La corrección-compensación en niños sordociegos con alteraciones motrices a través de actividades físicas adaptadas / Correction-compensation in the deafblind children with motor alterations through adapted physical activities

Introducción: La sordoceguera es una discapacidad doble que implica problemas en el campo auditivo y visual, provoca problemas comunicativos y motrices únicos. Por lo que es necesario trazar estrategias docente-educativas especiales y personalizadas. Objetivo: Proponer actividades físicas adaptadas como parte de la terapia ocupacional para la corrección-compensación de las alteraciones motrices presentadas en niños sordociegos que estudian en el Instituto Especial Mariana de Jesús. Métodos: La muestra estuvo conformada por 20 niños, entre los 6-10 años de edad con problemas visuales y auditivos parciales provocados por diferentes padecimientos. La investigación se inició con el diagnóstico realizado a 11 especialistas, que estaban implicados directamente en el proceso docente-educativo. Se delimitaron las variables de investigación antes de la implementación de la estrategia. Se diseñaron 10 juegos adaptados a las individualidades y necesidades de la muestra estudiada, y aplicados durante el curso docente 2016-2017. Resultados: Con la aplicación de las 7 pruebas motrices antes y después de implementada la mejora, se obtuvieron progresos significativos en las habilidades motrices de los sujetos, aumentando el porcentaje de evaluados de bien, según se demostró estadísticamente al calcular las proporciones para muestras relacionadas. Conclusiones: Las actividades físicas adaptadas, dentro de estrategias lúdicas como terapia ocupacional, permiten mejorar el trabajo correctivo-compensativo y las capacidades motrices de niños sordociegos. Estas estrategias deben desarrollarse bajo los principios de una ética humanista e inclusiva y sobre la base de una atención personalizada(AU)

Visual field, and causes unique communicative and motor problems. So, it is necessary to draw special and customised educational-teaching strategies. Objective: To propose adapted physical activities as part of the occupational therapy for the correction-compensation of motor alterations presented in deafblind children studying in Mariana de Jesus Special Institute. Methods: The sample consisted of 20 children in the ages from 6 to10 years old with visual and auditory problems caused by different diseases. The investigation began with a diagnosis to 11 specialists whom were directly involved in the educational process. The research variables were defined prior to the implementation of the strategy. There were designed ten games adapted to the individualities and needs of the sample studied, and those were used during the school year 2016-2017. Results: With the implementation of the 7 motor tests before and after the implementation of the improvement, significant breakthroughs in the motor skills of the subjects were achieved, and with it an increase in the percentage of subjects evaluated as well, as demonstrated statistically when calculating the proportions for related samples. Conclusions: The adapted physical activities, within playful strategies as occupational therapy, improve the corrective-compensative work and the motor abilities of deafblind children. These strategies should be developed under the principles of a humanist and inclusive ethics and on the basis of a personalized attention(AU)

Predictors of General Functioning and Correlates of Quality of Life: A Cross-Sectional Study among Psychiatric Outpatients.

INTRODUCTION: Functioning and quality of life (QOL) are negatively impacted as a result of mental illness. This study aimed to determine the: i) socio-demographic and clinical correlates of functioning and; ii) associations between functioning and QOL in a multiethnic sample of psychiatric outpatients. MATERIALS AND METHODS: This was a cross-sectional study of outpatients receiving treatment from a tertiary psychiatric hospital. Functioning was assessed using the Global Assessment of Functioning (GAF) scale, while QOL was measured using the World Health Organization Quality of Life-BREF (WHOQOL-BREF) which comprises 4 domains: physical health, psychological health, social relationships and environment. RESULTS: Various socio-demographic and clinical correlates were associated with functioning including employment and marital status, education and diagnosis. Depression was the only clinical characteristic which negatively correlated with functioning (P = 0.035). Amongst the whole sample, multiple linear regressions revealed that functioning was positively associated with all 4 QOL domains (physical health [P <0.001], psychological health [P <0.001], social relationships [P <0.001] and environment [P <0.001]). Further analysis of each diagnostic group revealed that functioning was positively associated with all 4 QOL domains in the anxiety, depression and obsessive compulsive disorder subsamples, while in the schizophrenia subsample, functioning was only significantly associated with all environment domain. CONCLUSION: Functional impairments were associated with different socio-demographic and clinical characteristics, which should be addressed when planning tailored treatment and interventions. Given that functioning is significantly associated with QOL, it is crucial to regularly assess and monitor them (in addition to symptomatic outcomes and adopting a more holistic and biopsychosocial approach).

