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Journal of Exceptional People

2018 – Volume1; Number 12

Institute of Special Education Studies

Faculty of Education – Palacký University Olomouc

Journal of Exceptional PeopleVolume 1, Number 12, 2018, published in 1. 5. 2018

Scientifics Board• ZsoltCséfalvay,UniverzitaKomenského,Bratislava,Slovakia• DariuszDziuba,UniwersytetŚlasky,Katowice,Poland• AntonioMiňanEspigares,FacultaddeCienciasdelaEducatión,Granada,Spain• SharonRaver-Lampman,OldDominionUniversity,Norfolk,USA• ValériaKerekes,ÁltalánosGyógypedagógiaiTanszék,Budapest,Hungary• KatarínaMajzlanová,UniverzitaKomenského,Bratislava,Slovakia• KarelPančocha,Masarykovauniverzita,Brno,CzechRepublic• EndreSzkárosi,EötvösLorándTudományosEgyetem,Budapest,Hungary• LaimaToméniené,ŠiauliaiUniversity,Lithuania• PavelVacek,UniverzitaHradecKrálové,CzechRepublic• IgorViktorovičVachkov,Moskovskijgorodskojpsichologo-pědagogičeskijunivěrsitět,Rassija• MilanValenta,UniverzitaPalackého,Olomouc,CzechRepublic• KateřinaVitásková,UniverzitaPalackého,Olomouc,CzechRepublic• PengYan,FacultyofEducation,SichuanNormalUniversity,ChinaEditorinChiefLibušeLudíkováExecutiveEditorsPavelSvoboda,JanChrastinaResponsibleEditorOtakarLoutockýEditorialBoardOldřichMüller,LuciaPastieriková,MartinDominikPolínek,PetraPotměšilová,MichalRůžička,VeronikaRůžičková,VojtechRegec,KateřinaStejskalová,JiříLanger,JiříKantor,ZdeňkaKozákováLanguageEditorsJanaMagdoňová,EditaSatinskáCoverDesignJiříJurečkaLayoutJiřinaVaclováEditorialOfficePdFUP,Žižkovonáměstí5,Olomouc,770 00,CzechRepublic

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Journal of Exceptional PeopleAnInternationalJournalforEducationandSpecialStudiesEditorPavelSvobodaVolume 1Number 122018

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JournalofExceptionalPeople,Volume1,Number12,2018 3

Content

Introduction .....................................................................................................................................5

ARTICLESEvaluationofspecialneedseducationliteracyforsustainablechangeinservice deliverytopersonswithdisabilitiesinUniversityofCalabar ....................................................7ORIM,SAMUELORIM

Teachingcomplexbehaviorswithacousticguidance .............................................................. 17KARELPANČOCHA

ImpactofphysicalactivityonqualityoflifeinCzecholderadults ........................................ 25JULIEWITTMANNOVÁ,IVAKLIMEŠOVÁ,LUCIEPIŇOSOVÁ

Migrationasaninfluencingfactoronidentityformation ...................................................... 37IVANALESSNERLIŠTIAKOVÁ

Selecteddramatherapytechniquesandtheireffectonaddictedclients indetoxicationward ..................................................................................................................... 45KRISTÝNAKRAHULCOVÁ,BOHDANAŠTĚPÁNOVÁ

Personalitycenteredapproachtoeducationofchildrenwithemotional andbehavioraldisorders:interventionthroughtheeyesofeducationalprofessionals fromresidentialeducationalfacilities ......................................................................................... 61KARELČERVENKA

Movementandorthopedicproblemsbasedonposturalinstabilityinvisually andhearingimpairedpeople ....................................................................................................... 77KRISTÍNATOMÁNKOVÁ,HANAMAJEROVÁ,VERONIKAŠVECOVÁ, VOJTECHREGEC

A caseanalysisonthecurriculumdevelopmentofadaptivefunctionaleducation forchildrenwithmentalretardationinmainlandChina ........................................................ 89XUBO

Theawarenessandvisualdiagnosisofwomenwithseverevisualimpairment asa mainfactorinthechoiceofdeliverymethodsinchildbirth .......................................... 103MGR. DANIELAKILDUFF,PH.D

4 JournalofExceptionalPeople,Volume1,Number12,2018

SurveyonPhysicalEducationStudentTeachers’AttitudestowardTeachingStudents withSpecialNeeds....................................................................................................................... 115LIYUN,ZHANGGUODONG

BOOK REVIEWSStructuredteachinginpractice:Applyingtheprinciplesofstructuredteaching instandardschoolenvironment ................................................................................................ 125REVIEWEDBYLUCIESCHWARZOVÁ

SensoryperceptualissuesinAutismandAspergerSyndrome ............................................. 129REVIEWEDBYMONIKASMOLÍKOVÁ

Informationforauthors .............................................................................................................. 133

JournalofExceptionalPeople,Volume1,Number12,2018 5

Introduction

Dearreaders,infrontofyou,youhavea newspringissueofTheJournalofExceptionalPeople,whereoureditorstriedtoincludeinterestingarticlesabout„extraordinary“people.Westriveforthisselectiontobevariedand,asfaraspossible,toincludecontribu-tionsfromthelargestpartoftheworldofspecialeducation.OureditorialteamalsoaspirestocontinuetoimprovethequalityofourmagazinebytheefforttomaximizetheinclusionofJEPinindexeddatabasesofinternationallyacclaimedandreputablemagazines.

Inthisissue,firstwepublishanarticlebytheNigerianauthor(Orim,S.)ontheassessmentoftheliteracyofchildrenwithspecialneedsinhiscountry.Thisisfol-lowedbythecontributionoftheCzechauthorK.Pančocha,whichdealswiththeassessmentofthecomplexbehaviorofchildrenwithspecialneeds.ThecontentofthefollowingcontributionbythreeCzechauthorsisthequalityoflifeofthesepeopleinthecontextoftheirphysicalactivity(Wittmannová,J.,Klimešová,I.,Piňosová,L.).TheformationandprocessofidentityofmigrantsisfollowedupinthestudyofSlovakauthorI.L.Lištiaková.Thefollowinginterestingarticleintroducesusthesubjectofaddictionsanddramatherapeuticinterventions(Krahulcová,K.,Štěpánová,B.).EmotionalproblemsandbehavioraldisordersaredescribedbyK.ČervenkafromMasarykUniversityBrno(CzechRepublic),whonotesinthiscontexttheroleplayedbythepersonalityofprofessionalworkersworkingwiththesechildrenwithbehavioraldisorders.PhysicalandorthopedicproblemsinvisuallyimpairedpeoplearedescribedbyK.Tománková,H.Majerová,V.ŠvecováandV.Regec(PalackýUniversity,Olomouc,CzechRepublic).

Thedevelopmentofadaptivefunctionaleducationinchildrenwithintel-lectualdisabilitiesisdealtwithbytheChineseauthorX.Bo.Furtherarticle

6 JournalofExceptionalPeople,Volume1,Number12,2018

ofChineseauthorsLiYunandZhangGuodong is named Survey on Physical Education Student Teachers’ Attitudes toward Teaching Students with Special Needs and isfocusedontheinvestigationofinterrelationbetweenteachersandtheirstudentsinphysicalcontext.

A numberofprofessionalscientificstudiesandreviewessays isendedby D.KildufffromtheOstravaUniversity(CzechRepublic),whichdealswiththediag-nosisofwomenwithseverevisionimpairment.

12thissueofourmagazineisconcludedbytwobookreviews.L.Schwarznotespublicationsonstructuredlearning,andM.Smolíkovárecommendsreadinga pub-licationdealingwithAspergersyndrome.

Wejustwishyoua pleasantreadingandbelievethatyoucanchoosewhatyouaremostinterestedininthisselectionofarticles.

Havea nicespringPavelSvoboda,JanChrastina

JournalofExceptionalPeople,Volume1,Number12,2018 Articles 7

Evaluation of special needs education literacy for sustainable change in service delivery to persons with disabilities in University of Calabar

(overview essay)

Orim, Samuel Orim

Abstract: This study evaluates the level of special needs education literacy for sustain-able change in service delivery to persons with disabilities in University of Calabar. It was guided by a research question, 180 Participants were randomly sampled from faculties and Institutes and open-ended questionnaire was designed, validated and used as instrument for data collection. Survey design and descriptive statistics were used as research design and statistical tool for data analysis. The findings reveal that majority of staff lack basic special needs education literacy; consequently, their services to per-sons with disabilities in different programmes in the University are inefficient. Based on the findings it was recommended among others that disability literacy awareness programme (DLAP) and blue print on disability should be developed, implemented and monitored as road map to ensuring fundamental literacy among staff in the University.

Keywords: Special Education, literacy, disabilities

1 IntroductionExceptionalityisa norminhumanexistenceorsociety.Therefore,anysocietywithoutpersonswithdisabilities(PWDs)isanabnormal,notworthyofhabitation.Whilepeoplemaynotwanttoseepersonswithspecialneedsparticularlythosewithdis-abilities,therealityisthattheyareneededtomakethesocietya balancedone.ThisisalsoapplicabletoeducationalinstitutionsespeciallyinthiseraofInclusion,increaseduniversalaccesstoeducationandrenewedagitationsforequalrightstoallcitizenswithorwithoutdisabilities.

Exceptionalityasmotherterminspecialneedseducationissignificantdevia-tionfromthepresumednorminintellectualabilitysocialandphysicalgrowthanddevelopmentofhumansina particularsociety.Thisdeviationhastwoends,the

8 Articles JournalofExceptionalPeople,Volume1,Number12,2018

positive(giftedness)andnegative(disabilities).Whena childispositivelyexceptionalhe/sheiswelcome,cherishedandwelleducatedbythesocietybutifthechildhasdisabilitiesheorsheisatriskofnotbeenwelcomerightfrombirth,educatingsucha childismoralconsiderationanda goodwill.

Suchdispositionshavetrailedspecialneedseducationanditsclientssinceitsorigin.Despiteabilityindisability,awarenessoneducationofPWDsaschampionbybothinternationalpoliciessuchasMDG,Inclusiveeducation,EducationforAll,goalofSDGsandUNconventiononRightsofPWDstheyarestillpronetodiscrimina-tion,denialofrightsandindifferenttreatment.InuniversityofPortHarcourt,a stu-dentwithdisabilitywouldhavebeendeniedadmissionifthecourthadn’tintervened.AccordingtoKen(2014)similarcasesaboundinmanyothereducationalinstitutions.

InUniversityofCalabarexperiencesandresearchessuchasIkpaya(1987),Obi(2012)personswithdisabilitiesareadmittedbutdonotreceivethedesiredservicesorattention.Mosttimesderogatoryoruncomplimentaryremarksaremadeonthemwithoutmindingthepsychologicalimplicationsofsuchcomments.Ozoji(2014)noted such disposition in the 21stcenturyisoutrightexpressionofabsolutelackofspecialneedseducationliteracy(SNEL).Theauthorfurtherpositslack/inadequateSNELnegativelyinfluencesthequalityofservicedeliverytoPWDsinthesocietygenerallyandinschoolsparticularly.

