Jodmse vol 4 no 2 july 2014 by Vivekananda University, Coimbatore Campus

JOURNAL OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION ISSN : 2229-5143 Volume 4

Number 2

July 2014

CONTENTS Editorial board

iii

Instruction to authors

Editorial

Impact of Customised Behavioural Intervention on Reduction of Problem Behaviours in Children with Autism : Kadambari Naniwadekar and S. Venkatesan

1-15

Deafness, Communication and Indian Sign Language — A Brief Overview for Professionals : Dr. Madan M. Vasishta

16-19

Inclusive Education: Strategy for Modification of Attitudes among Pre-service B.Ed. Teacher Trainees : P. Vijetha and Prithi Nair India’s Deaf: Whither not Wither : Michael W Morgan

20-30 31-45

Efficacy of Visual Imaginary Therapy on Selective Motor Control and Functional Independency of Lower Extremity in Subacute Stroke Patients : T. Karthikeyan 46-58 A Study of the Correlation between Cognitive Capabilities and Pre-arithmetic Skills of Preschool Children with Hearing Impairment : P. Rama Krishna and Dr. I.P. Gowramma

59-68

Inclusive Education: Study on Peer Group Relationship among Differently Abled Students : N.R. Prakash and S. Nirmala Devi

69-77

Indian Sign Language (ISL)

78-79

Success Story of Mr. Vasishta

80-82

JOURNAL OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION Journal of Disability Management and Special Education (JODMSE) is a bi-annual publication of the Ramakrishna Mission Vivekananda University (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 of this Journal 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 particulars about Journal of Disability Management and Special Education

1. Place of Publication : Coimbatore 2. Periodicity of Publication : Bi-annual 3. Printer’s Name : Vidyalaya Printing Press Nationality : Indian Address : Ramakrishna Mission Vidyalaya Printing Press, SRKV Post, Periyanaickenpalayam, Coimbatore 641 020 4. Editor’s Name : Abhishek Kumar Srivastava Nationality : Indian Address Ramakrishna Mission Vivekanada University, Faculty of Disability Management and Special Education, SRKV Post, Periyanaickenpalayam, Coimbatore 641 020 Tel: 0422 2697529, Mobile: 76392 66343 5. Name and addresses of Individuals & : Ramakrishna Mission Vivekananda University, shareholders holding morethan 1% of Faculty of Disability Management and the total capital Special Education, SRKV Post, Periyanaickenpalayam, Coimbatore 641 020 Tel: 0422 2697529 e-mail: jodmse@gmail.com, fdmedu@gmail.com I, Abhishek Kumar Srivastava, hereby declare that the particulars given above are true to the best of my knowledge and belief. ii

JOURNAL OF DISABILITY MANAGEMENT AND SPECIAL EDUCATION ISSN : 2229-5143 Volume 4

Number 2

July 2014

EDITORIAL BOARD CHIEF ADVISOR Swami Atmapriyananda

Vice-chancellor, Ramakrishna Mission Vivekananda University

ADVISORS Swami Abhiramananda

Administrative Head, FDMSE, RKMVU, Coimbatore

Br. Paramarthachaitanya

Asst. Administrative Head, FDMSE, RKMVU, Coimbatore

Dr. N. Muthaiah

Hon. Dean, FDMSE, RKMVU, Coimbatore

EDITOR Abhishek Kumar Srivastava Asst. Professor, RKMVU, FDMSE, Coimbatore

EXPERT MEMBERS Prof. R. Rangasayee

Dr. Jayanthi Narayan

Director, S.R. Chandrasekhar Institute of Speech and Hearing, Bengaluru Former Director, AYJ NIHH, Mumbai

Former Deputy Director, NIMH, Secunderabad

Dr. Asmita Huddar Principal, Hashu Advani College of Special Education, Mumbai

Dr. S. Venkatesan

Dr. S.P.K. Jena

C. Ananda Jothi

Professor, Clinical Psychology, AIISH, Mysore Chairman & Director, Sri Sugam Physiotherapy Institute, Chennai

Associate Professor, Dept. of Applied Psychology, University of Delhi, South Campus, New Delhi

iii

Instructions to the Author(s) The 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 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 Editor, JODMSE on the following e-mail: jodmse@gmail.com

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 – 3000 words) on new ideas/new areas work/innovation/ action research/ ongoing investigations/ conference and seminar and work shop outcomes. 3 Book reviews (1000-2000 words) Organization of the text: The general organization of research papers should be as follows: 1. Introduction should include important review of relevant studies which leads to the need, scope and objectives of the study. 2. Methodology should include sampling techniques, tool(s)/tool development and details of validation, data collection procedure and scheme of data analysis. 3. Results and discussion. 4. Conclusion. 5. Appendices may be used to amplify details where appropriate. Tables: Tables/figures should be typed at their apt position in the text. There should not be duplication of information by giving tables as well as graphs. Footnotes: Footnotes to the text should be avoided. References: References should be indicated in the text by giving the name of author(s) with the year of publication in parentheses. References should be alphabetically listed at the end of the paper. References should also be in tune with APA style.

Copyright: The authors are responsible for copyright clearance for any part of the contents of their articles. The opinions expressed in the articles of this journal are those of the authors, and do not reflect the objectives or opinion of RKMVU, FDMSE. Peer review: All Contributions submitted will be subjected to peer review. Format: The whole text manuscript must be typed in double space on one side A4 paper (including references) and should have oneinch margin at three sides and wide margin to the left side of the text. Every page should be numbered correctly including the title page. The article should confirm to APA style. Soft copy of the article should be attached and submitted to the above-mentioned e-mail. Title page: This should contain the title of the manuscript, the name of the author and at the bottom the address for correspondence including email-ID. The number of authors should not exceed three. Abstract: The second page should contain an abstract of not more than 150 words, iv

Vol. 4. No. 2 July 2014

Journal of Disability Management and Special Education

Editorial

ISSN: 2229-5143

Rethinking on Models of Disability Anything fresh on a topic of vital importance is always intellectually stimulating. Something akin to this stand included in this issue of the journal-an opinion article entitled ‘India’s Deaf: Whither not Wither’ by Michael W Morgan. It presents a new angle on specific model of the Deafness i.e. the cultural model. Triggered by this article, some prevailing perspectives on looking at disability are presented here. The way of looking at disability is technically known as model of disability, a sort of framework for understanding the related concepts. Up till now, there have been two prominent ways of looking at disability- the medical model and the social model, apart from many others. The medical model has dominated the spectrum of disability for a long time giving birth to many concepts and nomenclature. The medical model appeared on the disability scene in the 19th century. At that time, the medical science had just started to make great developmental leaps thereby increasing the role of doctors in society. Small wonder that the medical model holds the view that since the disability or the limitations are at the individual, therefore, it has nothing to do with the society or the physical environment in which the persons with disabilities live. And since the disability lies in the individual, hence its solution can only be found in him/her through medication or surgery as considered fit by the doctors. Over the years, so great has been the influence of this model that even the classification of impairment, disability and handicap by WHO are based on it. This model was the favourite of the policy makers spawning concessions and providing facilities by the state and the central governments to the Persons with Disabilities (PWDs) besides putting into place a reservation system for their admission to educational instructions and for recruitment in jobs. The medical model definitely has a therapeutic value. To a larger extent it did alleviate the physical and mental conditions of the PWDs. However, it also created prejudices against them. It generated some amount of discrimination against PWDs in public who imagined that persons with disability would become vulnerable to ill health and disease and gradually become less productive with time. It looks that the social model emerged as an improvement on the medical model. It views PWDs from an entirely different angle. Essentially it is a right- based model rather than the charity- based. It affirms that the problem does not lie in the individual but is a consequence of the environmental, social and attitudinal barriers. These hinder PWDs from taking full participation and performing well in life. This is corroborated by the World Report on Disability (2011). It states that person’s immediate environment has a massive impact on the experience and the extent of v

Srivastava, A.K. / Editorial

his/her disability. If the environment is not disabled friendly and not easily accessible, it creates disability by presenting barriers in normal functioning. Such a restricted environment not only affects PWDs but also so called normal human population. Therefore, this model gave rise to the right based society that must provide equal opportunity, full participation and anti-discriminatory legislations for PWDs. The major defeat of the social model is that it ignores the problems of PWDs at the individual levels. Of late, the World report on disability (2011) affirms that disability is a part of the prevailing human conditions. Hence, it proposed an eclectic model of disability i.e. bio-psycho-social model. This represents a workable compromise between the medical and the social models. Under this model, disability is an umbrella term for impairments, activity limitations and participation restrictions. It looks at the disability as a dynamic interaction between the health conditions and contextual factors that are personal as well as environmental for each PWD. Now here comes an article (in this issue) by Michael Morgan. It presents a totally unique way of looking at disability especially Deafness termed as cultural model. It neither blames the individual for his/her disability nor the environment. It transcends both the models by suggesting a totally pristine view of looking at Deafness. In this cultural model, Deafness is not a medical problem which needs treatment, surgery or medication rather it is an asset for the Deaf culture and community. As per this model Deafness is not a problem if it is respected and accepted in its totality rather than labelled as a specific problem. Those who are in favour of cultural model of Deafness; diagnosis, medical treatment and making deaf people speak verbal language is imposed by the will and wisdom of the majority. The cultural model, therefore, advocates that the majority community must respect the minority community of the Deaf people and accept the diversity and uniqueness. To conclude, none of the above discussed models are self sufficient by themselves. Each has a lopsided view. Hence, an acceptable and all encompassing model of disability must be decided by keeping in mind the nature of every individual’s problem vis-a-vis the society’s obligation and the environment in which the PWDs live. As usual the present issue of JODMSE carries a variety of articles which, I hope, the readers may find informative and interesting. We welcome your feedback, reaction or comments on them.

Abhishek Kumar Srivastava Editor, JODMSE vi

Vol. 4. No. 2 July 2014

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

Impact of Customised Behavioural Intervention on Reduction of Problem Behaviours in Children with Autism *Kadambari Naniwadekar* and **S. Venkatesan

Abstract Distinguishing problem behaviours from deficits in skill behaviours precede planning or implementation of intervention programs for children with autism. This study seeks to examine the impact of a customised behavioural intervention on reduction of problem behaviours in children with autism. A one-to-one ipsative pre-to-post test comparative intervention research design was employed in this investigation covering 20 children with autism between 3-6 years and identified as having problem behaviours on a standardized native tool. The problem behaviours were measured in terms of frequency, extensity and intensity. Following baseline assessment, the children were administered a customised behaviourally based intervention across 12 sessions covering manifold behavioural techniques. Results show statistically significant gains, maintenance and generalization for reduction of problem behaviours in terms of severity more than their frequency and extensity. The results are discussed with the challenges involved in their on-ground implementation for facilitating optimum behavioural acquisition, amelioration, inclusion, empowerment and mainstreaming of children with autism. Key words: Challenging Behaviours, Behaviour analysis, Functional utilitarian, Children with autism

Introduction Problem behaviours go by several synonyms: behavior problems, challenging behaviours, aberrant, undesirable, negative or maladaptive behaviours. Although minor distinctions are made between these terms based on the context, by and large, they are best explained in contrast to what is designated as positive, desirable, adaptive, or skill behaviours. Of course, there cannot be a single universal definition, taxonomy or classification of problem behaviours. Nonetheless, behaviorists insist that all behaviours-skill or problem, are learned as a function of the utility, benefit or contingencies they secure for an

individual either immediately before or after the occurrence of such behaviours. In saying so, they enunciate a specialized form of behavior assessment of the overt-observable actions as precursor to planning behaviorally based intervention programs for affected individual or groups of such persons (Venkatesan, 2004; Peshawaria and Venkatesan, 1992a). Although not a core feature, children with autism are no exemption to problem behaviours. However, owing to the constellation of their primary behavioral symptoms, it is daunting for clinicians and caregivers to distinguish learned problem behaviours from deficits in skill behaviours (Smith and Matson, 2010).

*Research Scholar, Department of PG Studies in Psychology, University of Mysore. Email: kadambarinc@gmail.com ** Professor in Clinical Psychology, All India Institute of Speech and Hearing, Mysore. Email: psyconindia@gmail.com or psyconindia@aiishmysore.in

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Journal of Disability Management and Special Education

For example, a child’s intermittent murmuring to self maybe an attention seeking problem behavior. It could also be a social skill deficit reflected in a wanting, unyielding, unavailable or impoverished environmental stimulation. In any case, a clear and correct understanding of the specifics involved in the antecedents, behavior and their consequences become the cornerstone for effective program planning or implementation of intervention programs for children with autism (Foxx, 2008; Harris and

packages follow recipe book format or activity based listings seeking to satisfy the hunger for the ever elusive magic-cure, quick-fixes and 2-minute remedy strategies being sought by the parents, teachers, caregivers or other market forces involved in the field of autism. While there are innumerable therapies, protocols, strategies, programs and practices claiming efficacy, the paradigm of ‘Applied Behaviour Analysis’ (ABA) stands apart as one of the best validated and scientifically proven technique for remediation of children with autism. ABA is defined as the science in which the principles of behaviour analysis are applied systematically to improve socially significant behaviour and in which experimentation is used to identify the variables responsible for change in behaviour (Cooper, Heron and Heward, 2007). In a sense, ABA is truly an applied experimental science with emphasis on treating each intervention as a truly case controlled double blind multiple baseline study based on reversal designs. No wonder, a synonym for ABA is Experimental Behaviour Analysis (EBA) and one of its steps is functional or experimental analysis.

Delmolino, 2002). In a recent study on netizen searches in a virtual group covering nearly 3500 email transactions, results showed that half the participant parents reported greatest concerns regarding therapy, treatment and management techniques for their wards identified as autism. This was followed by concerns on or about their behaviour problems. More significantly, the study reported that the parents followed more than 250 forms or types of therapies which were nutrition based, bio-medical, educationbehaviour based, sensory, alternative medicine systems, medication/drugs or instrument based for ameliorating their affected children with autism (Venkatesan and Purusotham 2008).

Mapping contemporaneous behaviours is the beginning and heart of ABA. The basic premise is to begin by undertaking an objective, systematic and clear chart of what a given child can do (skill behaviours or assets), what the child cannot do (deficits), what the child has never been given a chance to do (no opportunity) and what the child does not want to do (problem behaviours). This behaviour mapping is arduously undertaken through several sessions of parent or caregiver interviews, objective observation of the child across places, persons or settings. A single

Pre-canned servings on ‘what-to-do’ and/ or ‘how-to-do-it-yourself’ in rearing-caring of such children are growing popular in the virtual and real world. Some well known copyrighted programs (to list only a few) are: Strategies for Teaching Based on Autism Research (STAR), Discrete Trial Training (DTT), Pivotal Response Teaching (PRT), Picture Exchange Communication System (PECS), Applied Verbal Behaviour (AVB), Autism Intervention Program of Eastern Ontario (AIP-EO), Positive Behaviour Supports (PBS), etc. Many of these 2

Naniwadekar & Venkatesan S / Impact of Customised Behavioural Intervention

session observation or just one key-informant interview is insufficient (Matson, 2009; Keamey, 2008; Venkatesan, 1994).

observations of target behaviours in terms of situation, setting, condition, person, place, timing, site, or location of their happening. It involves noting on what, where, when, how or with whom or whom not is the occurrence of a behaviour. Many times, quantitative measures of the given behaviours in terms of how many times (frequency) or how long (duration) they occur is undertaken. Following these baseline indices, and simultaneously, the behaviour analysis procedure cover details on what happens immediately following the target behaviour which is referred to as consequence. It is imperative to keep a distinction between the actually occurring consequences of a given behaviour and the attribution or perception of ‘causes’ or ‘consequences’ as reported by the key caregivers (Venkatesan and Vepuri, 1992). In short, ABA enunciates a well laid out algorithm for undertaking behaviour change programs in individual or groups of affected

Many semi-standardized and standardized behaviour assessment tools are now available in our country and abroad to ease the task of undertaking objective or systematic behavioural mapping or assessment (Cipani and Schock, 2011). A few examples are: Autism Behaviour Checklist for Disability Estimation, Part A (A2E-A; Venkatesan and Ravindran, 2013), Problem Behaviour Survey Schedule (PBSS; Venkatesan, 2013), Activity Checklist for Preschool Children with Developmental Disabilities (ACPCDD; Venkatesan 2010; 2004a; 2004b), Communication DEALL Developmental Checklists (CDDC; Karanth, 2007), Autism Behaviour Checklist (ABC; Rellini et al. 2004), Autism Screening Instrument for Educational Planning (ASIEP; Krug, Arick and Almond, 1993), Behaviour Observation Scale for Autism (BOSA; Freeman et al. 1978), etc. These and many other such mapping devices facilitate, apart from screening and/or diagnosis, an exact diagrammatic representation of the behavioural assets, excess, deficits and problem behaviours in a given child. This serves as preclude to their individualized program planning, instruction, correction or remediation (Glasberg, 2006).

children. Against this background, there are hardly studies on bifurcating problem and skill behaviours before attempting to examine the impact of customised behavioural intervention on reduction of problem behaviours in individual cases of children with autism. Objectives of the study The specific objectives of this study were:

A typical ABA assessment protocol for individual/groups of children begins by undertaking an examination of the child’s contemporary behaviours and also, the circumstances under which they happen or do not happen. In other words, it involves collecting data on antecedents and consequences following given behaviours. Also called A-B-C model, the analysis covers

1. To identify, list and record a baseline on the different types, extent and specific instances of problem behaviours in individual children diagnosed as autism; 2. To carry out a customized case-by-case topological mapping of situations, triggers, antecedents, functions, maintaining aspects and consequences for the identified problem behaviours as observed in their 3

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Journal of Disability Management and Special Education

home and/or school settings for the enlisted children diagnosed as autism;

measurable actions of people which may be deemed as age or situation inappropriate, unproductive, interfering in their or others’ learning of new behaviours, harmful to self or others, occurring in magnitude sufficient to cause stress to others (Venkatesan, 2004a). Such behaviours may be seen extended over a period of time to such a marked degree and of such a nature that they could even adversely affect the educational performance of these children, their inability to build or maintain interpersonal relationships, and benefit from learning or teaching process. Typical categories of such behaviours seen in children are violent and destructive, self injurious, odd, antisocial, repetitive, or which involve throwing temper tantrums, misbehavior with others, anxieties or fears (Peshawaria and Venkatesan, 1992b). Examples of problem behaviours are hits others, screams, stamps feet, rolls on floor, pulls objects from others, sucks thumb, hoards unwanted things, bangs head, does not sit at one place for required length of time, etc.

3. To evolve a customized one-to-one and/or small group based behavioural intervention strategy based on the identified problem behaviours in home and/or school settings for the enlisted children diagnosed as autism; 4. To implement the evolved customized and/or small group based behavioural intervention strategy on the enlisted children with autism for the specified time frame and/or across envisaged sessions in home and/or school settings; 5. To list the reported problems and issues involved in the implementation of the customized behaviour inter vention strategies in home and/or school settings; and, 6. To undertake a terminal evaluation of the changes in problem behaviours in home and/or school settings for the enlisted children diagnosed as autism. Method A one-to-one ipsative pre-to-post test comparative intervention research design was employed in this study by drawing cases from a ‘Special School’ located at Pune, Maharashtra, covering the period between September-October, 2013. Each participant in the study underwent individualised behaviour assessment on the chosen tools.

Achenbach and Rescorala (2000) distinguished ‘externalizing’ and ‘internalizing’ behaviour disorders. Internalizing behaviours are inner directed maladaptive actions distressing to the person manifesting them. For example, head banging is an inner directed self injurious behavior. Internalizing behaviours are covert, such as anxiety, fears, depression, eating and sleeping or psychosomatic disturbances. Externalizing problems are, by contrast, outerdirected maladaptive actions disturbing others more than the person who is showing that behavior. For example, when a child turns violent and hits others or throws things, it poses danger and stress on others. Such overt behaviours are discernable, such as, attention

(a) Operational definitions The key terms used in this study are: (i) Problem Behaviour; (ii) ExternalizingInternalizing Behaviours; and, (iii) Customised Behaviour Intervention. The ter m ‘problem behaviour’ as defined in this study refers to observable and 4

Naniwadekar & Venkatesan S / Impact of Customised Behavioural Intervention

deficit and hyperactivity, conduct disturbances, etc. Internalizing problems include anxious, depressive, over controlled and inner directed behaviours, while externalizing problems include aggressive, hyperactive, noncompliant, and under controlled behaviours (Gimpel and Holland, 2003).

disorders, socialized/unsocialized disturbances of conduct-emotion, social anxiety, reactive attachment disturbances of infancy and early childhood, disinhibited disorder of childhood, child abuse-neglect, habit disorder and/or related medical conditions like Angelman Syndrome, Cornelia de Lange Syndrome, Landau Kleffner Syndrome, Hospitalism, or Hyperlexia mimicking few odd secondary features of autism were carefully excluded. The ICD-10-CM official criteria (WHO 2013; Buck 2012) were used for classification/ categorization of cases. All the cases were drawn on the basis of convenience sampling.