Parent Perspectives of Applying Mindfulness-Based Stress Reduction Strategies to Special Education.

Parents of children with (versus without) intellectual and developmental disabilities report greater stress; such stress may be exacerbated by dissatisfaction with school services, poor parent-school partnerships, and the need for parent advocacy. Increasingly, mindfulness interventions have been used to reduce parent stress. However, it is unclear whether parents apply mindfulness strategies during the special education process to reduce school-related stress. To investigate whether mindfulness may reduce school-related stress, interviews were conducted with 26 parents of children with intellectual and developmental disabilities who completed a mindfulness-based stress reduction intervention. Participants were asked about their stress during meetings with the school, use of mindfulness strategies in communicating with the school, and the impact of such strategies. The majority of parent participants reported: special education meetings were stressful; they used mindfulness strategies during IEP meetings; and such strategies affected parents' perceptions of improvements in personal well-being, advocacy, family-school relationships, and access to services for their children. Implications for future research, policy, and practice are discussed.

Do sixth-grade writers need process strategies?

BACKGROUND: Strategy-focused writing instruction trains students both to set explicit product goals and to adopt specific procedural strategies, particularly for planning text. A number of studies have demonstrated that strategy-focused writing instruction is effective in developing writing performance. AIM: This study aimed to determine whether teaching process strategies provides additional benefit over teaching students to set product goals. SAMPLE: Ninety-four typically developing Spanish sixth-grade (upper primary) students. METHOD: Students received 10 hr of instruction in one of three conditions: Strategy-focused training in setting product goals and in writing procedures (planning and revision; Product-and-Process), strategy-focused training in setting product goals (Product-Only), and product-focused instruction (Control). Students' writing performance was assessed before, during, and after intervention with process measures based on probed self-report and holistic and text-analytic measures of text quality. RESULTS: Training that included process instruction was successful in changing students' writing processes, with no equivalent process changes in the Product-Only or Control conditions. Both Process-and-Product and Product-Only conditions resulted in substantial improvements in the quality of students' texts relative to controls, but with no evidence of benefits of process instruction over those provided by the Product-Only condition. Teaching process substantially increased time-on-task. CONCLUSIONS: Our findings confirm the value of strategy-focused writing instruction, but question the value of training specific process strategies.

"Bill is now singing": joint engagement and the emergence of social communication of three young children with autism.

Young children with autism spectrum disorder meet significant challenges in joint attention skills and in social communication. A child-centered, improvisational, music therapy intervention model was implemented to promote engagement in three young children with autism in a kindergarten classroom. A multiple baseline design compared the children's performance through three phases of intervention: focus on faces, response to joint attention, and initiation of joint attention. A complimentary qualitative analysis of teacher and parent experiences allowed for an in-depth understanding of the role of social environment in supporting emerging social communication skills among three children. As all children showed improvement in joint attention and actions of social engagement, this study bears evidence on the potential of music therapy as a promising intervention for promoting social skills of young children with autism spectrum disorder.

A cluster randomized-controlled trial of a classroom-based drama workshop program to improve mental health outcomes among immigrant and refugee youth in special classes.