Okwudire(2007)arguesthattherateofliteracyofpeopledeterminedthelevelofdevelopmentofthesociety.Judgingfromtheabove,itcouldalsobearguedthata society/schoolwithSNELisdeveloped,open,objective,andhavescientificattitudestoSNEanditsclientele.ItisequallydisposedtoprovidequalityservicestoPWDs.InthecontextofthispaperSNELbroadlymeanshavingbasicandgeneralknowledgeaboutspecialeducationanditsclientswithemphasisonappropriateuseofitsbasictermsandcomplimentaryattitudes/regardsforpersonswithdisabilitiesaswellasawarenessofsimplecauses,preventionsandrightsofPWDsinthesociety.Howard(2000)observedthatthedifferenceinqualityofservicesprovidedfortheseclientsindevelopedanddevelopingsocietiesisdirectlyproportionatetothelevelSpecialneedseducationliteracyamongthepeople.TheimplicationofthistoNigeriansgenerallyandstaffofUniversityofCalabarinthiseraofchangeisthatconcreteeffortsshouldbemadetobespecialneedseducationliterateasconditionforsustainablechangeinservicedeliverytopersonswithdisabilities.

Sustainable Change in Service DeliverySustainablechangeasoneofthevariablesintheconferencethemeandtopicofthisstudyisa directresponsetothepresentadministrationchangeinitiativetoreori-entNigeriansonattitudetopublicservicedeliveryandgovernance.Changeentaila departurefromtheoldapproachtohandlingissuestoa betterwaywithfocus


onnationalinterest.Sustainablechangethereforemeansneworientationtoissues/serviceswithoutunderminingtheprospectofthefuturegeneration.Itistheabilitytoholdtonewandbetterorientationtopublicservicemattersovera longperiodoftimewithoutbeingconservative.Inthecontextofthisstudy,itisa well-plannedandpurposefulshiftfromtheoldpatternofthinkingandhandlingofissuesofdisabil-ity/specialeducationtobeingopen-minded,objectiveandscientificinmeetingthepresentneedsofPWDswithoutcompromisingthepossibilityofa brighterprospect.Itisa departurefrompityingPWDstoempathizingwiththeclients.

InHeward(2000),changeindispositionofthesocietytospecialneedseducationanditsclientsisdirectlyrelatedtothelevelofservicedelivery.TheauthorfurtherpositsthatpoorlevelofservicedeliveryindevelopingcountrylikeNigeriaispropor-tionatetohowfastorslowthependulumswims.Ikpaya(1987)observedthatchangeinspecialneedseducationisslowlyprogressiveandsustainable.Itprogressedthroughtheeraofextermination,ridicule,asylum,educationandlitigation.Eachofthesestageswasproceededbymanyevents,policiesandlaws.Intermsofitsnomenclature(name)ithaswitnessedtochangesfromhandicapeducationtospecialeducationtoa morerefined,professionalandinclusivename,specialneedseducation.Evenindescriptionoftheclients/categorizationithaschangedfromusingconditionfirstap-proach(thedeafmanorblindchild)topersonfirstapproach(themanwithhearingImpairment/childwithvisualImpairment).Theformeronewasderogatoryandsawnothinginthepersonapartfromthedisabilitybutthelaterseesthehumandignity/abilityinthepersondespitehis/herdisability.Ozoji(2014)notedthatthelatterisexpressionofthelevelofspecialneedseducationliteracyandithasproportionatelyimprovedthenatureofservicedeliverytoPWDs/contributestothedevelopmentofspecialneedseducation.Theimplicationofthistostaffintheuniversityisthatbothpersonal,informal,cooperateandformaleffortsshouldbegearedtowardsspecialneedseducationliteracyifimprovedservicesmustbedeliveredtopersonswithdis-abilitiesintheuniversityinlinewithglobalstandards.

Special Needs Education Literacy Literacyinitstraditionalcontextmeansabilitytoread,writeanddo arithmeticwhichiscommonlycalled3Rs.Inmoderntermsitexpandedtoincludeabilitytoeffec-tivelycommunicateusingcomputerandrelatedmeans.Inthispaper,specialneedseducationliteracysimplymeansbasicknowledgeaboutspecialneedseducationanditsclientswithemphasisoncorrectuse/applicationofbasictermsthatfacilitateunderstandingandcommunicationinthefield.AccordingtoOzoji(2014),specialneedseducationliteracy“isabilitytoreadandwritespecialeducation.Itisreadingandwritingusingenlightenedtermsthatcorrectlymirrorsthesituationofchildrenwithspecialneeds,thatleadstotheirproperunderstanding,thatupliftsnotdebases


them,thatisguidedbydenotativeratherthanconnotativeperspective,thatcorrectsmisconceptions,platitudes,axiomsandtraditionsofeldersaboutthechildren.Writ-ingsthatemploydiscardedanddiscourteousterms/labels,thatarepejorativeofthechildren,thatheightentheirhelplessnessorhandicapscannotbeconsideredliteratebyanyacademicstandard.Suchwritingsepitomizespecialeducationilliteracyir-respectiveoftheprofessionalcallingofthewriter.”

Inbroaderperspective,specialneedseducationliteracyis:• abilitytoknowwhohasspecialneeds• abilitytoappreciateexceptionasnorminhumansociety• abilitytoempathizeratherthansympathize/pitythosewithspecialneeds• knowledgeofbasicetiologyofexceptionality• knowledgeofcommoncategoriesofexceptionalityinthesociety• knowledgeofbasicpreventivemeasuresandrightsofpersonswithdisabilities.

AccordingtoOrim(2015)knowledgeintheaboveparametersculminateinSNELwithcorrespondingimprovementinservicedeliverytoPWDs.Forinstance,ifsome-oneunderstandsthatitisonlynaturethatcandeterminewhen/typeofdisability(possibility/otherwise)he/shewillhavea betterdispositions/approachtoPWDsandspecialneedseducationmattersespeciallyonissuesthatconcernseducation,employmentandaccessibilitytoenvironment.

RiechmannandGrasha(2010)studyonspecialeducationliteracyamongteachersindevelopingnationsrevealsthatinevery100teachersonly5ofthemareliterate.Theauthorfurtherobservedthatteachersinruralareasaremorespecialeducationilliteratethanthoseintheurbanones.TheimplicationsofthesefindingsareNigerianteachersinbothruralandurbanarepredominatelyilliterate.Thistrendspeaksvol-umeofservicesrenderedtoclientswithdisabilitiesbothinschoolandthesociety.Ina similarstudyamongstaffinNigerianuniversitiessouth---southMoor(2013)findingsshowsthatspecialeducationliteracyamongacademicsis35%andthatofthenonacademicstaffis26%.Asnotedabovesuchfindingsareexpressionofthenatureofservicesstudents/staffwithdisabilitiesreceivesinsuchacademicsociety.LynchandHanson(2004)positsthatsuchlevelofSNELdoesnotfacilitateimplementationofInclusiveeducationandachievementofgoal4SustainableDevelopmentGoalsforpersonswithdisabilities.Inanotherstudy,thefindingsofMoon(2014)arecontrarytoothersabove,itindicatedthatspecialneedseducationliteracyis72%amongteach-ersinmostschoolsinAmericaandCanada.ThetablebelowgivesaninsightintothelevelofspecialeducationliteracythatcanenhancebetterservicedeliverytoPWDsandcontributetooptimaldevelopmentofspecialeducation.


Table 1. Indicate people’s level special education literacy

Specialneedseducationliteracy SpecialneedseducationilliteracyPersonswithdisabilities DisabledpersonsInclusion Exclusion

Scientific approach to disabilities and its causes Superstition approach to disabilities and its causes

Focusedonabilitydespitedisability FocusedonthedisabilitydespiteabilitySpecialneedseducationoreducationforpersonswithspecialneeds Educationforthehandicapped

Empathy Sympathy/pityUseperson’firstapproach(e.g.childrenwithlearningdisabilities

Useconditionfirstapproach(e.g.learning-dis-abledchildren)

Regularschool Normal schoolSchoolforchildrenwithlearningorvisual impairment Schoolfortheblind/deaf

Havepositiveattitudes Havenegativeattitudes

Sources:AdaptivefromHunt&Marshall(2005),Ozoji(2014)

2 Statement of ProblemOneofthemajorproblemsassociatedwithSpecialneedseducationanditsclien-teleismisconceptionaboutthefield,misapplication/useofbasictermsthatwouldhaveenhanceunderstandingandcommunicationamongprofessionalsandnon-professionalsaswellasindicationofthelevelofspecialneedseducationliteracyasa conditionforsustainablechangeinservicedeliveryforpersonswithdisabili-ties(PWDs)inthesocietyparticularlyamonguniversitycommunity.Theclientsarederogatorilyanduncomplimentarylabeled,remarkedanddescribed.Iftheseremarksareassociatedwiththeuneducatedtheycouldbeexcusedongroundsoftheirlevelofreasoningandunderstandingbutitiscommontoseeorhearthosewhoareeducatedtreatorreacttodisabilityissueswithcontemptanddisregard.ThisbecomesseriouswhenPWDstrytoacquireformaleducationathigherlevelortrytogainemployment.

Theyaredeniedadmission,employment,otherbasicrightsandtreatedindiffer-ently.Thesedispositionsaretoa largeextentexpressionofthelevelofspecialneedseducationliteracy.Suchstereotype,connotativeanduncomplimentaryattitudeswhetherindevelopedordevelopingsocietyinfluencesthequalityofservicedeliv-eryandbyextensionthwartthedevelopmentofspecialneedseducationandrelatedservices.ItisagainstthisbackgroundofthisstudywhichisdesignedtoevaluatethelevelofspecialneedseducationliteracyamongstaffinUniversityofCalabar.


3 Purpose of the StudyThemainthrustofthisstudyistoevaluatethelevelofspecialneedseducationliteracyamongstaffintheUniversityofCalabar.

4 Research QuestionThestudywasguidedbya researchquestionframedthus:

WhatisthelevelofspecialneedseducationliteracyamongstaffintheUniversityofCalabar?

5 Methodology Thestudyadoptedsurveydesign,180teachingandnon-teachingstaffwereran-domlysampledfromacrossfacultiesandInstitutes.A four-responsescaleQuestion-nairewith15itemswasdesignedbytheresearcher,validatedbyexpertsinspecialeducation,educationalmeasurementandusedasaninstrumentfordatacollection.Ithadreliabilityindexof0.81whichwasconsideredgoodenoughtobeusedforthestudy.Theresearcheradministeredtheinstrumentpersonallytotheparticipantswhosecontactsweregottenfromtheirgeneralofficesandinformedaheadoftimethroughemailandsocialmedia.Descriptivestatisticswereusedtoanalysedatafromthefield.

