specific place. For that, the training center should adopt the tele-conferencing facilities and the SITs technology of the EDUSAT to improve the trainee’s discussion skills and explore their knowledge by discussions with the experts situated at the distant locations.

Kabat, E. J., & Friedel, J. (1990). The d e ve l o p me n t , p i l o t - t e s t i n g , a n d dissemination of a comprehensive evaluation model for assessing the effectiveness of a two-way interactive distance learning system. ERIC, ED 322690. McKissack, C. E. (1997). A comparative study of grade point average (GPA) between the students in traditional classroom setting and the distance learning classroom setting in selected colleges and universities. (Doctoral Dissertation, Tennessee State University, 1997).

References: Bartlett, T. (1997). The hottest campus on the Internet. Business Week, 3549, 77-80. Bothun, G. D. (1998). Distance education: Effective learning or content-free credits? Cause/Effect, 21(2), 28-31, 36-37. Fitzpatrick, R. (2001). Is distance education better than the traditional classroom? Retrieved July 31, 2001.

Mortensen, M. H. (1995). An assessment of lear ning outcomes of student s taught a competency-based computer course in an electronically-expanded classroom (distance education). (Doctoral Dissertation, University of North Texas, 1995).

Fox, J. (1998). Distance Education: is it good enough? The University Concourse, 3(4), 3-5. Freeman, V. S. (1995). Delivery methods, learning styles and outcomes for distance medical technology students. (Doctoral Dissertation, University of NebraskaLincoln, 1993).

Schutte, J. G. (1996). Virtual teaching in higher education: The new intellectual superhighway or just another traffic jam? Sherry, L. & Morse R. A. (1995). An assessment of training needs in the use of distance education for instruction. International Journal of Telecommunications,1 (1), 5-22.

Gubernick, L., & Ebeling, A. (1997). I got my degree through e-mail. Forbes, 159(12), 84-92. Heines, R. A., & Hulse, D. B. (1996). Twoway interactive television: An emerging technology for university level business

Souder, W. (1993). “The Effectiveness of Traditional Verses Satellite Delivery in Three Management Technology Master’s Degree Programs.” The American Journal of Distance Education. 7. 37-53.

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Journal of Disability Management and Special Education ISSN: 2229-5143

Phonological Awareness: A Comparison between Children with Learning Disability and Poor Academic Performance * Akshatha S, **Deepthi M. & *** Narasimhan S.V.

Abstract The present study aimed at comparing the performance of phonological awareness in children with poor academic performance and children with learning disability across grade one to grade six. A total of 24 participants in the study were divided into three groups. Group 1 consisted of eight students with normal academic performance, group 2 consisted of eight children with poor academic performance, and group 3 had eight children who were previously diagnosed as learning disabled by a qualified psychologist /speech language pathologist. A Test of Learning Disability in Kannada was used to assess the phonological awareness in the above mentioned three groups. The test has 7 subtests which includes, phoneme oddity, phoneme stripping, syllable oddity, syllable stripping, rhyme recognition, clusters and blending. The words were presented orally by the investigator to the subjects. The subjects were instructed and were scored as per the test material. Paired sample t-test was done to compare the phonological awareness between the three groups and the results indicated that group 1 obtained the higher score followed by children with poor academic performance. And children with learning disability obtained the least score. The results also revealed significant difference between the three groups for all the tasks included except for the syllable oddity and final task. Further research should be carried out on aspects of phonological awareness between poor academic performers and children with learning disability and this could further strengthen the results of the present study and also be useful for the differential diagnosis of children with poor academic performance and children with learning disability. Key terms: Phonological Awareness, Learning Disability, Poor Academic Performance

Introduction: â&#x20AC;&#x153;Learning disability is a generic term that refers to a heterogeneous group of disorders manifested by significant difficulties in the acquisition and use of listening, speaking, reading, writing, reasoning or mathematical abilities. These disorders are intrinsic to the individual and presumed to be due to

central nervous system dysfunction. Even though a learning disability may occur concomitantly with other handicapping conditions (e.g. sensory impairment, mental retardation, social and emotional disturbance) or environmental influences (e.g. cultural differences, insufficient or inappropriate instructions, psychogenic factor), it is not the

M.Sc (Speech and Hearing),**Lecturer, Speech-Language Pathology

Lecturer, Speech-Language Pathology, J.S.S Institute of Speech and Hearing, Ooty Road, Mysore. e-mail: narasimhanslp@gmail.com

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direct result of those conditions of influences” (Larsen et al 1981).

It has been postulated that phonological awareness and metalinguistic skills are important for development of reading skills in children (Shapley, 2001). Metalinguistic skills in learning disabled have drawn the attention of researchers and have been studied. Metalinguistic skills are the ability to think about and reflect upon the structural and functional features of language or the ability to make judgment about those structures comprising language (Ehri, 1989). According to Bryant et al., (1990) since the phonological component is involved in phonological awareness tasks and reading, limitations in creating and using phonological representations might impede discovery of the phonological structure of words and delay in mastery of an alphabetic writing system. Research shows that a general category of students with learning disabilities have problems in both reception and expression compared with normally achieving students. Hence it is important to identify language problems because many note that language problems are directly related to academic areas, particularly reading.

Children with learning disability are usually of average or above average intelligence. However, scholastic failure is one of the known signs of learning disability since these children, despite being intelligent, are unable to process information in a way that is required for good academic performance. Learning disability can impede a child’s ability to read, write or compute mathematical problems. Learning disability is different from a difficulty in learning due to visual, hearing and motor handicap, mental retardation and emotional disturbances. Other problems such as self regulatory behaviours, social perception and social interaction can coexist with learning disability but they don’t by themselves constitute learning disability. Poor academic performance or scholastic backwardness is being increasingly recognised as one of the important problems in children (Dorr et al., 1980). Several Indian school surveys in the past decade have recorded prevalence rates of poor academic achievement or repeated failure in grades that range between 20 and 50% (Venugopal and Raju, 1988). In recent times, the prevalence of specific arithmetic difficulty has also been recorded, and the rates are found to range between 1.3% and 6%. Further, specific associations have been recorded between poor academic performance and poor concentration and school absence, poor school functioning, large family size, father’s occupational status, and adverse family conditions. Interestingly, some researchers have also investigated specific aspects of scholastic backwardness such as reading retardation (Rutter et al., 1970).

The relation between phonological awareness and the ability to read has received much research concern. Vellutino & Scanlon (1987) suggested that reading is acquired in four phases which include pre alphabetic, partial alphabetic, full alphabetic and consolidated alphabetic phases. In the pre alphabetic stage children attend to distinctive visual cues. In the partial alphabetic phase children gain knowledge of some letters and sounds and uses those phonetic cues when trying to read. In the full alphabetic phase children can fully analyse the spellings of words and in the consolidated alphabetic phase which develops with reading 78

Akshatha, Deepthi, & Narasimhan / Phonological awareness in children with LD and PAP

practise, the spelling patterns are combined into “multi letter units consisting of the sounds matches”. Phonological awareness skills are important for all the 4 phases.

largely as a consequence of the orthographic learning required to read an alphabetic script. According to their psycholinguistic grain size theory, as more and more vocabulary items are acquired, the number of similar sounding words (neighborhood density) for a particular lexical entry increases, and this phonological similarity is one developmental driver for the representation of the larger grain sizes of syllable and rhyme. This effect of neighborhood density might be predicted to be particularly evident in onset/rime tasks, because it has been found that in spoken English at least, the majority of phonological neighbors (similar-sounding words) are in the same neighborhood because they rhyme. According to Ziegler & Goswami (2005), the preliterate brain may thus depend on phonological similarity in terms of onsets, vowels, and codas for lexical restructuring. The literate brain may develop fully specified phonemic representations as a consequence of orthographic learning. According to Ziegler & Goswami (2005), orthographic learning becomes a mechanism for the development of phonological awareness at the phonemic level.

