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Perceptions about Barriers to Sexual and Reproductive Health Information and Services among Deaf People in Ghana

MPRAH, W K
2013

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Purpose: This study aimed to provide insights into factors that influence the acquisition, accessibility, and utilisation of Sexual and Reproductive Health (SRH) information and services by deaf people who communicate using Ghanaian Sign Language (GSL).

 

Method: The study explored deaf people’s perceptions about barriers to SRH information and services in Ghana. There were 26 participants in 3 focus groups: 10 executives of Ghana National Association of the Deaf (GNAD), 7 deaf adult males and 9 deaf adult females. A key informant, who had experience in working with deaf people, was also interviewed. Review of documents and observations helped to clarify data gathered from the focus groups.

 

Results: Study findings indicated that when accessing SRH information and services in Ghana, deaf people encounter numerous barriers such as problems with communication, ignorance about deafness, negative attitudes, and services that are not customised to their needs.

 

Conclusion: If it is to succeed, any SRH programme for the deaf community must make the eradication of communication barriers a priority, since communication is fundamental to all challenges that deaf people encounter.

The Rapid Assessment of Disability – Informing the Development of an Instrument to Measure the Effectiveness of Disability Inclusive Development Through a Qualitative Study in Bangladesh

HUQ, N L
EDMONDS, T J
BAKER, S
BUSJIA, L
DEVINE, A
FOTIS, K
MARELLA, M
GOUJON, N
KEEFFE, J
2013

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Purpose: The Rapid Assessment of Disability (RAD) questionnaire was developed to provide governments and development agencies with an appropriate instrument to determine the prevalence of people with disability within theirtarget populations, and to design and evaluate the effectiveness of disability inclusive activities in addressing their priorities and needs.

 

Method: The RAD questionnaire was developed using two conceptual frameworks: the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), and the International Classification of Functioning, Disability and Health (ICF). Existing instruments were reviewed to inform the structure and content of the RAD questionnaire. The RAD questionnaire that was developed for field testing in Bangladesh comprised both a household questionnaire and a questionnaire for individuals within each household, with 5 sections: 1) Demographic information, 2) Assessment of functioning, 3) Awareness of rights of people with disability, 4) Well-being and quality of life, 5) Participation in the community. Prior to field-testing the RAD questionnaire in Bangladesh, a qualitative study was conducted to ensure the relevance of the questionnaire in the context of a developing country. In-depth interviews with 9 people with disability and a focus group of 8 parents of children with disability were conducted in Dhaka, Bangladesh. 

 

Results:Qualitative findings highlighted factors relevant to the lives of people with disability in Bangladesh, including discrepancies between the awareness and attainment of rights for people with disability, the wellbeing of people withdisability and their families, as well as numerous barriers to full participation in their community. While the findings confirmed that the design and content of the questionnaire reflected all these aspects, some changes were made to the items in the questionnaire to ensure that it reflected the views of people with disability from the context of a developing country.

 

Conclusion and Implications: This qualitative study was an important step in the development of the RAD questionnaire as it helped to achieve its aim - namely, to establish the prevalence of disability and to assist in the design and evaluation of disability inclusive interventions in the setting of a developing country.

Evaluation of Environmental Barriers faced by Wheelchair Users in India

DEVI, S
GOYAL, S
RAVINDRA, S
2013

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Purpose: Environmental factors restrict the extent to which people with disabilities can participate in society. The reduction of environmental barriers will increase their participation in the social, educational and vocational spheres of life. With the use of a valid and reliable tool - the Craig Hospital Inventory of Environmental Factors (CHIEF) questionnaire - this study aimed to evaluate the environmental barriers faced by wheelchair users in Bangalore city, India.

 

Method: A convenience sample of 100 wheelchair users, between 16 and 40 years of age, and working in different institutions in Bangalore, participated in the study. The CHIEF questionnaire was administered to each participant. It consisted of multiple questions pertaining to the 5 components of environmental barriers faced by wheelchair users: Accessibility, Accommodation, Resource availability, Social support and Equality. Percentage values for the responses in each component were calculated.

 

Results: The results showed that 52% of wheelchair users faced problems in Accessibility on a daily basis, and 77% of them felt the problem was big. With respect to Accommodation, 41% faced problems once a month and 50% of them felt that this was a big problem. The maximum percentage of participants did not face problems in Resource availability (43%), Social support (50%) and Equality (59%), and therefore these aspects were not felt to be a big problem.

