Empowerment Practice in Families Whose Child Has a Developmental Disability in the Serbian Context.

PURPOSE: To evaluate the extent to which families of children with developmental disabilities, in relation to parents of typically developing children, feel empowered and the way that their empowerment manifests itself. DESIGN AND METHODS: The comparative research design was used in a quantitative, descriptive analysis of 99 families (57.6% were parents of children with developmental disabilities and 42.4% were parents of typically developing children). With regard to the research instrument, the Family Empowerment Scale was used based on a conceptual framework consisting of two dimensions: the level of empowerment and the way it is expressed. RESULTS: The highest levels of parental empowerment were observed in the Family domain (M = 3.9; SD = 0.6), while the lowest were in the Community domain (M = 2.9, SD = 0.9). The statistical differences between the comparing groups of parents were most pronounced in the Family domain (Mann-Whitney U = 693.00, p = 0.00). Parents of children with developmental disabilities have demonstrated a lower level of family empowerment associated with attitudes, as well as behaviours and knowledge about specific ways in which they can help their child. CONCLUSION: Based on data obtained from this study, it can be concluded that parents of children with developmental disabilities require extra support and empowerment in order to take a more active part in working with their child and making decisions relevant to his/her development in order to utilize all community - based resources available.

Differentiation of Cognitive Deficit Profiles in Multiple Sclerosis Patients: Latent Profile Analysis.

OBJECTIVE: The purpose of this study was to ascertain whether the application of the Audio Recorded Cognitive Screen (ARCS) in cognitive functioning screening of persons with multiple sclerosis (MS) differentiates profiles of existing cognitive deficits (CDs) and whether this instrument can discriminate accurately between subjects who are cognitively intact (CI) and those with a cognitive disorder. SUBJECTS AND METHODS: The research was conducted on a sample of 359 subjects, with two subsets of participants: 108 persons with a relapsing-remitting form of MS and 251 persons from the general population. RESULTS: We labeled the three profiles obtained by applying the ARCS questionnaire: the CI profile, the profile of CI with visuospatial difficulties, and the profile of persons with CD. CONCLUSION: ARCS has the ability to differentiate persons with a CD from those without, both in a sample of persons suffering from MS and in a sample of persons from the general population. This finding indicates that this instrument is well suited for profiling the cognitive status into specific categories, which puts it among the instruments with a wide range of implementation.

Engagement of Preschool-Aged Children in Daily Routines.

Child engagement refers to the time spent interacting with physical and social environments according to age, abilities, and a situation. The aim of this study is to assess the functioning of children in early childhood routines using engagement assessment instruments relative to the presence of developmental disabilities, age, gender, and parental characteristics within the contexts of preschool and family routines. The sample comprised 150 children aged 3-5 (AS = 4.02, D = 0.78), including typically developing children (N = 49) and children with developmental disabilities (N = 101). To assess the children's engagement in preschool classrooms, we used the Classroom Measure of Engagement, Independence, and Social Relationships (ClaMEISR), and the Child Engagement in Daily Life Measure was used to assess the children's engagement in family routines. The results obtained indicate a significantly higher rate of engagement in routines and activities among girls and older children. Parental characteristics associated with children's engagement included employment and marital status. Children with developmental disabilities, compared to their typically developing peers, had lower levels of engagement in social relationships and functional independence in daily routines. The results indicate that both instruments have a high internal consistency and are thus suitable for future use in the Republic of Serbia.

Phonological Awareness as the Foundation of Reading Acquisition in Students Reading in Transparent Orthography.

Phonological skills have been found to be strongly related to early reading and writing development. Accordingly, the aim of this study was to examine the extent to which the development of phonological awareness facilitates reading acquisition in students learning to read a transparent orthography. Our research included 689 primary school students in first through third grade (Mean age 101.59 months, SD = 12,690). The assessment tools used to conduct this research include the Phonological Awareness Test and the Gray Oral Reading Test. According to the results from the present study, 13.7% of students have reading difficulties. Students with reading difficulties obtained low scores in phonological awareness within each subscale compared to students who do not have reading difficulties (p < 0.01). Components of phonological awareness which did not singled out as strongly related to early reading success include Phoneme Segmentation, Initial Phoneme Identification, and Syllable Merging. Thus, understanding the nature of the relationship between phonological awareness and reading should help effective program design that will be aimed at eliminating delayed development in children's phonological awareness while they are still in preschool.

Relations between handedness and motor abilities in preschool children.