According to some theories, the ability to succeed in phonological awareness tasks is related to the representational status of words in the mental lexicon (Ziegler & Goswami, 2005). For example, according to the Lexical Restructuring Model (LRM; Metsala & Walley, 1998) the development of well-specified phonological representations is a byproduct of increases in receptive vocabulary size. Early in development, phonological entries in the mental lexicon are proposed to code fairly global phonological characteristics. As more and more words are acquired, these global features are thought to become insufficient for distinguishing between the increasing numbers of similar-sounding words, necessitating the development of phonemicbased representation. According to the LRM, receptive vocabulary growth drives lexical units toward phonemic representations. Hence, words from denser neighborhoods appear to have better specified phonological representations.

Hence the research reviewed has established clearly that the students with learning disability and children with poor academic performance have deficit in phonological awareness that has suggested that, children with phonological disorders may be at risk for developing spelling difficulties, reading comprehension, literacy performance that includes spelling and a variety of reading tasks that may give rise to future reading and writing difficulties. In the recent past many studies have focussed on phonological awareness in learning disability. But limited studies have been carried in order to compare

Ziegler and Goswami (2005) suggested that words in the mental lexicon were represented at different phonological “grain sizes” during development: syllable, rhyme, and phoneme. The dominant grain sizes early in development were the larger grain sizes, corresponding to the linguistic units of syllable and onset/rime. In their psycholinguistic grain size theory, Ziegler and Goswami (2005) argued that it was necessary to add the concept of grain size to the LRM. They proposed that phonemic representation emerged 79

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the phonological awareness in children with poor academic performance and children with learning disability. In India however, very little work has gone into the understanding phonological awareness in poor academic performers and children with learning disability, despite the increasing recognition of this area as an important one, at least in clinical practice. Hence the present study aimed to compare the phonological awareness skills between the children with poor academic performance and children with learning disability across grade 1 to grade 6.

present study. Proforma B consists of 26 items seeking behavioural and emotional problems shown at school, to be rated on a three-step response scale of 2, 1 and 0 for ‘certainly applies’, ‘applies somewhat’ and ‘doesn’t apply’ respectively. A total score of 9 or more was considered to show evidence of some disorder, as suggested by Rutter (1967). Group 3 consisted of 8 children who were diagnosed as learning disability by a qualified psychologist and speech language pathologist. Multi Group Cross Sectional Comparative Design was used in the present study.

Method Participants: A total of 24 native Kannada speaking children within the age range of 6 to 12 years were selected for the study and were divided into 3 groups. Group 1 consisted of 8 students with normal academic performance selected on the basis of academic details obtained from the class teacher. Group 2 consisted of 8 students with poor academic performance. The Children’s Behaviour Questionnaire (Rutter, 1967) or CBQ was used in order to rule out the learning disability component in this group. The CBQ is designed to be used as a screening instrument to be completed by teachers for purposes of screening the ‘disturbed’ from the ‘non disturbed’ children in a school setting. The CBQ consists of proforma A and B. Proforma A has 9 items those seek information about educational performance, consistency in academic work, attendance, sports, reading and writing difficulties, nicknames, physical handicaps and teacher’s opinion about the need for psychological help. One item dealing with arithmetic difficulty was added to this proforma by the investigator in the

Parent of each participant was asked whether they would allow their child to participate in the research study. The first eight participants under each group who agreed to participate constitute the pool of participants. Each parent signed the Free and Informed Consent Form agreeing their child’s participation in the study and to the dissemination of results. All participants were in generally good health and ruled out hearing impairment through informal hearing screening, Mental retardation through Seguin Form Board, learning disability by assessing skills like decoding, gist comprehension, reading and reversals, informally and considering those children who are academically poor in languages irrespective of poor performance in other subjects. Materials: ‘A Test of Learning Disability in Kannada’ – Standardised test material to assess Learning Disability (Deepthi, 2009) was chosen as this test was standardised on the same population considered in the present study. The test contains seven subtests which include two proformae, visual discrimination tasks, reading, writing, arithmetic (addition, 80

Akshatha, Deepthi, & Narasimhan / Phonological awareness in children with LD and PAP

subtraction, multiplication and division), reading comprehension and phonological awareness tasks. As the present study focused only on phonological awareness skills, only a part of this test, i.e., the section for assessing phonological awareness skills was chosen. This section consisted of seven subsections i.e. Phoneme Oddity, Phoneme Stripping, Syllable Oddity, Syllable Stripping, Rhyme Recognition, Clusters and Blending (appendix 1).

multisyllabic words. The instructions were repeated to the subjects who could not follow instructions when given once. This was followed for all the tasks. Procedure: All data were obtained at Speech Science Lab at JSS Institute of speech and hearing, which exhibits nominal ambient room noise. Present in the room were the participant and the primary examiner (in all cases, the first author). The subjects were seated comfortably on a chair opposite to the investigator across the table and later rapport was built by speaking with the subjects, in order to get the co-operation. The test was carried out in a single sitting and the time consumed was around one hour per participant. Further, the responses given by the subjects were noted by the investigator in the response sheet. The

Instructions: The words were presented orally by the investigator to the subjects. The subjects were instructed as per the test material. Specific instructions were given to the subjects regarding each task. A practice trial was given prior to the test administration. In each section words were arranged in the increasing order of complexity that is from bisyllabic to

Fig 1: Mean scores for phonological awareness tasks between students with LD, PAP and normal academic performance

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scoring of the response was done according to the instructions given in the test material, i.e., each correct response received a score of one and no score for an incorrect response. These responses were collected and calculated from all the three groups and paired sample t test was done as a part of statistical analysis between all the three groups to find out the significant difference between each of the groups across all the eight tasks using SPSS (version 17.0)

Results The scores that were obtained were subjected to the statistical analysis. Mean and standard deviation values were extracted. Pair sample t-test was administered in order to find out the significant difference in performance of phonological awareness tasks between normals, children with poor academic performance, and children with learning disability.