6 Presentation of ResultFigure 1A and B shows participants responses

6

Results in figure 1a & b above indicates that 78 (43.3%) of staff have very low level of literacy, while 65 (36.1%) have low, 22 (12.0%) have high and 15 (8.4%) have very high literacy. From this result it obvious that majority of staff of the university of Calabar are special education illiterate unlike few who are literate. One hundred and forty (143) participants substantiate this who responses fall within very low and low in the response scale as against 37 that fall between high and very high scale. The implications of this that the can hardly be any substantial and sustainable change in service delivery to persons with disabilities in the university in line with Federal government change initiative.

7 Discussions of Result

The main thrust of study is asses the level of special education literacy as a condition for sustainable change in service delivery to persons disabilities in University of Calabar. The study reveals that

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Results in figure 1a & b above indicates that 78 (43.3%) of staff have very low level of literacy, while 65 (36.1%) have low, 22 (12.0%) have high and 15 (8.4%) have very high literacy. From this result it obvious that majority of staff of the university of Calabar are special education illiterate unlike few who are literate. One hundred and forty (143) participants substantiate this who responses fall within very low and low in the response scale as against 37 that fall between high and very high scale. The implications of this that the can hardly be any substantial and sustainable change in service delivery to persons with disabilities in the university in line with Federal government change initiative.

7 Discussions of Result

The main thrust of study is asses the level of special education literacy as a condition for sustainable change in service delivery to persons disabilities in University of Calabar. The study reveals that

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Resultsinfigure1a&baboveindicatesthat78(43.3%)ofstaffhaveverylowlevelofliteracy,while65(36.1%)havelow,22(12.0%)havehighand15(8.4%)haveveryhighliteracy.FromthisresultitisobviousthatmajorityofstaffoftheuniversityofCalabararespecialeducationilliterateunlikefewwhoareliterate.Onehundredandforty(143)participantssubstantiatethiswhoresponsesfallwithinverylowandlowintheresponsescaleasagainst37thatfallbetweenhighandveryhighscale.TheimplicationsofthisisthattherecanhardlybeanysubstantialandsustainablechangeinservicedeliverytopersonswithdisabilitiesintheuniversityinlinewithFederalgovernmentchangeinitiative.

7 Discussions of ResultThemainthrustofstudyistoassessthelevelofspecialeducationliteracyasa con-ditionforsustainablechangeinservicedeliverytopersonswithdisabilitiesinUni-versityofCalabar.Thestudyrevealsthatmajorityofstaffarenotspecialeducationliterateconsequentlytherecannotbeanymarkedimprovementintheprovisionofanddeliveryofservicestothetargetpopulation.ThiscurrentstudyisinaffirmationwithAnderson(2009)whoseresearchonspecialeducationliteracyamongteachersinmostdevelopingsocietiesindicatesthatonly5out100areliterate.ThisstudyisalsocorroboratedbythatofYinka(2015)studyonspecialneedseducationliteracyamonguniversitystaffinsouth–southNigeriawhichindicatesthat65%and75%ofacademicsandnon-academicsareilliterate.Ontheotherhand,itisatvariancewithHeward(2000)whosestudyshowsthat72%ofteachersindevelopedcountrieslikeAmericaandCanadaarespecialeducationliterate.Thisisprimarilyamongother


reasonswhyspecialeducationandrelatedservicesinthesecountriesaredevelopedandareadequatelyandpromptlyprovided.

Consideringthehighlevelofilliteracyamonghighlyesteemedmembersofaca-demiaitisworrisomethatinthe21stcenturytheeffectofglobalizationisyettoinfluencethisaspectofnationallifeascriticalasitis.Theimplicationofthefindingsofthisresearchisthatacademiaissympathetic,pitiful,biasandunscientificintheirdispositiontopersonswithdisabilitiesinsteadofbeingempathicandscientific.A so-cietywithsympatheticperspectivetodisabilitiesmattersseesprovisionofservicestotheseclientsasa moral/actofgoodwillwhileempatheticoneislegallycommittedtoprovidingneedfulservices.Westson(2016)notedthatsuchsocietymakescon-sciousefforts,policiesandprogrammestoeducateandempowerthosedisabilitiestotheextentoftheirability.Furthermore,thisstudyshowsthatPWDsinNigeriaandUniversityofCalabarparticularlywillnotbeabletocompetewiththeirpeersgloballyandtheywillbeconsequentlyrankedverylowintheglobalcommunityofpersonswithdisabilities.Again,itisanindicationthatNigeriaisnotpreparedtoachieveglobaldream(SDGs)forpersonswithdisabilities.

8 ConclusionHistoryhasshownthatdisabilityhasbeenandwillremainanintegralparttocomplete.BasedonthisdeliberateandinstitutionalizedeffortshouldbemadetoprovideneededservicestoPWDsinlinewithglobalpoliciesandconventions.NigerianUniversitiesasmajoragentofnationaldevelopmentshouldformulatepoliciesonthissubjectmattertoimprovetheliteracylevelofstafftoenhancetheircapacityfortheprovisionofqualityservices.ThishasbecomeimperativenowthatPWDshasaroletoplayinsocioeconomicdevelopmentofnationasshowninthe2016specialOlympicandthetaskofachievingSDGsasthechangeagendaoftheFederalgovernment.Basedonthefindingsofthisstudyitisrecommendedamongothersthat:• Disabilityliteracyawarenessprogramme(DLAP)shouldbeformulatedimple-

mented and monitored in schools.• Stakeholders’particularlyspecialeducationalprofessionalsshouldtakeadvantage

ofincreasedusageofsocialmediatoeducatethepublicondisabilitymatters.• Personswithdisabilities(PWDS)organizationsshouldhaverobustinformative

andeducativeprogrammestoimprovetherateofliteracyonthesubjectmatteramongthepublic

• Governmentshouldprovidelegalframeworkthatwillenhancelegislationandlitigationonspecialeducationanditsclientsratherthanhavingwindowdressinglawsondisability.


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grammesdevelopment.The school and disability, 14(2) 31-45Hunt,N.&.Marshall,K.(2005).Exceptionality Children and youth 4th edition.Boston:Houghton

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PearsonEducationIkpaya,B.O.(1987).Exceptional children and youth. Introduction to special education.CalabarClear

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tionality, 15(1)27-38Yinka,H.(2015).LiteracyamongNigerians:A concernforthefutureofspecialneedseducation.Semi-

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Orim,SamuelOrimDepartmentofSpecialEducationUniversityofCalabarNigeriae-mail:[email protected]

http://www.currenttrends/special

http://www.currenttrends/special

mailto:[email protected]


Teaching complex behaviors with acoustic guidance

(overview essay)

Karel Pančocha

Abstract: Misunderstanding of the principles of behavior and the overuse of aversive stimuli are common to many educational situations, including teaching complex behav-iors to children with special education needs. Derived from behaviorism and studied by experimental analysis of behavior, applied behavior analysis uses dozens of evidence-based methods and techniques to teach new complex skills to variety of learners. This literature review presents selection of published studies of teaching complex behaviors by successive approximations and differential reinforcement. Teaching with Acoustic Guidance (TAG) method, which uses shaping as its major component, proved to be an effective intervention across educational settings. Examples from seven studies focusing on TAG application in general and special education settings are discussed.

Keywords: Applied Behavior Analysis, TAG, acoustic guidance, shaping, differential reinforcement

1 IntroductionBehavioranalysisisa sciencestudyingtheprinciplesoflearningandbehavior.(Cooperetal.,2014).Theapplicationofbehavioranalysisfindsitsusenotonlyintherapeuticapplicationsforindividualswithspecialneeds,butinthewidestrangeofeducationalsettings.Educationisa plannedandinstitutionalizedlearningprocess,however,shallnotbeperceivednarrowlyasschoolbased.Onthecontrary,educationshallbeviewedbroadlyasa continuouslifelongjourney(Peters,1972).

Asthegoalofeducationistochangebehavioroflearners(soastobeabletoperformcertaintasksandavoidothers),thestudyofhumanbehaviorprovidesthenecessaryinformationabouttheconditions,underwhichpeoplearelikelytolearnandbehaveincertainway(Alberto,2003).Educationisanactivitythatcantakemany


forms(ex.formal,non-formalandinformal)andischaracterizedbysetsofbehaviorslabeledaslearningandteaching.Teachingasanyactivityperformedtobringaboutlearning(Jarvis,2010)regardlessofthetopographyofthebehavior.Learning,ontheotherhand,couldbedefinedasbehavioralchanges,whichareresultsofchangeintheenvironmentofthelearner(Vargas,2013).

Wecouldimplythatlearningmayhappenwithoutteaching,simplybecauseofchangesintheimmediateenvironmentofthelearner.However,teachingoccursonlywhenitresultsinlearning(onthesideofthestudent).Despitethisconceptualknowl-edgeineducation,manyconcreteeducationalactivitiesarenotdesignedwiththisfundamentaldistinctioninmind.AsVargas(2013,p. 4)pointsout“Unfortunately,presentingisnotteaching.Youcouldpresenta brilliantlectureinanemptyroom.”Asteachingiffarmorethantransmittinginformation,teacherscanbenefitfromtraininginappliedbehavioranalysistobebetterabletounderstand,predictandultimatelyalsoeffectivelychangesociallysignificantbehaviorsoftheirstudents(Vargas,2013).

Applicationofbehavioralprinciplesandtechniquesineducationalsettingshasbeenresearchedsincethe1960s’.AsdescribedbySnowandBrooks(1974),behav-iormodificationtechniquesresearchfocusednotonlyonproblembehaviors,butalsooneducationalachievementsinschools.Inthefollowingdecades,researchersstudiedmanydifferentstrategiesandtechniquesusedineducationthatwerede-rivedfromappliedbehavioranalysis.Forinstance,researchonacademicachieve-mentinschoolsprovedtheefficacyofpeertutoringwithhome-basedreinforcement(TrovatoandBucher,1980),thepositiveacademicachievementsandlastingeffectsoftheComprehensiveApplicationofBehaviorAnalysistoSchooling(CABAS)hasbeenanalyzedbySelinskeetal.(1991).TacklingproblembehaviorsineducationalsettingshasbeenthefocusofABAresearch,asshownforexampleinthestudyofschoolwideinterventionprogramsforpreventionofbullyingandpositivebehaviorsupport(RossandHorner,2009).

DespitethepositiveresearchfindingsandwiderangeofapplicationsofABAprinciplesineducation,behavioralinterventionhasnotbecomepartofmanyteachertrainingcurricula.Thismaybeoneofthereasonsfortheoveruseofpunishmentandaversivestimuliinschools.AsSkinner(1953,p. 405)pointedout“…thepositivereinforcersavailabletoschoolsandcollegesareoftenusedasthebasisforconditionedaversivestimulationintheformofa threatoffailureordismissal.”

Withbetterunderstandingofbehavioralprinciples,educationshallfocusmoreontheuseofstrategiesbasedonpositivereinforcement,asstatedbyVargas(2013,p. 10)“theonlypostcedentsthatbuildbehaviorarethepositiveones.”