Relations between laterality and motor abilities were assessed in preschool children. Study sample included 202 children aged 5-7.5 decimal years. Upper extremity usage and gesture laterality was assessed by a battery of tests and used on children evaluation according to harmonious or inharmonious laterality. The performance of motor tasks that require whole body coordination, the speed of alternating hand motion frequency and the precision of hand aiming were assessed according to the type of laterality. There were no statistically significant sex differences in laterality distribution, and no differences according to laterality harmonization. There was no statistically significant difference in motor test performance between the children with harmonious and inharmonious laterality.

Influence of Cognitive and Motor Abilities on the Level of Current Functioning in People with Multiple Sclerosis.

INTRODUCTION: Multiple sclerosis (MS) results in a wide range of disabilities. The effects of cognitive and motor dysfunctions are significant and affect level of functioning in people with MS. OBJECTIVE: The aim of the research was to determine the common contribution of neurological, motor and cognitive status to the overall functioning of MS patients. METHOD: The sample consisted of 108 subjects with RRMS. The instruments used in the research included: The General Questionnaire, the World Health Organization Disability Assessment Schedule, the Audio Recorded Cognitive Screen, Paced Auditory Serial Addition Test, the Nine Hole Peg Test, the 25 Foot Walk Test, and the Expanded Disability Status Scale. RESULTS: Subjects with a mild neurological deficit had a higher level of current functioning in all domains (a lower WHODAS 2.0 score) than subjects with a moderate neurological deficit (r=0.43, p<0.001). We found a positive correlation between the level of cognitive impairment and motor deficits of both upper and lower extremities and the level of neurological deficit (p<0.001). Subjects with lower neurological deficits had significantly lower WHODAS 2.0. scores, i.e. better motor abilities of both upper and lower extremities than subjects with moderate neurological deficits (p<0.001). The greatest contribution to explaining the overall level of current functioning of people with MS had subjects' age, cognitive abilities and motor abilities of the upper extremities. CONCLUSION: Inverse relationship of neurological, motor and cognitive status affects the overall daily functioning of people with MS, requiring planning of comprehensive programs in the rehabilitation of people with MS.

THINGS THAT CAN BE CHANGED IN EARLY INTERVENTION IN CHILDHOOD.

INTRODUCTION: Early intervention implies a model of support focused on a child, family and a broader community from early childhood. The aim of this study was to analyze the elements of the successful early intervention in childhood, as well as to assess the role of a special educator and rehabilitator and level of their involvement in implementing the program on the territory of Novi Sad. MATERIAL AND METHODS: The study sample included 100 parents of children with disabilities (aged 3-7), who completed the questionnaire designed for the purposes of this research, based on a similar questionnaire design. RESULTS: Speech delay is one of the most common reasons (over 50%) why parents seek professional help. By the end of the first year of life of their child, 43% of parents responded that they had noticed the first problems, that is, a problem was identified in 25% of children of this age group, and the same number was included in the treatment. About 55% of children were involved in organized treatment from 3 years of age onwards. Special educators and rehabilitators are usually involved in treatment when the team consists of three or more professionals. CONCLUSIONS: It is necessary to improve early intervention services, to educate staff, and provide conditions which would make it possible to overcome the existing disadvantages in treating children from an early age. In addition, the involvement of special education and rehabilitation professionals in treatment teams since children's early age is vital.

Agreement in quality of life assessment between adolescents with intellectual disability and their parents.

Intellectual disability affects different aspects of functioning and quality of life, as well as the ability to independently assess the quality of life itself. The paper examines the agreement in the quality of life assessments made by adolescents with intellectual disability and their parents compared with assessments made by adolescents without intellectual disability and their parents. Participants included 67 adolescents with intellectual disability and the same number of their parents. Control group consisted of 122 typically developed adolescents and an equal number of their parents. In order to assess the quality of life we used The PedsQL 4.0 Generic Core Scale questionnaire, for adolescents aged between 13 and 18 and their parents. Agreement in assessing quality of life between adolescents and parents was analyzed using t-test, Kappa Statistics and Pearson correlation. The agreement between adolescents with intellectual disability and their parents was found to be acceptable (k=0.43), while the agreement between adolescent from control group and their parents was judged to be good (k=0.84). Correlations between adolescents with intellectual disability and their parents varied across subscales from weak (r=0.31) on the physical health subscale to moderate (r=0.56) on the social subscale. Adolescents with intellectual disability were less satisfied with their social functioning. The highest agreement, as well as the lowest means value was found on the social agreement scale. Assessment of the quality of life by both adolescents and their parents provides a comprehensive insight into functioning and different aspects of quality of life in these adolescents.

Effects of exercise on physical fitness in children with intellectual disability.

This paper presents the results of the study which examined the effects of carefully designed physical exercise programs on the development of physical fitness in children with ID. The study sample consisted of 42 children with ID and 45 typically developing children. All the participants were assessed using Eurofit Test Battery. The results were analyzed in terms of participation in the exercise program and level of intellectual functioning. While ID children scored significantly lower on fitness tests when compared with typically developing children, the study revealed an association between degree of ID and physical fitness.