OBJECTIVES: The aim of this cluster randomized trial was to evaluate the effectiveness of a school-based theatre intervention program for immigrant and refugee youth in special classes for improving mental health and academic outcomes. The primary hypothesis was that students in the theatre intervention group would report a greater reduction in impairment from symptoms compared to students in the control and tutoring groups. METHODS: Special classrooms in five multiethnic high schools were randomly assigned to theater intervention (n = 10), tutoring (n = 10) or control status (n = 9), for a total of 477 participants. Students and teachers were non-blinded to group assignment. The primary outcome was impairment from emotional and behavioural symptoms assessed by the Impact Supplement of the Strengths and Difficulties Questionnaire (SDQ) completed by the adolescents. The secondary outcomes were the SDQ global scores (teacher and youth reports), impairment assessed by teachers and school performance. The effect of the interventions was assessed through linear mixed effect models which incorporate the correlation between students in the same class, due to the nature of the randomization of the interventions by classroom. RESULTS: The theatre intervention was not associated with a greater reduction in self-reported impairment and symptoms in youth placed in special class because of learning, emotional and behavioural difficulties than a tutoring intervention or a non-active control group. The estimates of the different models show a non-significant decrease in both self-reported and impairment scores in the theatre intervention group for the overall group, but the impairment score decreased significantly for first generation adolescents while it increased for second generation adolescents. CONCLUSION: The difference between the population of immigrant and refugee youth newcomers studied previously and the sample of this trial may explain some of the differences in the observed impact of the theatre intervention. TRIAL REGISTRATION: ClinicalTrials.gov NCT01426451.

Influence of service-learning on kinesiology students' attitudes toward P-12 students with disabilities.

Employing a grounded theory approach, the purpose of this study was to qualitatively examine the influence of service-learning (SL) on undergraduate kinesiology students' attitudes toward and experiences working with P-12 students with disabilities. Fourteen (9 female, 5 male) kinesiology students enrolled in an adapted physical education class participated in one of three focus group interviews regarding their experiences of working with P-12 students with disabilities. All interview data were analyzed following procedures outlined by Strauss and Corbin (1998). The following five themes represent the participants' experiences and attitudes toward P-12 students with disabilities after their involvement in a SL project: (a) initial reactions, (b) selection of P-12 students, (c) preconceived attitudes, (d) the benefits of SL, and (e) positive experience. All 14 of the participants who volunteered to share their experiences indicated that the SL experience positively affected their attitudes toward individuals with disabilities.

Portugal's special education law: implementing the International Classification of Functioning, Disability and Health in policy and practice.

PURPOSE: The International Classification of Functioning, Disability and Health (ICF) was introduced in Portuguese education law as the compulsory system to guide eligibility policy and practice in special education. This paper describes the implementation of the ICF and its utility in the assessment process and eligibility determination of students for special education. METHODS: A study to evaluate the utility of the ICF was commissioned by the Portuguese Ministry of Education and carried out by an external evaluation team. A document analysis was made of the assessment and eligibility processes of 237 students, selected from a nationally representative sample. RESULTS: The results provided support for the use of the ICF in student assessment and in the multidimensional approach of generating student functioning profiles as the basis for determining eligibility. The use of the ICF contributed to the differentiation of eligible and non eligible students based on their functioning profiles. CONCLUSIONS: The findings demonstrate the applicability of the ICF framework and classification system for determining eligibility for special education services on the basis of student functioning rather than medical or psychological diagnose. IMPLICATIONS FOR REHABILITATION: The use of the International Classification of Functioning, Disability and Health (ICF) framework in special education policy is as follows: • The functional perspective of the ICF offers a more comprehensive, holistic assessment of student needs than medical diagnoses. • ICF-based assessment of the nature and severity of functioning can serve as the basis for determining eligibility for special education and habilitation. • Profiles of functioning can support decision making in designing appropriate educational interventions for students.

Mindfulness training effects for parents and educators of children with special needs.

Parents and teachers of children with special needs face unique social-emotional challenges in carrying out their caregiving roles. Stress associated with these roles impacts parents' and special educators' health and well-being, as well as the quality of their parenting and teaching. No rigorous studies have assessed whether mindfulness training (MT) might be an effective strategy to reduce stress and cultivate well-being and positive caregiving in these adults. This randomized controlled study assessed the efficacy of a 5-week MT program for parents and educators of children with special needs. Participants receiving MT showed significant reductions in stress and anxiety and increased mindfulness, self-compassion, and personal growth at program completion and at 2 months follow-up in contrast to waiting-list controls. Relational competence also showed significant positive changes, with medium-to-large effect sizes noted on measures of empathic concern and forgiveness. MT significantly influenced caregiving competence specific to teaching. Mindfulness changes at program completion mediated outcomes at follow-up, suggesting its importance in maintaining emotional balance and facilitating well-being in parents and teachers of children with developmental challenges.