Table 1: Mean scores, Standard Deviation and signiď&#x20AC; cance for Phonological Awareness Tasks between normals, children with poor academic performance and children with learning disability. NORMAL

PAP

MEAN (SD)

NORMALS VS PAP

PAP VS LD

LD VS NORMALS

Phoneme Oddity(Initial)

13.5 (1.9)

9.6 (0.5)

8.3 (2.3)

T = 5.5 P < 0.05

T = 1.1 P < 0.05

T = 3.0 P < 0.05

Phoneme Oddity (Final)

13.2 (1.9)

7.7 (1.5)

7.1 (3.9)

T = 11.0 P < 0.05

T = 0.09 P < 0.05

T = 3.6 P < 0.05

Phoneme Stripping

11.6 (4.6)

5.1 (1.2)

2.0 (1.8)

T = 4.1 P < 0.05

T = 4.3 P < 0.05

T = 3.5 P < 0.05

Syllable Oddity(Initial)

14.3 (1.4)

7.8 (1.6)

5.0 (1.8)

T = 6.0 P < 0.05

T = 1.9 P < 0.05

T = 8.7 P < 0.05

Syllable Oddity (Final)

13.1 (0.9)

8.3 (3.0)

5.1 (3.6)

T = 5.3 P < 0.05

T = 1.6 P > 0.05

T = 6.4 P < 0.05

Syllable Stripping

14.5 (1.4)

6.8 (2.1)

4.6 (5.9)

T = 14.3 P < 0.05

T = 0.8 P < 0.05

T = 4.2 P < 0.05

Rhyme Recognition

13.7 (1.2)

10.1 (3.2)

6.6 (5.8)

T = 2.8 P < 0.05

T = .9 P < 0.05

T = 3.6 P < 0.05

Clusters

14.5 (0.5)

3.1 (1.3 )

1.8 (1.6)

T = 27.0 P < 0.05

T = 1.3 P < 0.05

T = 19.0 P < 0.05

Blending

13.3 (1.8)

3.8 (2.1)

2.1 (1.9)

t = 16.7 p < 0.05

t = 0.9 p > 0.05

t = 10.6 p < 0.05

TASKS

SIGNIFICANCE

Akshatha, Deepthi, & Narasimhan / Phonological awareness in children with LD and PAP

It is clear from the figure 1 and table 1 that for all the 9 tasks, group 1 had the highest score followed by children with poor academic performance. Children with learning disability had the least score. It is evident that, there is significant difference (p < 0.05) in scores for all the tasks between normals, children with poor academic performance and children with learning disability. But there was no significant differences seen between children with poor academic performance and children with learning disability for the syllable oddity final task.

scores for Initial Syllable Oddity were better than Final Syllable Oddity. This can be attributed to the complexity of the task which is acquired later when compared to the other task. Hence this acts as a contributing factor for obtaining no significant difference between children with poor academic performance and children with learning disability. As evidenced from table 1 normals do perform better in phoneme oddity (initial) task when compared to phoneme oddity (final) task. Hence it is in consonance with those studies reported by Stanovich, Cunningham and Cromes (1984). It states that initial phonemes are easier for the children to segment than the final phonemes.

Discussion The present study sought to examine if there was any significant difference for phonological awareness tasks which included phoneme oddity (initial and final), phoneme stripping, syllable oddity (initial and final), syllable stripping, rhyme recognition, clusters and blending between normals, children with poor academic performance and children with learning disability. As a part of statistical analysis the performance between the 3 groups was examined using paired sample T test. Significant difference (p< 0.05) was found in all the three groups for all the 8 tasks between normals, children with poor academic performance and children with learning disability. But there was no significant differences seen between children with poor academic performance and children with learning disability for the syllable oddity final task. In the syllable oddity task, the scores were lower for final task in all the 3 groups when compared to the initial task. This is in accordance to Liberman et al (1974), who reported that, between the Initial Syllable Oddity and Final Syllable Oddity task, the

The present study is in consonance with the study done by Van Kleeck (1982) who stated that the mean scores for phoneme stripping task in children with learning disability were less when compared to normal children. According to Van Kleeck (1982), it may also be speculated that children with learning disability have difficulty in phoneme deleting (stripping) which is meta phonological skill which is essential in coding information phonetically and in understanding printed words. The present study also revealed poor meta phonological skills in children with learning disability. Hence poor metaphonological skill can be one of the factors for impaired development of reading and writing difficulties. The results revealed that children with learning disability have scored least in syllable stripping task. The result obtained are in accordance to Wagner & Torgesen (1987) who states that children with learning disability have difficulty in syllable deleting (stripping) 83

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which is metaphonological skill which is essential in coding information phonetically and in understanding printed words. Several researchers have also stated that syllable deleting (stripping) is one among the task which is highly related to word identification skills.

Conclusion Results revealed that for all 9 tasks, normals had the highest score followed by children with poor academic performance. Children with learning disability had the least score. And results also revealed that there was significant difference between normals, children with poor academic performance and children with learning disability. But for syllable oddity (final) task, there was no significant difference between children with poor academic performance and children with learning disability. The reason for these changes can be attributed to the possible consequences of poor metalinguistic skills both in children with poor academic performance and children with learning disability. The study was carried on the grounds that, phonological awareness skills are a foundation stone for the academic skills. The data obtained will foster the understanding about the phonological awareness. Further research can be done regarding the phonological awareness between poor academic performers and children with learning disability across different grades and languages. It will be a useful tool in the differential diagnosis of children with poor academic performance and children with learning disability.

Children with learning disability performed poorly in the rhyme recognition task when compared to normals, followed by children with poor academic performance which is supported by the studies given by Karanth and Prakash (1996) who stated that rhyme recognition is more associated with syllable awareness skills which in turn are associated with reading disability. And the scores of children with poor academic performance is also lower when compared to children with learning disability, which is in accordance with the study done by Hoffman (2000). They have stated that rhyme comprehension and production is poor in academically poor children. Hence rhyme recognition can be one of the early indicators for developing reading difficulties as rhyme recognition ability develops as 2 years 8 months as reported by Van Kleeck (1982). The results showed that children with learning disability have problem with alliteration (cluster) which is one of the requisite in the development of reading. This can be accounted as one of the cause of developmental difficulties in reading. In tasks such as segmentation, clusters and blending greatest difference was observed indicating a significant problem in these tasks among the academically poor children with that of children with learning disability.

References Bryant, P. E., MacLean, M., Bradley, L., & Crosland, J. (1990). Rhyme, alliteration, phoneme detection, and learning to read. Developmental Psychology, 26, 429â&#x20AC;&#x201C;438 Deepthi, M. (2009). â&#x20AC;&#x2DC;A Test of Learning Disability in Kannadaâ&#x20AC;&#x2122;. A unpublished dissertation submitted as a partial fulfillment of Master degree to University of Mysore, Mysore. 84

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Dorr, D., Stephens, J., Pozner, R. & Klodt, W. (1980). The use of the AML scale to identify adjustment problems in fourth fifth -, and sixth grade children, American Journal of Community Psychology, 8, 341-352

preliminary findings. Journal of Child Psychology and Psychiatry, 8, 1-11. Rutter, M., Tizard, J. & Whitmore, K. (l970). Education, health and behaviour. London: Longmans. Shapley (2001). A newspaper in education teaching supplement for reading first no child left behind act of 2001. Newspaper Association of America Foundation.

Ehri, L. C. (1989). The development of spelling knowledge and its role in reading Acquisition and reading disabilities, Journal of Learning Disabilities, 22 (6), 356

Stanovich, K, E, Cunningham, A, E, & Feeman, D, J, (1984). Intelligence, cognitive skills, and early reading progress, Reading Research Quarterly, 19, 278-3

Hoffmann, C. (2000). Bilingual and trilingual competence: Problems of description a nd dif f ere nt ia tio n. Est udi os de Sociolinguistics, 1, 83-92.