Customised Behaviour Intervention (CBI) traditionally addresses problem behaviours in children with exceptional needs. The focus of these interventions is typically to provide a restructured learning environment and an opportunity to develop appropriate pro-social behaviours in home, school and community settings. Early Intensive Behaviour Intervention Program (EIBI), a variant of the CBI, starts early during the developmental stages or ages of children. Both the programs share common characteristics in terms of being coordinated, customised, continuous, caregiver involved, individualised, intensive, inclusive, non-aversive, non-coercive, poneto-one, or home-oriented. They are known by several names: Behaviour Management Program, Behaviour Support Program, Positive Behaviour Facilitation Program, Applied Behaviour Analysis, Behaviour Intervention Program, etc.

(c) Tools The measurement of problem behaviour and their associated characteristics in the enlisted sample was undertaken by the use of both formal as well as informal techniques. As a formal procedure, the ‘Problem Behaviour Sur vey Schedule’ (PBSS; Venkatesan, 2013) was used to identify and list the quantitative particulars of problem behaviours in the sample children. Details were taken on frequency, intensity, duration, and/or extensity of problem behaviours in home, school and community settings. This 100-item tool is an elaborately developed and standardized system of problem behaviour assessment for a given child with special needs. The items are grouped into 11 domains. The instrument has a prescribed scheme of administration, recording observations, scoring, profiling and interpretation of results. There is provision for periodic assessment of each child at every quarter (or three months) and to calculate raw score convertible into cumulative percentages and graphic profiles. All items in the scale are written in clear

(b) Participants The study covered 20 children in age range between 3-6 years (Mean: 5; SD: 0.89) diagnosed as autism. Care was taken to ascertain the final diagnosis of each case by weighing against differential diagnostic conditions like mental retardation, hearing loss, moderate-severe-profound developmental delays and specific receptive-expressive speech delays. Cases with co-morbid conditions like sensory-motor impairments, attention deficit 5

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Journal of Disability Management and Special Education

observable and measurable terms. The scoring is carried out on two counts: ‘Frequency Count Score’ (FCS) based on presence or absence of given problem behaviours; and ‘Intensity/Severity Count Score’ (I/SCS) of the problem behaviour for a given child. The former is marked as ‘present’ (score: one) or ‘absent’ (score: zero). The latter is calculated on a 3-point rating scale: ‘never’ (score: zero), ‘occasionally’ (score: one), and ‘frequently’ (score: two). The maximum possible FCS on PBSS is 100 and I/SCS is 200 for a given child. Additionally, the tool facilitates for each child another ‘Directionality Score’ (DS) in terms of ‘internalizing’ and/or ‘externalizing’ patterns of problem behaviour. Further, one can derive a problem behaviour severity index, and deduce the deviation score of problem behaviour for a given child against available norms. The inter-rater reliability coefficient was reported high (r: 0.911; p: <0.001). Another 3-week test-retest reliability exercise undertaken on a sample of 15 cases equally representing all clinical categories was reported to be 0.89 (p: <0.001).

(d) Procedure

As informal procedure, another semistructured ‘Demographic Data Sheet’ and ‘Open Ended Interview Probe’ were exclusively developed and used to elicit additional information on antecedents, consequences, reward preferences, baseline, parents/teacher perceived ‘causes’ of problem behaviours or their report on problems and issues involved in implementation of the intervention program by using multi-procedural strategies including direct observation of the children, unstructured or open ended interview of significant others, field notes, case studies, etc.

The core of CBI was implemented across 12 structured hourly sessions spread over two weeks by involving the parent, teacher, caregiver and first author as therapist. The on-ground behavioural techniques were drawn from several sources (Venkatesan, 2004; Peshawar and Venkatesan 1992a). It included compliance training, activity scheduling, using rewards, environmental manipulation, token economy, time out, extinction, restitution or over correction. Supporting verbal, written and bibliographic guidelines were supplied on how to handle the child on target behaviour/s,

Data collection for this study involved individualized or one-to-one administration of the PBSS at baseline without imposing constraints of time limits or over burdening the informants. The informants included parents, teachers and the therapist. Informed consent was undertaken and response anonymity was assured in consonance with ethical guidelines mandated for such studies (Venkatesan, 2009). Following identification of problem behaviours, about 5-10 targets were short listed for intervention in each child. Information was elicited on instances describing what happens ‘before’, ‘during’ and/or ‘after’ occurrence of the problem behaviour. Home based and school situation oriented recordings of how many times or how long, with whom, where, when, and which problem behaviour occurred were noted. Instances of non-occurrence of the same problem behaviour in some other situations or with specified persons were also recorded. Such elaborate mapping became the basis for behavioural formulation, planning and programming of the CBI.

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sort out issues related to implementation of the chosen techniques and achieve generalization of results across settings. The behavioural changes of each child were recorded during every follow up.

35.9; SD: 9.9) even though these differences are also not statistically significant (F: 0.128; p: 0.880; NS). Analysis of results for FS within parent respondent groups between pre-treatment (N: 20; FS: 690; Mean: 34.5; SD: 8.5) and post treatment (N: 20; FS: 604; Mean: 30.2; SD: 8.6) (T-Value: 1.5904; df: 38; p: 0.12; NS) shows no significant difference as against the gain reported within teacher respondents between pre-treatment (N: 20; FS: 708; Mean: 35.4; SD: 7.4) and post treatment (N: 20; FS: 617; Mean: 30.9; SD: 6.7)(T-Value: 2.0160; df: 38; p: 0.0509; S) and/or within therapist respondent between pre-treatment (N: 20; FS: 700; Mean: 35; SD: 7.5) and post treatment (N: 20; FS: 601; Mean: 30.1; SD: 7.0)(T-Value: 2.1360; df: 38; p: 0.0392; S). Does this imply that parents perceive no significant reduction in frequency of problem behaviours in their children following the CBI as compared to therapist and teachers?

Results and discussion The results are presented in inter-linked but discrete sections: (a) Comparative pre to post-treatment gains; (b) Domain analysis; (c) Cluster analysis; and, (d) Analysis of qualitative findings. (a) Comparative pre to post-treatment gains At baseline pre-CBI, b e t w e e n respondents, it is seen that teachers report greater Frequency Score (FS) and Intensity Score (IS) of problem behaviours in this sample of children with autism (N: 20; FS: 708; Mean: 35.4; SD: 7.4; IS: 1120; Mean: 56; SD: 13.2) compared to therapist (N: 20; FS: 700; Mean: 35; SD: 7.5; IS: 1103; Mean: 55.2; SD: 13.6) and parents (N: 20; FS: 690; Mean: 34.5; SD: 8.5; IS: 1076; Mean: 53.8; SD: 16.9) although the differences are not statistically significant (FS-F: 0.067; p: 0.936; NS) (IS-F: 0.115; p: 0.891; NS)(Table 1). Compare this with postCBI scores between respondents, wherein teachers report decrease in FS (N: 20; FS: 617; Mean: 30.9; SD: 6.7) almost equal to what is reported by therapist (N: 20; FS: 601; Mean: 30.1; SD: 7.0) and parents (N: 20; FS: 604; Mean: 30.2; SD: 8.6) (F: 0.068; p: 0.934; NS). The same is true for post-CBI IS as reported by parents (N: 20; IS: 749; Mean: 37.5; SD: 12.8), teachers (N: 20; IS: 745; Mean: 37.3; SD: 9.7) and therapist (N: 20; IS: 717; Mean:

The efficacy of CBI in facilitating clinically significant gains for children with autism have typically focused on skill behaviours (Solomon, Necheles, Ferch and Bruckman, 2007; Ingersoll and Schreibman, 2006; Hwang and Hughes, 2000) at the cost of ignoring management of problem behaviours (Macintosh and Dissanayake, 2006; Campbell, 2003; Horner et al. 2002). Ideally, there is need to combine, integrate and develop a holistic approach to behavioural interventions. Remediation must target decrement of problem behaviours with simultaneous increment in scores of skill behaviours for individual or groups of children. 7

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Table 1 Comparative Pre and Post-treatment Scores on Problem Behaviours Parents Intensity Frequency

Teachers Intensity Frequency

Therapist Intensity Frequency

Total

1076

749

690

604

1120

745

708

617

1103

717

700

601

Mean

53.8

37.5

34.5

30.2

37.3

35.4

30.9

55.2

35.9

30.1

16.9

12.8

8.5

8.6

13.2

9.7

7.4

6.7

13.6

9.9

7.5

7.0

Variables 

Analysis of results for IS within parent respondents between pre-treatment (N: 20; IS: 1076; Mean: 53.8; SD: 16.9) and post treatment (N: 20; IS: 749; Mean: 37.5; SD: 12.8)(T-Value: 3.4384; df: 38; p: 0.001; VHS) shows significant improvements as also within teacher respondent groups between pre-treatment (N: 20; IS: 1120; Mean: 56; SD: 13.2) and post treatment (N: 20; IS: 745; Mean: 37.3; SD: 9.7)(T-Value: 5.0803; df: 38; p: 0.0001; VHS) and within therapist respondent groups between pre-treatment (N: 20; IS: 1103; Mean: 55.2; SD: 13.6) and post treatment (N: 20; IS: 717; Mean: 35.9; SD: 9.9)(T-Value: 5.1310; df: 38; p: 0.0001; VHS). Does this imply that all respondents (parents,

teachers and therapist) unanimously perceive and report significant reduction in intensity of problem behaviours in their children following the CBI? In other words, from the foregoing, it is apparent that all the three respondents of this study view the pre as well as post treatment frequency and intensity of problem behaviours almost identically in their wards with autism. After the CBI, however, significant reduction in intensity as well as frequency of problem behaviour is reported only by teachers and therapist. The parents report improvements only in terms of intensity of the problem behaviour and not so much in their frequency. 8

Naniwadekar & Venkatesan S / Impact of Customised Behavioural Intervention

(b) Domain analysis A next layer analysis of the results was carried out to discover any trends in the domain wise pattern of decrease of problem behaviours following CBI as assessed on PBSS.

(N: 130-111: 19), followed equally by, both, ‘repetitive behavior’ (N: 99-82: 17) and odd behavior’ (N: 104-87: 17). Although not very considerable, it is heartening to note some decline in the frequency of problem behaviours in the areas of ‘self injurious behavior’ (N: 6860: 8) and ‘rebellious behaviours’ (N: 55-47: 8). Nonetheless, none of these domain-wise improvements are found to be statistically significant (p: >0.05).

In relation to FS (Table 2), cutting across respondents, the greatest reduction of problem behavior appears to have occurred in the domains of ‘violent and destructive behavior’

Table 2: Domain wise analysis of Frequency of Problem Behaviours Domains 

VandD B

TT B

MO F

47 57 51

SIB

Rep. Beh.

Reb. Beh ASB

Any Other

B F B

B F B F B

B F B F B F

Total

130 111 53

104 87

Mean

6.5 5.6 2.7 2.4 2.9 2.6 3.4

5.0

4.1

5.2 4.4 3.6 3.3 2.8 2.4

0 1.8 1.5 1.3 1.1

2.5 2.4 0.8 0.9 1.4 1.5 1.9 2.0 1.5

1.5

1.5 1.3 0.6 0.7 1.0 1.3

0 1.1 0.9 1.3 1.1

T-Value

1.161

1.114

0.654

0.649

1.897

1.802

1.455

1.091

0.944

0.525

Probability

0.253

0.272

0.517

0.521

0.065

0.079

0.154

0.282

0.351

0.603

KEY: VD: Violent-Destructive; TT: Temper Tantrums; MO: Misbehaviour with Others; SIB: Self Injurious Behaviour; Rep. B: Repetitive Behaviour; OB: Odd Behaviour; H: Hyperactivity; Reb. B: Rebellious Behaviour; ASB: Anti-Social Behaviour; F: Fears;

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In relation to IS (Table 3), once again, cutting across respondents, the greatest reductions of problem behavior appears to have occurred in domains of ‘violent and destructive behavior’ (N: 195-129: 66), followed by ‘odd behavior’ (N: 170-107:

63), ‘repetitive behaviours’ (N: 164-103: 61), ‘Hyperactivity’ (N: 125-71: 54), ‘rebellious behavior’ (N: 87-51: 36) and so on. Moreover, most of these domain-wise improvements are found to be statistically significant (p: <0.05).

Table 3: Domain wise analysis of Intensity of Problem Behaviours Domain 

VandD B

TT B

MO F

SIB F

Rep. Beh F

OB B

H F

Reb.Beh ASB F

F B F B

Other F

Total

195 129 91 50 84 66 95 71 164 103 170 107 125 71 87 51 0 0 53 37 38 31

Mean

9.8 6.5 4.6 2.5 4.2 3.3 4.8 3.6 8.2 5.2 8.5 5.4 6.3 3.6 4.4 2.6 0 0 2.7 1.9 1.9 1.6

4.5 3.2 1.6 1.1 2.5 2.2 2.9 2.7 2.6 2.2 2.6 2.3 1.1 0.8 1.8 1.4 0 0 1.7 1.4 1.9 1.5

t-value

2.673

4.837

1.612

1.354

3.939

3.999

8.878

3.530

1.625

0.554

Probability

0.01

0.001

0.115

0.184

0.001

0.113

0.583

was attempted for the next layered analysis

Going by the trends in this direction (Ganesha and Venkatesan, 2013; Gimpel and Holland, 2003; Achenbach and Rescorala, 2000; 2001), grouping of the eleven individual domains on PBSS into the two broad clusters of ‘externalizing’ and ‘internalizing’ behaviours

(Table 4). It is reconfirmed that the intensity of problem behaviour intensity have reduced significantly (p: <0.001) from their pre-to-post intervention without comparable reductions in their frequency scores (p: >0.05)(Table 4). 10

Naniwadekar & Venkatesan S / Impact of Customised Behavioural Intervention

Table 4: Cluster wise Comparative Pre and Post-treatment Scores on Problem Behaviours Internalizing Externalizing Variables Intensity Frequency Intensity Frequency  B F B F B F B F Total

523

354.5

332

283.5

580

361.5

368

316.5

Mean

26.2

17.7

16.6

14.2

18.1

18.4

15.8

8.6

6.5

4.9

4.2

8.2

6.3

4.2

4.7

t-value

3.5262

1.6631

4.7140

1.8447

Probability

0.001(S)

0.1045 (NS)

0.0001 (VHS)

0.0729 (NS)

(d) Analysis of qualitative findings Analysis of the contents from transcripts of ‘Open Ended Interview Probe’ brought up few issues related to implementation and generalization of the CBI as admitted by the respondents. The major themes of the expressed concerns included: 1. Challenge of obtaining concurrence across people or situations for consistently applying the CBI techniques on a given child; 2. Apprehension that elders or older generation in the family may misinterpret their ‘new’ ways of rearing and caring

as prescribed under CBI as a sign of ‘disrespect’ or ‘disobedience’; 3. Admission of feeling ‘uneasy’ or ‘guilty’ to execute the CBI, which they initially perceived as possibly ‘harsh’ upon an already ‘sick’ or ‘vulnerable’ child; 4. Tendency to giving undue credence to what ‘others may think’ if they went about implementing the CBI in home, public or community settings; 5. Lurking hesitation of ‘what if’ the whole CBI program ‘did not succeed’, ‘failed’ or ‘the problem behaviours aggravated’; 11

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6. Differential motivation between therapeutic agents and their ‘will to implement’ the CBI program;

addressed. Given explanations on the perils of not executing the program, risks of inconsistent handling, futility of hazards of losing out on critical time for early problem behaviour intervention and following ‘modelling’ the ‘success stories’ of peer parents during behavioural counselling sessions, these initial hiccups related to implementation of the CBI were quickly sorted. The issue related to inconsistencies across people in handling the child with autism was more frequent for those hailing from large joint family than smaller families or those with senior citizens expecting the mothers to be condescending or avoid being ‘harsh’ upon the already ‘unwell child’. Further, it was noted that many respondents expressed serious intra-psychic conflicts between wishing to be an effective mother by wanting to implement the CBI and also aspiring to be the typically ‘dutiful daughterin-law’ and ‘obedient wife’ by not wishing to ‘disrespect’ the over-bearing mother-in-law or a husband about rearing or caring their children with autism. In sum, the results of this study show that:

7. Peer pressure to try alternative ‘quick-fixes’ or that there might be some other easier and quicker solutions or techniques of problem behavior reduction; and, 8. Over-expectation or wishful thinking that the problem behaviours might ‘vanish on own’ with passage of time or as the child grows older. In a related study, respondents attributed ‘causes’ for problem behaviour to primary condition of the child, psychological illness, early childhood insults or trauma, perceived discrimination, fluctuating moods, heredity, etc. Others faulted poor parenting, dire environment, boredom, under-stimulation and/ or malevolent magical-religious influences as ‘cause’ for behaviour problems in their children. The same study reported use of variety of ad hoc behaviour management techniques or strategies including appeasement, bargaining, coaxing, cajoling, loving, advising, begging, nagging, promising, pleading, waiting, distraction or comparison at one end as they also used reprimand, shouting, scolding, threat or physical abuse on the same child for the same behaviour problems at different times. A segment of parents admitted to being clueless when faced with behaviour problems in their child. In short, inconsistent, unclear, arbitrary and contradictory ways of handling children was the hallmark of behaviour management reported by parents which is also reconfirmed in this study (Venkatesan and Vepuri, 1992).

1. There are no baseline differences between the reported frequency and intensity scores of children with autism as reported by parents, teachers and/or therapist; 2. At terminal evaluation, after CBI, all the respondent equally agree that there are decrements in frequency as well as intensity of problem behavior scores in their children with autism; 3. When analyzed separately, parents estimate significant drop only in intensity of problem behavior following CBI, while not agreeing with teacher and therapists,

Nonetheless, as part of CBI, some of the above mentioned issues were indeed 12

Naniwadekar & Venkatesan S / Impact of Customised Behavioural Intervention

who report considerable decrease in intensity as well as frequency of problem behaviours;

Maharashtra. Thanks are also due to Director, AIISH, Mysore, for the permission granted to undertake the doctoral work. This work is part of the doctoral dissertation being undertaken by the first author under the guidance of the second author.

4. Cutting across respondents, the greatest reductions of problem behavior appears to have taken place in domains of ‘violent and destructive behavior’ followed by ‘repetitive behavior’ and odd behavior’ respectively;

References Achenbach, T.M. and Rescorla, L.A. (2000). Manual for the ASEBA Preschool forms and Profiles. Burlington, VT: University of Vermont Department of Psychiatry, 3(2) 45-58.

5. Only marginal decline is reported in the areas of ‘self injurious behavior’ and ‘rebellious behaviours’;

Achenbach, T.M. and Rescorla, L.A. (2001). Manual for the ASEBA School-Age Forms and Profiles. Burlington, VT: University of Vermont, Research Center for Children, Youth, and Families.

6. Going by a scheme of clustering problem behaviours as propagated by Achenbach and Rescorala (2000; 2001), the findings reconfirm reduction only in intensity of problem behaviours following CBI while the changes in frequency of the problem behavior is marginal; and,

Buck, C.J. (2012). The 2012 ICD-10-CM draft standard edition. Miamisburg, OH: Elsevier Health Science Division.

7. The qualitative impressions derived with regard to problems or issues in implementation of CRI need to be taken as impressionistic and provisional requiring a separate more detailed investigation.

Campbell, J.M. (2003). Efficacy of behavioral interventions for reducing problem behavior in persons with autism: a quantitative synthesis of single-subject research. Research in Developmental Disabilities, 24(2): 120-138.

Furthermore, while these findings are encouraging, they must be also viewed as invitation to undertake more such studies on larger samples, with greater matched and double blinded controls, or probably even with greater structure and longer duration of the CBI program before they are proclaimed as possibility or panacea for facilitating optimum behavioural acquisition, amelioration, inclusion, empowerment and mainstreaming of children with autism.

Cipani, E. & Schock, K.M. (2011). Functional behavioural assessment, diagnosis, and treatment: a complete system for education and mental health settings. New York: Springer Publishing Company Cooper, J.O., Heron, T.E. & Heward, W.L. (2007). Applied Behaviour Analysis. Merril, Prentice Hall. Foxx, R.M. (2008). Applied behaviour analysis treatment of autism: the state of the art. Child and Adolescent Psychiatric Clinics of North America. 17(4): 821-834.