 

Conclusion: An understanding of the environmental barriers faced by wheelchair users can provide guidance in mapping policies and strengthening laws which would help to improve their quality of life.

Effect of an Experiential Dysphagia Workshop on Caregivers’ Knowledge, Confidence, Anxiety and Behaviour During Mealtimes

HETTIARACHCHI, S
KITNASAMY, G
2013

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Purpose: Children with cerebral palsy who have associated feeding difficulties are at risk of aspiration and poor nutrition. This study aimed to measure the changes in knowledge, confidence, anxiety and behaviour among 25 Sri Lankan mothers with responsibility for feeding children diagnosed with cerebral palsy, after they attended an experiential workshop.

 

Method: Data collection was done through pre- and post-workshop questionnaires, observations and semi-structured interviews.

 

Results: There was a significant improvement in reported levels of knowledge and confidence and a decrease in the caregivers’ level of anxiety during mealtimes. The qualitative data analysis indicated changes in participant knowledge, particularly about the signs of aspiration and positioning during mealtimes. Observations showed better adherence to recommendations on communication, bolus size and utensils.

 

Conclusion: The findings support the utility of experiential training for caregivers, to ensure that children with cerebral palsy are fed safely.

Disability, CBR and inclusive development (DCID), 2013, Vol. 24 No. 3

2013

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Reviews

  • Organisations of Persons with Disabilities and Community-based Rehabilitation

Original Research Articles

  • Perceptions about Barriers to Sexual and Reproductive Health Information and Services among Deaf People in Ghana
  • The Rapid Assessment of Disability – Informing the Development of an Instrument to Measure the Effectiveness of Disability Inclusive Development Through a Qualitative Study in Bangladesh
  • Evaluation of Environmental Barriers faced by Wheelchair Users in India
  • Effect of an Experiential Dysphagia Workshop on Caregivers’ Knowledge, Confidence, Anxiety and Behaviour During Mealtimes

Brief reports

  • Use of Skype to Educate Underprivileged Blind Children in India: Motivations, Barriers and Teaching Strategies

Experiential Accounts

  • Protecting Children with Disabilities from Violence in CBR Projects: Why we need to work with a different form of child protection policy for children with disabilities
  • CBR for Inclusion of People with Mental Illness

Case Studies

The Role of Resource Information Centres in the Community Based Rehabilitation Framework

Disability, CBR and inclusive development (DCID), 2013, Vol. 24 No. 2

2013

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Original Research Articles

  • Training CBR Personnel in South Africa to contribute to the Empowerment of Persons with Disabilities
  • Exploring Knowledge and Attitudes towards HIV/AIDS among Deaf People in Ghana
  • The Application of ICF-based Functioning Data on Home Environment Adaptation for Persons with Disabilities
  • Social Skills Training of Children with Learning Disability
  • Early Care following Traumatic Spinal Cord Injury (TSCI) in a Rehabilitation Centre in Bangladesh - An Analysis
  • Effects of Multisensory Training on Balance and Gait in Persons with Type 2 Diabetes: A Randomised Controlled Trial

Brief reports

  • Speech and Language Disorders in Children with Intellectual Disability in Bosnia and Herzegovina

Case Studies

  • An Integrated Multimodal Intervention of Remedial and Adaptive Approaches in Secondary Dystonia of Hand: A Case Report

Letters to the Editor

  • Virtual Volunteerism and its Impact on International Community Development

Disability, CBR and inclusive development (DCID), 2013, Vol. 24 No. 1

2013

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Original Research Articles

  • Challenges Faced by Malaysians with Disabilities in the World of Employment
  • Risks to Client Confidentiality when Communicating Health Information to Blind and Partially Sighted Persons
  • Leprosy: Knowledge and Attitudes of Physiotherapists in Nigeria
  • Inclusive Education in Bangladesh: Are Pre-service Teachers Ready to Accept Students with Special Educational Needs in Regular Classes?
  • Factors related to Recovery and Relapse in Persons with Stuttering Following Treatment: A Preliminary Study
  • Problem Behaviour and Academic Grade Level Performance of Adjudicated Children with Juvenile Delinquency