Vellutino, F. R., & Scanlon, D. (1987). Phonological coding, phonological awareness, and reading ability: Evidence from a longitudinal and experimental study. Merrill-Palmer Quarterly, 33, 321-363.

Karanth, P. & Prakash, P. (1996). A developmental investigation of onset, progress and stages in the acquisition of literacy; Project funded by NCERT, India. Larsen, S.C., Hammill. D.D., Leigh. J.E & Gaye Mc Nutt. (1981).A new definition of learning disabilities, Learning Disability Quarterly.4(4) 336-342.

Venugopal, M. & Raju, P. (1988). A study on the learning disabilities among IVand V standard children, Indian Journal of Psychological Medicine, 11, 119-123.

Liberman, I.Y., Shankweiler, D., Fischer, F.W. & Carter, B. (1974). Explicit syllable and phoneme segmentation in young children, Journal of Experimental Child Psychology, 18, 201-212.

Van Kleeck, A. (1982). The emergence of linguistic awareness: A cognitive framework. Merrill-Palmer Quarterly, 28 (2), 237-266.

Metsala, J.L., & Walley, A.C. (1998). Spoken vocabulary growth and the segmental restructuring of lexical representations: Precursors to phonemic awareness and early reading ability, In J.L. Metsala & L.C. Ehri (Eds.), Word recognition in beginning literacy (pp. 89– 120). Mahwah, NJ: L awrence Erlbaum Associates.

Wagner, R.K., & Torgesen, J.K. (1987). The nature of phonological processing and its causal role in the acquisition of reading skill, Psychological Bulletin, 101, 192–212. Ziegler, J. C., & Goswami, U. C. (2005). Reading acquisition, developmental dyslexia and skilled reading across languages: A psycholinguistic grain size theory. Psychological Bulletin, 131, 3–29.

Rutter, M. (1967). A children’s behaviour questionnaire for completion by teachers: 85

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APPENDIX 1

set consisted of four words, of which three of them end with same syllable and one word end with different syllable. The subjects would be instructed to listen to the words and to choose the one which did not belong to the set.

Phoneme Oddity (Initial): The test material consisted of fifteen set of words. Each set consisted of four words, of which three of them begin with same sound (phoneme) and one word begin with different sound (phoneme) and this word with different phoneme should be identified by the client.

Syllable Stripping: This section consisted of fifteen words. The words were arranged in the increasing order of complexity i.e. from bisyllabic to multisyllabic words. The subjects would be asked to listen to the word carefully and they would be instructed to strip (delete) a particular syllable from the word and say the rest of the word.

Phoneme Oddity (Final): The test material consisted of fifteen set of words. Each set consisted of four words, of which three of them end with same sound (phoneme) and one word end with different sound (phoneme) and this word with different phoneme should be identified by the client.

Rhyme Recognition: This section consisted of fifteen pair of words, both rhyming and non rhyming. Subject was instructed to identify whether the paired words were rhyming or not.

Phoneme Stripping: This section consisted of fifteen words. The subjects would be asked to listen to the word carefully and they would be instructed to strip (delete) a particular sound from the word and say the rest of the word.

Clusters: This section consisted of fifteen words. The words were arranged in the order of complexity i.e. bisyllabic to multisyllabic. Subjects were instructed to identify the cluster in the presented word and then were asked to simplify the cluster by naming the sounds which constituted the clusters.

Syllable Oddity (Initial): The test material consisted of fifteen set of words. Each set consisted of four words, of which three of them begin with same syllable and one word begin with different syllable. The subjects would be instructed to listen to the words and to choose the one which did not belong to the set.

Blending: This section consisted of fifteen pair of phonemes. The pair of phonemes was read aloud by the investigator and the subjects were instructed to combine the two sounds to make a cluster orally.

Syllable Oddity (Final): The test material consisted of fifteen set of words. Each

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Disability - Bane or Boon: A Spiritual Perspective *Swami Anuragananda

Scientists are generally sympathetic, if not agreeable, to psychological theories of yoga as long as these are individual specific. The real opposition is mainly due to the cosmic dimension, the Karmasaya of the yogis. According to holistic worldview postulated by the yogis, all our little minds are part of a cosmic mind. All powers of clairvoyance, clairaudience, etc., which people ignorantly believe as miracles, are the natural outcome of this fact. This connection is always there in every one of us but is suppressed by our heightened sense of being individuals. Our inability to get connected to this cosmic source of knowledge in conscious state does not deny its existence just as non perception of stars in the day does not amount to its non existence. The yogis claim that it is possible to consciously acquire this ability provided we reduce our

preoccupation with our little selves, i.e. being Mr/Ms so and so. The access to the universal mind is, so to say, trapped under the door of our body-consciousness. By cultivation specific mental and moral disciplines, yogis transcend this barrier and gain access to universal mind. Is this claim of interconnectivity between minds too farfetched in view of recent advances in modern sciences? We donâ&#x20AC;&#x2122;t think so. There is a tremendous revival happening in the scientific circles, about the possibility of survival of individual personality after death and existance before birth. In fact, it can be safely surmised, at least in the field of psychology, that the greatest breakthrough in modern times is the acceptance, implicit or implied, of religious psychology of the ancients. The Freudian school that can justly claim to

* Asst. Administrative Head, FDMSE, RKMVU, Coimbatore

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have paved the way for modern psychology, and was very active in the earlier part of the 20th century, gave way to many subsequent developments in psychology, mainly the school of thought known as behaviourism. In turn, behaviouristic school is being replaced by the Humanistic School postulating a holistic view of life. It is matter of time before the Humanistic Psychology will become the major, dominant force.

professors of his time in America and Europe. We give below the gist of the theory as stated by Swami Vivekananda because it forms the basis of cosmic mind of the yogis: “The whole universe is composed of two materials, one of which they call Akasha. It is the omnipresent, all penetrating existence. Everything that has form, everything that is the result of combination, is evolved out of this Akasha. It is the Akasha that becomes the air, that becomes the liquids, that becomes the solids; it is the Akasha that becomes the sun, the earth, the moon, the stars, the comets; it is the Akasha that becomes the human body, the animal body, the plants, every form that we see, everything that can be sensed, everything that exists. It cannot be perceived; it is so subtle that it is beyond all ordinary perception; it can only be seen when it has become gross, has taken form. At the beginning of creation there is only this Akasha. At the end of the cycle the solids, the liquids, and the gases all melt into the Akasha again, and the next creation similarly proceeds out of this Akasha.

Eminent scientists, biologists, botanists, cosmologists, physicists, acknowledge that we are living in an inter-connected world. Quantum physicist asserts that observer affects his observations by mere act of observing. Medical researches acknowledge that the mental phenomenon can no longer be confined to once sacrosanct confines in the cerebrum for it has attained cosmic dimensions. Study of behaviour of animals, plants, and almost every field of scientific investigation worth the name, lend support to this claim of the yogis. Our cosmos is alive, interconnected and interdependent at physical and mental planes of existence. In fact the so called “String Theory” being tested by the physicists to verify the God’s own particle is a theory of an all-pervasive ether-like force-field. The physicists believe that this theory has the potential to realize the elusive Unified Field Theory of the physicist. It is interesting to note the similarities between the modern theories of creation with that of the ancient.