Acknowledgements The authors seek to place on record the gratitude and credits due to participants in the study from the Special School at Pune, 13

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Freeman, B., Ritvo, E., Guthrie, D., Schroth, P. & Ball, J. (1978). The behaviour observation scale for autism: initial methodology, data analysis, and preliminary findings on 89 children. Journal of the American Academy of Child Psychiatry, 17, 576–588.

children with autism using a naturalistic behavioral approach: effects on language pretend play, and joint attention. Journal of Autism and Developmental Disorders, 36(4): 487-505. Karanth, P. (2007). Communication DEALL Developmental Checklists (CDDC).

Ganesha & Venkatesan, S. (2013). Domain and item wise principal component analysis of problem behaviours in children from single-dual parent families. International Journal of Psychology and Psychiatry, 1(2): 43-55; DOI: 10.5958/ j.2320-6233.1.2.008

Bangalore: Communication DEALL. Kearney, A.J. (2008). Understanding applied behaviour analysis: An introduction to ABA for parents, teachers and other professionals. Philadelphia: Jessica Kingsley Publishers.

Glasberg, B.A. (2006). Functional behaviour assessment for people with autism: making sense of seemingly senseless behaviour. Philadelphia: Woodbine House.

Krug, A. & Almond, (1993). Autism Screening Instrument for Educational Planning Macintosh, K. & Dissanayake, C. (2006). Social

Harris, S.L. & Delmolino, l. (2002). Applied behaviour analysis: its application in the treatment of autism and related disorders in young children. Infants & Young Children. 14(3): 11-17.

skills and problem behaviours in school

Horner, R.H., Carr, E.G., Strain, P.S., Todd, A.W. & Reed, H.K. (2002). Problem behavior interventions for young children with autism: A research synthesis. Journal of Autism and Developmental Disorders, 32 (5): 423-448.

Matson, J.L. (2009). Applied Behaviour

Hwang, B. & Hughes, C. (2000). The effects of social interactive training on early social communicative skills of children with autism, Journal of Autism and Developmental Disorders. 30(4): 331343.

mentally handicapped children: A manual

aged children with high-functioning autism and Aspergers disorder. Journal of Autism and Developmental Disorders. 36(8): 1065-1076. Analysis for Children with Autism Spectrum Disorders. New York: Springer. Peshawaria, R. & Venkatesan, S. (1992a). Behavioral approaches in teaching for teachers. Secunderabad: National Institute for the Mentally Handicapped. Peshawaria, R. & Venkatesan, S. (1992b). Behaviour Assessment Scale for Children with Mental Retardation. Secunderabad:

Ingersoll, B. & Schreibman, L. (2006). Teaching reciprocal imitation skills to young

National Institute for the Mentally Handicapped. 14

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Rellini et al. (2004). Autism Behaviour Checklist.

Venkatesan, S. (2009). Ethical guidelines for bio behavioural research. Mysore: All India Institute of Speech and Hearing.

Smith, K.R.M. & Matson, J.L. (2010). Behavior problems: differences among intellectually disabled adults with comorbid autism spectrum disorders and epilepsy. Research in Developmental Disabilities. 31(5): 1062-1069.

Venkatesan, S. (2010). Toy Kit for Kids with Developmental Disabilities: User Manual. Mysore: All India Institute of Speech and Hearing. Venkatesan, S. (2013). Preliminary try out and validation of problem behavior sur vey schedule for children with developmental disabilities. Journal of Disability Management and Special Education. 3(2): 9-22.

Solomon, R., Necheles, J., Ferch, C. & Bruckman, D. (2007). Pilot study of a parent training program for young children with autism: The PLAY Project Home Consultation program. Autism. 11(3): 205-224.

Venkatesan, S. & Ravindran, N. (2014). Autism Behaviour Checklist for Disability Estimation, Part A (A2E-A). Psychological Studies. (In Press).

Venkatesan, S. (1994). Recent trends and issues in behavioral assessment of individuals with mental handicap in India. The Creative Psychologist. 6(1): 1-7.

Venkatesan, S. & Vepuri, V.G.D. (1992). Parental perceptions of causes and management of problem behaviours in individuals with mental handicap. Disabilities & Impairments, 7(2): 29-37.

Venkatesan, S. (2004a). Children with developmental disabilities: A training guide for parents, teachers & caregivers. New Delhi: Sage (India) Publications. Venkatesan, S. (2004b). Efficacy of home training program in skill enhancement of children with developmental disabilities. Indian Journal of Clinical Psychology, 31(1): 121-127.

Wo r l d H e a l t h O r g a n i z a t i o n . ( 2 0 1 2 ) International classification of diseases-10clinical modification: official guidelines for coding and reporting. Geneva: World Health Organization.

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Deafness, Communication and Indian Sign Language — A Brief Overview for Professionals *Dr. Madan M. Vasishta

Abstract This brief paper covers some salient factors about deafness. This may not answer many questions about deafness. However, I hope it will whet the readers’ appetite for learning more about deafness. This is not a research article; just a general information paper. However, some important bibliographical information have been added for people who would like to learn more and hopefully most of you will do that. Key words: Deafness, Communication and Indian Sign Language, Oral vs. Manual communication.

Introduction Deafness is the most misunderstood disability. Since most hearing people cannot communicate with deaf people, these misunderstandings become more prevalent. Deafness is also an invisible disability. One does not know if the person is deaf until one tries to communicate with him or her. People have often asked me for directions and when I tell them I am deaf, they suddenly walk away with a puzzled expression. How could a welldressed professional looking person be deaf and how could he not be able to communicate?

and cannot benefit from hearing aids except for hearing environmental noises. Deafness and intelligence Because of deaf people’s inability to speak and lower educational levels, people at time believe that deaf people have subnormal intelligence. However, research has shown that deaf people have normal intelligence. Deaf people with proper education can achieve anything that hearing people do. There are dear lawyers, scientists, medical doctors, professors, dentists and whatnot. Most deaf people achieve much under their potential because of lack of education and training.

Types of deafness There are deaf, there are deaf and there are deaf! Not two deaf people are alike, just like not two hearing people are alike.

Communication Deaf people cannot hear. It seems simple; however, that is the tip of the iceberg. This lack of hearing results in a deaf person results in being cut off from all communication around him or her. We live in the age of communication and when someone is cut off from all that communication, that person is cut off from the mainstream of the society. This huge barrier in communication can be

People who can, with or without hearing aids, understand speech and carry on communication by hearing alone are called hard of hearing. Some deaf people can hear partially with hearing aids and can understand part of communication. At the end of the spectrum are deaf persons who are totally deaf

* * Chief Advisor, Indian Sign Language Research and Training Centre (ISLRTC), New Delhi and Former Professor, Gallaudet University, Washington, DC, USA. Email: madan.vasishta@gallaudet.edu or madanv41@gmail.com

Vasishta M / Deafness, Communication and Indian Sign Language

removed by captioning all communication media including, but not limited to television, cinema, public announcement systems, cyberspace (Utube, internet, for example) and whatever is based on hearing. But for that it is important that deaf be given quality education opportunities to develop good literacy skills.

others can understand only a part of what is being said. Some deaf people have good lipreading skills and use these augmented by hearing aids or cochlear implants. One must keep in mind that only 30% words spoken are visible on lips. The remaining 70% have to be gleaned through contextual clues and guesswork. However, many professionals have this misconception that if a deaf person is smart, he/she can read lips and speak and deaf people who have limited intelligence use sign language. The ability to read lips and speak has nothing to do with intelligence. These are skills that some people have and others do not. Lipreading training helps, however, there are some deaf people who because of inherent skills can lipread very well while others fail despite a lot of training.

Most of you may have seen some deaf people talking to each other in sign language and either you wondered what they were doing or simply ignored it. Sign language plays a very important role in communication, education and social lives of deaf people. Generally, the public has this misconception that signs are just gestures and they are universal. Nothing can be further from truth. Sign languages are languages in their own right with distinctive grammar, vocabulary, syntax and other linguistic characteristics. Each country has its own sign language and is independent of the spoken language(s) of that country. For example, in the US, for the majority language is English, but the American Sign Language (ASL) is not related to it. English is also the main language in the United Kingdom; however, the British Sign Language (BSL) is different from ASL. In India, the sign language used by 8 millions deaf people is known as Indian Sign Language (ISL). ISL, like other sign languages, is not influenced by regional spoken languages. The ISL used in Tamil Nadu is the same as used in Himachal Pradesh or Bihar. Thus, a deaf person from Haryana can communicate with a deaf person from Kerala very easily.

Learning a spoken/written language and academic achievement The greatest obstacle a deaf child faces is learning the spoken language. Hearing children learn the language spoken by his family without any effort. By the time, a hearing child is about two years old; he has a good command of the language used by his family. When this child arrives in school when he is 4 or 5 years old, he is fluent in the language used in the school. The hearing child thus focuses on learning how to read and write and the grammar of that language which he already knows to speak fluently. He also learns other skills as mathematics, social studies, science and other languages.

Not all deaf people use ISL. There are deaf people who have oral communication skills at various levels. Some of them with hearing aids can speak fluently as well understand, while

The deaf child does not get any auditory input during his early years. Despite the use of hearing aids or cochlear implants, most deaf 17

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Journal of Disability Management and Special Education

children only get a rudimentary linguistic input, even that much. Some deaf children with good residual hearing do benefit from aural input.

at grade level or better because they have learned a language—sign language—during the crucial years and use this first language as a base to learn the second—spoken/written— language. They did not miss the boat and their mastery of first language helped them master the second (and third and fourth) language. Most of Indian people are polyglot, therefore, can appreciate and understand this very well.

Research shows that if the part of the brain that is devoted to learning languages is not used by age three, it starts to atrophy. Thus, deaf children who do not get any or get limited linguistic input arrive in schools without the language that is used by the family or the school. Since the deaf child has missed the crucial time of learning language, he has the uphill task of mastering a language that he has not heard. For this reason, the average reading level of deaf children after 12 years of schooling is only about 4.5 grade level. These children are of normal intelligence and had the benefit of good schooling. However, as stated above, they had “missed the boat.”

The question arises: Why not all use bilingual approach to teaching deaf children? This is a simple question and I wish there was simple answer to that. There are several factors. First, parents of deaf children want them to be “normal.” They think that using signs will hinder their speech acquisition. This belief is infused by supporters of oral education. Research has shown that using sign language does not hinder acquisition of speech. Instead, it helps. The problem is deaf children with limited residual hearing and/or lack of hearing aids fail to learn to speak. These “oral failures” are then recommended to learn sign language; but learning of signs is blamed for failure of oral skills. There are millions of deaf children who have “missed the boat” because of parents insistence on oral education. Were those children given the opportunity to learn signs when they were babies, they would have been academically successful.

This linguistic deficiency causes a domino effect on total academic performance of deaf children as other subjects depend on a student’s reading and writing skills. In addition to that, a deaf child has to spend much more time in learning writing and reading as well as speech that hearing children do in less time. Bilingual Education That does not mean deaf children cannot achieve well in schools. They can and they do. The key to deaf children’s academic success is early intervention and parental involvement from the day deafness is identified. A deaf child who gets linguistic input from birth can and does perform at his hearing peers level in school. A very small percentage benefits from oral input at early age. Others need sign language input from birth. Research has shown that deaf children of deaf parents who get visual linguistic input from early age perform

It is important to mention here that speech and language are not the same thing. Even a hearing person with wonderful speech can have very poor language and a deaf person with excellent language can have no speech. These two skills are mutually exclusive. However, people confuse them with each other. 18

Vasishta M / Deafness, Communication and Indian Sign Language

Oral vs. Manual In the end, I would like to discuss the centuries-old question whether deaf children should be educated orally or manually (using signs). The answer is: both. As I wrote in the beginning, no two deaf children are alike. Each deaf child (or hearing child) is unique and has different set of skills. Our duty is to focus on a child’s strengths and provide whatever works for him best. What works best for one child will not work for the other. What educators and parents of deaf children have to do is to rise above their beliefs and not sacrifice children on the altar of their dogmas.

Mahshie, S. N. (1995). Educating deaf children bilingually. Washington, DC: Gallaudet University. Mayberry (Eds.), Language acquisition by eye (pp. 165-190143-163). Mahwah, NJ: Lawrence Erlbaum Publishers. Newport, E & Supalla, T. (1987). A critical period effect in the acquisition of a primary language. Unpublished manuscript. Randhawa, S. P.K. (2005). A Status Study of Special Schools for the Deaf and Identification of Intervention Areas, Ph.D thesis submitted to Indian Institute of Technology Roorkee, Roorkee ( India). Randhawa, S. P.K. (2007). Am Here Mamma: From Invisible to Visible...Informed C h o i c e s f o r t h e Pa re n t s , a r t i c l e published in ‘Lakshnaya’ a Publication of International Deaf Children’s Society (IDCS).

There are schools for the deaf that provide excellent education using the bilingual education or oral approach. Both these approaches work. We have to, again, focus on the child and not the method.

Vasishta, M., Woodward, J. & DeSantis, S. (1981). An Introduction to Indian Sign Language: Focus on Delhi. New Delhi: All India Federation of the Deaf.

I hope this brief introduction has helped you orient to deafness and deaf people. Again, the goal of this paper is to give you some basic information and get you more interested. To this end, a selected bibliography is given below: References

Zeshan, U. (2000). Sign Language in IndoPakistan: A Description of a Signed Language.: Amsterdam: John Benjamins.

Immanuel, S. Prabakar, K., Claudia, & Tesni, S. (eds.) (1998) Listening to Sounds and Signs. Trends in deaf education and communication. Bangalore: ChristoffelBlindenmission, and Books for Change.

Zeshan, U., Vasishta, M. & Sethna, M. (2004). Implementation of Indian Sign Language in Educational Settings. Asia Pacific Disability Rehabilitation Journal 15, 2: 15-39.

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Inclusive Education: Strategy for Modification of Attitudes among Pre-service B.Ed. Teacher Trainees *P. Vijetha and **Prithi Nair

Abstract The present study aimed at finding out the existing attitudes of pre-service B.Ed. teacher trainees (B.Ed. trainees) and their teacher educators towards Inclusive education in B.Ed. colleges of Mysore. For measuring their attitudes, SACIE (Sentiments, Attitudes and Concerns about Inclusive Education) by Loreman, Earle, Sharma, & Forlin (2008) was used. Pre-data were collected from 968 pre-service B.Ed. trainees and 32 teacher educators from 13 B.Ed. colleges. The results revealed that majority of them were having favorable attitude towards inclusive education. However, there were trainees who expressed their attitudes to be neutral, undecided and unfavorable. Five B.Ed. colleges were randomly selected and pre-service teacher trainees of those colleges who showed neutral or unfavorable attitude as per predata were given orientation programme about various aspects of inclusive education. When the scores of pre-data and post-data of pre-service B.Ed. trainees were compared, significant difference was found in the results which can be attributed to the orientation program. This study suggests some strategies for modification of attitudes among Key words: Attitudes, Pre-service educators, Inclusive education.

Introduction Inclusive education means children with special needs studying along with typically developing children in a regular classroom that adapts and changes to meet the needs of all students in the classroom. Loreman (1999) states “inclusive education involves students from a wide range of diverse backgrounds and abilities learning with their peers in regular schools that adapt and change the way they work in order to meet the needs of all students”. The principle of Inclusive Education was adopted at the world conference on Special needs Education: Access and Quality (Salamanca, Spain, 1994). According to Salamanca Framework for Action (UNESCO, 1994), “Inclusive schools must recognize and respond to the diverse needs of their learners, accommodating all learners,

regardless of any difficulties of learning differences. Governments should ensure that both initial and in-service teachers training address the provision of Inclusive education”. In recent times, two major initiatives have been launched by the government for achieving the goals of universalization of elementary education (UEE): the District Primary Education Programme (DPEP) in 1994 and the Sarva Shiksha Abhiyan (SSA) in 2002. Inclusive education is an integral component of SSA. The objectives of inclusive education are to educate all children together for their mutual benefit and to change attitudes towards different children by forming the basics for a ‘just and non-discriminatory’ society which encourages people to live and learn together. In a country as large and diverse as India where large number of children with special

*Lecturer in Special Education, All India Institute of Speech and Hearing, Mysore. Email: vijetha_k21@yahoo.co.in **Lecturer in Special Education, All India Institute of Speech and Hearing, Mysore. Email: prithinair23@gmail.com

Vijetha P & Prithi Nair / Strategy for Modification of Attitudes

needs must be addressed and only with the availability of limited resources, the best option is to promote inclusive education.

needs in general education is becoming more prevalent (Crawford, Almond, Tindal and Hollenbeck, 2002).

Research has suggested that inclusive classrooms do not hinder the academic achievement of typical students and may have many social and developmental advantages for students both with and without disabilities (Peltier, 1997; Staub and Peck, 1995). Studies of both pre-service and in-service teacher attitudes towards inclusion of pupils with Special Educational Needs (SEN) in mainstream classrooms have also shown that attitudes were affected by the quality of preparation received. Lambe and Bones (2006) concluded that improving and increasing training provision at the pre-service phase of teacher education would be the most effective method of promoting better attitudes to inclusion, more specialized training and professional support is viewed as critical (Hammond and Ingalls, 2003). Teachers’ attitudes towards inclusive education are effected by variables such as children’s age, the type of child’s handicap, the level of the handicap, the level of the support the teacher and the students receive from the school and local education authority administration, the support services, their knowledge about inclusion and in-service training courses they receive (Sari, 2007). A study by Chopra (2008) on elementary school teachers’ attitude towards inclusive education found that the teachers are aware of inclusion of children with special needs in regular classroom. It also revealed that teachers belonging to rural areas are less positive towards inclusion compared to their urban counterparts. And also female teachers were less positive than their male counterparts towards inclusive education. The inclusion of learners with special educational

Context, need and importance of the study If inclusion has to be successful, one of the crucial points is that teachers’ attitudes must be given importance. Although this is an important area, only few studies have been carried out in India to understand preservice teachers’ concerns and preparedness to teach children with diverse needs. Such research may have useful implications both for teacher trainees. As there is pressing need of implementation of inclusive education, it is the obligation of teacher training providers to ensure that teacher trainees acquire the favourable attitudes towards inclusion. Most of the newly graduated teachers hardly have the necessary skills and favorable attitutde to meet the diverse needs of students in their classrooms. While training institutions are increasingly updating their content, a review of the syllabus of B.Ed. of University of Mysore reveals only one unit under paper ‘Educational Psychology’ where trainees study in brief about special or inclusive education which is inadequate for them to work in inclusive classrooms. In addition, this insufficient training hinders the establishment and success of inclusive classrooms. Therefore, a need was felt by the researchers to carry out the present study with the following objectives. Objectives of the study 1. To find out the attitudes of pre-service B.Ed. teacher trainees and their teacher educators (only for Pre-data). 2.

To find out the effect of orientation programme on the attitudes of pre-service B.Ed. teacher trainees towards inclusive education.

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Hypothesis 1. There is no significant difference in the pre and post scores of pre-service B.Ed. teacher trainees towards inclusive education trained through specific training package.

other relevant literature, the attitude scale for the present study was prepared. Phase III: Validation and finalization of the attitude scale Modifications were made as per the suggestions of 12 experts and the final attitude scale for the study was developed. The final attitude scale was translated into Kannada for collecting data from Kannada medium teacher trainees.

Method Participants Initially Nine hundred and sixty-eight (968) B.Ed. trainees and thirty-two (32) number of Teacher educators in Thirteen (13) B.Ed. Colleges in and around Mysore were selected as participants for the present study. Purposive sampling technique was used.

Phase IV: Collection and analysis of pre-data For collecting pre-data, the attitude scale was administered on 968 pres-service B.Ed. teacher trainees and 32 teacher educators in 13 B.Ed. colleges of Mysore. The pre-data were analyzed using appropriate statistics. Pre-data were analyzed in order to find out the participants having favorable, neutral and unfavorable attitudes towards inclusive education so that based on unfavourable and neutral attitude; sample can be selected for the orientation programme on inclusive education.

Phases involved in the study There were six phases involved in this study, the details of which are presented below: Phase I: Selection of B.Ed. colleges and preparation of the Attitude scale Sixteen (16) B.Ed. colleges in and around Mysore were shortlisted to participate in the study and the B.Ed. curriculum of University of Mysore was reviewed. It was found that the pre-service educators are exposed to the concept of Inclusive Education in brief in the Paper titled – ‘Educational Psychology’ under Unit 4 titled ‘Learners with special needs’. In addition, based on the relevant literature for the study, few domains and the statements for the attitude scale were prepared.