2 Teaching with Acoustic Guidance (TAG) Oneofthesuccessfulstrategiesbuildingnewcomplexbehaviorsisbasedonthepro-cessofdifferentialreinforcementandsuccessiveapproximation.Thetermshaping,coinedbyB.F.Skinner,hasbeenusedtodescribeit.IthasfirstappearedinSkinners’articleentitledHowtoteachanimals(Skinner,1951).Shapingprocedureshavebeennaturallypartofteachingforthousandsofyears.However,ithasnotbeenscientifi-callydescribedpriortoSkinnerdefiningit(Peterson,2004).Sincethattime,itbe-cameanintegralpartofmanybehavioranalyticteachingstrategies,includingclickertrainingandeducationalpackagessuchasTAG(TAGteachInternational,2016).

Beforefirstexperimentalstudiesinvolvingshapingwereconductedwithhumansubjects,substantialamountofresearchaccumulatedintheanimalworld.Clickertraining,i.e.theuseandeffectsofanacousticstimulusasa conditionedreinforce-mentinshapingprocedureshasbeeninvestigatedinanimaltraining(Gilliset.al.,2012;McCallandBurgin,2002;Pryoretal.,1969).Followingthesuccessinteachingcomplexbehaviorstoanimals,itslowlyenteredthehumanworldandiscurrentlyusedindependentlyorasa partofeducationalpackagessuchasTAG.TAGdevelopedintoa teachingtoolthatusesshapingextensively,nexttootherbehavioralprinci-plesandproceduresincludingtaskanalysis,positivereinforcement,chainingandprompting.OneofthemainfeaturesofTAGistheuseofacousticstimulitomarkcorrectbehaviors.Itdevelopedfroma clickertrainingandiscurrentlyusedinmanyeducationalsituationsandsettings(Fogeletal.,2010).

3 MethodsWeexaminedresearcharticlesontheuseofTAGpublishedinpeerreviewjournalswithinthelastsevenyears.A literaturesearchwasconductedusingonlineelectronicdatabases(EBSCO,Medline,ProQuestandPsycINFO)andGoogleScholarwith2010yearofarticlelimitations.Thekeywordsusedinthesearchforselectionofarticlesincluded“TAG”and“TAGteach”,“acousticguidance”,“tagger”,“terminalbehavior”.OnlyempiricalresearcharticlesintheEnglishlanguagewithclearlydescribedre-searchmethodologyusingowndatacollectionandanalysiswereselected.

Despite thegrowingbodyof literature includingbookchaptersonTAG(HoldamsbeckandPennypacker,2015;Gabler,2013;Vargas,2013)onlysevenstud-iesonTAGwerefoundpublishedinpeerreviewjournals.ThesestudiesfocusedontheuseofTAGindifferentteachingsituationsandwithdifferentpopulations.Fourstudiesfocusedonbehavioralcoachingofhighschoolfootballplayers,novicegolfersandyoungdancers(Quinnet.al.2015;HarrisonandPyles,2013;Fogeletal.,2010,Stokesetal.,2010),twoinvolvedtheuseofTAGinteachingchildrenwithAutism


SpectrumDisorders(Persikeetal.,2014;Pinedaetal.,2014)andonestudyexaminedtheuseofTAGinteachingmedicaluniversitystudents(Levyetal.,2016).

4 Results and Discussion MostoftheresearchersstudyingapplicationsofTAGarguethattraditionalteachingapproachesrelyheavilyonaversiveprocedures.Teachersandcoachesfocustheirat-tentiononthebehaviorthatisperformedincorrectlyanddo notmakeuseofteachingstrategiesbasedontheprinciplesofoperantlearning(Levyetal.,2016;Quinnetal.2015;Fogeletal.,2010).

Fogeletal.(2010)studiedtheuseofTAGina golfplayerwithnopreviousexpe-riencewithgolf.Theaimofthetrainingwastoteacha behaviornotexistingintherepertoireofthelearner,i.e.swingwitha golfclub.Fouroutoffiveskillsetshavebeensuccessfullytaughtwithinseventrainingsessions.ThisstudyisoneoftheveryfewthatexaminedTAGonly,withoutanyadditionalinterventions.

Thenextstudy(Stokes,etal,2010)focusedonhighschoolfootballersandevaluatedtheeffectsofseveralbehavioralcoachingstrategiesonline-passblock-ing.Treatmentconditionsincludeddescriptivefeedbackonly,descriptivefeedbackcombinedwithvideofeedback,andfinallythetwopreviousinterventionstogetherwithTAG.Theblockingbehaviorhasbeentaskanalyzedandfiveparticipantswithbelowthenormativepassblockingperformancewereselectedforthestudy.VideofeedbackandTAGwerefoundtobethemosteffectiveproceduresasalltheplayersreachedabovethenormperformance.Ontheotherhand,descriptivefeedbackonlydidnotresultinincreaseofpassblockingbehavior.Unfortunately,itisnoteasytoseparatetheeffectsofTAGfromtheotherinterventions,andthereforeevaluatetheuniqueeffectsofTAG.Thesecondfootballstudy(HarrisonandPyles,2013)focusedontacklingbehaviorofthreehighschoolplayers.Again,twoprocedureswerecom-bined.VerbalinstructionandTAGhavebeenimplementedwithfocusonsuccessiveapproximationsoftheterminalbehavior.Thelowperformanceatbaselineincreasedsharplyduringshapingsessionsandgeneralizedtotacklingofliveballcarrierfollow-ingterminalbehavioracquisition.ThisstudyexemplifiesthepossiblegeneralizationofbehaviorslearnedbyTAGtonaturalenvironments.

DancingskillshavebeentaughtwiththeuseofTAGtofouryoungstudents.Quinnetal.(2015)useda clickerasa conditionedreinforcerforsuccessiveapproxi-mationsofthreedancemovements–turn,kickandleap.Thenecessityofpairingoftheconditionedreinforcer(tagger)withotherreinforcersiswelldescribedhere.Duetotheyoungageoftheparticipants(6to9years)moreelaborateprocessofpairingtheclickingwithexistingconditionedreinforcerswasneeded.Tokeneconomyhadtobeintroducedafterclickingsoundprovednottobereinforcingbyitselfintheyoungerparticipant.Incongruencewiththepreviousstudies,largeimprovementin


thetargetbehavioroccurredaftertheimplementationofTAGtrainingineducationalsettings.

TwostudiesexaminedthepossibleuseofTAGwithchildrenwithAutismSpectrumDisorders(ASD).Thefirststudy(Persicke,etal.,2014)showedthatTAGmaybeusednotonlytobuildnewbehaviors,butalsoinreducingproblembehavior,i.e.toe-walking.A four-year-oldboywithASDhasbeensuccessfullytaughtanin-compatiblebehaviortotoewalkingwiththeuseofacousticconditionedreinforcer.ThesecondstudyinvolvingchildrenwithASD(Pinedaetal.,2014)suggestedthatTAGmaybea feasiblemethodforteachingchildrenwithASDtoparticipateinneurofeedbacktraining.However,thisstudylacksimportantinformationaboutthetargetbehavior,implementationofTAGproceduresandsubjectsinvolved.

Thelaststudy(Levyetal.,2016)implementedTAGinuniversitycourseandcomparedTAGteachingoftwosurgicaltaskswithclassicalapproachusingdemon-strationalone.Twelveparticipantswereallocatedtothetreatmentgroupandtwelvetoa controlgroup.Clickerhasbeenusedastheconditionedreinforcertomarkthecorrectexecutionofeachstep.Eventhoughthefinalspeedoftheperformancewassimilarinbothgroups,thetreatmentgroupoutperformedthecontrolgroupintheprecisionofthebehaviorlearned.

OneofthemostimportantstrategiesthatmustbewellimplementedduringTAGsessionsisshaping.Itisrecommendedtobeusedininstances,wherethetargetbehaviorisnotpartoftherepertoireofthelearner.Thetwoimportantskillstobelearnedbythepractitioneraredifferentialreinforcement,whichmeansthatreinforce-mentisdeliveredininstancesofbehaviorincreasinglyclosertotheterminalbehaviorandsuccessiveapproximation,i.e.gradualchangeofthecriterionforreinforcement.Thebehaviorfurtherawayfromtheterminalbehaviorisbeingfadedasitisnotreinforcedanylonger(Cooperetal.,2014).

Priortoanyshaping,theteachermustbeabletoclearlyspecify(1)theterminalbehavior–whatTBshallthestudentperformandcurrentlylacksinherrepertoire,(2)initialbehavior–behaviorthatisalreadyintherepertoireofthestudentandsharessomeimportantpropertieswiththeTB(ex.topography,force,rate,etc.)and(3)intermediatebehaviorstobereinforcedonthewaytowardsTB(Alberto,2003).

Alltheabove-mentionedstudiesexceptPinderaet.al(2014)clearlydescribedtheinitialbehavior,calledPointofsuccessinTAGterminology.Terminalortargetbehaviortobeshapedandtaskanalysisthatclearlymarkedintermediatebehaviorstobereinforcedwerealsopresented.ThiscorrespondswiththeBID(breakitdown)ruleandTagpointselectioninTAGmethodology(Fogeletal.,2010).

Taskanalysisincludedasfewasfour(HarrisonandPyles,2013)tomaximumoftenstepsinStokesetal.(2010).Whenperformingtaskanalysisandselectingthepointsofsuccess,itisnecessarythatpractitionersfollowtheWOOFcriteria.Thatmeanseachsteporapproximationmustbewelldefined(W),observableand


measurable(O),teachersshallfocusononeaspectofthebehaviorata time(O)andstepdescribedbyfivewordsorless(F)(Quinn,etal,2015).

Anothernecessarydecisionforthepractitioneristheselectionofa deviceemittinga brief,distinctanduniformaudiblestimulus,i.e.theTagger(TAGteachInternational,2016).Differentdeviceshavebeenusedbasedontheenvironmentalpropertiesandnoiselevels.Fogeletal.(2010)usedclickerasthetooltodeliverim-mediatefeedbackandmarkedthecorrectformofeachstepofthebehaviorbeingshaped.Inmorenoisyenvironmentsa bullhornsirenhasbeenusedastheaudiblestimulusfollowingcorrectexecutionofthetargetbehavior(Stokeset.al.,2010).HarrisonandPyles(2013)shapedwiththeuseofmegaphonebeeptoindicateskillcompletedcorrectly.

Someofthestudiesalsofollowedthesocalledthree-tryrule(Quinnetal.,2015;Fogeletal.,2010),whichmeansmovingthelearnerquicklyforwardincaseanap-proximationpointhasbeenreached.However,italsomeansthelearnershallberedirectedtoeasiertaskincaseheisnotsuccessfulintagpointproductionforthreesuccessivetimes.Finally,majorityofthestudiesrecommendedTAGtrainingforthepractitioners(teachers,coaches,etc.)priortoimplementingTAGintheirteaching.

5 Conclusion Teachingwithacousticguidanceseemstobea promisingmethodoriginallydevel-opedforteachingthegeneralpopulationandmayfinditsapplicationinwidevarietyofeducationalsituationsincludingspecialeducation.ItisbasedontheprinciplesofbehaviorelaboratedbyB.F.Skinnerandreliesheavilyoncorrectlyappliedstrategiesof(1)successiveapproximationtowardstheterminalbehaviorand(2)differentialreinforcement.Thesetwostrategiesarethemaincomponentsofshaping,whichmaybeusedinteachingdifficultandcomplextaskstovarietyoflearners,includingthosewithspecialeducationneeds.