Brief reports

  • Excluded in Inclusive Schools: Experiences of Children with Disabilities, their Families and Teachers in Sri Lanka
  • Perceptions of Primary Caregivers of Children with Disabilities in two Communities from Sindh and Balochistan, Pakistan
  • Accessibility of Students with Physical Disability to Washrooms in Bungoma Bus Terminus, Kenya

Letters to the Editor

  • Disease and Disability in the Elderly: A Call for Research
  • Disability Evaluation Related to Movement Disorders in India: A Need for Policy Revision

Disability, CBR and inclusive development (DCID), 2013, Vol. 24 No. 4

2013

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Original Research Articles

  • Impact of Community-based Rehabilitation on Persons with Different Disabilities
  • Empowerment in Community-based Rehabilitation and Disability-inclusive Development
  • Caregiver's Involvement in Early Intervention for Children with Communication Disorders
  • The Relationship Between Gross Motor Function and Quality of Life Among Children with Cerebral Palsy
  • India’s Disability Policy – Analysis of Core Concepts of Human Rights
  • Presentation and Impact of Pain in Persons with Post-Polio Syndrome: A Cross-sectional Survey Study

Brief reports

  • Barriers and Facilitators to Family-centred Paediatric Physiotherapy Practice in the Home setting: A Pilot Study

Experiential Accounts

  • Total Hip Arthroplasty Rehabilitation in Cambodia

Training CBR Personnel in South Africa to contribute to the Empowerment of Persons with Disabilities

RULE, S
2013

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Purpose: Recent conceptualisations of community based rehabilitation include empowerment of persons with disabilities as a key activity. This article reports on a study which explored the training of mid-level CBR workers in South Africa, with a specific focus on the ability of the course participants to address the oppression and empowerment of persons with disabilities.

 

Method: Over a three-year period, one cycle of action research was conducted in a non-government organisation that conducts mid-level CBR training in South Africa. Data collection methods included in-depth interviews with staff, students and past graduates of the course, document analysis, participatory rural appraisal techniques and two focus group discussions with the students’ clients.

 

Results: Personnel, who had been trained in CBR before the year 2003, were found to have some difficulty in explaining the social model of disability and the oppression of persons with disabilities at a cultural and structural level. It was noted that after changes were implemented in the CBR course, the students had an orientation to working with, rather than for, persons with disabilities. They began to understand the complexities of empowerment and also engaged in social action to address the oppression of persons with disabilities.

 

Conclusions: The CBR Guidelines require a new skill-mix in mid-level CBR personnel. This study illustrates a possible training approach which can contribute to the development of these skills.

Exploring Knowledge and Attitudes towards HIV/AIDS among Deaf People in Ghana

MPRAH, W K
2013

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Purpose: By exploring the level of knowledge about HIV/AIDS and attitudes towards persons with HIV/AIDS among deaf people in Ghana, this article aims to identify and correct possible gaps in awareness.

 

Method: A participatory sexual and reproductive health (SRH) needs assessment was conducted, targetting deaf people who were fluent in the Ghanaian Sign Language (GSL). The study design was a two-phase, sequential, mixed methods approach. Three focus groups assisted in the development of a survey, which was then implemented for needs assessment data collection. The 179 study participants consisted of 26 focus group participants, 152 survey respondents and 1 key informant. Of the focus group participants, 7 were executives of Ghana National Association of the Deaf (GNAD), 10 were adult males, and nine were adult females. Apart from the key informant, all the participants were deaf persons.

 

Results: The study indicated that many respondents still had misconceptions about HIV/AIDS and had difficulty identifying preventive methods, but their attitudes towards persons with HIV/AIDS was generally positive.

 

Conclusion: More attention needs to be paid to the requirements of the deaf community and to designing HIV/AIDS programmes and services that are deaf-friendly and accessible.

The Application of ICF-based Functioning Data on Home Environment Adaptation for Persons with Disabilities

TONGSIRI, S
HAWSUTISIMA, K
2013

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Purpose: This study illustrates how the International Classification of Functioning, Disability and Health (ICF) domains and qualifiers could be used to create functioning profiles of persons with disabilities in order to plan environmental changes. The outcome of the interventions can be measured by before-and-after comparisons of these profiles.

 

Method: 33 persons with disabilities (11 each from three provinces), with an average age of 43 years, were interviewed between November 2011 and May 2012. 67% of them were male. The functioning profiles of all the subjects were used as guidelines for home environment adaptations.