Memory skills of deaf learners: implications and applications.

The author reviews research on working memory and short-term memory abilities of deaf individuals, delineating strengths and weaknesses. Among the areas of weakness that are reviewed are sequential recall, processing speed, attention, and memory load. Areas of strengths include free recall, visuospatial recall, imagery, and dual encoding. Phonological encoding and rehearsal appear to be strengths when these strategies are employed. The implications of the strengths and weaknesses for language learning and educational achievement are discussed. Research questions are posed, and remedial and compensatory classroom applications are suggested.

Programa de capacitación para defectólogos que asisten a niños sordo-ciegos con disfunción sensorio-integrativa en atención primaria de salud / Training program for defectologists working with deaf-blind children with Sensory-integrative dysfunction in primary health care

Fundamento: la preparación del defectólogo para la atención a personas sordo-ciegas, constituye un tema deactualidad investigado por diferentes autores. Objetivo: evaluar la efectividad de un programa de capacitaciónpara defectólogos que asisten a niños sordo-ciegos con disfunción sensorio-integrativa en la Atención Primariade Salud. Métodos: investigación de intervención con diseño de antes y después, que incluyó todos losdefectólogos de la Atención Primaria de Salud de la provincia de Cienfuegos, en el período comprendido entre junio del 2006 y julio 2008. Se determinó laatención defectológica que recibieron los niños sordociegos en la provincia, se identificó la formación inicial de los defectólogos, su nivel de conocimientos para rehabilitar niños sordo-ciegos con disfunciones sensoriointegrativas,a través de un examen diagnóstico quepermitió el diseño y aplicación de un programa de capacitación y un material de consulta; la evaluación final se realizó mediante un ejercicio de rehabilitación y entrevista a los defectólogos para medir satisfacción.Resultados: ninguno de los niños recibió atención especializada; el 87, 5 por ciento de los defectólogos recibiópreparación especializada, sin embargo en el examen diagnóstico ninguno fue evaluado de B; después de lacapacitación el 84, 3 por ciento fue evaluado de B. Conclusiones: el programa de capacitación permiteuna adecuada preparación, con base científica y en correspondencia con nuestras necesidades reales(AU)

Background: defectologists´ training for the management of deaf-blind people is a topic being currently investigated by different authors. Objective:To evaluate the effectiveness of a training program for defectologists working with deaf-blind children withsensory-integrative dysfunction in primary health care. Methods: before and after intervention researchincluding all defectologists in primary health care in the province of Cienfuegos from June 2006 to July 2008. With this research some aspects were determined: special defectologists´attention received by children who are deaf-blind in the province and initial trainingand expertise level to rehabilitate deaf-blind children with sensory-integrative dysfunction. Defectologists´capacities were measured through a diagnostic test that allowed the design and implementation of a trainingprogram and a reference material. The final evaluation was conducted through a rehabilitation exercise andinterviews to defectologists in order to measure their satisfaction levels. Results: None of the children hadreceived specialized attention. 87, 5 percent of defectologists received specialized training, but none of them reached the necessary proficiency level (B) in the diagnostic test. After training, 84, 3 percent of them reached the appropriate proficiency level. Conclusions: The training programallows adequate preparation with an accurate scientific basis and a matching with our real needs(AU)

Dynamic assessment and response to intervention: two sides of one coin.