By what power is this Akasha manufactured into this universe? By the power of Prana. Just as Akasha is the infinite, omnipresent material of this universe, so is this Prana the infinite, omnipresent manifesting power of this universe. At the beginning and at the end of a cycle everything becomes Akasha, and all the forces that are in the universe resolve back into the Prana; in the next cycle, out of this Prana is evolved everything that we call energy,

In 1895, Swami Vivekananda wrote about this theory of creation of ancient India in his famous book ‘Rajayoga’, while introducing yogic psychology to the western world for the first time. This immediately caught the attention of many scientists and university 88

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everything that we call force. It is the Prana that is manifesting as motion; it is the Prana that is manifesting as gravitation, as magnetism. It is the Prana that is manifesting as the actions of the body, as the nerve currents, as thought force. From thought down to the lowest force, everything is but the manifestation of Prana. The sum total of all forces in the universe, mental or physical, when resolved back to their original state, is called Prana. “When there was neither aught nor naught, when darkness was covering darkness, what existed then? That Akasha existed without motion.” The physical motion of the Prana was stopped, but it existed all the same.”

What happened afterwards is not known. But it is improbable that he tried it seriously because an understanding and possibility of interchangeability of force and matter is a prerequisite. Whereas, it is matter of recorded history that in later life Tesla is known to have reservations to Einstein’s contention that mass and energy are interchangeable. Hence, it is reasonable to surmise that Tesla also had reservations about the ancient theory of creation notwithstanding his fascination. But then what an opportunity he missed. For within a decade of this publication, Einstein made the ground breaking theories that shook the scientific world providing interchangeability of matter and force. Einstein in turn suffered a similar fate in opposing the radical theories of a young scientist named Heisenberg in later years. Years later, in the light of new perspective about the nature of matter and holistic nature of reality as formulated by Einstein and Heisenberg, Tesla acknowledged the infinite possibility the ancient Indian theory holds for mankind. So, forty years after knowing Swami Vivekananda, Tesla wrote that “Long ago [Man] recognized that all perceptible matter comes from a primary substance, or a tenuity beyond conception, filling all space, the Akasha or luminiferous ether, which is acted upon by the life - giving Prana or creative force, calling into existence, in never ending cycles, all things and phenomena. The primary substance, thrown into infinitesimal whirls of prodigious velocity, becomes gross matter; the force subsiding, the motion ceases and matter disappears, reverting to the primary substance.

“At the end of a cycle the energies now displayed in the universe quiet down and become potential. At the beginning of the next cycle they start up, strike upon the Akasha, and out of the Akasha evolve these various forms, and as the Akasha changes, this Prana changes also into all these manifestations of energy.” The great scientist Nikola Tesla, whose extraordinary genius is not commensurate with his fame, was one of those who were fascinated by this theory. Tesla is best remembered for the polyphase alternating dynamos he invented providing the western civilization with, cheap and affordable power. He was a true scientist who combined a rare ability to formulate abstruse theoretical models and had the ability to transform these into saleable products. When he met Swami Vivekananda, he was in prime of his fame and prosperity. Impressed by the theory, Tesla volunteered to demonstrate this concept mathematically.

Can Man control this grandest, most awe - inspiring of all processes in nature?... If he could do this, he would have powers almost 89

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unlimited and supernatural.... He could cause planets to collide and produce his suns and stars, his heat and light. He could originate and develop life in all its infinite forms. (Such powers] would place him beside, his Creator, make him fulfill his ultimate destiny”.

hundred recordings of past lives of individuals he supplied under the heading ‘Life Readings’. On whatever subject he spoke in hypnosis, he exhibited a masterly knowledge of that subject, though in waking state he was an ordinary man with very ordinary literary credentials. What was the source of Cayce’s inexhaustible reservoir of knowledge? He himself supplied the answer stating that there are two sources of information available to him in hypnosis. The first source he said is the unconscious mind of individuals seeking information from Cayce. That the unconscious retain the memory of past events is acknowledged by the modern psychologists, though most of them restrict its depth only to one life span. According to Cayce, the unconscious stores memory of past lives besides that of the present. However, the information from this source is not always reliable was the opinion of Cayce, because individuals retain the ability to tamper information if it is deemed embarrassing or uncomfortable.

Luminiferous ether may not be popular with scientists belonging to classical Newtonian physics in recent past. But modern cosmological theories based on quantum mechanics work on a possibility of an ether pervading the interstaller space. In fact the ‘String Theory’ is a theory that may well prove the ancient’s right in their conclusions. This veering round to Truth, ancient or modern, is in the interest of humanity. We must remember that “Truth never pays homage to societies and civilizations, it is they that must pay homage to Truth or perish.” But unknown to the scientists, the great American Psychic, Edgar Cayce (1877-1945), validated the creation theory of yogis under entirely different circumstances. During his brief life span, Cayce was to pour out astonishingly varied information covering almost every subject worth the name. He left behind more than 14,000 documented records and related correspondence with his patients. Most of these documented texts, now onwards called readings in line with the Cayce tradition, were given to help people seeking diagnoses of their mental and physical sufferings under hypnosis. These records were stenographically recorded and preserved in the archives of the Edger Cayce Foundation that came into existence after his demise in Virginia, USA. Apart from this data that mostly dealt with physical suffering, hence the name ‘Physical Readings’, Cayce is better known for the two thousand five

The famous patient Catherine is well known to readers of the best selling classic “Many Lives, Many Masters”. Her past life memories were inadvertently recalled by an open-ended, non directional suggestion during hypnosis by the author Dr Brain Weiss. During her first sitting, she recalled her past three lives one of which was lived in Spain. Dr Brain noted that she suppressed the information that in this life her profession was prostitution. Whereas, the second source of Cayce’s information could not be tampered by individual minds as the records can be accessed only after transcending the barriers of individuality. He called this memory as 90

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“Akashic Records”. As per Cayce the ‘Akasha’ is the basic material of the universe that retains the record of every activity, including thought, since the beginning of time. If a person can transcend his individual consciousness, this “Universal Memory of Nature” or the “Book of Life,” alternative epithets given to Akashic Records by Cayce, opens its secrets to all minds.

eastern theory unknowingly to himself and his associates. So all mental activities are actions of prana, and, that being so, the ethereal Akasa preserves these actions producing an individual specific and a cosmic effect known to yogis as samskara and karmasaya, as stated earlier. Abilities and disabilities according to theory of reincarnation: A stenographer typing at terrific speed is complimented, as ‘experienced’. But when it comes to children born with talents, otherwise difficult to acquire even in a lifespan, why do we hesitate in passing similar compliments? Indian logician talk of “smoke-fire logic”; if there is smoke, it is a proof that there is fire. This inference is equally true of all our talents. If the baby is talented, it is so because there is an experience to account for the talent. Dr. K. Anders Ericsson, professor of psychology at Florida State University, is of the opinion that people need 10,000 hours learning to internalize and perfect their crafts. May be that is why it is said that success is 99% perspiration and 1% inspiration. However, not everyone agrees with the Professor. There are many researchers who conclude that talent is in-born and not as postulated by the learned professor. Else how do you explain child prodigy like mandolin Shrinivas and others of his ink who cannot be fitted under this category? The suffix mandolin is complimentary surname, a reminder to the fact that Mr Srinivasa was born with this ability; nature not nurture to begin with. One day, when he was only six years old, he surprised his parents by playing on his father’s mandolin. Mozart is another prodigy well known to history, learnt to play piano at the age of four, composed his first pieces at five and