Phase V: Orientation about inclusive education As one of the objectives was to orient preservice B.Ed. teacher trainees and their teacher educators on inclusive education, appropriate training package on inclusive education to orient the participants was developed and validated. Only Five B.Ed. colleges were selected on random basis for orientation program. Among these 05 B.Ed. colleges, out of 366 number of B.Ed. trainees, those participants having neutral and unfavorable attitudes towards inclusive education were only selected for orientation program becuase of their willingness to participate in the study. Others were either absent or not interested. Therefore, only 249 pre-service B.Ed. teacher trainees were selected for orientation on

Phase II: Finalization of B.Ed. colleges and preparation of the attitude scale Out of 16 B.Ed. colleges, 13 B.Ed. colleges following University of Mysore B.Ed. curriculum were selected for the study. Based on SACIE (Sentiments, Attitudes, and Concerns about inclusive Education) by Loreman, Earle, Sharma, & Forlin, 2008) and 22

Vijetha P & Prithi Nair / Strategy for Modification of Attitudes

Procedure for data collection For the purpose of data collection, permission was sought from the respective Principals of the B.Ed. colleges by highlighting the objectives and purpose of the study. The data from 13 B.Ed. colleges was collected separately. The attitude scale for pre-data was administered on selected participants with proper instruction and supervision in one session of one hour duration. After collection of pre-data, an orientation program along with distribution of educative materials was also done only for selected 249 pre-service B.Ed. teacher trainees having neutral and unfavorable attitudes. Later Post-data was also collected in one session of one hour duration. The duration between the orientation program and the post-data collection was one month.

Inclusive Education for one hour duration for three weeks. Based on training package, participants were oriented and the handouts of training package were also distributed to them for their reference. Simultaneously, the researchers also checked for the completion of unit 4 ‘Learners with special needs’ under the paper titled ‘Educational Psychology’ in B.Ed. syllabus in these five B.Ed. colleges which were selected on a random basis. Phase VI: Collection and analysis of post-data After training 249 pre-service B.Ed. teacher trainees through orientation program, researchers distributed the handouts of training package. Post-data were collected from 5 B.Ed. colleges. using the same attitude scale wherein the order of statements was changed to avoid the repetition of responses. Out of 249 participants, post-data were collected from only 217 number of B.Ed. trainees as the remaining 32 B.Ed. trainees were absent. The post-data were analyzed using appropriate statistics.

Procedure for scoring The adapted attitude scale for the study is a four point rating scale consisting of both positive and negative statements. There are totally 25 statements in the attitude scale on a Likert–type classification and the total maximum score is ‘100’ and the minimum score is ‘0’. If the scores fall in the range from ‘0- 40’, it indicates unfavorable attitude, scores falling in the range from ‘41- 65’, it indicates neither favorable nor unfavorable attitude i.e. undecided and the scores falling in the range from ‘66 -100’ indicates favorable attitude towards inclusive education on the attitude scale.

Description of the scale An adapted version of SACIE (Sentiments, Attitudes, and Concerns about Inclusive Education by Loreman, Earle, Sharma and Forlin, 2008) was used to collect data from participants. The first section was designed to gather necessary demographic details of the participants. The second section contained 25 statements and was designed to elicit participants’ attitudes towards the inclusion of students with special needs into regular classes. All the statements pertaining to inclusive education which involves students from a wide range of diverse backgrounds and abilities learning with their peers in regular schools, which adapt and change the way they work in order to meet the needs of all.

Results and discussion Pre-data were collected from 968 B.Ed. trainees and 32 teacher educators from 13 B.Ed. colleges and the same was analyzed using quantitative and descriptive analysis. The details are given in Table A: 23

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Table A: Quantitative and Descriptive Analysis of the Pre and Post Data Table 1: Scores of B.Ed. trainees on Attitude scale Scores

Particulars

Total number of participants

Percentage

< 40

Unfavorable attitudes

41 - 65

Undecided(neutral)

374

38%

66 - 100

Favorable attitudes

593

61%

Total

968

100%

Figure 1: Scores of B.Ed. trainees on Attitude scale Table 2: Scores of teacher educators on Attitude scale Scores

Particulars

Total number of participants

Percentage

< 40

Unfavorable attitudes

None

41 - 65

Undecided(neutral)

28%

66 - 100

Favorable attitudes

72%

Total

100%

Figure 2: Scores of teacher educators on Attitude scale 24

Vijetha P & Prithi Nair / Strategy for Modification of Attitudes

Table 3 Descriptive Statistics of Pre test Scores of Pre-service B.Ed. trainees on Attitude scale Statistical measures

Figure 3. Descriptive statistics for Pre-test scores

Values

Mean

62.76

Median

63.00

Std. Error of Mean

0.475

Std. deviation

6.993

Skewness

– 1.017

Kurtosis

3.036

Table 4 Descriptive Statistics of Post test Scores of Pre-service B.Ed. trainees on Attitude scale Statistical measures

Figure 4. Descriptive statistics for Post-test scores

Values

Mean

66.30

Median

66.00

Std. Error of Mean

0.396

Std. deviation

5.828

Skewness

0.227

Kurtosis

– 0.158

Interpretation As can be seen from the table 1, overall pre-service B.Ed. teacher trainees responded favorably towards inclusive education with regards to the inclusion of children with special needs. It should be noted that studies reviewed reveal both favorable and unfavorable attitudes

towards inclusive education. The present investigation confirms the findings of the study by Van Reusen, Shosho & Barker (2000) which indicated that pre-service educators have a positive attitude towards inclusive education. On the other hand the studies by Crawford, Almond, Tindal and Hollenbeck, (2002) 25

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indicated that the majority of teachers shared apprehensions about inclusion of learners with special educational needs. The Table 1 reveals that 61% of pre-service B.Ed. teacher trainees have favorable attitude towards inclusive education which should be viewed with excitement as it appears that inclusive education is perceived as a progressive option. And the reason behind could be their willingness to accept new challenges. And the remaining 1% and 38% revealing unfavorable attitudes and undecided respectively needs attention and measures have to be taken to mould their attitude positively about inclusive education.

higher attitude towards Inclusive Education. The standard error of the mean is 0.475. It means that the true mean of 62.76 falls in the interval ranging from 61.829 to 63.691. The skewness value is -1.017. It indicates that the given distribution is slightly negatively skewed. From the Figure 3, it is observed that the frequency curve is almost normal even though it is having slightly negatively skewed curve. From the table 4, it is observed that the mean value of 66.30 is slightly higher than the median value of 66.00. The nature of the distribution is very near to the normality. The pretest scores are distributed with a skewed curve. The post test scores are almost normally distributed. The standard error of the mean is 0.396. The skewness value is 0.227 which indicates that the given distribution is slightly positively skewed with almost near to the normal distribution. The Standard deviation of pretest scores is 6.993 and post test scores are 5.828. The variation of the scores is reduced from 6.993 to 5.828. The reduction in the variation among the scores is due to the intervention. This can also be observed in the frequency curve in the figure 4 that the obtained distribution is normal even though it is having slightly negatively skewed curve.

It can be seen from the table 2, among the teacher educators who participated in the study majority were having favorable attitudes towards inclusive education (72%). The remaining 28% were undecided and this may be attributed to their apprehensions about dealing with children with special needs in classrooms. These apprehensions expressed have to be eliminated slowly, steadily and systematically. If fundamental knowledge and skills to deal with children with special needs in classrooms can be taught, there might be more encouragement among teacher trainees and teacher educators in welcoming the concept of inclusive education practically.

Comparison of Pre and Post test Data of B.Ed. trainees The pre-test and post-test scores are compared to find out if there are any improvements in the attitudes of B.Ed. trainees towards inclusive education in five B.Ed. colleges. To test the above mentioned hypothesis, t - test was applied, the result of which is given below:

Descriptive analysis The Descriptive Statistics like Mean, Median, Standard Deviation, Skewness and Kurtosis for the Pre-test scores and Post-test scores. From the table 3, it is observed that the mean value of 62.76 is smaller than the median value of 63.00. It means the large number of B.Ed. trainees were having slightly 26

Vijetha P & Prithi Nair / Strategy for Modification of Attitudes

Table 5: Showing t-test Results of Pre and Post Tests of B.Ed. trainees Group

Mean

Pre

217

62.76

6.993

Post

217

66.30

5.828

Correlation

t- value

0.051

5.88

Significant at 0.05 level Figure 5: Figure showing the Pre and Post-Test scores

From the above table 5, it can be observed that that the calculated t-value for pre and post test scores is 5.88. Therefore, it indicates that there is a significant difference between pre and post test scores of pre-service B.Ed. teacher trainees. The mean post test score of 66.30 is significantly higher than the mean pretest

score of 62.76. This can also be observed in figure 5. This difference is due to the experimental intervention. Hence, it shows that the orientation program was significantly influencing in promoting favorable attitude towards inclusive education.

Comparison of Pre and Post Test Scores of B.Ed. Trainees of Five B.Ed. colleges Figure 6: Figure showing the Pre and Post-test scores of Five B.Ed. colleges.

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Table 6 reveals the consolidated pre and post scores of five B.Ed. colleges. This can also be observed in the figure 6 that there is significant difference between pre and post scores of five B.Ed. colleges indicating that the orientation program was effective and significant in promoting favorable attitudes towards inclusive education. This is in accordance with Mastropieri and Scruggs, (2001) that inclusion is more successful when teachers have access to resources such as information about students with particular special needs and the nature of the disability of particular children in their classroom, expert guidance gained through special education teachers and professional development, as well as adequate funding to support adapted

toward inclusion (Shoho, Katims and Wilks 1997) The resourcing of schools is essential if the anxieties around the implementation of inclusive education are to be addressed. The fact that literature seem to reveal both unfavorable and favorable attitudes towards inclusive education is indicative of the fact that a lot of work need to be done nationally. It should be acknowledged that India is one of the leading countries in the world in terms of the implementation of inclusive education. However, an observation has been made that educators, learners and parents are not fully educated about inclusive education. Several conclusions can be drawn from this study. Favorable attitudes of B.Ed. trainees can be viewed with excitement as they are willing to accept new challenges. But it is not to be forgotten that they expressed unfavorable attitudes and were undecided which might be because of their lack of knowledge and practical exposure to handle children with special needs in inclusive classrooms. The observation made by the researcher during the process of the orientation and post-data clearly indicate that many of the B.Ed. trainees expressed their apprehensions about handling children with special needs in inclusive classrooms. Another important observation was most of the teacher educators of B.Ed. trainees in selected B.Ed. colleges hardly provided any co-operation in either attending the orientation program or participating in collection of post-data. The reason could be their lack of interest in understanding the importance of the study, either their openness to accept new concept or their professional regular commitments to complete their portions. However this behavior clearly indicates that inclusive education and

instructions in their classrooms. Discussion For inclusive education to succeed, it is very important that teachers, principals and other service providers maintain a favorable attitude towards inclusion. They must be firmly convinced of the benefits that inclusive practices bring to all children. Even if inclusive education is made mandatory, it will be successful only when there is enthusiastic support from all service providers. To obtain such support, behavior and attitudinal change are involved which does not happen quickly or easily. It is clear from the preceding analysis that pre-service training in inclusive education and continued professional development are of paramount significance if inclusive education is to be successfully implemented. Increasing the knowledge base of educators about students with disabilities and ways to meet their learning needs can be a good strategy to promote positive teachers attitude 28

Vijetha P & Prithi Nair / Strategy for Modification of Attitudes

the teachers attitudes are viewed as least important. Being teachers of the future, some of them hardly realized the importance of the study about inclusive education in spite of taking appointments prior for orientation program and the post-data collection by the researcher. This result is in accordance with the results of research conducted by LeRoy and Simpson (1996) and Villa et al (1996) which indicated that teachers who had active experiences of inclusion, resulted in favorable inclusion. When teacher educators and their respective colleges themselves are not interested in understanding the importance of inclusive education then how can their students (B.Ed. trainees) realize the importance of inclusive education? During the study, it was also realized by the investigator that one unit -Learners with special needs in one theory paper titled -Educational Psychology in B.Ed. Syllabus of University of Mysore is not sufficient for B.Ed. trainees to practically prepare them to handle children with special needs in Inclusive

to ensure that future generations of teachers enter the profession with sufficient skills and knowledge to work in an inclusive environment, and in-service training to improve the capacity of teachers already working in the field. Therefore, concerned authority need to take measures at the teacher training level itself. Since pre-service years of teacher trainees are a critical period for the modification of teachers’ attitudes, teacher education program must be focused on promoting favorable attitudes towards inclusion among pre-service B.Ed. teacher trainees. References Chopra, R. (2008). Factors influencing elementary school teachers attitude towards Inclusive Education. Educationline database on 26th September. Crawford, L., Almond, P., Tindal, G & H o l l e n b e c k , K . ( 2 0 0 2 ) . Te a c h e r perspectives on inclusion of students with disabilities in high school stake assessments. Special Services in the Schools. 18 (1-2), 95-118.

classrooms. Limitations of the study 1. Due to paucity of time, post-data were collected only from five B.Ed. colleges which were selected on random basis. 2.

Duration of the orientation program was only one hour.

During the orientation program, very few strategies have been used by the researcher due to lack of time.

Hammond, H., & Ingalls, L. (2003). Teachers attitudes toward inclusion: Survey results from elementary school teachers in three Southwestern rural school districts. Rural Special Education Quarterley, 22(2), 24-30. Lambe, J. & Bones, R. (2006). Student teachers’ perceptions about inclusive classroom teaching in Northern Ireland prior to teaching practice experience. European Journal of Special Needs Education, 21 (2) 167-186.

Conclusion To conclude, if inclusive education has to be successful, three essential components to be considered are - the attitudes of teachers and other staff, pre-service training programs

Loreman, T. (1999). Integration: Coming from the Outside. Interaction, 13 (1), 21-23. 29

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Loreman, T., Sharma, U., Forlin, C., & Earle, C. (2005). Pre-service teachers’ attitudes and concerns regarding inclusive education. Paper presented at ISEC 2005, Glasgow.

Taylor, R. L., Richards, S. B., Goldstein, P. A., & Schilit, J. (1997). Teacher perceptions of inclusive settings. Teaching Exceptional Children, 29(3), 50-54.

Mastropieri, M. A. & Scruggs, T. E. (2001). Promoting inclusion in secondary classrooms. Learning Disability Quarterly, 24(3), 265-274.

UNESCO (1994). The Salamanca Statement and Framework for Action on Special Needs Education. Adopted by the World Conference on Special Needs Education: Access and Quality. Salamanca, Spain, 7-10 June.

Peltier, G. L. (1997). The effect of inclusion on non-disabled children: A review of the research. Contemporary Education, 68, 234-238.

Van Reusen, A. K., Shoho, A. R., & Barker, K. S. (2001). High school teacher attitudes toward inclusion. The High School Journal, 84(2), 7-17.

Sarı, H. (2007). The influence of an in-service teacher training (INSET) programme on attitudes towards inclusion by regular classroom teachers who teach deaf students in primary schools in Turkey. Deafness and Education International, 9(3), 131-146.

Acknowledgement This research report has been derived from the study titled “Attitudes of Pre-service teachers towards inclusive education” carried out under the AIISH Research Fund. The authors would like to thank Director, AIISH for permitting us to conduct the study under AIISH Research Fund reference no. 3.52/IV. We would also like to express our sincere thanks to all the Participants and Principals of B.Ed. colleges for their support.

Staub, D. & Peck, C. A. (1995). What are the outcomes for non-disabled students? Educational Leadership, 52, 36-40.

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

India’s Deaf: Whither not Wither

*Michael W Morgan

Abstract In this paper the author argues for the need for recognition, understanding, and promotion of Deaf Identity, Deaf Culture and Deaf language (i.e. sign language) for Deaf individuals. As such, he specifically addressed hearing scholars and professionals (audiologists, speech thearpaists, teachers at schools for the deaf, etc), members of what he calls the “deaf rehabilitation industry“, in large part because, within India, this industry has largely been ignorant of the importance of Deaf cultural identity in the development and realisation of the potentials of Deaf individuals.To such end, an overview of the history and development of concepts of Deaf Identity and Deaf Culture within the the global and also within the Indian conext is discussed, with emphasis on Deaf-centred positive conceptualisation of “Deafhood“, over a traditional negative, stigmatising view of deaf as “hearing impaired“. Key words: Deaf, Deaf identity, Deaf culture, Sign language, Deaf community in India

Introduction: Complexities of Identity and Culture The concepts of culture and of identity are exceedingly complex to be sure, and to boil the social and cultural “essence” of any group down into an article-, or even a book-length synopsis would be a daunting task. Even if we could attempt to make the matter somewhat more manageable by delimiting the topic, say, geographically, the task remains a challenge. For instance, if we were to write an introductory chapter on the “Culture of Mumbai”, how would we proceed? How would we define our subject? Would we focus solely on that minority living and working south of Dadar, who still largely prefer to call their city “Bombay”, a city which is, arguably, the cultural capital of India? Or should we instead limit our discussion to the majority of “suburbanites” who know the city as “Mumbai”? Do we include the suburb of Mulund, while excluding the city of Thane, a thirty-second foot-bridge crossing away, *

although events in the latter neighbouring city are often telling reflections of a certain side of the culture (and politics) of Mumbai? (As for example in the riots in October 2008 over the issue of All-India Railway Recruitment Board entrance exams not being advertised in the local Marathi-language press). If we talk about peoples rather than places, our task becomes no less complex. What is, for example, “Punjabi culture”? Do we talk only about the culture of the bearded Sikh residing in Amritsar who attends his local gurudwara, or do we also venture to talk about the culture of his clean-shaven cousin brother who lives in Delhi? Or his nephew who lives in New York City and whose “Punjabiness” seems to be limited to the fact that he listens to Bhangra hip-hop? And what about his kin who live in Pakistan’s Punjab? Although they may write the language in a different script, and mostly practice a different religion, Pakistani’s

National Federation of the Deaf, Nepal, (formerly at IGNOU & Ishara-Mumbai). E-mail: MWMBombay@gmail.com and MWMKdu@gmail.com

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Punjabis are without question the linguistic and genetic kin of India’s Punjabis. Do we include in the discussion Hindi cinema, given the fact that, all dancing in Hindi cinema these days seems to be “Punjabi”? Whatever the decision, whether we paint Punjabi culture with a broad brush or a narrow one, ultimately the focus will be on a culture which harks back to a certain place called “Punjab”, practised by people who are genealogically Punjabi because their

son’s preferred Bangla spelling), but speak of its inhabitants as “small-b” bengalees? This would be unthinkable, something which our auto-correcting spell-checkers make virtually impossible to do, whereas those self same spellcheckers, our modern “thought police”, insist that we spell “deaf” with a small-d!? The issue is, in part at least, respect, and also how to define the essence, or at least the “centre” of Deafness without excluding or losing sight of all the individuals who, for whatever reason, may not reside exactly in that centre.

parents and grandparents were Punjabi. 1. “Deafnicity”: Deaf Culture and Deaf Identity Considering the examples and problems introduced by way of example above, think now how much more difficult it is to open a discussion of a people who have no ancestral homeland, who generally cannot trace any common lineage through parent and grandparents, indeed a group whose own parents do not even share their cultural “heritage”. And indeed a group of individuals whose very group membership is denied (or at least ignored) by nearly everyone who isn’t one of them? Such is the dilemma of writing about the Deaf, when almost all non-Deaf choose to refer them as “hearing impaired” or “hearing handicapped” (as in the Government of india’s main institution “aimed” at their problems, the Ali Yavar Jung National Institute for the Hearing Handicapped, NIHH), or, worse yet, “deaf and dumb” (And, just as offensively, refer to themselves as “normal”, with the logical implication that Deaf are abnormal!). And even when non-Deaf choose to use the preferred autonym of the Deaf, they do not honour this name with a capital letter? What if I were to write of the culture of Calcutta (or Kolikata transliterating its most famous

As with any discipline, there are a wide variety of sociological, psychological, cultural, medical, educational Weltanschauungen which can be applied to “deafness”, and many of them are not entirely lacking in a certain positive heuristic, practical or other value. However, this does not mean that all of them are equally valid, nor equally useful, and certainly not equally valid and useful in all contexts. Nor does it imply that those approaches with practical or other value in one limited sphere might not result in greater existential damage overall. (I will ignore the possibility that some are self-contradictory if not self-defeating.) While acknowledging a certain reductionism to the approach herein adopted, for ease (and compactness) of explication, as well as for what is felt to be the heuristic benefits of so doing, and with certain validity both historically and institutionally, the author proposes that approaches to “deafness” can be characterized as being: (1) basically negative, or (2) basically positive. 32