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Experimental Analysis of Behavior, 82(3),pp.317-328.Pineda,J.A.,FriedrichE.V.C.andLaMarca,K.(2014)‘Neurorehabilitationofsocialdysfunctions:

a model-basedneurofeedbackapproachforlowandhigh-functioningautism‘,Frontiers of Neuroengineering,7(29)[Online].Availableat:http://journal.frontiersin.org/article/10.3389/fneng.2014.00029/full(Accessed15.12.2017)

Pryor,K.W.,Haag,R.andO’Reilly,J.(1969)‘Thecreativeporpoise:Trainingfornovelbehavior‘,Journal of the Experimental Analysis of Behavior,12,pp.653–661.

Quinn,M.J.,Miltenberger,R.G.andFogel,V.A.(2015),‘UsingTAGteachtoimprovetheproficiencyofdancemovements‘,Journal of applied behavior analysis, 48(1),pp.11-24.

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Skinner,B.F.(1951)‘Howtoteachanimals‘,Scientific American,185,pp.26–29.Snow,D.L.andBrooks,R.B.(1974)‘BehaviorModificationTechniquesintheSchoolSetting‘,Journal

of School Health, 44(4),198-205.Stokes,J.V.,Luiselli,J.K.,Reed,D.D.andFleming,R.K.(2010)‘Behavioralcoachingtoimproveof-

fensivelinepass-blockingofhighschoolfootballathletes‘, Journal of Applied Behavior Analysis, 43(3),pp.463–472.

TAGteachInternational.(2016).Availableat:http://www.tagteach.com(Accessed15.12.2017)Trovato,J.andBucher,B.(1980)‘Peertutoringwithorwithouthome‐basedreinforcement,forreading

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(reviewedtwice)

doc. PhDr. KarelPančocha,Ph.D.InstituteforResearchinInclusiveEducationFacultyofEducation,MasarykUniversityPoříčí31a603 00BrnoCzechRepublice-mail:[email protected]

http://journal.frontiersin.org/article/10.3389/fneng.2014.00029/full

http://journal.frontiersin.org/article/10.3389/fneng.2014.00029/full

http://www.tagteach.com


Impact of physical activity on quality of life in Czech older adults

(scientific paper)

Julie Wittmannová, Iva Klimešová, Lucie Piňosová

Abstract: The present study was conducted to evaluate the relation between the subjec-tive perception of quality of life and the level of physical activity and its frequency in elderly people. The study recruited 58 elderly volunteers aged 65–89 years (23 male, 35 female). All subjects were in good health without medical treatment and living inde-pendently. We used the questionnaire Subjective Quality of Life Analysis – SQUALA and The International Physical Activity Questionnaire – IPAQ-short. The present work showed positive increase in the subjective perception of the life quality with realization of physical activity twice a week and more.

Keywords: active ageing, elderly, IPAQ, SQUALA

1 IntroductionInrecentyears,therehasbeenmuchconvincingevidenceofthepositiveimpactofregularphysicalactivity(PA)onhealthandtherelatedqualityoflife(QOL)ofolderpeople.IthasbeenscientificallyproventhatregularPAhelpstoleadanindependentlifeasitreducestheriskoffallsandfractures;thesymptomsofanxiety,depression;overallreducetheriskofprematuredeathandhealthconstraintsasa consequenceofheartdisease,diabetes,osteoarthritisandsometypesofcancer(Nelsonetal,2007;U.S.DepartmentofHealthandHumanServices,1996).Despitethesefacts,olderpeoplestillbelongtotheleastactiveagegroupwithinthesociety(Gutholdetal.,2008).WeconsiderdifferentfactorsasthemainattributesofQOL,butallexpertsagreeononeofthemanditisautonomy.ThemodelofQOLfortheolderpeopleofSarvimäkiandStenbock-Hult(2000)listsnexttoautonomysuchelementsasthesenseofwell-being,meaningandvalue.Heunetal.(1999)extendstheresearchtoa confirmedlistofpredictorsthatpositivelyaffectthelevelofsatisfactioninoldage:goodhealth,lack


ofdepression,marriage,independentliving,socialinvolvement,andtheabsenceofalcoholism.ThedeclineintheQOLofolderpeopleisoftenassociatedwitha lossofautonomy.Olderpeoplethemselvesusuallybasetheirlifephilosophyonlifeopti-mism,thepresenceofthesignificantothers,andtheirownactivity.PAisindicatedasthemainstimulusforincreasingolderpeople’sself-sufficiencyandautonomy.Duetothesefindings,thepaperpresentedisdealingwiththeevaluationoftheQOLoftheelderlyinrelationtotheamountofthePAperformedanditsfrequency.

AimsThemainaimofthestudyistoevaluatetherelationbetweenthesubjectiveperceptionofQOLandthelevelofPAanditsfrequencyinelderlypeople.Subsequentgoalsare:(a) TopresentthegathereddatafromIPAQ-shortquestionnairedealingwithrealiza-

tionofPA.(b) ToevaluatethesubjectivelyperceivedQOLbyresultsfromSQUALAquestion-

naire. (c) Toevaluatethesuitabilityofthequestionnairesusedforfieldresearch.

2 Material and MethodsResearch sampleParticipantswerevoluntariesrecruitedatmunicipalclubslocatedatBrnoregionandattheCzechTouristClub.Theexclusioncriteriawereageunder60,beinginstitu-tionalized,sufferingfroma physicalormentalillnessthatwouldhavelimitedtheirabilitytorespondtothequestionnaires.A totalof58subjects,23male(39.7%)and35(60.3%)femalesaged60–89yearsoldwereincludedinthisstudy.

Alldatagatheringwasdonepersonallyfacetoface,eachparticipantwasin-structedaboutthegoals,themethodsofresearch,thewayinwhichtheresultswereprocessedandinterpretedand,inparticular,aboutensuringanonymity.ThestudywasperformedaccordingtotheprinciplesestablishedintheDeclarationofHelsinkiandapprovedbytheEthicalCommitteeoftheFacultyofPhysicalCulturePalackýUniversityOlomouc.Writteninformedconsentwasobtainedfromallparticipants.

Physical activityThelevelofPAdonebyparticipantswasassessedbyvalidatedself-reportedtheInternationalPhysicalActivityQuestionnaire(IPAQ-shortquestionnaire)(Craigetal.,2003).TheshortformoftheIPAQquestionnairecoversthreespecificactivities.Thesearewalking,moderate-intensityactivitiesandvigorousintensityactivitylevel,frequency(measuredindaysperweek)andduration(timeperday)arecollectedseparatelyforeachspecifictypeofactivity.Inadditiontothemeasureofintensityof


thePAcarriedout,theIPAQ-shortquestionnairealsoobtainsgeneraldemographicdatafromtherespondents(gender,age,education,occupation,residence,height,andweight/BMIcalculation/,habits,smoking,lifestyle,dogownership,andparticipationinorganizedPAlessons).

Thisquestionnaireidentifiesthemovementactivityandinactivityrealizedinthelastsevendaysandcategorizesindividualsasinactive,minimallyactiveandHEPAactive(healthenhancingphysicalactivity;a highactivecategory).Thecriteriausedfollowsthecurrentfindingsthat30minutesofmoderateexerciseactivityperformedinmostdaysduringtheweekhasa keypreventiveroleincardiovasculardisease,type2diabetes,obesity,andsomecancers.

BasedontheIPAQ-shortquestionnaire,theenergyoutput(MET-minutes/week)ofeachparticipantwascalculated.

AccordingtothePAlevels,theparticipantsweredividedintothreecategories:• Inactive:thoseindividualswhodonotmeetcriteriaforcategoriesminimallyac-

tiveorHEPAactive;• Minimallyactive:3ormoredaysofvigorousactivityofatleast20minutesperday;

or5ormoredaysofmoderate-intensityactivityorwalkingofatleast30minutesperday;or5ormoredaysofanycombinationofwalking,moderate-intensityorvigorousintensityactivitiesachievinga minimumofatleast600MET-min/week;

• HEPAactive:vigorous-intensityactivityonatleast3daysachievinga minimumofatleast1500MET-minutes/week;or7ormoredaysofanycombinationofwalking,moderate-intensityorvigorousintensityactivitiesachievinga minimumofatleast3000MET-minutes/week.

Quality of lifeForthedatagatheringonQOL,theSQUALAquestionnaire(SubjectiveQualityofLifeAnalysis)wasused(Dragomireckáetal.,2006).Authorsofquestionnaire(Drago-mirecká&Škoda,1997)understandthequalityoflifeasoverallperceptionofthesatisfactionordissatisfactionofanindividualthroughouthislife,whilesatisfactionwithdifferentaspectshasvaryingimportance.TheoriginalFrenchversionofthequestionnairecontained23itemspertainingtotheexternalandinternalrealitiesofeverydaylife.WeusethestandardizedCzechversionofthequestionnaireSQUALA(Dragomireckaetal.,2006),whichisreducedintwoitems(politicsandreligiousbeliefs).Theresultsofthecurrent21areasareexpressedintheformofpartialscoresandoverallscoreofqualityoflifeandasfivedimensions(seeTable1).Thepartialscoreofindividualareasisgivenbytheproductoftheimportancescorewhichisratedbytherespondentona five-pointscalefrom0=insignificantto4=neces-saryanda scoreofsatisfaction,whichisscoredonscale1=verydisappointedto 5=completelysatisfied.Partialscoringisdisplayedasa QLFprofile,theoverall


scoreisthesumofallpartialscores.Thedomainsare(1)abstractvalues,(2)health,(3)closerelationships,(4)leisuretimeand(5)basicneeds(Dragomireckaetal.,2006).TheSQUALAquestionnaireiswidelyusedinmedical,social,pedagogicalorpsychologicalfieldsintheCzechRepublic.Table 1: SQUALA – summary of dimensions and items

Dimensions ItemsSQUALA1(SQ1)Abstractvalues Feelingofsafety,Equity,Freedom,BeautyandArt,TruthSQUALA2(SQ2)Health Health,PhysicalSelf-sufficiency,Wellbeing,Self-careSQUALA3(SQ3)Closerelationships Familyrelationships,Love,SexuallifeSQUALA4(SQ4)Leisuretime Sleeping,Relationships,Relaxation/resting,HobbiesSQUALA5(SQ5)Basicneeds Environment/livingcondition,Money,Food

Statistical analysisDescriptivevaluesareshownasmean,mode,median,frequency,standarddeviation,minimum,maximum,coefficientofvariation,skewnessandkurtosis.AnalysisofVariance(ANOVA)andpost-hocScheffe’stestwereperformedtoanalysedata.AllanalysiswereperformedusingtheStatSoftCRs r.o.STATISTICA12.0andvaluesofp<0.05wereconsideredtobestatisticallysignificant.