Psychometric properties of the Pediatric Symptom Checklist in preschool children in Serbia.

AIM: To demonstrate the use of the Pediatric Symptom Checklist (PSC) as a tool for screening problems in psychosocial development in preschool children in Serbia. METHODS: The form was filled out by parents to 269 children. The statistical and metric characteristics of the Pediatric Symptom Checklist were analyzed, while cut-off values were compared with the values reported from other countries. RESULTS: The PSC scale filled out by parents was found to have acceptable reliability in our sample of preschool children. A high level of reliability of the scale was achieved (á = 0.86). Average values on the scale were lower than in other analyses. There was no statistically significant difference in behavioral traits in regards to children's gender (p=0.53). Factor analysis of the Pediatric Symptom Checklist scale (promax solution) established an existence of a general factor. This general factor is structured with internal and external behavioral traits, as well as with impulsiveness and attention deficit in preschool children. Based on our cut-off value, the need of further follow up was established in 10.4% of study children (n=28, 17 male and 11 female). CONCLUSIONS: The study revealed that the PSC filled out by parents is a good tool for early and rapid identification of potential problems of psychosocial functioning of preschool children. It should be noted that a positive PSC score was not a diagnosis but an indication for additional analysis and assessment of the children and their families.

[Robot--a member of (re)habilitation team].

INTRODUCTION: The rehabilitation process involves a whole team of experts who participate in it over a long period oftime. DEVELOPMENT OF ROBOTICS AND ITS APPLICATION IN MEDICINE: The Intensive development of science and technology has made it possible to design a number of robots which are used for therapeutic purposes and participate in the rehabilitation process. ROBOTICS IN MEDICAL REHABILITATION: During the long history of technological development of mankind, a number of conceptual and technological solutions for the construction of robots have been known. By using robots in medical rehabilitation it is possible to implement the rehabilitation of peripheral and central motor neurons by increasing the motivation of patients for further recovery and effectiveness of therapy. The paper presents some technological solutions for robot-assisted rehabilitation of patients of different age groups and some possibilities of its use in the treatment. CONCLUSION: Using robots in standard physiotherapy protocols that involve a number of repetitions, exact dosage, quality design and adaptability to each individual patient leads to the significant progress in the rehabilitation of patients.

[Psychomotor re-education--movement as therapeutic method].

INTRODUCTION: Psychomotor re-education represents a multidimensional therapeutic approach in dealing with children and adults with psychomotor disorders. Therapeutic programs should be based on individual differences, abilities and capabilities, relationships, feelings and individual developmental needs as well as emotional condition of a child. BODY AND MOVEMENT AS THE Bases OF THE TREATMENT: A movement, glance, touch, voice and word, all being an integral part of a process of psychomotor re-education, are used with a purpose of helping children to discover their own body, their feelings, needs, behaviour. When moving, children discover the space of their own bodily nature, and, subsequently, gestural space and objective space. The body represents a source of pleasure and the freedom of movement, as well as one's own existence, are soon to be discovered. PRACTICAL APPLICATION: An adequate assessment is a precondition to design a work plan, select the best exercises for each child individually and direct the course of therapy. This is the most suitable method for treating children with slow or disharmonious development, mentally challenged children, children with speech and behaviour disorders. It is also used in the treatment of children with dyspraxic difficulties, difficulties in practognostic and gnostic development, pervasive developmental disorder and children with lateral dominance problems. CONCLUSION: Therefore, a systematic observation seems to be necessary as well as an increased number of research projects aimed at assessing results obtained by exercises in order to get a more precise insight into the process of re-education, selection of exercises, duration period and possible outcomes.

[Agreeing in assessment of hyperactivity in children].

INTRODUCTION: The study analyzes the accuracy and agreeability in evaluating hyperactivity in children. MATERIAL AND METHODS: The study sample was made of 139 children of pre-school age who participated in organized forms of physical activity. The mean age in the sample was 6.38, with a standard deviation of 1.00 years. Conner's Rating Scale was used to measure hyperactivity, and tests were also conducted to evaluate attention levels. Four independent reviewers observed each child's behavior by completing the scale. RESULTS AND DISCUSSION: Eighteen children, or 13.5 percent of the sample, were identified as hyperactive in the analysis. These children also scored lower in the attention level tests. The results of the study show a correlation between the evaluators to be relatively high, bearing in mind the sources' independence. CONCLUSION: It can be concluded that there is a mid to high-level correlation between certain reviewers' evaluations. However, even with a clearly defined view on categorizing certain behaviors as problematic, category labels still differ among evaluators.