Morgan M W / India’s Deaf: Whither not Wither

2. Negativising Deafness: Enter the missionaries and colonizers It is very unfortunate that discussions by scholars and professionals about the Deaf, especially almost all discussion outside the West, are all too often talking about “them”, about “the other”, and rarely involve Deaf “voices”, or even dialogue with Deaf themselves. It is not only a question of Deaf being under-represented (or unrepresented) among scholars and professionals, but also about the “foreignness” of scholarly discourse. For the mass of India’s Deaf, having obtained a school leaving certificate at best, it is not only the content, language, and, unfortunately, all too often the attitudes expressed in this discourse which is off-putting, but also the dry academic style of the discourse. And so too perhaps, hearing scholars and professionals who serve (or at least serve in) the “deaf rehabilitation industry” might find Deaf discourse “alien”. One purpose of this paper is to present a hopefully coherent overview of Deaf discourse for members of that industry, so that they might better understand the needs of their “clients”. And, it is the author’s understanding that one of the needs of the Deaf community is that practitioners within the “deaf rehabilitation industry” change themselves and their practices to become more “Deaf friendly” and respectful of Deaf identity and Deaf culture. And that is only possible through awareness-raising, increased understanding, and ultimately motivation for change on the part of practitioners themselves.

it has been the only acceptable, acknowledged approach to the subject, and this view has been largely oblivious to, and dismissive of, all other forms of discourse. Essentially, this view boils “deafness” down to a single negative: hearing loss, hearing handicap, hearing disability. The entire raison d’être for all professional focus on the deaf is what they do not have (hearing) and what they cannot do (hear, and– although this is often a mistaken extension – speak). Within this world view, all medical energies are directed at curing or at least mitigating the perceived lack, whether by means of witchcraft, or surgery, or of mechanical aids (so-called hearing aids). While educational energies are slightly less monolithic in their focus, nevertheless the primary goal (primary as determined by the inordinate amount of the school-day spent, either in structured “instruction”, or less structured correction) of “deaf education” is remedial and rehabilitative: to teach the deaf to speak and to be learn to read speech on the lips (as well as to make use of residual hearing, even when it is insufficient for the task). Before dealing with practical issues of efficacy, or efficiency, let us look at what is wrong with these approaches philosophically. Wherever you look in what I will hereafter refer to here as the “deaf rehabilitation industry” (by this term I mean all the professions, including audiology, speech therapy, implantation surgery, deaf education, and indeed to a certain extent the profession of parenting, whose aim, either sole or primary, is to “rehabilitate” deaf children and making them “normal”), overwhelmingly these approaches are both (1) colonialist, and (2) missionary. To teachers and principals at deaf schools in

Unfortunately, for the vast majority of history and in the vast majority of the world (both historically and currently), a negative view of “deafness” has not only dominated, but 33

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India, to speech therapists and audiologists throughout the country, a country which has itself experienced first-hand the excesses of both colonialism and missionary-ism (and which 60 years after independence all too often continues to blame colonialism for its ills!), these accusations may seem outrageous. Therefore, let me demonstrate.

as with religious missionaries, those in the deaf rehabilitation industry feel that if the deaf do not see the virtue in being converted to hearing (or at least oral), then it is only because they are incapable of deciding for themselves. Hence enters the element of paternalism; “we” know best, and therefore “we” decide, “we” make the rules, etc. Granted, when a deaf child is two or three years old, they are incapable of making informed decisions. However, unless the parents and medical and educational specialists are themselves Deaf, and know the positives and negatives involved in being Deaf, they too are incapable of making informed decisions. As Lane writes regarding cochlear implanting:

A demonstration of the colonialist aspects of the deaf rehabilitation industry is simple: if you are a member of this industry, if you are an audiologist, or a speech therapist, or a teacher at a school for the deaf, look around you and ask:. how many of your colleagues are themselves Deaf? Ask yourself, how much of the money being spent within my profession goes into the pockets of Deaf people? Ask yourself, who is making the decisions in my professions about what needs to be done and how it needs to be done (and in whose language are these decisions and discussions being made)? Unless the answer is “the majority of my colleagues, the majority of the monetary beneficiaries, the majority of the decision makers are deaf”, then your profession is colonialist, plain and simple.

The ethical basis for the parent acting as surrogate for the child is predicated on the assumption that the surrogate knows the child or is close to his or her cultural or ethical values. The surrogate’s choices should approximate what the patient would have wanted were he or she able to express a choice (Ramsey, 1970). Unfortunately, hearing parents often do not know the patient because they have lacked a common language with their Deaf child. In fact, most Deaf children would likely refuse that consent to surgery if they were old enough to decide. We infer that because Deaf adults who were once Deaf children but are now old enough to make a considered decision are overwhelmingly opposed to pediatric implant surgery. Numerous Deaf organizations worldwide and the

The goal of missionary-ism is to convert. Religious missionary zeal does not allow for the possibility of alternative value systems or belief systems; “my way is the only true correct way, my beliefs are the only correct beliefs”. So too, the medical and educational establishments do not even conceive of the possibility that someone might actually feel they are okay Deaf, much less allow that someone might actually be okay Deaf. As religious missionaries cannot imagine anyone wanting not to “see the light”, so too medical and educational missionaries cannot imagine anyone not wanting to “hear the sound” (and speak)! And, 34

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World Federation of the Deaf have formally protested childhood implant surgery. (Lane, 1994: 300)

-isms signifying prejudice and bias against individuals (and groups of individuals) based ultimately on an insignificant and accidental character trait being given primacy in determining that one individual is better than another. Whites are better than blacks. Brahmins are better than Shudras. Fair-skinned people are better than dark skinned people. Males are better than females. Young people are better than old people. Attractive people are better than unattractive people. And people with more “normal” hearing are better than those with hearing loss. (And those with less hearing loss are better than those with more hearing loss.)

Unfortunately, too few parents and too few “professionals” working in the “deaf rehabilitation complex” listen to what the Deaf say. Too few parents and too few “professionals” choose to even try to listen to what deaf have to say. Reverend Jesse Jackson upon the occasion of the “Deaf President Now” movement at Gallaudet University in the United States in 1988: “The problem is not that the students do not hear. The problem is that the hearing world does not listen.” If they are not deaf themselves, then it is incumbent upon them to inform themselves by bringing Deaf adults and the Deaf community into the discussion. And it is incumbent on them to learn to speak with the Deaf rather than just about the deaf, and to do this requires becoming fluent in the language of the Deaf, requires fluency in sign language. Even religious missionaries the world over have for centuries been learning the language of the colonized!

While professionals within the deaf rehabilitation industry may deny that they are audist, we must look again. Who are the deaf who are praised in deaf schools? Well, as long as the school is an oral school, or places value on pupils being “oral” -- or even “written” -- successes (and, in my experience, that is all the deaf schools in South Asia!), then it is precisely those deaf with less hearing loss, the pupils with more residual hearing, and pupils who lost their hearing at an older age who are praised, for almost invariably these are the pupils who perform well by such measures. And, in India even in deaf schools of all places, if a deaf person is employed, the type of job and the degree of status and responsibility (and power!) they have within the school will correlate extremely well with the degree and nature of their hearing loss status. Oral Deaf are allowed to be teachers (but usually only in kindergarten and lower elementary school, or in “vocational” courses like sewing or woodworking), signing Deaf sweep the halls and clean the toilets! (It might not be inappropriate

Unfortunately, in the deaf rehabilitation industry this is rarely if ever done, neither in individual cases, nor in general. Deaf input, perspective and language generally are not (at least not in India) part of the training and education curriculum of future audiologists, future speech therapists, future deaf school teachers, nor of parents of deaf children. 3. The new racism: “Audism” In addition to smacking of colonialism and missionary-ism, these views can also be described as audist. The term “audist” is the audiological equivalent to racism, caste-ism, sexism, age-ism, lookism, or any other such 35

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– even if unkind -- to make an analogy: in the United States in the early nineteenth century, under slavery, it was the light-skinned blacks who were allowed to serve the master in his house; dark-skinned slaves were left to work

success. It is not “good enough”, to say “See many of our students have become successful tailors and carpenters; those are good jobs … for a deaf person.” And, as an educator I might add, if an even smaller number of deaf school graduates decide they want to become teachers than of students in other schools, then maybe it is because their experience in school has been less than “enjoyable”.

the fields!) 4. Negative expectations lead to loss for the Deaf Leaving for now the question of whether such colonialism and missionary zeal is right or wrong, let us turn to practical issues. While it cannot be argued that these medical and educational endeavours fail to achieve the above-stated goals in every instance, any honest appraisal would show that they fall far short of claims for “rehabilitation”. I say “would show”, because in fact generally there has never been an honest appraisal, at least not in the educational “wing” of the deaf rehabilitation industry. In India and in many countries information is generally not even collected, even less frequently evaluated, and certainly never advertised openly and transparently. And the negative outlook on the deaf makes it all too easy for deaf schools to claim even mediocre returns as success!

Negative audist views also potentially help create within the Deaf community divisions and hierarchies of privilege and power among Deaf which are in some cases be in conflict with values and belief systems held by members of that community. Seeing all too many Deaf communities, in India and elsewhere in Asia, where presidents, general secretaries, board members, and other representatives are not only “oral Deaf” but also poor signers – thus able to speak to the people with power (the hearing) but unable to fully communicate with the Deaf they are elected to represent – one wonders if maybe the elections (to say nothing of the system) aren’t rigged. If nothing else, rigged by a systematic and pervasive de-valuing of Deafness in the society at large.

Taking deaf education as an example, in judging whether a deaf school is a success or not, it is only fair and honest to judge them by the same standards as other schools are judged. If a similar percentage of students fail to matriculate, then it has failed to provide an equal education. If a similar percentage of students fail to go on to college and university, and to major in academically challenging fields which will lead to well paying jobs in professional careers, and to graduate college, and to obtain good, well-paying jobs, if a school fails to produce these results, then it is not a

None of what has been said here should be interpreted as reflecting negatively on those members of the Deaf community who might, for whatever reason, be judged “successful” by the non-Deaf established powers. It is a critique only of the way the status quo establishment skews things to create an uneven playing field which makes it more difficult for more prototypical – and more numerous -- members of the Deaf community. And, it is unfortunate and lamentable that within the Deaf community, 36

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against the resolution, but also in refusing, upon return to the United States, to abide by the (rigged) results. In this way an essential seed perhaps for later developments in the Deaf Weltanschauung was preserved: continuity in the use of sign language in what was then and remained for another eighty-five years the world’s only college or university catering to the needs of the world’s Deaf communities. Many subsequent developments in the sociocultural life of the Deaf -- not only in the United States but in the entire world -- in one way or another trace back to this university campus, as it remained through the post-Milan “dark ages” a Mecca for Deaf from all over the world, and many seminal actors on many national Deaf cultural stages the world over have been involved in the life of this university.

there are at times reactive comments and actions taken against Deaf “oralist” success cases. It is often the case – and this is true in “argumentative India” as much so as any other country – that important community issues are often only looked at when they are heavily politicized in the most caricatured and un-nuanced ways. 5. Becoming Deaf: The evolution of Deafness into Deafhood, Deafnicity What then is the positive alternative to this negative audist approach to “deafness”? Deaf views are much less unitary, and much less static than the audist, oralist world view of “deafness”. It is an evolving set of views, the narration of which typically begins in the 1970s, but in fact whose roots go back much further. No event is more pivotal in the audist/oralist movement that the so-called Second International Conference of Teachers of the Deaf which took place in Milan, Italy in 1880, at which a vote decided that henceforth all education of the Deaf should be conducted using oral methods, and oral methods alone. As pointed out in memoirs of the events (Gallaudet, 1881), there was nothing democratic about the vote, as the entire conference was rigged so that the results would be inevitable. In addition, the Milan conference is important for our narrative, in that in general one small group of attendees and that group alone opposed the resolution, and that group was the only group with any Deaf representation (as well as, one might add, the two Gallaudet brothers, son’s of a Deaf mother). In addition, their anti-audist protest (long before the term “audist” was ever first used!) consisted not only in voting

Indeed, positive Deaf approaches to “deafness” can, in large part, be seen as a reaction, a rebellion, a revolution against the oralist, audist status quo. Although this has been a gradual evolution, with many stages, here I will focus on only three stages, each being rather simplistically characterized by single concepts. To simplify the positive, Deaf view as a chain of developments, as an evolution of concept, we can characterize it into three concepts: (1) Deaf Culture and (2) Deafhood, and (3) Deaf Gain, with the understanding that no conceptual stage became extinct when the next conceptual stage arose, nor in fact has any of these concepts been superseded by subsequent ones. Rather, the process of conceptual development has been additive. The first stage in this evolution is the realization and recognition of “Deaf Culture”. One distinction which was first used in 1972 was that between “deaf” and “Deaf” (Woodward, 37

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1972). According to this distinction, the “small d” spelling would be used, as was common practice, to refer to persons with profound hearing loss. However, since this usage did not encompass what was felt by Deaf people themselves to be more central to their essence as a group – that something being their sign language and the concomitant social and cultural values and practices which we have come to call Deaf Culture --, it was proposed that, on the model of names of other linguistic cultural (ethnic) groups to use capitalized or “big D” Deaf to refer to Deaf as members of a linguistic and cultural group. It was felt that this usage more clearly reflected how Deaf saw themselves, and so was a more appropriate usage.

and just without the outer border of the outer rings). It should be noted that however well or poorly this model actually shows the dynamics of membership in the Deaf community, that membership is, in fact, dynamic and not static. An individual’s positional status in the Deaf community, whether at the centre or the periphery or wherever, is often fluid depending on the setting, the situation, who s/he is interacting with, and so forth. Indeed, membership and positioning within the Deaf Community, unlike “hearing impaired” status under the audist model, is not based on a single criteria, nor necessarily an essentialist set of criteria, all of which must be present in order to qualify. Yes, typically members of the Deaf community have profound hearing loss. Typically they attended Deaf schools. Typically they are married to other members of the deaf community (assuming they are married, and assuming the marriage was not arranged by their non-Deaf family).2 Typically most of their close friends and those they spend their free time with are likewise Deaf.

Subsequently a model for the Deaf community and Deaf Culture developed, composed of concentric circles (like the rings of an onion), with the centre representing the core of the Deaf community, developed. Certain people – for example, Deaf who were not only born Deaf but born into Deaf families (who also therefore acquired sign language from birth, in a natural way), and Deaf who attended residential Deaf schools -- were located in the centre of the circle as being the heart, the core of the Deaf community and of Deaf Culture. Various other Deaf people occupied various concentric rings closer to or farther removed from this centre circle. And certain people, including many who would not even be defined as “deaf” under a medical model of Deafness – people like non-Deaf children of Deaf parents (CODAs), sign language interpreters, signing teachers at Deaf schools, etc. – might occupy the most peripheral rings (or they might waiver between being just within

As Lane (2006) points out, communities and cultural/ethnic groups generally share characteristics in a number of areas. Deaf are no different and can be seen as sharing many traits; few (if any) individual feature is essential to membership, but rather what is important is whether a person generally accepts the “package” of deaf values and beliefs (and experiences). However, if one feature stands out as being more essential than the others, it is both a respect and a preference for sign language. This has led to Deaf being described as linguistic minority, as “Sign Language peoples”, as “People of the Eye” (because sign 38

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language is a visual language, even more than it is a manual language, although of course the hands are what non-Deaf and non-signers tend to focus on).

this literature is expressed), and community (a sense of belonging rather than exclusion, and a community which nurtures both cognitive and creative gains).

A more recent development is the concept of “Deafhood”, originally introduced as early 1993, expounded in great scholarly detail in (Ladd, 2003), and thereafter having gone “viral” in the deaf world.3 Ladd writes: “[The] term [Deafhood] was developed ... in order to begin the process of defining the existential state of Deaf ‘being-in-the-world’. … Deafhood is not seen as a finite state but as a process by which Deaf individuals come to actualize their Deaf identity, positing that those individuals construct that identity around several differently ordered sets of priorities and principles, which are affected by various factors such as nation, era and class.” (Ladd, 2003: xviii)

In addition to those gains which accrue to the Deaf individual, it can be argued that “Deaf Gain” also has “global” impact. In addition to the gain which accrues (at least when viewed from a modern secularist point of view) from any increase in diversity, here we will focus on two of those gains, two contributions to world culture, which could not accrue if Deaf communities, and their native sign languages, did not exist. These are just two representative examples of Deaf Gain; others could easily be added but for limitations of space. The first is sign language literature. Just as one could argue that the plays of William Shakespeare themselves are enough of a contribution to world literature and world culture to justify the existence of the English language (and people, if indeed English needs a justification!), so too the rap music literature of SignMark is enough of a positive contribution (because of its “beauty” and creative novel style of expression” and what it has to say not only about Deaf condition but, by extension, the human condition) to justify the existence of Finnish Sign language and the Finnish Deaf community. Likewise, the poetry of Clayton Valli and Ella Mae Lentz or the story-telling of Ben Bahan and Sam Supalla are enough to justify American Sign Language; Dorothy Miles’ poetry to justify British Sign language; Wim Emmerik’s poetry; and so on. This is not to say that any of the above listed sign language poets is an equal to Shakespeare; but then, neither are most recipients of the Nobel Prize for literature (in

One last aspect of the evolution of Deafhood and its impact on the Deaf community is a turning of the label “hearing loss” on its head. So, instead of “hearing loss” we have its positive antithesis the concept of “Deaf Gain” (Bauman & Murray 2010). Deaf Gain can, in fact, be viewed in terms of two independent and equally valid contributions: (1) a positive gain for the deaf themselves, and (2) a gain to society and the larger community due to the very existence of Deaf. These gains can no doubt be seen in many different areas, and are perhaps more evident when it comes to the Deaf individual. Gains which accrue to the Deaf themselves include: cognitive (due to access to information and discourse), creative (which can be argued to accrue to humanity as well, even if most of humanity does not chose to learn the language in which 39

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my opinion). And that there has yet to appear a deaf “Tagore” is not due to any limitation in the creativity or the beauty of Indian Sign Language4, but rather to the restrictions placed upon that language by oralist schools, by oralist teachers and principals, by hearing aids and cochlear implants, by audiologist and speech therapist practices, by parents who refuse to encourage and nurture their children through that language.

and Kusters (2007, 2009) have given us glimpses of a number of local manifestations of Deaf Identity in Bangalore, Mumbai, and Delhi; with luck, the near future will see an exponential growth in such research. Until that time, however, we must accept limited and local glimpses as indicative of the “big picture”. The concept (if not the fact) of “Deaf Culture” is fairly new to India, and although it has been assumed in certain works (such as the materials for the NIHH ISL interpreter training courses prepared by Dr. Ulrike Zeshan), and although many Deaf assert the fact of deaf Culture, assumption and assertion are no substitute for proof, nor even for demonstration, and unfortunately such proof and demonstration have largely been lacking. However, part of the problem is that there is a misunderstanding of what “culture” is. “Culture ... means a system of ideas and signs and associations and ways of behaving and communicating” (Gellner, 1983: 7). Given this definition, clearly Deaf Indians have a way of behaving and communicating which is significantly different from members of the surrounding hearing communities. They, or at least those Deaf who associate themselves with an “Indian Deaf Community” also possess certain ideas and values which differ from those of the surrounding communities (and indeed from those of their parents). Among these differing values are the centrality of their way of communicating, i.e. the centrality of sign language for their deaf identity, and also the valuing of “sameness” (i.e. a closer sense of identification with other Deaf, and thus with Deafhood, than with members of the larger community).