This article compares and contrasts the main features of dynamic testing and assessment (DT/A) and response to intervention (RTI). The comparison is carried out along the following lines: (a) historical and empirical roots of both concepts, (b) premises underlying DT/A and RTI, (c) terms used in these concepts, (d) use of these concepts, (e) evidence in support of DT/A and RTI, and (f) expectations associated with each of the concepts. The main outcome of this comparison is a conclusion that both approaches belong to one family of methodologies in psychology and education whose key feature is in blending assessment and intervention in one holistic activity. Because DT/A has been around much longer than RTI, it makes sense for the proponents of RTI to consider both the accomplishments and frustrations that have accumulated in the field of DT/A.

Exploring the comparative responsiveness of a core set of outcome measures in a school-based conductive education programme.

BACKGROUND: Conductive education (CE) is a holistic educational system that uses an active cognitive approach to teach individuals with motor disorders to become more functional participants in daily activities. While CE's popularity continues to grow in North America and Europe, its effectiveness has not been established. The lack of definition of responsive outcome measures for evaluation of CE programmes has limited the interpretability of conclusions from earlier studies evaluating effectiveness. OBJECTIVE: To determine which measures from a core set were most responsive to physical, functional and psychosocial changes associated with a school-based CE programme. METHODS: This was a one-group before and after data collection design using an 8-month follow-up period. We enrolled a referral sample of nine children with cerebral palsy in Kindergarten or Grade 1 (Gross Motor Function Classification System levels 3, 4 or 5). The study took place within a school-based CE programme at a Canadian children's rehabilitation centre. Children participated in a CE full-day class for an entire school year. Physical, functional, psychosocial and participation measures included: Gross Motor Function Measure (GMFM), Quality of Upper Extremity Skills Test (QUEST), Peabody Developmental Motor Scales, Paediatric Evaluation of Disability Inventory (PEDI), Pictorial Scale of Perceived Competence and Social Acceptance for Young Children, Individualized Educational Plan, and Goal Attainment Scaling (GAS). Four children from the study's second year were also evaluated on the Impact on Family Scale (IFS), GAS and School Function Assessment. RESULTS: The Gross Motor Function Measure, QUEST, PEDI (Caregiver Assistance) and IFS were most responsive to change. GAS was useful in documenting and quantifying goals. Problems were encountered in evaluating self-esteem and school participation. CONCLUSIONS: Several strong measures of outcome were identified. Further work is needed to find valid and sensitive psychosocial and school participation measures for these young children.

Training locked-in patients: a challenge for the use of brain-computer interfaces.

Training severely paralyzed patients to use a brain-computer interface (BCI) for communication poses a number of issues and problems. Over the past six years, we have trained 11 patients to self-regulate their slow cortical brain potentials and to use this skill to move a cursor on a computer screen. This paper describes our experiences with this patient group including the problems of accepting and rejecting patients, communicating and interacting with patients, how training may be affected by social, familial, and institutional circumstances, and the importance of motivation and available reinforcers.

The effects of an early intervention music curriculum on prereading/writing.

This study evaluated the effects of music sessions using a curriculum designed to enhance the prereading and writing skills of 25 children aged 4 to 5 years who were enrolled in Early Intervention and Exceptional Student Education programs. This study was a replication of the work of Standley and Hughes (1997) and utilized a larger sample size (n = 50) in order to evaluate the efficacy of a music curriculum designed specifically to teach prereading and writing skills versus one that focuses on all developmental areas. Both the experimental (n = 25) and control (n = 25) groups received two 30-minute sessions each week for an entire school year for a minimum of 60 sessions per group. The differentiating factors between the two groups were the structure and components of the musical activities. The fall sessions for the experimental group were focused primarily on writing skills while the spring sessions taught reading/book concepts. Music sessions for the control group were based purely on the thematic material, as determined by the classroom teacher with purposeful exclusion of all preliteracy concepts. All participants were pretested at the beginning of the school year and posttested before the school year ended. Overall, results demonstrated that music sessions significantly enhanced both groups' abilities to learn prewriting and print concepts. However, the experimental group showed significantly higher results on the logo identification posttest and the word recognition test. Implications for curriculum design and academic and social applications of music in Early Intervention programs are discussed.