It is a recorded fact in Cayce’s biographies that he was brought up in a conservative Christian tradition completely ignorant of eastern religious belief. So when he started pouring out data validating many concepts that are parts of eastern religious thought, he sufferred a period of self-doubt and selfexamination. Cayce seriously thought that he was being possessed by the devil during hypnosis otherwise why he should validate concepts totally alien to his religion? Is this not pagan belief, he pondered? The idea repelled Cayce. He came to terms with it only after a long process of dialogue with his well-wishers and gaining an understanding of hitherto unknown passages in the Bible that indicate that early Christian fathers did believed in reincarnation before the church labed it as heretical. In fact, he realized that many sayings in the Gospel become greately illuminating only if these are supported by an understanding of reincarnation principle. It is also interesting to note that the mental imaginary experienced by Cayce in accessing the “Akashic Records” parallels characterization of mythical person named Chitragupta, the recorder of human deeds described in the book of ancient Indian lore, the Puranas!. So when Cayce spoke of “Akashic Records”, he also validated another 91

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at eight was an accomplice master. Moreover, there are many cases of children exhibiting Xenogloosy (speaking in foriegn language) or Xenography (writing in foriegn language). Prof. Adrain Finkestein, psychiatrist and famous author of “Your Past Lives and Healing Process” recorded the true story of a boy who often spoke a completely different language which his mother could not understand. After listening to the boy for some time, a professor of Asian Languages discovered that the boy was speaking a dialect spoken in the northern region of Tibet. On further enquiry it was found that the boy was drawing on his memory of past life in a Tibetan Monastery. Impressed by the vivid description of the past life incidents, the professor undertook a long journey to Tibet and found the monastery in Kuen Lun Mountains.

maintain that as long as we are sense bound, we will be unable to manifest our true potential. But why then an individual is born with disabilities or abnormalities that only increase the limitation of his senses? A careful study of literature related to working of reincarnation principle, and we will lean heavily on Cayce database in subsequent narration, it is abundantly clear that there are many varied reasons that causes disabilities of equally varied type. A sure sign of karmic roots of any disability is the stubborn tendency to persist in spite of proven standard therapeutic procedures failing to show expected results. Root cause being psychic, the treatment on physical plane does not prove effective. For the sake of easy comprehension, we have categorized karma rooted disabilities under three broad headings as discussed below:

Reincarnation school believe that talents are based on both nurture and nature. There is no dichotomy between the two because nature is solidified nurture; it is involved will. Moreover, these are not of paramount importance from yogic view of life. If being a child prodigy means being selfish and selfcentred, then it is better to be plain and ordinary but caring human beings. This is so because, unlike in animal kingdom, man is honoured and respected for having love, compassion and concern for others than acquisition of skills whatever be its nature and quality.

I: Karma of Classical Punitive type: “When the experience (of a life) is used for self-indulgence, self aggrandizement, or self-exaltation, the entity does so to its own undoing, and creates for itself that which has been called karma and which must be met” ... Edgar Cayce. The most well-known type of karmic rooted disability is the punitive type. It is this type of karma which is deemed barbaric, fatalistic, because of faulty understanding. When an individual perform deeds overtly selfish, taking undue advantage of power, place and circumstances, it produces a punitive karmic debt in psychological realm. Such negative karma can only be compensated by corresponding corrective experience in another life. It is a well known fact that we learn from

Disabilities from the point of view of Reincarnation school: The very fact that we are born with a sensory system that distorts our perception, has a limited range of operation, is to acknowledge that all humans are born disabled by default to some degree. All Indian religious traditions 92

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adversities more than from experiences without it. Somewhat analogous with this principle, individuals perform corrective psychological deeds when faced with disabilities. Cayce files abound with such cases. Without going into detailed past life histories, operating principles involved in a few cases are listed below:

change in speech and action” combined with “application of material things suggested” there will be improvement. The body is built by what it eats and mind by what it thinks. By being good to others we do good to ourselves and by hating others we cause injury to ourself. The necessity of cultivating healthy attitudes is evident in the case cited above. Indian traditions also maintain that, if good or bad deeds are very intense, the individual will get the karmic retribution in this life itself. The Gospel of Sri Ramakrishna records a similar incident:

A patient who suffered from a severe case of asthma was admonished by Cayce; “you cannot press the life out of others without seeming at times to have it pressed out of oneself”. A deaf person was told “then do not close your ears again to those who plead for aid”. A case of tuberculosis was made to understand that “the entity thwarted others and is meeting it now in himself.” The quintessence of karmic retribution and need for corresponding corrective compensation is brought out neatly in the case of a 34 yrs old electrician who was afflicted with Multiple Sclerosis. The gentlemen in question was unable to work, too blind to read or write and he fell when attempted to walk. His situation was diagnosed as karmic and Cayce exhorted him to change his mental outlook and eliminate “all hatred and malice from his consciousness” besides applying physical remedies suggested. But the individual applied the physical part of the treatment ignoring the spiritual. After initial improvement, the electrician experienced a relapse and requested another reading. This time Cayce reprimanded him: “So long as mechanical things were applied for physical correction, improvements were seen. But when the entity becomes so self-satisfied, so self-centred, as to refuse spiritual things, and does not change its attitude, there cannot be any healing. If there is a change in mind and purpose, and if the entity expresses the

MASTER: “I used frequently to visit a certain house at Kamarpukur (native place of Sri Ramakrishna). The boys of the family were of my age. The other day they came here and spent two or three days with me. Their mother, like Hazra, used to hate people. Then something happened to her foot, and gangrene set in. On account of the foul smell, no one could enter her room. I told the incident to Hazra and asked him not to hate anyone.” Lest one is confused and attribute all causes of disabilities to karmic origin, we mention two cases from Cayce files, among many, where the causes were attributed to purely physical conditions. A girl who developed depression was explained that a wisdom tooth had impacted itself in a manner which affected certain nerves leading to her brain. He was right and the girl made a swift, full recovery by appropriate surgery that released the pressure on nerves. Another case is of a man who suffering from manic depression psychosis and had to be admitted to a mental institute. Cayce diagnosed his condition arising from spinal derangement 93

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in coccyx area due to an accident. As per the directions given in the Cayce readings, the patient was given osteopathic adjustments & electrical treatment. Within six months he was declared normal.

and sufferings. The Lord appreciated her for having grasped the essentials of life. A man came to Cayce having lost his leg. He was told that this experience is for his “better unfoldment. Not in payment of something, but that you may know the Truth that might set you free”. A 34-year-old woman whose sister was diagnosed as afflicted with progressive muscular dystrophy was made to understand that her situation arose from a prenatal condition, but Cayce added, “yet not that which might be called the sin of the fathers, nor of the entity itself, but rather that through which patience and consistency might be the lesson for the entity in this experience”.