3 ResultsThestructureoftheinterpretationoftheresultsisanalogoustothegoalssetinourre-search.Firstly,wepresentthedataobtainedfromtheIPAQ-shortquestionnaire.Secondly,thedescriptivestatisticsofthewholeresearchintheSQUALAquestionnairebasedonpartialscoresanddimensionsispresentedandthelastsectionconsistsofevaluationoftheinfluenceofthePAlevelandfrequencyonsubjectiveperceptionoftheQOL.

DatacollectedwithIPAQ-shortquestionnaireareshowninTable2.Table 2: Analysis of IPAQ

Categories Number of participants (%); N=58PAFrequency 0–NoPA 13(22.41%)

1–Oncea week 21(36.21%)2–Twicea week 13(22.41%)

3–Threetimesand/ormorea week 11(18.97%)PAlevel Inactive 16(27.59%)

Minimallyactive 24(41.38%)HEPAactive 18(31.03)

Notes:PAfrequencyindicatesthenumberofdaysoftheweekinwhichparticipantswereengaged/notengagedinintenseormoderatePA.


Analysis of SQUALA questionnaire:Thegraphofpartialscores(Figure1)clearlyshowsthelowestratedareaps11(3.62)„sexuallife“.Theaveragemaximumvaluesofthepartialscoresarealreadymorebalanced,thehighestvalueoftheitemps9„takecareofitself “(12.31)followedbyps3„mentalwell-being“(12.16).Others,highimportanceandsatisfaction,areattributedtoareasofps1„health“,ps2„physi-calself-sufficiency“,ps6„familyrelationships”,ps8„children“andps14„safety“.TheSQUALAdimensionsscores(Figure2)showsasthehighestdimensionSQ2„health“(47.84),theattributionofa verylowvaluetotheSQ3dimension„closerelationships“(24.74)isunexpected.OnepossiblecausemaybethefactthattheSQ3dimensionincludes,amongotherthings,theps11„sexuallife“,whoserankwasthelowest.RespondentsexpressedtheleastsatisfactionwiththeSQ5dimension„basicneeds“.

Figure 1: The partial scores of SQUALA questionnaire

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Notes: SQ1 – Abstract values, SQ2 – Health, SQ3 – Close relationships, SQ4 – Leisure time, SQ5 – Basic needs Figure 2: The dimensions of SQUALA questionnaire The relation between the subjective perception of the QOL and the level of PA and its frequency: According to the calculated energy output level (MET-minutes/week), participants were divided into three categories: inactive, minimally active and HEPA active (Table 2). Figure 3 shows scoring of each SQUALA dimension depending on the PA level. All respondents similarly, regardless of the level of PA, rated the dimensions Abstract values (SQ1) and Close relationships (SQ3). For the Leisure time (SQ4) and Basic needs (SQ5) dimensions, the differences in the evaluation of the groups of respondents categorized as minimally active or HEPA active are diminished. Participants inactive feel less satisfied in their leisure time (SQ4) and basic needs (SQ5). The HEPA active participants evaluate at the health dimension the highest (SQ2) and close relationships the lowest (SQ3). The participants minimally active find the abstract values (SQ1) as the most satisfactory dimension and basic needs (SQ5) as the lowest. The Scheffe's test showed statistically significant difference between participants minimally active and HEPA active in dimensions Health (SQ2) and Leisure time (SQ4) at p≤0.01. With increasing PA level, the satisfaction with Health dimension increases and increasing intensity of PA also corresponds with the subjective evaluation of increased satisfaction with the respondents' leisure time. A statistically significant difference was seen both in the results of group inactive and group minimally active as well as group HEPA active.

Notes:SQ1–Abstractvalues,SQ2–Health,SQ3–Closerelationships,SQ4–Leisuretime,SQ5–Basic needs

Figure 2: The dimensions of SQUALA questionnaire

ps1 ps2 ps3 ps4 ps5 ps6 ps7 ps8 ps9 ps10 ps11 ps12 ps13 ps14 ps15 ps16 ps17 ps18 ps19 ps20 ps210

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Notes: SQ1 – Abstract values, SQ2 – Health, SQ3 – Close relationships, SQ4 – Leisure time, SQ5 – Basic needs Figure 2: The dimensions of SQUALA questionnaire The relation between the subjective perception of the QOL and the level of PA and its frequency: According to the calculated energy output level (MET-minutes/week), participants were divided into three categories: inactive, minimally active and HEPA active (Table 2). Figure 3 shows scoring of each SQUALA dimension depending on the PA level. All respondents similarly, regardless of the level of PA, rated the dimensions Abstract values (SQ1) and Close relationships (SQ3). For the Leisure time (SQ4) and Basic needs (SQ5) dimensions, the differences in the evaluation of the groups of respondents categorized as minimally active or HEPA active are diminished. Participants inactive feel less satisfied in their leisure time (SQ4) and basic needs (SQ5). The HEPA active participants evaluate at the health dimension the highest (SQ2) and close relationships the lowest (SQ3). The participants minimally active find the abstract values (SQ1) as the most satisfactory dimension and basic needs (SQ5) as the lowest. The Scheffe's test showed statistically significant difference between participants minimally active and HEPA active in dimensions Health (SQ2) and Leisure time (SQ4) at p≤0.01. With increasing PA level, the satisfaction with Health dimension increases and increasing intensity of PA also corresponds with the subjective evaluation of increased satisfaction with the respondents' leisure time. A statistically significant difference was seen both in the results of group inactive and group minimally active as well as group HEPA active.


The relation between the subjective perception of the QOL and the level of PA and its frequency:Accordingtothecalculatedenergyoutputlevel(MET-minutes/week),participantsweredividedintothreecategories:inactive,minimallyactiveandHEPAactive(Table2).Figure3showsscoringofeachSQUALAdimensiondependingonthePAlevel.Allrespondentssimilarly,regardlessofthelevelofPA,ratedthedimensionsAbstractvalues(SQ1)andCloserelationships(SQ3).FortheLeisuretime(SQ4)andBasicneeds(SQ5)dimensions,thedifferencesintheevaluationofthegroupsofrespondentscategorizedasminimallyactiveorHEPAactivearediminished.Participantsinactivefeellesssatisfiedintheirleisuretime(SQ4)andbasicneeds(SQ5).TheHEPAactiveparticipantsevaluateatthehealthdimensionthehighest(SQ2)andcloserelationshipsthelowest(SQ3).Theparticipantsminimallyactivefindtheabstractvalues(SQ1)asthemostsatisfactorydimensionandbasicneeds(SQ5)asthelowest.TheScheffe’stestshowedstatisticallysignificantdiffer-encebetweenparticipantsminimallyactiveandHEPAactiveindimensionsHealth(SQ2)andLeisuretime(SQ4)atp≤0.01.WithincreasingPAlevel,thesatisfactionwithHealthdimensionincreasesandincreasingintensityofPAalsocorrespondswiththesubjectiveevaluationofincreasedsatisfactionwiththerespondents’leisuretime.A statisticallysignificantdifferencewasseenbothintheresultsofgroupinac-tiveandgroupminimallyactiveaswellasgroupHEPAactive.

Figure 3: The SQUALA dimensions in inactive, minimally active and HEPA active groups

Figure 3: The SQUALA dimensions in inactive, minimally active and HEPA active groups Influence of PA frequency on the subjective perception of the quality of life SQUALA: After the distribution of the research group according to the PA frequency, we obtained four categories: 0 – no PA, 1 – PA once a week, 2 – PA twice a week and 3 – PA three times and/or more a week (Table 2). The data analysis showed that there is a very small difference in the QOL of the participants in category 2 and 3 (participation in PA twice a week and more) and their ratings in all dimensions of SQUALA are among the highest (Figure 4). The participants who belong to category 0 showed the lowest satisfaction with the QOL in all SQUALA dimensions, except dimension Abstract values (SQ1) (feeling of safety, equity, freedom, beauty and art, truth). We found statistically significant differences in Overall score (QOL_SUM), Health (SQ2) and Leisure time (SQ4) (Scheffe's test; p≤0.05). In other dimensions of the SQUALA (SQ1 – abstract values, SQ3 – close relationships, SQ5 – basic needs), the statistically significant difference at level p≤0.05 did not occur. The values referring to the Health dimension (SQ2) clearly showed that the highest evaluation of the quality of life was perceived by the members from categories 2 and 3, these were most satisfied with their health. The lowest values in the health dimension were found in the participants categorized no PA. In the Health dimension, a statistically significant difference occurred between the categories 1 and 2 and 3 (p≤0.01). The same situation was shown in the Leisure time dimension (SQ4) at the p≤0.01.

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Influence of PA frequency on the subjective perception of the quality of life SQUALA: AfterthedistributionoftheresearchgroupaccordingtothePAfrequency,we


obtainedfourcategories:0–noPA,1–PAoncea week,2–PAtwicea weekand3–PAthreetimesand/ormorea week(Table2).Thedataanalysisshowedthatthereisa verysmalldifferenceintheQOLoftheparticipantsincategory2and3(partici-pationinPAtwicea weekandmore)andtheirratingsinalldimensionsofSQUALAareamongthehighest(Figure4).Theparticipantswhobelongtocategory0showedthelowestsatisfactionwiththeQOLinallSQUALAdimensions,exceptdimensionAbstractvalues(SQ1)(feelingofsafety,equity,freedom,beautyandart,truth).

WefoundstatisticallysignificantdifferencesinOverallscore(QOL_SUM),Health(SQ2)andLeisuretime(SQ4)(Scheffe’stest;p≤0.05).InotherdimensionsoftheSQUALA(SQ1–abstractvalues,SQ3–closerelationships,SQ5–basicneeds),thestatisticallysignificantdifferenceatlevelp≤0.05didnotoccur.

ThevaluesreferringtotheHealthdimension(SQ2)clearlyshowedthatthehigh-estevaluationofthequalityoflifewasperceivedbythemembersfromcategories2and3,theseweremostsatisfiedwiththeirhealth.ThelowestvaluesinthehealthdimensionwerefoundintheparticipantscategorizednoPA.IntheHealthdimen-sion,a statisticallysignificantdifferenceoccurredbetweenthecategories1and2and3(p≤0.01).ThesamesituationwasshownintheLeisuretimedimension(SQ4)atthep≤0.01.