 

Results: The data helped to understand the limitations of persons with disabilities and identified the areas that needed enhancement to improve their functioning. Modification lay-outs were provided for all 33 persons with disabilities.

 

Conclusion and Implications: It was demonstrated that the ICF framework could help create functioning profiles to guide modifications in the home environment. Future studies should examine whether ICF can measure actual changes that occur after the modifications.

Social Skills Training of Children with Learning Disability

BHAN, S
FAROOQUI, Z
2013

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Purpose: The ability to recognise emotions in oneself and in others is a fundamental prerequisite to function successfully in the social world. Emotion recognition deficit in people with learning disability may therefore be an important contributory factor to deficits in social skills and poor social adaptation. This study aimed to examine the level of emotional understanding in students with learning disabilities (LD).

 

Method: A pre-test, post-test equivalent groups design was adopted for this study. The focus was on identification of emotions through verbal and pictorial situations, and the appropriate expression of emotions. Training was provided to enhance the emotional understanding of students through the use of ‘I C ME’ module. The 6 emotions addressed in this study were anger, excitement, embarrassment, jealousy, love and anxiety. 30 children with LD, in the age group of 9-12 years, were selected for the study.

 

Results: It was seen that while children with LD had difficulty in the identification of an emotion, they found it more difficult to express the emotion in a socially appropriate way. The post-test results indicated that the training provided to the students significantly improved their emotional understanding.

 

Conclusions: The students learnt about the 6 emotions (anger, excitement, embarrassment, love, jealousy, and anxiety), the vocabulary associated with these emotions, and also the appropriate way to express, self-monitor and self-regulate each emotion.

 

Limitations: Intervention was done for only 6 emotions

Early Care following Traumatic Spinal Cord Injury (TSCI) in a Rehabilitation Centre in Bangladesh - An Analysis

RAZZAK, A T M A
2013

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Purpose: The study aimed to explore the outcome of current practices in the treatment of persons with traumatic spinal cord injuries (TSCI) in Bangladesh, through the stages of rescue and first contact with physician, transportation to the tertiary hospital and intermediate admission.

 

Method: This observational study was conducted between June and August 2011, at the Centre for the Rehabilitation of the Paralysed (CRP), in Dhaka, Bangladesh. From the 113 persons with SCI admitted at CRP during this period, 56 persons with TSCI were selected. With the help of a questionnaire, data were collected from these persons or their attendants by trained staff, and also taken from hospital records. Data were processed and analysed by SPSS software version 16.

 

Results: The male-female ratio among the study participants was 5.25: 1, with a mean age of 33.02 years. 55.3% of them were paraplegic, while 44.7% were tetraplegic. About 70% of the injuries were complete according to ASIA impairment scale (AIS) during admission at CRP.

 

The most common causes of injury were falls (50%), followed by road traffic accidents (RTA) and carrying loads on the head. 74.8% of the injured persons had been rescued from the accident site by local people but only 16.1% had been transported by ambulance. The spine board had never been used. More than half of the injured received initial treatment only at a sub-district or district hospital where none of the requisite facilities were available.

 

While being transported from one hospital to the other, 10.7% experienced neurological deterioration of some sort. Significant statistical correlation was found between mode of transfer (P <0.03) and intermediate admission (P<0.001)with neurological deterioration.

 

Conclusions: There is an urgent need to implement pre-hospital trauma care in Bangladesh. Since resources and places for the rehabilitation of persons with TSCI are scarce, regional and national spinal injury centres should be established without delay.

 

Limitations: The study focussed only on a small sample of persons with TSCI undergoing treatment at a single centre.

Effects of Multisensory Training on Balance and Gait in Persons with Type 2 Diabetes: A Randomised Controlled Trial

KUTTY, N A M
MAJIDA, N A
2013

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Purpose: Progressive deterioration of physical function occurs in persons with Type 2 diabetes and peripheral neuropathy. This study assessed the effects of multisensory training on balance and gait in persons with diabeticneuropathies.