Not all disabilities are of karmic origin. Having said so, we continue with our analysis of disabilities/abnormal behaviour having karmic origin. II: Karma of choice: “Know that in whatever state you find yourself - of body, of mind, of physical condition - that is what you have built and necessary for your unfoldment” ... Edgar Cayce

A young man who had many autistic features was exhibiting repetitious, involuntary movements and antisocial behaviours. The parents were at their wits end and occasionally resorted to harsh and crude means to restrain him. A reading from Cayce brought forth the following conversation:

Bible contains the following conversation between Jesus and his disciples about a blind man and cause of his blindness: “Master, who did sin, this man or his parents, that he was born blind?” Jesus, “Neither hath this man sinned, nor his parents; but that the works of God should be made manifest in him”.

Parent: What is the reason for, and what can be done for the habit reaction he has; such as the spitting, drawing of the mouth down, and waving of the fingers before his nose and mouth?

This represents another class of karmic related disability; the karma of choice. Here the disability is a choice and not a retribution because individuals have chosen to learn patience and consistency in this rather difficult manner. Kunti Devi was mother of the Pandava heros in the great epic Mahabharata. There seems to be no end to her sorrows and sufferings throughout the epic. Once it so transpired that, being pleased with her, Lord Krishna wanted her to ask a boon. To the great surprise of all, she preferred to have sorrows

Cayce: These, as indicated, are reflexes through the sensory nerve system; lack of coordination between impulses and the guided or directed forces in the mental reactions of same. Keep up the applications indicated for corrections, making the suggestions - and not attempting to control by violent means! Parent: Would you advise scolding or hitting him, when he is so uncontrollable? or what method would you advise? 94

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Cayce: Patience, kindness, gentleness, ever; not in that of scolding or tormenting at all. But in cajoling, and in kindness and in patience, these are the manners. Remember, these conditions are for purposes. While they become very trying to the individuals who attempt to administer to the needs of the body, know that these are purposeful in thine own experience also.

Many Masters”. If today he is known as the pioneer in promoting a better understanding of parapsychology in western world and in scientific circles, it is mainly due to a message from his dead father through Catherine, divulging details of his personal life that he knew she had no way of knowing. One of the information was related to his child who died young due to heart ailment of rare type. Dr Brain wrote that “Greatest tragedy in my life had been the unexpected death of our firstborn son, Adam, who was only twenty three days old when he died early in 1971. Heroic open heart surgery could not save Adam, who died several days later. We mourned for months. At the time of death, I had been wavering about my earlier choice of psychiatry as career. After Adams death, I firmly decided that I would make psychiatry my profession. I was angry with modern medicine, with all of its advanced skill and technology, could not save my son”. The epoch making episode of Catherine’s transmitting message to Dr Brain’s from his deceased father also contained the revelation about his firstborn son Adam that “He made a great sacrifice for you out of his love. His soul is very advanced ... his death satisfied his parent’s debts. Also he wanted to show you that medicine could only go so far, that its scope is very limited.” If Dr Brain thought that the death of his dear child was the greatest tragedy of his life, he was greatly comforted to know, from Catherine, that this was premeditated death by his son. Without the sacrifice of his son, Dr. Brain would have remained, in his own words, “left-brained, obsessive-compulsive, and completely skeptical of ‘unscientific’ field such as parapsychology”.

III: Inspirational Karma: “When an entity has prepared itself through constant forward movement towards service, the necessary circumstances for change will come about so that he may see the next step, the next opportunity” ... Edgar Cayce The animal kingdom develops instinct which gives way to rationality in human. The seat of instinct is sensory system, whereas rationality is culture of head. Yogis believe that the quantum leap from human to divine is achieved only when heart is cultured which is the seat of inspiration. The third type of karma belongs to entities who are aspirants of godly qualities and that is why we have named it Inspirational Karma. A couple who were grieving death of their infant were told by Cayce that this “was necessary experience of grief for the parents” and not for the child. In fact the child has appeared only briefly, in a sacrificial spirit, to help the parents experience the healing agony they need for soul growth. The child loved the parents and wanted them to undergo a corrective experience, “spiritualization of values that has become overtly materialistic”. Readers have already been introduced to Dr Brain Weiss the author of “Many Lives, 95

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Conclusion: Abilities and disabilities are not important in themselves. “Karma is psychological law and acts primarily in psychological realm, the physical circumstances being merely the means whereby the psychological purpose is fulfilled.” That being the case, what should concern us more is the purpose for which abilities or disabilities arise in an individual. What is conducive for progress of an entity in its onward journey being the vital ingredient? If being disabled is to progress towards perfection, then isn’t it worth asking; is the disability a bane or a boon? In doing so we should remember the following definition of happiness given in Bhagavat Gita:

ideal attitude of service to the disabled? It is to serve them with an understanding that we are the greatest benefactors in doing so. Let us not serve because someone is in need but serve because it is a privilege to be of service to others: God has not fallen into a ditch for you and me to help Him out by building a hospital or something of that sort. He allows you to work. He allows you to exercise your muscles in this great gymnasium, not in order to help Him but that you may help yourself. Do you think even an ant will die for want of your help? Most arrant blasphemy! The world does not need you at all. The world goes on, you are like a drop in the ocean. A leaf does not move, the wind does not blow without Him. Blessed are we that we are given the privilege of working for Him, not of helping Him. Cut out this word “help” from your mind. You cannot help; it is blaspheming. You are here yourself at His pleasure. Do you mean to say, you help Him? You worship. ... said Swami Vivekananda.

yÄd¢e iv;imv pir[ame=m&taepmm!, tTsuo< saiÅvk< àaemaTmbuiÏàsadjm!. 37. Chapter 18 That happiness is most beneficent though distastefully bitter, as if swallowing poison, in the beginning, that ends in being most beneficial producing serenity of mind. Let us then keep in mind that all abilities are founded on disabilities. So what is the

........................ concluded.

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Success Story: What Sanjay Could Achieve, with Encouragementâ&#x20AC;Ś.. Sanjay was born with Downsâ&#x20AC;&#x2122; Syndrome features, and poor health. His sweet smile and patient optimism made light of his delayed milestones. He went through regular schooling in reputed convents till 10 years. The supportive and caring teachers and limited students in each class made a difference. It helped him to pick up healthy attitudes, right reasoning, correct diction, vocabulary and social skills. Most important he started with a positive self image that served as a buffer against harsh challenges.

where he developed interest in yoga and sports. Also at Arunodaya Center for Children with Differential Ability, located in RDSO, Lucknow, he got a special award for teaching Physical Education to primary class students in the vicinity. With Special Olympics, he got opportunity to travel to different places for sports camps under Special Olympics. He loves to do shopping and then gives back part of the balance, and part as his pocket money. Here too, he never indulged himself, but took small amounts and returned the rest. He attended a job development course at Spastic Society of Karnataka, where he was exposed to a variety of vocational skills. This included among other things, office skills, which proved a stepping stone to being computer savvy. Then he tried his hand at magneto therapy but gave

He expressed a sense of calm assurance and confidence about his abilities and took interest in everything about him. He participated in skits and cultural programs, which improved his speech. At one stage good regular schools were difficult to find, so he joined special schools

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He has been Master of Ceremonies for Special Employees Meet at NIMH and for Special Olympics, Andhra Pradesh. Earlier he was a member of the Executive Committee of Special Olympics, AP. Recently he presented a paper on “How Yoga helped me” at a Conference in Ramakrishna Mission Vivekananda University, Coimbatore titled “Positive Aspects of Adaptation in Physical Education”. He was sponsored by Special Olympics, Andhra Pradesh.

it up to work in the National Institute for the Mentally Handicapped, Secunderabad, at the hospitality services. It helped him to become

programmes. He has just ended a yoga

Sanjay enjoys internet surfing and reading, besides working on computer. He has a nice sense of humour. Sanjay prefers quietness and meditation to loud parties and social occasions. He wants to help people in whatever way he can, he says. He is a source of joy and support to us and popular among friends and relatives. Sanjay recently did a cameo in a documentary highlighting the capability of special children. He hopes it will lead to an opportunity to act in films. He says he would like to adopt two small children and bring them up with loving care. I hope it will be possible some day…. (based on a talk with Sanjay)

instruction course and started reading BKS Iyengar’s book on yoga to understand it better.