In addition, the contributions made to science by cognitive and neurological research – both the quality and the quantity of rigorous scientific research – on Deaf people and sign language users in general (research which is reported regularly in dozens of scholarly journals such as Cognitive Neuroscience, NeuroImage, Brain and Language, etc.) has contributed significantly to our understanding about how the brain uses language, providing us with information, knowledge and understanding that would not be possible through study of non-Deaf people and spoken language alone. 5. 6. Deaf India So, what about Deaf India, and Deaf Indians? As the academic discussions on Deafness outlined above originated in the West (the United States and Western Europe), to what extent can it be said that they also characterize the Indian Deaf community, and to what extent do these developments effect the mass of Indian Deaf, their social and cultural practices, behaviours, beliefs, values and the way they see themselves? Unfortunately, until recently very little work on Indian Deaf Identity (or rather Deaf Identities) has been carried out. Recent researches by Friedner (2008, 2010, 2011) 40

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Of course it must be recognized that we human beings are all complex individuals, and all possess multiple intersecting identities. We all have “plural affiliations and social contexts” (Sen, 2006: 23). Deaf Indians do not cease to be Indian by mere fact of choosing to identify themseleves as Deaf, no more than hearing young urban Indians cease to be Indian by wearing blue jeans and T-shirts and by congregating at coffee shops rather than tea stalls. As Sen points out the modern tendency to demand that primacy be given to one single cultural identity (most often a national, ethnic or religious identity), and that this cultural identity is taken to be a given (given by the situation of one’s birth) and not a matter of choice on the part of the individual, is the source of much modern violence. I would argue it is also the case that ignorance of (in the sense of both “unawareness of” and the sense of “disregard for”) a Deaf cultural identity as one of many possible and appropriate identities for developing young Deaf individuals to chose is a great violence to their personhood. And in fact, promotion of that identity (among others, of course!) is the best way to encourage cognitive, intellectual, academic, professional, and indeed spiritual development in Deaf people. Because that identity as I have said above gives centrality to sign language, a visual-gestural which, unlike oral-aural language, is fully accessible to all Deaf and thus allows for full and unimpeded communication.

an implant into India from the West (see above regarding the decisions of the Milan Conference and the fact that the first schools for the deaf in India were established shortly after that conference under European guidance). This is also true of other countries throughout Asia. Second, although the academic discussion may have originated in the West, this does not mean that the developments themselves have not taken place from within India itself. It cannot of course be said that they have taken place entirely independently from Western developments; after all we live in an international and globalised world now, and so transnationalism is a feature of modern Indian Deaf culture, just as it is also a feature of (urban) Indian culture in general. Many South Asian Deaf have been abroad to attend universities with programmes for Deaf, to participate in various deaf leadership programmes in Japan, Denmark, or elsewhere. Every year there are even more foreign Deaf who visit India as tourists, and also occasionally as researchers. Many Deaf in urban centres throughout India have had contact with foreigners either here or abroad, and so have been exposed to the sociocultural movements discussed above. In addition, as noted above -- the internet, and especially such networking tools as Facebook and YouTube. Deaf empowerment has become a common topic among Deaf Indians in Mumbai/ Bombay, in Delhi, in Coimbatore, in other urban centres; a topic not only among individuals but also at Deaf clubs and other organizations. And, Deaf empowerment activities and events are becoming equally common; World Deaf Day celebrations across urban India now draw many hundreds,

Lest “nationalist” Indian oralists among the readership scoff at the introduction of these concepts and movements into India as foreign, it should be pointed out that their own audist world view, oralism, is lock, stock and barrel 41

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7. Conclusion (with a Vision to the Future) It will be noticed by now that through this article the conventional distinction between “small-d deaf” and “big-D Deaf” has been ignored in favour of one unified big-D Deaf category, and thus to capitalizing the word “Deaf” whenever it refers to Deaf people. Although I grant that this may not be unequivocally felicitous, it avoids the problem of seeming to claim that certain issues effect only big-D (i.e. culturally) Deaf or only small-d (i.e. audiologically) deaf, or the problem that one and the same person might be described as big-D Deaf in certain instances and in other instances as small-d deaf, since many members of the community move fluidly though certain grey areas, depending on circumstances, and on who they are dealing with. Over the course of time, most Deaf persons evolve; yet there are no intermediate fonts at various stages between a small d and a big D. Thus, it was felt, just as one does not un-capitalize the “I” of NRI (or PIO), by analogy one should not un-capitalize the big D of “Deaf”. An Indian person, even if no longer residing in India, even if they have given up their citizenship for that of another country and are no longer legally Indian, that person was once and potentially can once again be “Indian”. And in fact, most likely, s/ he culturally retains large bits of “Indianness” wherever s/he may reside and whatever citizenship s/he may hold (yes, even our clean-shaven, Bhangra hip-hop loving Punjabi of the opening paragraphs!). So with Deaf persons; they are all born with the potential for joining the Deaf community, the potential for developing their Deaf identity in a positive way, and that potential remains open to them, allowing only the stipulation that they accept

sometimes even over a thousand, of (mostly) Deaf participants; and lectures, dramas and discussions at such events revolve around issues that would be familiar to a Western Deaf audience. This, however, does not mean that Deaf Indians now perceive of themselves in the same way as western Deaf do. Friedner (2010), for example, argues, at least with respect to deaf women in Delhi, that Western discourse on Deafness may have more to do with public activities, than with private identity. These observations and conclusions differ rather significantly from my own experiences in Mumbai and Delhi, granted with more activist groups of perhaps younger Indian Deaf who have also had more contact with Western Deaf Deafhood discourse. As always, awareness that Deafness is both an individual and a community experience indicates that more study, across a broader swathe of India’s Deaf individuals and communities is needed. And, we must also allow, that although what is evolving in India can indeed be called “Deafhood”, it is clearly Deafhood with an Indian face. Still, India is a large country, and the urban/rural divide is as much a part of the lives of Deaf Indians as it is of non-Deaf Indians. A large block of Deaf, perhaps even a majority, do not live in urban areas, and so do not at present have ready access to the same Deaf Culture (nor, as noted above, to appropriate education). However, as rural Deaf move to urban areas (like their non-Deaf compatriots, primarily for jobs), and as technology – and the infrastructure to support it -- becomes more and more pervasive even in rural areas, in the near future it might be safe to say that such will not be the case. 42

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the value systems of the Deaf community. And one of the values of the Indian Deaf Community, like Deaf communities worldwide, is that, while being deaf may sometimes be a handicap (or at least a hindrance) in the wider world, “Deafness” inside (inside one’s self and inside the deaf community) is a positive thing.

years from discussions with Deaf colleagues, Deaf students and Deaf friends in India, Nepal, Japan, Ethiopia, and from those from the US, Europe, and elsewhere. It goes without saying, however, that the author maintains his own idiosyncratic scholarly opinions. Also, thanks to Donna Fujimoto for proofreading several

Academics are famous for their ability to offer sweeping conclusions based on even the scantiest of data. Perhaps if I were a better academic I could do the same here. However, given the fact that to a large extent Indian Deaf Studies, long delayed by misguided paternalistic attitudes and endeavours (guided by what might be called a sense of “Hearing Man’s Burden”, analogous to the “White Man’s Burden” of the colonial era), has only recently begun in earnest, I feel especially handicapped. The best I can do is offer a hopeful “vision”: with the advances in education opportunities and access for Indian Deaf both within and without India, I expect that positive developments in potential for Deaf Culture and Deaf identity will move at an ever more rapid pace towards Deaf people being able to real-ise their Deafhood. And it is time for the members of what I somewhat irreverently call the “deaf rehabilitation industry” to step up to their ethical, moral, and professional responsibilities in respecting that identity. To continue to hinder Deaf people’s development of a cultural identity appropriate to their person and their situation is an act of violence, an act of himsa, and therefore counter to India’s dharmic traditions!

Endnotes

early versions of this paper. 1

This is a revised version of a chapter commissioned for a Rehabilitation Council of India (RCI) handbook. In fact, only a much shortened and redacted version of that original appeared as subsections 1.1-1.5 of Chapter 7, “Hearing Impairment” (pages 145-150) in Rehabilitation Council of India (2013) Status of Disability in India - 2012, published by Department of Disability Affairs, MSJE, GOI. The current paper is then an expansion on the original paper, retaining some elements of what was published in the RCI handbook, but removing or reducing sections appearing there when they were not strictly essential for the arguments presented here, as it is assumed that anyone reading this journal article will also read the RCI handbook.

Acknowledgement The author would like to acknowledge the tremendous amount he has learned over the 43

This is one of many traits of Deaf people the world over which sets them apart from members of such handicapped/ disabled groups as the blind but which they share with members of ethnic minorities, indicative that they behave more like the latter than the former (Lane, 2006).

As an indication of the “viralness”, a search on 20 April 2014 for “deafhood”

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and “deaf gain” within YouTube turned up 9,650 and 9,910 videos respectively. Although there is likely to be a certain degree of overlap between the two searches, it seems safe to say that there are over ten thousand videos on one or both of these two concepts. (A search for the more general “deaf culture” turned up 65,500 videos.) And, while it is not possible to go through each and every video to see how many times each had been viewed, a quick check of the first ten listed for each of the above three searches showed an average of 19,829 views per video. (While these are worldwide totals, it should be noted that there are now dozens of YouTube postings in Indian Sign Language, and some of these at least have been viewed over a thousand times... presumably mainly by Indian viewers) 4

respected, encouraged and developed, for it is through that local sign language that individual Deaf are likely to develop their Deaf identities most fully, as they are likely first and foremost to be members of that local Deaf community. Acquisition of a standard Indian Sign Language should be a matter of choice. 5

Although it might also be listed here, we will pass over the contribution sign languages make to the area of “Baby Sign”, except to quote from (Padden & Humphries, n.d.): “We don’t think it is harmful or ill-advised for hearing parents to sign with hearing babies. At the same time, we can’t ignore the irony that some hospitals and doctors will advise hearing parents that they shouldn’t sign with their deaf babies in order to encourage them to learn spoken language.”

References Bauman, D. & Murray, J. (2010). Deaf Studies in the 21st Century: “Deaf Gain” and the Future of Human Diversity, In: Marc Marschark (ed.) Oxford Handbook on Deaf Studies, Language and Education, Volume 2. (pp. 210-225) Oxford: Oxford University Press.

Throughout this paper whenever I refer to sign language in the Indian context, and whenever I refer specifically to Indian Sign Language, I am referring to the natural sign language used by and in the Deaf community. And as at the local level this language may differ to a greater or lesser degree from the semi-standardized version of Bombay-Delhi sign usually referred to as “Indian Sign Language” (and, e.g. taught in ISL interpreter training courses at various branches of NIHH), I find it necessary to point out that I do not necessarily give primacy to any particular version of Indian Sign Language. In fact, within the local context, whichever variety of sign language is used by the local deaf community itself should be

Friedner, M. (2008). On Flat and Round Worlds: Deaf Communities in Bangalore, Economic & Political Weekly, September 20, 2008, 17-21. Friedner, M. (2010). Focus on Which (Deaf ) Space? Identity and Belonging among Deaf Women in New Delhi, India. In: S. Burch & A. Kafer (eds.) Deaf and Disability Studies: Interdisciplinary 44

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Perspectives. (pp. 48-66.) Washington, DC: Gallaudet University Press.

Ladd, P. (2003). Understanding Deaf Culture: In Search of Deafhood. Clevedon, England: Multilingual Matters Ltd.

Friedner, M. (2011). “Future Life How?”: The Making of Deaf Sociality and Aspiration in Urban India. (Ph.D. Dissertation) University of California at BerkeleyUniversity of California at San Francisco, Medical Anthropology.

Lane, H. (2006). Construction of Deafness. In: L.J. Davis (ed.) The Disability Studies Reader. (pp. 79-92).New York / Oxon (UK): Routledge. Padden, C. & Humphries, T (n.d.). Q & A: Carol Padden and Tom Humphries. UCSD Chancellor’s Office. http:// www-chancellor.ucsd.edu/qa_padden_ humphries.asp

Gallaudet, E.M. (1881). The Milan Convention, American Annals for the Deaf, 26(1), 1–16. Gellner, E. (1983). Nations and Nationalism. Ithaca, NY: Cornell University Press.

Sen, A. (2006). Identity & Violence: The Illusion of Destiny. London / New York / etc.: Penguin Books.

Kusters, A. (2007). ‘Reserved for Handicapped’? Deafhood on the Lifeline of Mumbai. (MSc Dissertation) University of Bristol.

Woodward, J. (1972). Implications for Sociolinguistics Research among the Deaf, Sign Language Studies, 1, 1-7.

Kusters, A. (2009). Deaf on the Lifeline of Mumbai, Sign Language Studies, 10(1), 36-68.

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Efficacy of Visual Imaginary Therapy on Selective Motor Control and Functional Independency of Lower Extremity in Subacute Stroke Patients *T. Karthikeyan

Abstract The study aims at finding out efficacy of visual imaginary therapy along with conventional therapy in comparison to sham visual imaginary therapy along with conventional therapy on selective motor control of affected lower extremity. The design used for this study is double blinded comparative study. Total thirty (30) patients with acute ankle inversion sprain were selected for the study. They were conveniently divided into two different groups: experimental and control group. Both the groups having 15 subjects each. The experimental group received visual imaginary therapy along with conventional therapy whereas control group received sham visual imaginary therapy along with conventional therapy. The outcomes were measured using Barthel Index, Dynamic Gait Index and Modified Ashworth scale. The result showed experimental group was having significant improvement in comparison to control group in functional independency and gait pattern whereas no significant effect was found in experimental group with regards to spasticity. The present study concludes that visual imaginary therapy combined with a conventional therapy enhanced selective motor control and functional independency of lower extremity in sub acute stroke however there is no significant effect of visual imaginary therapy along with conventional therapy to reduce spasticity. Key words: Sub-acute stroke, Stroke rehabilitation, Visual imaginary therapy for lower extremity, Motor recovery.

Introduction Stroke is defined as “rapidly developed clinical signs of focal or global disturbance of

3 phase acute, subacute and chronic phase. Mostly 3 to 7 days are referred to as acute phase. First one to six months are defined as subacute phase whereas chronic phase begins after 3 or 6 months.

cerebral function lasting more than 24 hour’s leading to death, with no apparent cause other than vascular origin” (Park, 2002). Stroke patient incidence rate range from 0.2 to 2.5 per 1000 population per year in India. Prevalence rate in India was reported to be 56.9 per 1000,000 (Park, 2002). Stroke is leading cause of serious long term disability in adults; more than 60% of survivals suffer from persistent neurological deficit (Jongbloed, 1986). Traditionally strokes are distinguished in

Visual imaginar y therapy is new therapeutic intervention that focuses on moving the unimpaired limb (Julie et al, 1998). It was first introduced by Ramchandran and Ramchandran. It involves performing movement of unimpaired limb while watching its reflection, supper imposed over impaired limb thus creating visual illusion & enhancing movement capability of impaired limb (Janis et

*Physiotherapist, DNR, NIMHANS, Bangalore. Email: karthik_77in@yahoo.co.in

Karthikeyan T / Efficacy of Visual Imaginary Therapy

al, 2011). Studies reveal that visual imaginary therapy is effective in improving upper limb function like ROM, speed, accuracy of arm movement in hemiparetic stroke patients than without. It was found that 2 weeks of intense visual imaginary therapy in chronic stroke patients resulted in significant recovery of grip strength and hand movement of paretic arm (Gert et al 2006). Visual imaginary therapy is simple, inexpensive and has no side effect (Fadiga et al, 2004). So it can be used for old age stroke patients those who are having difficulty to perform other type of exercise. Research suggested that visual imaginary therapy will improve motor activity, gait pattern and reduction in spasticity (Julie et al, 1998).

There are many literature that support the efficacy of visual imaginary therapy in improving hand function of hemiparetic upper extremity, but there is lack of literature studied on effect of visual imaginary therapy in hemiparetic lower extremity. Hence, the need of the study was felt to find the effect of visual imaginary therapy on lower extremity recovery after stroke which may be used in clinical aspect to increase dorsiflexion, prevent compensation, improve gait pattern and improve functional independence if found effective. Objective of the study 1. To find out the effect of visual imaginary therapy on selective motor control of affected lower extremity.

Most of case of stroke ankle dorsiflexors becomes weak and spastic due to this particularly in stance phase, heel strike to foot flat, dorsiflexors have lack of ability to oppose plantarflexors causes foot to slap the floor (O’ Sullivan and Schmitz, 2007).

Sub-objectives of the study I. To find out the effect of visual imaginary therapy with conventional therapy treatment on voluntary ankle dorsiflexion, gait pattern, reduction in spasticity of affected lower limb and functional ability of stroke patients.

Need for the study As a result of stroke, dorsiflexion is lost in affected lower extremity. It leads to abnormal gait pattern, compensation, delay in motor recovery & restriction in functional mobility. Based on all the above studies it is hypothesized that visual feedback from visual imaginary therapy of non paretic lower extremity would help to restore the function in affected lower extremity. Visual imaginary therapy is simple, inexpensive and has no side effect. So it can be used for old age stroke

II.

To find out the effect of sham visual imaginary therapy with conventional therapy treatment on voluntary ankle dorsiflexion, gait pattern, reduction in spasticity of affected lower limb and functional ability of stroke patients.

III. To compare the effect of visual imaginary therapy along with conventional therapy over sham visual imaginary therapy with conventional therapy treatment on voluntary ankle dorsiflexion, gait pattern,

patients who are having difficulty to perform other type of exercise. 47

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reduction in spasticity of lower extremity and functional ability of stroke patients.

volitional ankle dorsiflexion were selected for the study.

Experimental hypothesis 1. H1-Sham visual imaginary therapy has significant effect on motor recovery of the affected lower limb extremity, to reduce spasticity and functional independence.

Patients between age range 55 to 65 years were selected for the study.

Those stroke patients diagnosed by neurologist and confirmed by CT/MRI were only selected.

H2- Visual imaginary therapy along with conventional physiotherapy has significant effect on motor recovery of the affected lower limb extremity, to reduce spasticity and functional independence.

Had score between I to III on Brunstrom stage of motor recovery of lower extremity.

Had modified Ashworth scale score b/w 1 to 3

Methods Research design For this study double blinded experimental comparative study with experimental and control groups design were adopted.

No severe cognitive disorders( MMSE score > 24 )

Patient should be ambulatory before stroke.

Patients with acute ankle inversion spasticity are only included in the study.

Sampling technique With convenient sampling technique, thirty subjects with subacute stroke were s e l e c t e d . T h e p a t i e n t s w e re a l l o t t e d conveniently experimental group and control group respectively i.e. first patient to group A and second patient to group B and so on.

Exclusion criteria

2. Patients with perceptual deficit were not included.

II.

The following exclusion criteria were followed: 1. Patients having associated psychological disorders were not included in the study.

Experimental Group –Fifteen subacute stroke patients (12 male and 3 female) received visual imaginary therapy along with conventional therapy

3. Clients having significant visual and/or auditory impairment did not form the sample of the study

Control Group - Fifteen subacute stroke patients (14 male and 1 female) received sham visual imaginary therapy)

4. Patients facing acute stroke were not included.

Inclusion criteria The following inclusion criteria were followed to select sample for the study: 1.

Materials needed for study The following materials are needed for the present study:

First episode of unilateral stroke within the duration of 12 month & patients without

1. 48

Visual imaginary therapy box. (Length -47 inch,width-24 inch,height-30 inch)

Karthikeyan T / Efficacy of Visual Imaginary Therapy

Treadmill.

according to D’lorme regime) and Over ground

Weight cuff (0.5kg, 1kg, 1.5kg, 2kg, 2.5kg.)

gait training. This treatment strategy was

Static bicycle.

Low stool

Ankle pump with spring

applied for paretic /non paretic limb to warm up the muscles. Intervention for experimental group – Subject who received an additional 30 minutes visual imaginary therapy program

Procedure

consists of nonparetic ankle dorsiflexion and

Subjects who fulfilled the inclusion

eversion movement. Subject sits on chair

and exclusion criteria were selected for the

in front of mirror box where to keep his/her

study. First the entire subject was assessed

nonparetic limb inside the box which comes

with detailed neurological assessment form

in front of mirror reflection, its top uncovered.

(including MMSE). Details of intervention

At the same time subject has to keep his/her

programme were explained to the patients

paretic limb inside the covered part of the box.

before taking their informed consent. All

Subject was instructed to observe the reflection

subjects were conveniently divided into

of the nonparetic leg while doing dorsiflexion

experimental group (Visual imaginary therapy

eversion of both ankles simultaneously given

with conventional therapy) and control

command to try to do paretic limb ankle

group (Sham therapy with conventional

dorsiflexion and eversion also.

therapy). Total duration of treatment was 6

Intervention for control group -

weeks (5 days/week). Every day treatment

Subject who performed the same exercise for

session was 1 hour 30 minutes for both the

the same duration, but they were requested to

group. Experimental Group was treated with

observe the movement through nonreflecting

visual imaginary therapy 30 minutes after

side of the mirror. Total treatment time was 1

the conventional therapy. Control Group

hours 30 minutes. Conventional treatment was

treated with sham visual imaginary therapy

given for 1 hour to both groups. Experimental

for 30 minutes after conventional therapy.

group received visual imaginary therapy on last

Conventional therapy includes stretching

30 minutes and control group received sham

of Tendo Achilis & hamstrings, Bridging

therapy for 30 minutes, but sham group was

(10x2 repetitions), Ankle pump exercise using

not given command to do paretic limb ankle

spring (10x2 repetition), Sit to stand exercise(

dorsiflexion and eversion. Modified Ashworth

10x2 repetition), Supported squatting (10x2

scale, Dynamic Gait index and Barthel index

repetition), Isometric exercise for hip extensors

were administered before treatment and at the

& quadriceps (10x2 repetitions),Static bicycling

end of treatment i.e. after 3 months (at the time

(5minute), Resisted exercise for quadriceps

of follow up). The following materials were

with weight cuff (0.5kg,1kg,1.5kg,2kg,2.5kg-

used for treatment: 49

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Journal of Disability Management and Special Education Figure 1: Materials for Conventional Therapy

Figure 2 & 3: Mirror box and Materials for Visual Imaginary Therapy for Lower Extremity

Data collection procedure and analysis scheme

after orienting them the purpose of the study. Subjects in both the groups were tabulated to know about the distribution and later the significance was analyzed. The data were analyzed using SPSS version-15. Paired t-test

First the informed consent were received from the subjects. The demographic data like age and sex from the subjects were collected 50

Karthikeyan T / Efficacy of Visual Imaginary Therapy

was used to find out the difference within the group and independent t-test for between the

and measure of dispersion respectively. The intergroup comparisons were done by parametric Independent t test. Comparison of both experimental and control groups was made between BI, DGI and MAS scales. Paired t test further used to compare BI, DGI and MAS within each group.

group comparisons. Result Mean and standard deviation were computed as measure of central tendency

Table-1: Age distribution among groups Age

55-60

60-65

Experimental Group

Control group

The above table shows age distribution of subjects in both groups. In both groups subjects

of 55- 60 years were more as compared to 60-65 years.