 

Method: Thirty two persons with peripheral neuropathies were enrolled, randomised, and subdivided into 2 groups - an experimental group of 16 participants with diabetes (65 ± 2.12 years) and a control group of 16 participants with diabetes (68 ± 2.17 years). For 6 weeks, both groups were given health education on diabetes for 30 minutes a week. In addition, the experimental group practised a multisensory exercise programme for 30 minutes, 3 times a week over 6 weeks. Outcome measures used were ‘timed up and go’ test for assessing balance and ‘6-minute walk’ test for gait. Standard descriptive statistics were used to report means, standard deviation, and range for baseline characteristics. Paired and unpaired ‘t-tests’ were used wherever necessary, to determine significant differences in data among groups and between pre-test and post-test scores (p<0.05).

 

Results: By the end of the trial period, the intervention group showed a significant improvement in scores of the ‘timed up and go’ test (t= 14.7092), but there was no statistically significant difference in the ‘6-minute walk’ test scores (p=0.7206, t= 0.3644).There was no difference for both measures in the control group.

 

Conclusion: The study showed that multisensory exercises could improve balance in persons with Type 2 diabetes and peripheral neuropathy. The findings suggest that along with physiological sensory factors, cognitive-behavioural factors and strengthening of the lower limb muscles should be considered when treating diabetic persons with gait alterations.

Challenges Faced by Malaysians with Disabilities in the World of Employment

TA, T L
LENG, K S
2013

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Purpose: This paper aims to explore and understand the challenges that are encountered by Malaysians with disabilities in the world of employment.

 

Method: A survey was undertaken in four Northern Malaysian states (Perlis, Kedah, Penang and Perak) to obtain the primary data. Two sets of questionnaires were formulated. The first questionnaire was addressed towards Malaysianpeople with disabilities, while the second one was for the employers. Descriptive statistics were used to explore, summarise and describe the data collected.

 

Results: This paper argues that integrating people with disabilities into the mainstream workforce should be the way forward, given that they are a pool of untapped human resources. Crucially, this study also highlights some of the key challenges faced by Malaysian people with disabilities, such as discrimination and exploitation at work.

 

Conclusions: This paper concludes that equal employment and training opportunities should be extended to Malaysian people with disabilities, in an effort to integrate them into the mainstream workforce. The existing Disability Act 2008 should be revised to address the challenges and issues highlighted in this paper.

Risks to Client Confidentiality when Communicating Health Information to Blind and Partially Sighted Persons

THURSTON, M
THURSTON, A
2013

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Purpose: This research was carried out to give a more accurate picture of the particular needs of the blind and partially sighted people living in Scotland. It explores the risks to client confidentiality if information is not provided in accessible formats.

 

Method: Data were gathered from a survey of 228 blind and partially sighted persons in 15 Health Authorities across Scotland. The survey reported NHS clients’ experiences of receiving health information in accessible reading formats.

 

Results: The data indicated that about 90% of blind and partially sighted persons did not receive communications from various NHS health departments in a format that they could read by themselves.

 

Conclusions: The implications for client privacy, confidentiality and the wider impact on life and healthcare have been highlighted. The implications for professional ethical medical practice and for public policy are discussed, and recommendations for improved practice are made.

Leprosy: Knowledge and Attitudes of Physiotherapists in Nigeria

AYANNIYI, O
DUNCAN, F O
ADENIYI, A F
2013

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Purpose: The objectives of this study were to investigate the knowledge and attitudes towards leprosy of physiotherapists in Nigeria.

 

Method: A cross-sectional survey of 330 physiotherapists, with minimum 1-year work experience in public hospitals in the 6 geo-political zones of Nigeria, was carried out. A pre-tested, self-administered questionnaire with open and close- ended questions was employed. Data obtained were analysed using descriptive and inferential statistics of Chi-square tests with Alpha level at 0.05.

 

Results: The respondents’ mean and range of years of job experience was 8.6 + 5.51 and 1 to 27 years respectively. Close to half (44.5%) of the physiotherapists had only a fair knowledge about leprosy and 165 (50%) had poor attitudes towards leprosy and persons with leprosy. There were significant associations between the schools of training and each level of knowledge (χ2 = 45.04; p = 0.0001) and attitudes of physiotherapists to leprosy and to persons who have suffered from leprosy (χ2 = 20.26; p = 0.009). There was, however, no significant association between years of job experience and each of knowledge (χ2 = 4.76; p = 0. 312), or attitudes of the physiotherapists to leprosy (χ2 = 4.55; p = 0.337).