By Shiela Rao Sanjay’s Mother

more independent and deal with situations and conflicts that inevitably emanate everywhere. He operates a bank account and knows the value of money. So much so he discourages any extravagance at home. His hobbies are embroidery, acting, music, reading and yoga. Through self discipline and practice he has improved his speech to a great extent, and likes to take responsibility for running our home, beginning with menu planning, to caring for visitors and weekend entertainment

During a visit to United States, he was invited to demonstrate yoga to the members of ARC, in Virginnia. He made a power point presentation of the benefits of yoga and explained some asanas followed by demonstration. The program was well received and he was invited the next day to demonstrate yoga to a larger group. What the group appreciated most was his gentleness, patient assistance, clarity of instructions and poise. 98

Vol. 2. No. 1 January 2012

Journal of Disability Management and Special Education ISSN: 2229-5143

INCLUSIVE EDUCATION RESOURCE TEACHERSâ&#x20AC;&#x2122; TRAINING MANUAL Book review: Edited By Dr. A.T. Thressiaku y Published by: Ramakrishna Mission Vivekananda University Faculty of Disability Management and Special Educa on, Coimbatore Pages: 360

Inclusive Education Resource Teachersâ&#x20AC;&#x2122; Training Manual has been specially designed for Inclusive Education Resource Teachers (IERTs); however it is equally valuable for special educators, resource teachers, general educators, Anganwadi workers and professionals who are involved in providing education and rehabilitation to children with various disabilities. The present manual came into existence as a result of twelveday residential training programme for resource teachers of Andhra Pradesh on therapeutic skills, training and management of children with special needs studying in general schools conducted by Ramakrishna Mission Vivekananda University, Faculty of Disability Management and Special Education, Coimbatore.

with various disabilities, educational technology, teaching learning materials, co-curricular activities, different types of adaptations and its techniques, record maintenance across the three major disabilities viz. Mental Retardation, Hearing Impairment and Visual Impairment. The first section of the manual deals with mental retardation and the topics covered are early identification and intervention, assessment tools, curriculum adaptation, training in ADL, methods and techniques for training in functional academics, role of physiotherapists, and preparation for transition from school. The second section of the manual covers hearing impairment emphasizing aural and oral rehabilitation, speech therapy, audiometry, assistive listening devices for children with hearing impairment, Indian Sign Language, methods and techniques of teaching language to children with hearing impairment and auditory training whereas the third and the last section of the manual concentrates on visual impairment and the topics dealt with

The entire manual is divided into three major sections which is centered on programme content pertaining to early identification and intervention strategies, assessment techniques, plus curriculum, assistive devices for children 99

Vol. 2 No. 1 January 2012

Journal of Disability Management and Special Education

are identification ,assessment, plus curriculum, Abacus, Taylor frame, Braille, multisensory skill development, orientation and mobility assistive devices for children with visual impairment and strategies for successful inclusion.

of differently abled children. Undoubtedly a product of painstaking effort, the manual will be of enormous value to resource teachers, parents, caregivers, rehabilitation professionals and special educators.

The documentary intends to bring forth the successful aspects of inclusive education through a number of case vignettes which prove that as a result of inclusive education

The manual is available in English language and is likely to come in Telugu, too. For any further information, the readers can contact on the following address:

Each chapter in the manual explains the key concepts with practical inputs in simple language and lucid manner. With a view to making it user friendly, the manual makes minimal but the most essential use of jargons. The theoretical explanations are supplemented with well-labeled illustrations. Task at the end of each chapter provide ample opportunity for self-evaluation under “check your knowledge”. Present manual is a useful, concrete and instrumental reference and is essential reading for all those who involved in service

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Ramakrishna Mission Vivekananda University Faculty of Disability Management and Special Education, SRKV Post, Periyanaickenpalayam Coimbatore, Tamil Nadu PIN- 641020 Reviewed by Abhishek Kumar Srivastava Asst. Professor, FDMSE, RKMVU abhishekbhu2007@gmail.com Mob. – 07639266553

Vol. 2. No. 1 January 2012

Journal of Disability Management and Special Education ISSN: 2229-5143

ADAPTED GAMES AND ACTIVITIES FOR PERSONS WITH DISABILITIES Book review: Published By Ramakrishna Mission Vivekananda University Faculty of Disability Management and Special Education, Coimbatore Pages: 48

The present manual under review significantly throws light on the significance of adapted games and activities on overall development of persons with various disabilities. It is the established fact that adapted games and activities contribute to the overall development of children with special needs. Considering the strength of adapted games, the present manual is prepared which has six chapters. The opening chapter of the manual explains the significance of adapted games and techniques of conducting these games. It also describes three types of cues i.e. verbal cues, visual cues and physical cues to be given to athletes while they participate in adapted activities as a signal for them to proceed. The first chapter presents 9 adapted games for persons with hearing impairment; second focuses on 7 adapted games for persons with visual impairment; third deals with 7 games for persons with intellectual disabilities; fourth presents description of activities and 4 games for persons with physically handicapped and the last chapter explains the 2 activities for persons with paraplegic wheel chair-bound

athletes. Hence the reader can get as many as 29 adapted games at a time and can avail them. The manual is designed very systematically and in a coherent manner where each chapter has some introductory remarks about games, equipments required for conducting activities, description of procedure of conducting particular game and the scoring system for each game. Keeping in view the convenience of the readers, the manual has model pictorial presentation of the play-ground and sample of all the games. These pictorial illustrations are really helpful to the readers in visualizing the nature of ground for the games to be conducted. Present manual is a practical and invaluable reference to all special educators, resource teachers and to all those who involved in education and rehabilitation of persons with disabilities. Reviewed by Abhishek Kumar Srivastava Asst. Professor, FDMSE, RKMVU abhishekbhu2007@gmail.com Mob. â&#x20AC;&#x201C; 07639266553 101

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RAMAKRISHNA MISSION VIVEKANANDA UNIVERSITY PO Belur Math, Howrah, West Bengal, 711202, India, Phone: 91-33-26549999, Fax: 91-33-26544640, Web: www.rkmvu.ac.in

FACULTY OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION SRKV Post, Periyanaickenpalayam, Coimbatore - 641 020 Phone: +91 422 2697529, Fax: +91 422 2692353, E-mail: jodmse@gmail.com, fdmedu@gmail.com, Web: www.vihrdc.org