Table -2: Gender distribution among groups

Sex

Experimental group

Control group

Male

Female

Total

The above table shows gender distribution of the subjects in both groups. In experimental

group males were 12 and females were 3. In control group 14 were males and 1 was female.

Table 3: Analysis of Pre- test, Post- test and Follow up after Intervention Values in Experimental Group for BI, DGI and MAS by Paired t-test

Experimental group

Mean

Std. Deviation

Std. Error Mean

Pre test

51.67

16.76

4.32

Post test

70.0

12.24

3.16

Follow up

76.33

13.15

3.397

Pre test

8.13

4.45

1.15

Post test

13.53

3.68

0.951

Follow up

14.73

3.305

0.853

Barthel Index

DGI

tvalue

- 8.26

<0.001

-7.40

<0.001

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Journal of Disability Management and Special Education

Experimental group

Mean

Std. Deviation

Std. Error Mean

Pre test

1.53

0.516

0.133

Post test

0.87

0.352

0.91

Follow up

1.00

0.000

MAS

The above table shows analysis by paired t-test for BI, DGI and MAS in experimental group tested between, before and after and follow up (after 3 months) intervention by visual imaginary therapy for 6 weeks and conventional therapy for total 3 months. The mean± SD for BI pre intervention is51.67±6.76 and post intervention is70.0±12.24 and follow up 76.33±13.15 with ‘p’ value being less than 0.001 which shows that there is statistically significant improvement in functional recovery after intervention and in follow up mean ± SD shows less significant difference as compared to the post test. The mean± SD for DGI pre

tvalue

5.527

0.001

intervention is 8.13±4.45, post intervention is13.53 ±3.68 and at the time of follow up 14.73±3.305 with a ‘p’ value being less than < 0.05 shows that there is statistically significant improvement in gait pattern after MT intervention. The mean ± SD for MAS pre intervention is1.53±0.516 and post intervention is 0.87±0.352 and follower up (after 3 months) 1.00±0.000 with ‘p’ value being less than <0.05 post intervention shows that there is statistically significant reduction in post intervention and ‘p’ value of follow up is more than >0.05 shows no statistically significant reduction in follow up period.

Table 4: Analysis of Pre-test, Post-test and Follow up after Intervention Values in Control Group for BI, DGI, MAS by Paired t-test Mean

Std. Deviation

Std. Error Mean

Pre test

47.67

11.47

2.96

Post test

55.67

10.15

2.62

Follow up

59.67

9.15

2.36

Pre test

7.40

3.06

0.79

Post test

10.13

2.615

0.675

Follow up

11.00

3.024

0.78

Pre test

1.73

0.594

0.153

Post test

0.93

0.458

0.118

Follow up

1.27

0.458

0.118

Control group

DGI

MAS

t- value

-5.87

<0.001

-3.59

<0.003

-7.12

<0.001

-2.57

<0.002

5.52

0.001

-1.784

0.096

Karthikeyan T / Efficacy of Visual Imaginary Therapy

The above table shows analysis by paired t-test for BI, DGI and MAS in control group tested between before and after and follow up(after 3 months) intervention by sham visual imaginary therapy for 6 weeks and conventional therapy for total 3 months. The mean± SD for BI pre intervention is 47.67± 11.47 and post intervention is 55.67±10.15, at the time of follow up 59.67±9.15 with ‘p’ value being less than 0.001 and 0.003 shows that there is statistically significant improvement in Functional recovery after intervention and after 3month follow up less significant as compare to post intervention. The mean ±SD for DGI pre intervention is 7.40±3.06, post

intervention is10.13± 2.61 and at the time of follow up11.00± 3.024 with a ‘p’ value being less than < 0.001 to <0.02 respectively shows that there is statistically significant improvement after Sham MT intervention. The mean± SD for MAS pre intervention is1.73± 0.594, post intervention is 0.93±0.458 and at the time of follow up 1.27±0.458 with a ‘p’ value being less than < 0.001 but in follow up again ‘p’ value obtained for post intervention <0.001and at follow up ‘p’ value >0.09 shows that in 3 months after post intervention there is no statistically significant improvement after sham visual imaginary therapy intervention to reduce spasticity.

Table 5: Analysis of BI values at Pre-test and Post-test after Intervention by Independent t-test between Experimental Group and Control Group BI

Mean

Experimental Group

51.67

Std.

Std. Error

Deviation

Mean

16.76

4.32

Pre Test Control Group

47.67

11.47

2.96

Experimental Group

70.00

12.24

3.16

Post test

Follow up

Control Group

55.67

10.15

2.62

Experimental Group

76.33

13.15

3.39

Control Group

59.67

9.155

2.36

BI values at pre test, post test and follow up intervention were analyzed between experimental group and control group to find out the significant difference between groups by independent t-test. The values were shown in Table-5. Analysis of baseline values shows ‘p’

0.763

0.045

3.489

0.002

4.027

<0.001

<0.05 that proves homogeneity of groups post intervention. The analysis of post intervention values of BI for both groups have ‘p’ value < 0.05 shows that there is statistically significant difference between two interventions in improving functional independence. 53

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Figure 4 The mean values of BI pre test, post test and Follow up test in both groups

Table 6: Analysis of DGI Values at Pre-test and Post-test after Intervention by Independent t-test between Experimental Group and Control Group

Mean

Std. Deviation

Std. Error Mean

Experimental Group

8.13

4.45

1.150

Control Group

7.40

3.066

0.792

Experimental Group

13.53

3.68

0.951

Control Group

10.13

2.615

0.675

Experimental Group

14.73

3.305

0.853

Control Group

11.00

3.024

0.781

DGI

Pre Test

Post test Follow up

DGI values at pre test, post test and follow up intervention were analyzed between experimental group and control group to find out the significant difference between groups by independent t-test. The values were shown in Table-5. Analysis of baseline values shows 54

0.525

0.604

2.916

0.007

3.228

0.003

‘p’ > 0.05 proves homogeneity of groups post intervention and follow up. The analyses of post intervention values of DGI for both groups have ‘p’ value <0.05 shows that there is statistically significant difference between two interventions in improving gait pattern.

Karthikeyan T / Efficacy of Visual Imaginary Therapy

Figure 5: The Mean Values of DGI Pre-test, Post-test and Follow up Test in Both Groups

Table 7: Analysis of MAS Values at Pre-test and Post-test after Intervention by Independent t-test between Experimental Group and Control Group MAS

Mean

Std.

Std. Error

Deviation

Mean

Experimental Group

1.53

0.516

0.133

Control Group

1.67

0.617

0.159

Experimental Group

0.87

0.352

0.091

Control Group

0.87

0.516

0.133

Experimental Group

1.00

0.000

0.00

Control Group

1.27

0.458

0.118

Pre Test

Post test

Follow up MAS values at pre test, post test and follow up intervention were analyzed between experimental group and control group to find out the significant difference between groups by independent t-test. The values were shown in Table-5. Analysis of baseline values shows

0.624

0.526

0.331

1.00

0.000

0.032

‘p’ > 0.05 proves homogeneity of groups’ pre, post intervention and follow up. The analyses of post intervention values of for both groups have ‘p’ value >0.05 shows that there is no statistically significant difference to reduce spasticity. 55

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Figure 6: The Mean Values of MAS Pre-test, Post-test and Follow up Test in Both Groups

Discussion Previous studies have shown stroke is one of the leading causes of burden of disease, particularly in high and middle income countries (Kara et al, 2010). Each year approximately nine million people suffer a first ever stroke. According to recent studies approximately 80% of survivors have an upper or lower limb motor impairment, or both. Two third of patient with lower limb impairment are not able to walk independently soon after their stroke and after rehabilitation only 50 % have independent walking function (Julie et al, 1998).That’s why the purpose of this study was to find out effect of visual imaginary therapy in lower limb in subacute stroke function, gait pattern and spasticity by using Barthal Index, Dynamic Gait Index, Modified Ashworth scale respectively.

This study used the data from a sample of subacute stroke subject matched with age, Brunstrom stages, MMSE score and MAS score according to inclusion criteria. BI,DGI,MAS score used to establish baseline values to established pre intervention comparison values to showed the difference between post intervention and follow up period (after 3 months).The implication of the study justify that the visual imaginary therapy with conventional therapy is more effective than the sham visual imaginary therapy with conventional therapy. However, it was found out that visual imaginary therapy has no significant effect on reducing spasticity. This finding is in line with Janis et al, 2011 where they reported that visual imaginary therapy has no significant effect in reducing spasticity. 56

Karthikeyan T / Efficacy of Visual Imaginary Therapy

Greater effect of visual imaginary therapy along with conventional therapy is due to the concept of visual imaginary therapy has been substantiated neurophysiologically. Evidence suggests that the same cortical motor areas that are active during observation of movements are involved in the performance of the observed actions, Pablo Celnik, in normal participants, the mirror illusion increases cortico-muscular excitability. There is evidence which suggest that visual imaginary therapy facilitates the motor deficits of patients by activating ipsilateral M1 (pre motor area) and outside of cerebellum, which is possibly related to visual memory function.

In addition to the corticospinal tracts that project contra laterally from motor cortex there are some ipsilateral projections. Perhaps visual feedback acts, in part, by reviving these dormant ipsilateral connections. Recent studies suggest investigate that a time course of the effect using transcranial magnetic stimulation (TMS) they concluded that the facilitation of excitability in corticospinal tract last only in short duration in Visual imaginary therapy using a simple motor task, needs prolong or consolidated the effect of MT, repetition and conduction of more task is needed. Taking all result together we compare to both groups. The ‘p’ values of which is < 0.05 that is found to be statistically significant. Hence, null hypothesis (H0, H01) got rejected and experimental hypothesis (H1, H2) accepted. We found clear functionally relevant effect of visual imaginary therapy along with conventional therapy on motor recovery of lower extremity and functional dependence as compare to sham visual imaginary therapy along with conventional

Another explanation can also be invoked that takes advantage of the discovery of mirror neurons by Rizzolatti and his colleagues in the early 1990s. Such neurons are found in the frontal lobes as well as the parietal lobes (Gert et al 2006).These areas are rich in motor command neurons each of which fires to orchestrate a sequence of muscle twitches to produce simple skilled movement. Mirror neuron is functioning to learn new skills. Mirror neurons necessarily involve interactions between multiple modalities—vision, motor commands, proprioception—which suggest that they might be involved in the efficacy of mirror visual feed back in stroke.

visual imaginary therapy. Conclusion The study led to the conclusion that visual imaginary therapy combined with a conventional therapy enhanced selective motor control and functional independency of lower extremity in sub acute stroke and there is no significant effect of visual imaginary therapy to reduce spasticity. Finally this double blinded experimental comparative study provides an evidence use of visual imaginary therapy along with conventional therapy that proved to be an adjunct effective therapy in management of motor recovery of lower extremity and functional independence.

An additional possibility is that lesion is not always complete; there may be a residue of mirror neurons that have survived but are ‘dormant’ or whose activity is inhibited and does not reach threshold vs. ram so we could postulate that Visual imaginary therapy might owe part of its efficacy to stimulating these neurons, thus providing the visual input to revive ‘motor’ neurons (Fadiga and Craighero, 2004). 57

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References Donald A. N. (2005).Gait Kinesiology of Musculoskeletal system foundation for rehabilitation.2nd ed.Mosby Elsevier.

and Relationship to Dyscordination and Walking Disability after Stroke. Rehabilitation Research and Practice; 10.1155/2011/313980.

Fa d i g a L . & C r a i g h e r o, L . ( 2 0 0 4 ) . Electrophysiology of action representation. J Clin Neurology.; 21:157-69.

Kara K. Patterson, William H. Gage, Dina Brooks, Sandra E. Black, William E. McIlroy. (2010). Changes in Gait Symmetry and Velocity After Stroke: A Cross-Sectional Study From Weeks to Years After Stroke. Neurorehabil Neural Repair .; 24: 783.

Gert K., Boudewijn, K. & Jos, T. (2006). Impact of Time on Improvement of Outcome after Stroke. Stroke.; 37:2348-2353. Inga, K, Teismann (2011).Cortical swallowing processing in early subacute stroke.BMC Neurology ., 11:34.

O’ Sullivan SB, Schmitz TJ (2007). Stroke. Physical rehabilitation. 5th ed., New Delhi: Jaypee Brothers.

Jongbloed, L. (1986). Prediction of function after stroke: a critical review stroke; 17:765-76.

Park, K. (2002).Text book of preventive and social medicine.16th ed.Banarsidas Bhanot Jabalpur.

Julie D., Moreland, M. & Angela, R. (1998). Electromyographic Biofeedback to Improve Lower Extremity Function after Stroke: A Meta-Analysis. Arch Phys Med Rehabil.; 79:134-40.

Sütbeyaz S, Yavuzer G, Sezer N, Koseoglu F (2007).Visual imaginary therapy enhances lower- ex t re m i t y m o t o r recovery and motor functioning after stroke: a randomized controlled trial. Arch Phys Med Rehabil .; 88:555-9.

Janis J., Daly, R.K., Roger, C. & Robert, L. (2011). Abnormal Leg Muscle Latencies

Vol. 4. No. 2 July 2014

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

A Study of the Correlation between Cognitive Capabilities and Pre-arithmetic Skills of Preschool Children with Hearing Impairment *P. Rama Krishna and **Dr. I.P. Gowramma

Abstract Development of the cognitive process enables the child to deal with numerical concepts and deductive reasoning of mathematical thinking. The purpose of this study is to study the correlation between the cognitive capabilities and pre-arithmetic skills among preschool children with Hearing Impairment. The sample of the study constituted 40 CWHI from All India Institute of Speech and Hearing Preschool. The data was collected on different aspects of cognitive capabilities and pre-arithmetic skills in a preschool for children with hearing impairment with Padmini Cognitive Capability Test (PCCT) Pre-school Version-1 and Arithmetic Readiness Test (ART) adapted version of Grade Level Assessment Device (GLAD). The scores of PCCT and ART were compared and tested for correlation. Data was analyzed statistically to find out the correlation between PCCT and ART scores and also compared the PCCT scores of Preschool CWHI and hearing children based on the data of Shobha (2002). Pearson correlation r= 0.796 was obtained for correlation between PCCT and ART scores are significant at 0.001 level indicates positive correlation between cognitive capabilities and Pre-arithmetic skills. And comparison of PCCT scores of Preschool CWHI and normal hearing children with same age group reveals that there is no difference in the performance of cognitive capabilities in both Preschool CWHI and Children with normal hearing. Key words: Preschool Children with Hearing Impairment (CWHI), Cognitive Capabilities, Pre arithmetic Skills.

Introduction Preschool education is the most important stage in school education because this is a stage when significant physical, cognitive, emotional and social developments take place. Preschool education is the provision of education for children before the commencement of formal education. Several preschool programs for children with hearing impairment have promoted a cognitive/linguistic approach to learning (Grammatico & Miller 1974; Stone 1980; Moeller and Mc Conkey 1984; Moeller,

Obserger and Mordford 1986). In such an approach, language and thinking skills are emphasized in synchrony. Preschool is desirable for all the children, no doubt but it is necessary for disadvantaged and handicapped children. Preschool programs for CWHI strive to provide the child access to communicative competence through comprehensive habilitation, including amplification, parent guidance, perceptual and cognitive skill development and aggressive language intervention. Parents are primarily responsible for the child’s integration into the

* Asst. Professor, Ramakrishna Mission Vivekananda University, Faculty of Disability Management and Special Education, Coimbaore-20. Email: ramkipet@gmail.com ** Lecturer, Regional Institute of Education, Bhubaneswar. Email: ipgowri@gmail.com

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family, neighborhoods, school and community. The training, that families require, can best come from professionals at an infant or preschool program.

want to be like other people and they also possess the same feelings and emotions. The only difference is that they lack the ability to hear and consequently suffers from language handicap.

Cognitive development is an important aspect of overall child development. The term cognition or cognitive development is a highly generic term covering almost every aspect of behavior. It is a continuous process that begins at birth and increases when tasks are in child’s zone of proximal development level where child can almost accomplish task independently. Thus cognitive development is the development of ways and capabilities of understanding one’s world, representing it and dealing with it. Cognition develops through social interaction around problem solving abilities. Cognitive development involves progressive changes in children’s perception, knowledge, understanding, reasoning and judgments.

Among the developmental pre-requisite are object permanency, seriation, classification and conservation of quantity (Piaget & Inhelder, 1969). The children with hearing impairment are not basically different in their innate psychological potentialities from the hearing child. However, it is essential for the parents and teachers of children with hearing impairment to have an insight in understanding the psychological factors that are intimately related with their academic and communication skills. There is no reason to suspect limited mental ability because of impaired hearing itself, unless it is coupled with some deterioration or malfunctioning of the brain, which may also occur in other disability conditions. Hence, a need was felt to study correlation between cognitive capabilities and pre-arithmetic skills among CWHI.

Development of the cognitive process enables the child to deal with numerical concepts and deductive reasoning of mathematical thinking. Children’s cognitive development affects how they learn, understand, store knowledge, characterize and interpret information, see relationships between and among ideas retain and retrieve information, use prior knowledge to gain new knowledge, and utilize knowledge in functional contexts.

Objectives of the study 1. To study the cognitive capabilities among preschool children with Hearing Impairment in the age groups 4-6 years in the following specific cognitive capabilities like a) Length seriation b) Shape completion c) Action through signs d) Classification of picture.

The mental growth of children with hearing impairment is different in many ways from that of the hearing child; nevertheless, there are also certain points of similarity between them; they have the same intellectual endowment and the same desire to communicate. They

2. To study the pre-arithmetic skills among preschool children with hearing impairment in the age group of 4 – 6 years. 3. To examine the correlation of cognitive capabilities & pre-arithmetic skills of 60

Ramakrishna P & Gowramma I.P. / Cognitive Capabilities and Pre-arithmetic Skills

preschool children with hearing impairment in the age group of 4 – 6 years.

the Department of Special Education, AIISH to assess the arithmetic readiness of children in the age group of 4-6 years.

4. To examine the correlation of cognitive capabilities between preschool children with hearing impairment and normal hearing children in the age group of 4 – 6 years.

Padmini Cognitive Capability Test (PCCT) Pre-school Version 1 Padmini cognitive capability test has been developed and standardized by Padmini (1983), Department of studies in education, Mysore University. PCCT preschool version-1 consists of four tests as a) Length seriation b) Shape completion c) Action through signs d) Classification of picture. This tool was selected for various reasons. First, it must be based on a wide range of cognitive concepts and operations appropriate to the age level of preprimary pupils. Second, it should facilitate the measurement of cognitive capabilities of each child objectively and reliably yielding a total measure of the overall cognitive capability as an index of cognitive development status with their consideration, among others PCCT was selected for the study. The test covers a wide range of cognitive concepts appropriate to children of four to six years of age.

Hypotheses 1. There is no significant correlation between cognitive abilities and pre-arithmetic skills of children with hearing impairment in the age group 4-6 Years. 2. There is no significant difference between the scores of cognitive abilities of CWHI and normal hearing children. Method Research design This study employed descriptive research. Sample Forty children with hearing impairment, age ranging from 4 to 6 years, studying in All India Institute of Speech and Hearing (AIISH) pre-school were selected. Children with any other significant associated disabilities were not included in the study.

Data collection Arithmetic Readiness Test (ART) The adapted version of Grade Level Assessment Device-GLAD (Narayan, 1997) was used to assess the pre-arithmetic skills. The standardized tool GLAD was adapted by the Department of Special Education, AIISH to assess the arithmetic readiness of Preschool Children with Hearing Impaired in the age group of 4-6 years.