 

Conclusions and Implications: It was concluded that a substantial number of physiotherapists in Nigeria had fair knowledge but poor attitudes towards leprosy. The institution of training appears to have an influence on their knowledge and attitudes. It is therefore recommended that educational and training programmes on leprosy should be organised and emphasised at the basic training institutions for physiotherapists.

Inclusive Education in Bangladesh: Are Pre-service Teachers Ready to Accept Students with Special Educational Needs in Regular Classes?

MALAK, M S
2013

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Purpose: The aim of this study was to examine pre-service special education (PSpE) teachers’ attitudes towards inclusive education (IE) for students with special educational needs (SEN) in Bangladesh.

 

Method: 100 PSpE teachers from a leading teacher education institute in Bangladesh were purposively sampled. A 20-item based survey questionnaire was used to measure participants’ attitudes. Items of the survey were developed from a literature review in which Attitudes Towards Inclusive Education Scale (ATIES) by Wilczenski (1992), Concern about Inclusive Education Scale (CIES) by Sharma and Desai (2002), and Interaction with Persons with a Disability (IPD) Scaled by Gething (1994) were considered as the key specialist resources. Both descriptive and inferential statistics were utilised in the analysis.

 

Results: The results revealed that while the PSpE teachers hold favourable attitudes towards students with SEN, they are concerned about some basic issues of inclusion. Practicum and close contact with children with SEN were found to be important variables which shaped the attitudes of the PSpE teachers. Implications of the findings are discussed and further suggestions are made as to how teacher education institutes may engage PSpE teachers more effectively with their programmes to promote better inclusive practices.

 

Conclusion: The study suggests that there is a need for providing PSpE teachers with experiential learning prior to school practicum.

Factors related to Recovery and Relapse in Persons with Stuttering Following Treatment: A Preliminary Study

ARYA, P
GEETHA, Y V
2013

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Purpose: The aim of the study was to investigate and compare factors related to recovery and relapse outcomes after treatment, among adults with stuttering.

 

Method: The participants were 24 adults who underwent fluency therapy and reported for follow-up 6 months after cessation of treatment. Pre, immediate post and 6-months post-treatment follow-up evaluations were done using stuttering severity instrument SSI-3. On the basis of total scores and severity obtained, participants were then grouped as either recovered or relapsed persons with stuttering. A questionnaire was administered to obtain their ratings for the different domains of factors that contributed to treatment outcomes.

 

Results: A significant difference was found between both the groups with respect to factors contributing to recovery and relapse. The four domains which were found to be more responsible for treatment outcomes in persons with stuttering were: individual related, therapy related, environment related, and behaviour and personality related factors.

 

Conclusion: The study was conducted with fewer participants, and it is possible that there could be many other pre-treatment and post-treatment factors such as attitude, anxiety, and speech naturalness which may influence the treatment outcomes in persons with stuttering. Future research should include these other factors.

Problem Behaviour and Academic Grade Level Performance of Adjudicated Children with Juvenile Delinquency

VENKATESAN, S
SWARNALATHA, G
2013

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Purpose: This paper attempted to profile the contemporary grade level academic performance as well as the frequency, spread and intensity of problem behaviour in relation to a few associated variables, of children adjudged as juvenile delinquents in India.

 

Method: A cross-sectional exploratory survey design was employed, with randomised convenience sampling of 66 inmates, between 9 and 18 years of age, from two representative Observation Homes. To ascertain their current grade levels, a criterion referenced ‘Grade Level Assessment Protocol’ was prepared exclusively for this study. Another standardised ‘Behaviour Assessment Scale for Indian Children with Mental Retardation, Part B’ was used to profile their problem behaviour.

 

Results: The contemporary academic performance results satisfy the conventional two-grade discrepancy criteria, usually postulated for identifying children with learning disabilities. Among the associated variables examined in this study, inmates who were booked under sections of the Indian Penal Code showed significantly greater academic grade discrepancy compared to the other children. Similarly, poorer academic performance, greater grade discrepancy, as well as higher frequency, spread and intensity of reported problem behaviour were found among children from intact family backgrounds, where parents were illiterates or educated below primary school level, and more among boys than girls, and among those in the 10-12 year age group.

 

Conclusions: While these are tentative findings, they call attention to the need for extensive research on the possible links between academic performance, under achievement and learning disabilities, and juvenile delinquency in this country.

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