Figure 4: Frequency of PA

Figure 4: Frequency of PA 4 Discussion For the data gathering on QOL, the SQUALA questionnaire was used. This tool is understandable and suitable instrument to gather the data and interpret findings in the Czech environment. We have seen a disadvantage in the prevalence of use of instruments created by WHO such as WHOQOL-OLD and WHOQOL-BREF (The WHOQOL Group, 1998; Dragomirecká & Bartoňová, 2006) or SF-36 measure (McHorney, Ware, & Raczek, 1993; Andresen et al, 1999) in the past decade and insufficiency to easily compare the data with other research work. Comparison of results on SQUALA questionnaire and WHOQOL-BREF or OLD (Whoqol Group, 1998) are not available, due to lack of international use. The SF-36 and WHOQOL-BREF comparison with a huge sample n=11.440 in Taiwan population sample was done in 2001 by Huang, Wu, & Frangakis (2006). The findings underline the result that questionnaires measure different constructs: the SF-36 measures health-related QOL, while the WHOQOL-BREF measures global QOL. Clinicians and researchers should carefully define their research questions related to reported outcomes and select which instrument they should use. The level of PA was measured by questionnaire IPAQ-short version (Craig et al., 2003). The pitfall of this method in our research is the participants’ age. The IPAQ questionnaire is fine-tuned and verified in Central European conditions only on a sample of the population aged 15–69 (Sigmund, Sigmund, Mitas, Chmelík, Vašíčková & Frömel, 2009). Use in a sample of persons over 60 years old is a pilot, and the results are comparable with precaution. The data collection influence understanding the terms high and moderate intensity PA and decision making which of the PA activity belong to certain level of intensity (with the increase of age and dependency respondents tend to perceive as high intensity PA many of moderate and even low intensity activities) (Prachařová, 2013). Our goal was to re-evaluate the used methods and find an inspiration in sufficient latest research projects. The "Healthy People 2010" recommendation (USDHHS, 2000) for intensive PA is walking or moderate PA for at least 30 minutes at least 5 times a week, or intensive PA 20 minutes at least 3 times a week. In our research, a recommendation for an intensive PA was met by 19% of respondents. These findings fully correspond to the results of the Pelclová et al. (2008), where the criterion for intensive PA implementation reached 20.3% of participants at the age of 55–69 years. We attribute our "good" results in HEPA active with sample of respondents aged from 65 to 89 years old to selecting active seniors living independently in their homes, also the QOL satisfaction highly correlated with independency. The present study showed significant difference between the realized PA and subjective perception of the QOL. Similar conclusions, rewrote as recommendations, were drawn by World Health Organization recommendations (WHO, 2010). The WHO (2010) compared the impact of PA directly on the subjective perception of health. From

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4 DiscussionForthedatagatheringonQOL,theSQUALAquestionnairewasused.ThistoolisunderstandableandsuitableinstrumenttogatherthedataandinterpretfindingsintheCzechenvironment.Wehaveseena disadvantageintheprevalenceofuseofinstrumentscreatedbyWHOsuchasWHOQOL-OLDandWHOQOL-BREF(TheWHOQOLGroup,1998;Dragomirecká&Bartoňová,2006)orSF-36measure(McHorney,Ware,&Raczek,1993;Andresenetal,1999)inthepastdecadeandinsufficiencytoeasilycomparethedatawithotherresearchwork.ComparisonofresultsonSQUALAquestionnaireandWHOQOL-BREForOLD(WhoqolGroup,1998)arenotavailable,duetolackofinternationaluse.TheSF-36andWHOQOL-BREFcomparisonwitha hugesamplen=11.440inTaiwanpopulationsamplewasdonein2001byHuang,Wu,&Frangakis(2006).Thefindingsunderlinetheresultthatquestionnairesmeasuredifferentconstructs:theSF-36measureshealth-relatedQOL,whiletheWHOQOL-BREFmeasuresglobalQOL.Cliniciansandresearchersshouldcarefullydefinetheirresearchquestionsrelatedtoreportedoutcomesandselectwhichinstrumenttheyshoulduse.

ThelevelofPAwasmeasuredbyquestionnaireIPAQ-shortversion(Craigetal.,2003).Thepitfallofthismethodinourresearchistheparticipants’age.TheIPAQquestionnaireisfine-tunedandverifiedinCentralEuropeanconditionsonlyona sampleofthepopulationaged15–69(Sigmund,Sigmund,Mitas,Chmelík,Vašíčková&Frömel,2009).Useina sampleofpersonsover60yearsoldisa pilot,andtheresultsarecomparablewithprecaution.Thedatacollectioninfluenceun-derstandingthetermshighandmoderateintensityPAanddecisionmakingwhichofthePAactivitybelongtocertainlevelofintensity(withtheincreaseofageanddependencyrespondentstendtoperceiveashighintensityPAmanyofmoderateandevenlowintensityactivities)(Prachařová,2013).Ourgoalwastore-evaluatetheusedmethodsandfindaninspirationinsufficientlatestresearchprojects.

The“HealthyPeople2010”recommendation(USDHHS,2000)forintensivePAiswalkingormoderatePAforatleast30minutesatleast5timesa week,orintensivePA20minutesatleast3timesa week.Inourresearch,a recommendationforanintensivePAwasmetby19%ofrespondents.ThesefindingsfullycorrespondtotheresultsofthePelclováetal.(2008),wherethecriterionforintensivePAimplementa-tionreached20.3%ofparticipantsattheageof55–69years.Weattributeour“good”resultsinHEPAactivewithsampleofrespondentsagedfrom65to89yearsoldtoselectingactiveseniorslivingindependentlyintheirhomes,alsotheQOLsatisfac-tionhighlycorrelatedwithindependency.

ThepresentstudyshowedsignificantdifferencebetweentherealizedPAandsubjectiveperceptionoftheQOL.Similarconclusions,rewroteasrecommenda-tions,weredrawnbyWorldHealthOrganizationrecommendations(WHO,2010).


TheWHO(2010)comparedtheimpactofPAdirectlyonthesubjectiveperceptionofhealth.Fromourresearch,wecanalsogenerateresultsfocusedonSQ2(healthdimension).Wefinda statisticallysignificantdifferencebetweenminimallyactiveandHEPAactivegroups.Intermsoffrequency,a statisticallysignificantdifferenceoccurredintworelations:betweenindividualsperformingnoPAofmoderateandhigherintensity(category0)andthosewhoperformthePAoftherespectiveintensityatleasttwicea week(category2).Positivecorrelationwasalsoseenintherelationshipbetweenmembersofcategory0(withoutPAofthegivenintensity)andcategory3(PA3xandmoreperweek).

IfwelookbackattherelationshipbetweenthePAintensityandthesubjectiveperceptionofthequalityoflifeoftheoverallSQUALAscore(QOL_SUM),wefindnosignificantdifferenceatanyofthePAintensitylevels,incontrasttothefrequencyofPAperformed.Thestatisticallysignificantdifferencewasconfirmedintherela-tionshipbetweencategory0(withoutPA)andthosewhoperformPAtwicea week(category2)orPAthreetimesand/ormorea week(category3).

SimilarfindingsrelatedlevelandfrequencyofPAasindimensionHealth(SQ2)wecanseeinLeisuretimedimension(SQ4).SQ4consistsofitemssuchasSleeping,Relationships,Relaxation/resting,andHobbies.Thesuggestionstoimproveadher-enceinregularplacementofPAindailyscheduleoftheelderlyisoftenconnectedsimplywitha suggestion“tofind(PA)activitiestolovetodo withothers”(Růžičkaetal.,2013).

5 ConclusionThemainobjectiveofthestudywastoevaluatethecorrelationbetweenthelevelofPAperformedandthesubjectiveassessmentoftheQOL.ThePA’sleveldividedtheresearchgroupintothreegroups.HEPAactivemembersratedfourofthefiveSQUALAdimensionsabovetherestofthesample,exceptthedimensionSQ3(closerelationships).Ontheotherhand,theinactivePAmembershadtheoppositeeffect,intheSQ2,SQ4andSQ5scoreswerethelowest.A statisticallysignificantdifferencewasfoundinthedimensionSQ2(Health)betweenmembersbelongingtoinactiveandHEPAactive,andSQ4(Leisuretime)betweengroupsinactive,minimallyactiveandHEPAactive.

Ifweconsidera “PAlevel”asPAfrequencyinrelationtotheaveragevaluesoftheoverallscore(QOL_SUM),thestatisticallysignificantdifferenceoccursintworelationships.Itoccursbetweenparticipantsperformingnoactivity(category0)anda)thoseperformingthePAatleasttwicea week(category2),andb)thoseincategory3(PAthreetimesand/ormorea week).TheinvolvementofparticipantsinPAlessfrequentlythantwicea weekhasnoeffectonperceptionsofQOL.Ontheother


hand,whenperformingPAtwicea weekandmorefrequently,a positiveincreaseinsubjectiveperceptionoftheQOLoccursinthesampleexamined.QOL measurements presented by 5 dimensions of SQUALA questionnaire showed the Health dimension (SQ2) as subjectively highest perceived. On the other hand, the subjectively poor QOL dimension was perceived dimension of Close relation‐ships (SQ3), which we assume is affected by the item Sexual life, scored signifi‐cantly lowest.

Participantsingroups2and3(PAperformedtwicea week,andthree times and/ormorea week)accordingtoPA‘sinfluenceonQOLperception,evaluatedallSQUALA(SQ1–SQ5)dimensionshigherthanotherrespondentsperformingPAlessfrequently.Thestatisticallysignificantdifferencebetweenparticipantsperformedatleasttwicea weekandcategorieswithoutPAshowedonlythedimensionsSQ2(Health),SQ4(Leisuretime)andoverallscore(QOL_SUM).The goal for future research is to re-evaluate the used methods and find some inspiration for the creation of a research project with widely used instruments.

References [1] Andresen,E.M.,Gravitt,G.W.,Aydelotte,M.E.,&Podgorski,C.A.(1999).Limitationsofthe

SF-36ina sampleofnursinghomeresidents.Age and ageing, 28,562–566.[2] Craig,C.L.,etal.(2003).Internationalphysicalactivityquestionnaire:12-countryreliabilityand

validity.Medicine and Science in Sports and Exercise, 35(8),1381–1395.[3] Dragomirecká,E.,etal.(2006).SQUALA Subjective QUAlity of Life Analysis. Příručka pro uživatele

české verze Dotazníku subjektivní kvality života SQUALA.PsychiatrickécentrumPraha,Praha.[4] Dragomirecká,E.&Bartoňová,J.(2006).DotazníkkvalityživotaSvětovézdravotnickéorganizace

WHOQOL-BREF.Psychometrickévlastnostia prvnízkušenostis českouverzí.Psychiatrie, 10(3),144–149.

[5] Dragomirecká,E.&Škoda,C.(1997).QOL-CZ(PříručkaprouživatelečeskéverzeDotazníkukvalityživotaSQUALA).Praha:PsychiatrickécentrumPraha–Laboratořpsychiatrickédemo-grafie.

[6] InternationalPhysicalActivityQuestionnaire.(2005).Guidelines for Data Processing and Analysis of the International Physical Activity Questionnaire (IPAQ) – Short and Long Forms, revised on November 2005.Retrievedfromhttp://www.ipaq.ki.se/scoring.pdf

[7] Huang,I.C.,Wu,A.W.,&Frangakis,C.(2006).Do theSF-36andWHOQOL-BREFmeasurethesameconstructs?EvidencefromtheTaiwanpopulation.Quality of Life Research, 15(1),15–24.Doi:10.1007/s11136-005-8486-9

[8] McHorney,C.A.,Ware,J.E.&Raczek,A.E.(1993).TheMOS36-ItemShort-FormHealthSurvey(SF-36):II.Psychometricandclinicaltestsofvalidityinmeasuringphysicalandmentalhealthconstructs. Medical Care, 3l,247–263.