Tools used for the study To assess the cognitive capability of the pre-school CWHI, Padmini Cognitive Capability Test (PCCT) Pre-school Version-1 (Padmini, 1983) was made use of. The adapted version of Grade Level Assessment Device-GLAD (Narayan, 1997) was used to assess the pre-arithmetic skills. Both these tools were readily available. PCCT is a standardized tool, which is valid and reliable. The standardized tool GLAD was adapted by

Administration of PCCT and ART As the PCCT and ART were individual performance readiness tests without time restriction each child had to be given all the 61

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tasks of the PCCT and ART. The following steps were followed in collecting the data. Administrations of all tasks were carried out in a play way method and each child was given instruction, in his or her own mother tongue

and the same scores were compared and tested to find out the significant difference, if any. The mean performance of PCCT scores were compared among Preschool CWHI, Montessori, Kindergarten and Anganwadi normal hearing children from an earlier study Shobha (2002) and tested for significance. Table 1 shows correlation between PCCT and ART scores:

to complete the task Result Data was analyzed statistically to find out the correlation of PCCT and ART scores

Table 1: Correlation between PCCT and ART Scores Correlation ART score out of 46

PCCT score out of 70 Pearson Correlation

r = 0.796**

**. Correlation is significant at the 0.001 level. Figure 1: Graph Showing the Correlation between PCCT and ART Scores

The correlation r = 0.796 is significant at 0.001 level. This clearly indicates that there is a positive correlation between PCCT scores and ART scores. Hence hypothesis no.1, there is no significant correlation between cognitive abilities and pre-arithmetic skills of children with hearing impairment in the age group 4-6 years is rejected. The graph clearly shows

that as the cognitive scores improve, so does arithmetic scores. Under PCCT, four subtask were there namely shape completion, length seriation, action through signs and classification of pictures. Table 2 shows the correlation between the scores of PCCT subtasks and ART 62

Ramakrishna P & Gowramma I.P. / Cognitive Capabilities and Pre-arithmetic Skills

Table 2: Correlation between ART Score and PCCT Subtasks Scores PCCT subtasks Scores

(46)

Pearson Correlation

ART score

Shape Completion (20)

Length seriation (20)

Action through signs (12)

Classification of pictures (18)

r = 0.817*

r = 0.735*

r = 0.586*

r = 0.748*

* Correlation is significant at the 0.001 level. Figure 2 Graph Showing the Correlation between PCCT-Shape Completion and ART Scores

Figure 3 Graph Showing the Correlation between PCCT-Length Seriation and ART Scores

Figure 4 63

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Graph Showing the Correlation between PCCT-Action through Signs and ART Scores

Figure 5 Graph Showing the Correlation between PCCT-Classification of Pictures and ART Scores

The above mentinoned figures shows the correlations r = 0.817, r = 0.735, r = 0.586, r = 0.748 in Figure 2, 3, 4 and 5 respectively is significant at 0.001 level. This clearly indicates that there is a positive correlation between PCCT subtasks scores (Shape Completion,

Length Seriation, Action through signs and Classification of Pictures) and ART scores. It can be inferred that as the cognitive ability increases, there is improvement in arithmetic skills. 64

Ramakrishna P & Gowramma I.P. / Cognitive Capabilities and Pre-arithmetic Skills

Comparing PCCT scores of CWHI with normal hearing children

Shobha (2002) for normal hearing children in

The data collected in the present study was compared with the data collected by

as mentioned below gives the details:

three different preschool setups. The table 3

Table 3: Comparison PCCT Scores of CWHI with Normal Hearing Children PCCT SCORES CWHI

Montessori

Anganwadi

Kinder Garten

Mean

t-ratio

Mean

t-ratio

Mean

t-ratio

1. Shape Completion

15.15

3.84

15.50

0.576

4.30

17.870*

10.78

7.197*

2. Length Seriation

13.95

4.01

16.80

4.499**

6.50

11.762*

11.75

3.473*

3. Action through signs

14.73

3.23

12.50

4.351*

3.95

21.168*

8.78

11.625*

4. Classification of Pictures.

8.50

2.47

11.30

7.169**

5.05

8.833*

10.75

5.760**

t-value significant at 0.01 level in favor CWHI

** t-value significant at 0.01 level in favor of normal hearing children. arithmetic skills also improves. This is indicated by the significant correlation for PCCT subtask scores and ART scores of CWHI in the present study. No uniform trend is observed in the study in favor of either CWHI or normal hearing children. However, the following observations were made which suggest the importance of enriched environment in preschool training to enhance cognitive abilities.

No uniform trend is observed in the above table in favor of either CWHI or normal hearing children. Hence hypothesis no.2, “There is no significant difference between the scores of cognitive abilities of CWHI and normal hearing children” are accepted. However, the following observations are made. Discussion There is significant correlation between PCCT scores and ART scores of CWHI in the present study, as it is observed that the cognitive abilities improve arithmetic skills. Similar trend is observed by Lauwerier, Chouly & Bailly, (2003); Watson & Kidd, (2003) and Culbertson & Gilbert (1994). It is noticed in the present study that as the four subtasks of the cognitive ability assessed in the study improves

1. In the Shape completion task CWHI performed better than children attending Anganwadi and Kinder Garten. 2. In the Length Seriation task CWHI performed better than children attending Anganwadi and Kinder Garten. 3. In the Action through sings task CWHI performed better than children attending 65

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Montessori, Anganwadi and Kinder Garten.

3. The findings suggest that cognitive development must be deliberately taken up for children with or without disabilities.

4. In the task of Classification of Pictures CWHI performed better than children

4. Curriculum is a tool to help teachers to focus on child development. So special attention should be given to develop cognitive abilities in the preschool curriculum.

attending Anganwadi. Several studies Lennenberg (1964), Krivitski (2000), Trybun & Karchmer (1977), Zarfaty et al., (2004), Meadow & Orlans (1980), Swanwick, Oddy & Roper (2005), Schirmer (2000), Padmini (1983) and Tompkins & Horkisson (1991) highlight the need for enriched environment, systematic and organized intervention in preschool, hands on experience to promote better cognitive abilities among children attending preschool. Furth (1966) observed that during the earlier years, CWHI and normal hearing children performed similarly on cognitive tasks, as it does not require the support of linguistic system. Stone (1980) noticed that difficulties of CWHI on certain cognitive tasks could be due to lack of experience.

5. Specific activities can be suggested for teachers and parents to enhance cognitive development in the early years of development. 6. With the help of the knowledge of cognitive development stages given by Piaget, the teacher can organize his/her teaching learning activities. 7. Social interactions have a great educational value for cognitive development. When children interact socially with peers they can know the right answer of a problem, hence they should be encouraged to interact with their age mates. 8. The children should be allowed to discover things on their own.

Educational implications The findings of the present study present a detailed picture of the current status of cognitive abilities and pre-arithmetic skills of CWHI. Hence, there is an enormous scope to identify the strengths and weakness of preschool CWHI. Educational implications of the study are as follows:

Conclusion In the light of the above findings it is concluded that if enriched environment, systematic organized intervention in preschool and hands on experience are provided to CWHI, their cognitive abilities can be stimulated and promoted which in turn can benefit in other areas of development. These experiences help all the children irrespective of their disability to perform better academically. Preschool children with significant hearing loss should be given special preliminary instruction. It gives the CWHI a chance to gain valuable school experience before undertaking a full school curriculum.

1. This study gives an insight into relationship between cognitive abilities of CWHI and its correlation in learning maths, which can be utilized in teaching of mathematics. 2. The findings indicate the need to include activities to foster cognitive development in the pre-school curriculum for children with hearing impairment. 66

Ramakrishna P & Gowramma I.P. / Cognitive Capabilities and Pre-arithmetic Skills

References

A, and Roper, T. (2005). ‘Mathematics and Deaf Children: an explor barrier to successes. Deafness and Education International, 7(1).

Culbertson, J. L. & Gilbert, L. E (1994, 2003). ‘Children with unilateral sensori neural hearing loss: cognitive, academic, and social development’, Journal of American Annals of the Deaf, 139(4): 430-7 & Arch Pediatrics, 10(2): 140-6.

Internet source, Retrieved from http://www. audiblox2000.com/early_childhood/ early_education.htm, on dated 21.01.08. Kidd, G.R., Connell, P.J. & Lowther, A. (2003). ‘Sensory, Cognitive, and Linguistic Factors in the Early Academic Performance of Elementary School Children’, Journal of Learning Disabilities, Vol. 36, No. 2, 165-197.

Donald, B. B. Jr, & Wolery, M. (1989). ‘Assessment of Cognitive skills in the preschool-Aged child’, Assessing infants and pre-schoolers with handicaps, Columbus, Merrill publishing company. Downing, P. (1972). As cited in Valletuttu, P.J. & Dunnett. L. (1992). ‘Cognitive Development; Cognitive Development a functional approach’, California, Singular publishing group.

Kingma, J. (1984). ‘Traditional intelligence, Piagetian task, and initial arithmetic in Kindergarten and primary school grade ‘I’, Journal of psychology, 145, 49-60.

Flexer, A. & Carol, M. (1999). ‘Facilitating hearing and listening in young children’. San Diego, CA: Singular.

Krivitski, E. C. (2000). ‘Profile Analysis of Deaf Children Using the UNIT’, Dissertation Abstracts International, 61(7-A), 2593.

Fuchs, L. S. & Fuchs, D. (2005). ‘Enhancing Mathematical problem solving for students with disabilities’, The journal of Special Education, Volume-39.

Lauwerier, L., Chouly, M.B. & Bailly, D. (2003). ‘Hearing impairment and cognitive development’, Archives de Pediatrie, Volume 10, Number 2, pp. 140-146(7).

Furth, H. G. (1964). ‘Research with the deaf: Implications for language and cognition’. Psychological Bulletin, 62, 145–164.

Meadow, K. P, & Orlans, S. (1980). ‘Deafness and child development’, Berkely, CA: University of California press.

Furth, H. G. (1966). ‘Thinking without language: Psychological implications of deafness’. New York: Free Press.

Moeller, S & McConkey. (1984). As cited in Bess, F. H. (Edited, 1988). ‘Hearing impairment in children, Management of pre-school hearing impaired children’, A c o g n i t i v e - l i n g u i s t i c a p p ro a c h , Maryland, York Press.

Grammatico, L. F. & Miller (1974). ‘Curriculum for the Preschool Deaf Child’, Volta Review, 76, 5, 280-9.

Moeller, S., Obserger, V. & Mordford, S. (1986). As cited in Bess, F. H. (Edited, 1988). ‘Hearing impairment in children, Management of pre-school hearing impaired children’, A cognitive-linguistic approach, Maryland, York Press.

Gowramma, I.P. (2005). ‘Development of remedial instruction program for children with Dyscalculia in primary school’, Mysore, Chetan book house. Hitch. S. (1983). ‘Mathematics and deaf children’. As cited in Swanwick, R, Oddy, 67

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Narayan, J. (1997). ‘Grade Level Assessment Device’, Secunderabad, NIMH.

Stone, P. (1980). ‘Developing thinking skills in young hearing impaired children’, Volta Review, 82.

Nunes, T. & Moreno, C. (1998). ‘Is hearing impaired a cause of difficulties in learning mathematics?’, In C.Donalan (Ed). The development of mathematical skills.

Swanwick, R., Oddy, A. & Roper, T. (2005). ‘Mathematics and Deaf Children: an exploration of barriers to success’. Deafness and Education International, 7(1).

Padmini, T. (1983). ‘Fostering cognitive development in Primary school entrants’, New Delhi, Bahri publication private ltd.

Tompkins, G. E. & Hoskisson, K. (1991). ‘Language arts: Content and teaching strategies’, New York: Macmillan.

Pau, S. C. (1995). ‘The deaf child and solving problems of arithmetic, The importance of comprehensive reading, education and Deafness’.

Valletuttu, P. J. & Dunnett, L. (1992). ‘Cognitive Development; Cognitive Development a functional approach’, California, Singular publishing group.

Piaget, J. (1964). ‘The early growth of logic in child, classification & seriation’, by E.A, Lunzer & D.Papert, London, Routledge and Kegan Paul.

Watson, C. S.& Kidd, G. R.(2003). ‘Sensory, Cognitive, and Linguistic Factors in the Early Academic Performance of Elementary School Children’, Journal of Learning Di sabil ities , Volu me 36, Number 2, pp. 165-197(33).

Rittenhouse, R. (1977). ‘Horizontal decalage: The development of conservation in deaf students and the effect of the task instructions on their performance’, Champaign – Urbana, University of Illinois.

Wood, D., Wood, H., Griffith, A. & Howarth, I. (1993). ‘Teaching and talking with deaf

Schirmer, B. R. (1989). ‘Relationship between imaginative play and language development in hearing impaired children’. American Annals of the Deaf, 134-3), 219-222.

Children’, New York: Wiley. Yang, X. & Shaftel, J. (2005). ‘Latent Class Analysis of Mathematical Ability for Special Education Students’ (Qualitative or Quantitative Differences?), The Journal of Special Education, Vol. 38, No. 4, 194-207 .

Sen, A. (1988). ‘Psychosocial integration of the handicapped- A challenge to the Society’, Delhi, Mittal publications.

Zarfaty, Y., Nunes, T. & Bryant, P. (2004). ‘The Performance of Young Deaf Children in Spatial and Temporal Number Tasks’, Journal of Deaf Studies and Deaf Education, 9:3.

Shobha, B.N. (2002). ‘Cognitive capabilities among Pre-school children of three D i f f e re n t s e t t i n g – M o n t e s s o r i , Kindergarten & Anganwadi Centers in Mysore’, Mysore, University of Mysore.

Vol. 4. No. 2 July 2014

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

Inclusive Education: Study on Peer Group Relationship among Differently Abled Students *N.R. Prakash and **S. Nirmala Devi

Abstract Peer groups help in students’ social development, provide companionship, feelings of community and belongingness. Without peer group relationship, a student can feel lonely and isolated that can lead into many physiological, psychological and severe emotional problems. The main objective of this investigation is to find out whether there is any difference in the peer group relationship among differently abled students in inclusive education pattern in relation to certain personal and demographic variables. Sample for this study consists of 60 differently abled students who are studying (both male and female) in government and private colleges in and around Chennai. The researcher made tool i.e. “Peer Group Relationship Scale” was used for data collection. Collected data were subjected to statistical analysis and scores of the sample were computed. The result showed significant difference with regards to various personal and demographic variables. Hence, it is concluded that government, schools and colleges should take responsibility to build peer group relationships in inclusive education to increase the students’ enrollment in higher education and to provide better educational opportunities for the differently abled students. Keywords: Inclusive education, Peer group relationship, Differently abled students

Introduction Inclusive Education means welcoming all children, without discrimination, into regular or mainstream schools. It refers to the process of educating all children in their neighborhood school, regardless of the nature of their disabilities. Students participating in inclusive programme follow the same schedule as their classmate and participate in age appropriate academic activities without any discrimination. Inclusion provides appropriate support for everyone involved in its process. Friendship between students with and without disabilities becomes a possibility in a school that builds up peer group relationships.

The term peer group refers to an individual’s small, relatively intimate group of peers who interact on a regular basis. Peer groups consist of individuals who share friendship, hang around and talk to each other as well as do activities together. As children develop into adolescents, they spend an increasing amount of time with their peers compared to their parents or other adults (Brown, 2005). Research indicates that peer group exhibit similarity in many characteristics and attributes. The tendency of individuals to affiliate with others who share similar attributes is a social

* Ph.D., Research Scholar, Department of Education, Institute of Advanced Study in Education, Saidapet, Chennai.Email: nrprakash.edu@gmail.com ** Principal, Institute of Advanced Study in Education, Saidapet, Chennai. Email: rmaladevielango@

gmail.com

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dynamic called homophily. Homophily of peer groups has also been found among peers along academic characteristics such as Grade Point Average (GPA), college aspirations, time on homework and general engagement in schoolwork. Two processes contribute to homophily, socialization and selection. Socialization refers to the tendency for friends to influence similar attributes in each other over time. Selection refers to the tendency for individuals to choose friends with similar attributes.

Conroy, 2001). A child with a disability is defined as a child assessed as having mental retardation, hearing impairment, speech or language impairment, visual impairment, serious emotional disturbance, orthopedic impairment, autism, traumatic brain injury, any other health impairment, specific learning disability, or multiple disabilities, and who, by reason thereof needs inclusive education and related services to develop and maintain mutual relationship between normal students and disabled.

A friend is someone attached to another by affection or esteem; a favored companion (Merriam-Webster, 2002). Friendship with peers serves many functions that can contribute to the quality of life of the student. They help children’s social development, they provide companionship and they can provide feelings of community and social support. Friendships assist students to learn about themselves and mature, they provide security and validation of self-esteem. Without friends, a child can feel lonely and isolated (Geisthardt, Brotherson & Cook, 2002).

Need and significance of the study Inclusion in education is an approach to educate students with special educational needs. Under the model of this education, students with special needs spend most or all of their time with non-disabled students. Peer group relationship is a strategy that involves placing students in pairs or in small groups to participate in learning activities that support academic instruction and social skills. Peer group relationship provides teachers with a learning tool to enhance instruction for students with and without disabilities. Hence, the study of peer group relationship between the normal and disabled students studying in inclusive education would be the most appropriate and give additional support for the inclusive education. The finding may help in improving the peer group relationship concepts to understand the physical, psychological and emotional feeling of the disabled to provide with suitable learning climate and increase self-confidence among disabled students. This investigation may help in understanding the individual differences in their peer group relationship.

Research indicates a link between children’s self-worth and friendships (Vaughn, 2001). According to Vaughn, children with disabilities need at least one friend to increase their self-perception. Also, children with disabilities most of the times feel more rejection than acceptance from their peers. Children with disabilities tend to have fewer friends and have less exposure to peers. Despite this, students with disabilities are not without friends (Vaughn, 2001). Students with disabilities have peer relationship difficulties (Brown, Odom & 70

Prakash N.R. & Nirmala Devi S / Study on Peer Group Relationship

Objectives of the study To find out the peer group relationship based on the following personal and demographical variables: (i) Gender (ii) Educational qualification (iii) Parent’s educational qualification (iv) Parent’s occupation (v) Parent’s annual income (vi) Place of living (vii) Type of disability (viii) Birth order and (ix) Type of family.

Data collection The investigator personally visited the institutions for collecting the data. First, he took permission from the principal of the college by telling the purpose and contribution of the study. A list was received with help of principal and then all the differently abled students were contacted personally to get their willingness to participate in the study. The differently abled students were given the copies of the rating scale and requested to respond to all item in it. ‘Scribe’ was used for collecting data from visually challenged students.

Hypotheses of the Study There is no significant difference in the peer group relationship with respect to the following personal and demographical variables:

Scoring procedure The investigator used Likert’s type of attitude scale on a five-point scale and it has been scored by assigning 5, 4, 3, 2 and 1 in the case of positive items and 1, 2, 3, 4 and 5 in the case of negative items, respectively. The grand total to each individual on the entire scale was obtained by adding the assignments on all the statements. The information provided by the respondents in the personal data sheet was numerically coded to suit the computer analysis.

(i) Gender (ii) Educational qualification (iii) Parent’s educational qualification (iv) Parent’s occupation (v) Parent’s annual income (vi) Place of living (vii) Type of disability (viii) Birth order and (ix) Type of family. Methods Research design In the present study, survey method was adopted. Tool used in the study A five-point attitude scale with 25 items on peer group relationship was developed by the researcher. The questionnaire consists of 14 positive and 11 negative statements.

Statistical techniques used In the present study, following statistical analysis were used:

Sample Sixty differently abled students (Male 33 and Female 27) studying in various Arts and Science Colleges in and around Chennai constituted the sample for this study. Sample includes 17 physically challenged, 22 visually challenged and 21 hearing challenged students from various Arts and Science Colleges.

Descriptive Analysis (Mean, Standard Deviation)

Differential Analysis (t-value, F-ratio)

Analysis and interpretation of the data The collected data were subjected to statistical analysis and it is analyzed using SPSS package. The mean and standard deviation for the variable peer group relationship scores were computed for the entire sample. 71

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Testing of hypotheses There is no significant difference in the Peer Group Relationship with respect to the following personal and demographical variables: (i) Gender (ii) Educational qualification (iii)

Parent’s educational qualification (iv) Parent’s occupation (v) Parent’s annual income (vi) Place of living (vii) Type of disability (viii) Birth order and (ix) Type of family and (x) Type of management.

Table 1 Showing the Mean, S.D., and t-values on Peer Group Relationship with Respect to Gender, Place of Living, Family Type and Type of Management Variable

Background Variables