Experiencias construtivas em educacao especial: uma contribuicao a formacao do educador / Constructivist experiences in spacial education: a contribution towards the formation of the educator

O presente estudo foi elaborado com os seguintes objetivos: (a) verificar a possibilidade de duas professoras, com formacoes e experiencias profissionais diferentes, desenvolverem orientacoes monograficas em conjunta a quatro orientadas do curso de especializacao em Educacao Especial - DM; (b) verificar os efeitos no desempenho das pos-graduandas em termos de efetivacao da pesquisa e; (c) verificar os resultados na elaboracao da leitura e escrita de alunos classificados como deficientes mentais, visto que eles deveriam ser os maiores beneficiados de todo esse processo. Os alunos classificados como deficientes mentais, que fizeram parte desta pesquisa, estudavam em 3 turmas de ensino especial de escolas especiais distintas e em uma turma de ensino regular, onde havia um aluno deficiente mental incluso. Visando a formacao em servico das professoras, pois as 4 pos-graduandas eram regentes dessas turmas, a pesquisa foi levada a efeito na propria turma, onde atraves das assessorias dadas durante as orientacoes as pos-graduandas recebiam aportes teoricos e elaboravam os encaminhamentos das eulas. Ao final da pesquisa constatou-se que os alunos tiveram avancos nos niveis de leitura e escrita e comecaram a interessar-se mais pelas atividades, uma vez que as professoras trabalhavam atraves de jogos e isso tornava o processo prazeroso. E importante ressaltar que a mudanca de postura das professoras fez com que a escola solicitasse cursos sobre a abordagem construtiva para todos os professores para a iniciacao proposta. A pesquisa mostra que e possivel a capacitacao em servico e a orientacao conjunta de dois profissionais traz resultados relevantes. Outro aspecto que precisa ser destacado que os professores que atuam na educacao especial podem libertar-se dos antigos manuais e atuar como pesquisadores da propria pratica pedagogica, para reve-la, analisa-la ou predize-la(AU)

Dança: influência no desenvolvimento da criança com paralisia cerebral / Dance: The influence on the development of the child with cerebral palsy

Este trabalho teve como finalidade utilizar a dança e a música como recurso auxiliar para estimular a experimentaçäo sensorial, o ritmo, o desenvolvimento motor e a sociabilizaçäo de crianças com paralisia cerebral. Participaram do trabalho quatro indivíduos com diagnóstico de paralisia grave ou moderada, do sexo feminino, na faixa etária de 10 a 15 anos. No período entre março de 1994 e fevereiro de 1996, foram realizadas aulas semanais de dança com duraçäo de duas horas, durante as quais eram desenvolvidas atividades de relaxamento global, normalizaçäo de tônus, inibiçäo de padröes patológicos, estimulaçäo sensorial, de ritmo e movimentos de expressäo corporal. Posteriormente realizou-se análise qualitativa por meio de registros de conteúdo (em caderno) e das atividades executadas e do desempenho de cada crianças (em vídeo). No aspecto ritmo, os indivíduos conseguiram acompanhar a marcaçäo de tempo proposto por meio de palmas, instrumentos musicais e movimentos coreográficos. No desenvolvimento motor, verificaram-se melhoras nas atividades que exigiam a execuçäo de movimentos simétricos ou dissociados de membros superiores. Também notou-se maior independência nas atividades de vida diária, melhora na auto-estima e asseio pessoal

[Responsibilities of pediatric medicine in integrated rehabilitation of handicapped children in Bremen]. / Jugendärztliche Aufgaben bei der integrativen Förderung behinderter Kinder in Bremen.

Integrated education of handicapped children in Bremen is both goal and method. In the case of infants (0-3 years old) integration means integrating the child into the family by working with and within the family; for pre-school children (3-6 years old) this means education with non-handicapped children in a pre-school setting; integration in school settings using various approaches is still a goal. Integrated education is understood as a multi-disciplinary approach with the necessary inclusion of sociopaediatric competencies. The contribution to the concept of integration by paediatricians in Bremen is presented in this article. The work described is viewed as a perfect fit for paediatricians in the Public Health Services if they have the necessary preliminaries in self-understanding and qualification.