[9] Pelclová,J.,Vašíčková,J.,Frömel,K.,DjordjevicI.etal.(2008).Vlivdemografickýchfaktorůna pohybovouaktivitua sezeníu obyvatelČeskérepublikyve věku55–69let.Tělesná kultura, 31 (2),109–119.

[10] Prachařová,Š.(2013).Hodnocení kvality života seniorů Šumperska.MasterThesis,Olomouc:PalackýUniversityOlomouc.


[11] Růžička,M.,etall.(2013).Krizová intervence pro speciální pedagogy.Olomouc:PalackýUniversityOlomouc.

[12] Sigmund,E.,Sigmundová,D.,Mitáš,J.,Chmelík,F.,Vašíčková,J.&Frömel,K.(2009).Vari-abilityofselectedindicatorsofphysicalactivityinrandomizedsampleoftheCzechpopulationbetweenyears2003–2006:Resultsfromtheshortandlongself-administeredformatoftheIPAQquestionnaire.Acta Universitatis Palackianae Olomucensis, Gymnica, 39(2),23–31.

[13] USDepartmentofHealthandHumanServices.(2000).Healthy People 2010: Understanding and Improving Health. Washington,DC,USA:GovernmentPrintingOffice.

[14] WHOQOLGroup.(1998).DevelopmentoftheWorldHealthOrganizationWHOQOL-BREFqualityoflifeassessment.Psychological Medicine 28(3),551–558.

[15] WorldHealthOrganization.(2010).Global recommendations on physical activity for health.Geneva,Switzerland:WorldHealthOrganization.

(reviewedtwice)

Mgr. JulieWittmannová,Ph.D.,PhDr. IvaKlimešová,Ph.D.,Mgr. LuciePiňosováPalackýUniversityOlomouc,FacultyofPhysicalCultureTr.Miru115771 22OlomoucCzechRepublice-mail:[email protected];[email protected]


Migration as an influencing factor on identity formation

(overview essay)

Ivana Lessner Lištiaková

Abstract: The process of identity formation may be influenced by multiple factors. The study focuses on migration as one of these influencing factors. In a qualitative study, the researcher focused on the process of identity building and reconstructing after migrating from one country to another. It provides an analysis of the processes of adaptation in the new environment that people identified and could reflect upon after their experi-ence of migrating from their countries of origin. Factors of age, language and culture in regard to attaining their new personal identities are considered. Migration is viewed from a perspective of an individual. The goal of the study was to capture personal reflections individuals on the process of their adaptation in a new environment. Data was collected by semi-structured interviews and processed through phenomenological analysis. The results pointed to questions of defining home, accepting or rejecting the local language and applying various ways of adaptation depending on age. The study provided insight into the topic and confirmed the importance of considering individual experience of individuals when analysing migration issues. The results of the study will further be used in creating educational and therapeutic programmes for people with the experience of migration.

Keywords: migration, identity, adaptation, home, language, culture

1 IntroductionSelf-perceptionconsistsofrelativelystablepersonalitytraits.Ontheotherhand,itisalsocreatedbya dynamicprocessofself-reflectingandre-creatingself-imagebasedoninteractionswiththeenvironment.Peoplegainandcreatetheiridentity–personal,gender,social(age,familystatus,orfamilyroles),national,local,cultural,religious,socio-economical,racial,language,professional,orpolitical.


Identityrepresentsa setofcognitive,behavioralandaffectiveaspectsofa person,basedonwhicha personperceivestheirownexistence,suchaswhotheyareandwheretheybelongbasedontheirattitudesandvalues.Personalidentityincludeslifegoals,valuesandbeliefsintheareaofcareer,relationships,orspirituality.Culturalidentityrelatestoculturallyandethnicallyinfluencedvaluesandpractices.Searchingforpersonalidentityisthemainissueforadolescents,whereasprotectingculturalidentitybecomesimportantincaseofmigratingorbeinga minoritypopulationgroup(Schwartzetal.,2013).

Ting-Toomey(2005)elaboratedontheidentitynegotiationtheorythatdescribeschangesinidentityandfactorsthatinfluenceitdependingonsocialandculturalenvironments.Shetalksaboutthesearchforoverlapsinbelongingtoa certainsocialorculturalgroupandinhavinga personalidentity.Ithappensininterculturalandinterpersonal communication.

Schwartzetal.(2013)studiedacculturationofyoungadultsofthefirstandsecondgenerationofimmigrantsintheUnitedStatesdependentontheirstatusandprocessofcreatingpersonalidentities.TheresultsacrossallethnicgroupssuggestedthatindividualswhowereinthephaseofsocialmoratoriumkepttheirculturalheritageaswellasacceptedAmericanculturalpracticesandvalues.However,individualswhowereinthephaseofdiffusionofpersonalidentitywerenotidentifiedwithneitherthevaluestheiroriginalnorthenewculture/country.

Identityformationisa naturalprocessinfluencedbyvariouslifeevents,bothsignificantandevery-dayones.Massivechangesinidentitycanbeobservedduringandafterovercomingpsychosocialcrisesthatareoftenconnectedwithsocialritesofpassageservingassupportivemechanisms;e.g.:schoolenrollment,employmentchanges,marriage,childbirth,orretirement.SuchchangesarenaturallyconnectedwiththelifecycleasdescribedbySatir(1991).

Incaseofforcedidentitychanges,(e.g.lossofa familymember,trauma,naturaldisasters,wars,oremploymentloss)naturalritualsinthesocietyaremissing–prob-ablywiththeexceptionoffunerals.Itiscountedonwithcopingthankstoresilienceofpeople(Antonovsky,1996;ŤulákKrčmáriková,Kováčová,2016).However,healthycopingmechanismmaybesubstitutedbymaladaptivemechanismsuchasdevelop-ingaddictions–drug,alcoholorworkaddictions.Crisesthata personwasnotabletocopewithmayleadtopsychosomaticproblemsorsocial-emotionaldifficulties(behaviordisorders,neuroticissues,ordepression).

Migrationasa lifeeventmaycausepositiveornegativeemotions.Itmaybelongtopositivefactorsofinfluencingidentitychanges.Forexample,itcancontributetohigherflexibility.However,itmaycausenegativedistress.Itmayevenbeperceivedastraumatic.Theadaptationtomigrationdependsonthecharacteristicsoftheeventsuchasreasons,process,wayofleaving,settlinginthenewcountry,conditionsand


supportivemechanisms,barriersinthesystem,surroundings,closeenvironment,personalityandpreviousexperience.

TheresultsofAscher’sstudy(1989)suggestedthatadolescentswhomigratedattheageolderthan11yearsexperiencedtheeventashighlystressfulbecausetheywerealsogoingthroughchangesinformingtheirpersonalidentity.Tartakovsky(2013)mentionedthatmostofmigratingadolescentsisfullyemployedbytheirefforttosurvive–meaninglearningthelanguageandcreatingsocialnetworks;andincaseofinvoluntarymigrationalsobyphysicalsurvival.Ifmigrationisvoluntary,youngpeoplehavechancetoenrichtheiridentitybyculturalelementsofthenewcountryandtocreatea newconceptoftheirownidentitywitha possibilitytobelongtobothcultures.Migrationthereforecontributestoimprovingflexibilityandsupportsmentalandsocialwellbeing.

2 Goal of the studyFromthepositionoftheauthorasa helpingprofessionalintherapyandeducation,thegoalofthepaperistoemphasizetheneedofpsychosocialsupportofpeoplebefore,duringandaftertheprocessofmigrationwiththefocusonreconstructinganddevelopingtheirpersonalidentity.Thegoalofthestudywastogaininsightintothesituationofmigrationandtheprocessofadaptationintheenvironmentofthenewcountry.Througha self-reflectiveviewofanindividualontheprocessitwaspossibletodiscussidentitychangesbasedonthemigrationprocess.Theresultsofthestudywillbelaterusedincreatingandperformingsupportprogramsforpeopleintheprocessofmigrationandadaptationperiods.

3 Research participantsThestudywasbasedonaninterviewwitha femaleparticipant(P1),whoreflecteduponherownsituationaswellasdescribedandcommentedonexperiencesofotherpeoplewhohavetheexperienceofmigratingandtheypresentedtheirviewsina publicdiscussionfocusedonthistopic.Datafromtheinterviewiscomple-mentedbyinformationfrominformaltalksandadditionalresearchquestions(P2)andcasestudiesfromthepracticeoftheauthor(P3).TheparticipantsaredescribedinTable1.


Table 1: Description of the participants

Participant Current age

Age at the time

of migra-tion

Gender Migration route Description

P1 22 15 female Iran–>Slovakia migrationforparent employment

P2 31 30 female Slovakia–>Germany migrationfora partnerP3 40 40 male Slovakia–>England migrationforwork

4 Research methodologyQualitativemethodologywaschosenforthestudybasedontheneedtounderstandpersonalexperiencesoftheparticipants.TheinterviewwithP1wasaudio-recorded.Datacollectionwasconductedthrougha semi-structuredinterview.Thequestionsoftheinterviewwerefocusedondescribingthestrategiesofadaptationinthenewenvironmentafterparticipant’smigration.Othercollecteddatawasbasedonfieldnotesoftheauthor.Collecteddatawasprocessedthroughphenomenologicalanaly-sis,codedandcategorized.Theinterpretationofthecategoriesisprovidedintheresultssectionofthepaper.

5 Results and discussionP1isa 22-yearoldwomanfromIranwhomovedtoSlovakiawithherwholefamily(mother,father,olderbrother,youngerbrother)attheageof15.Fromherownre-flectionofthesituationwelearnedthathermaineffortafterthearrivaltothecoun-trywastofullymergewiththenewenvironment,nottostickout,accepthernewidentityandtogetridofheroriginalone.Shetriedmanywayshowtofitin,whichisnaturalinadolescence,however,theneedwasevenstrongerbasedontheefforttoovercomethefeelingofbeingdifferent.Later,shefoundheridentityinacceptingwhoshewaswithkeepingheroriginalcultural/nationalidentityandwithgaininga feelingofbelongingtothenewenvironment.

P2isa 30-yearoldwomanfromSlovakiawholeftthecountrytofollowherpart-nertoGermany,hiscountryoforigin.Shehasbeeninthenewenvironmentfora yearandsheisexperiencingan“identitycrisis”anda feelingoffrustrationconnectedwithit.Sheidentifiedseveralreasons:1)lossofsocialstatus–froma professioninherfieldinthecountryoforigin,shebecameanunqualifiedpart-timeworkerinanotherfiled;2)languagebarrier;3)culturalbarrier–asa foreignershedoesnotfeelacceptedbythesocialenvironment;4)limitedsocialcontacts.


P3isa 40-yearoldmanwholeftSlovakiainordertogotoworkinEngland.Heworkedmanuallyanddidnotspeakthelanguageofthecountryatall.Hewasisolatedfromallsocialcontacts.Afterthreemonths,schizophreniaoccurred(note:itisnecessarytoconsiderfactorsofmentalvulnerabilitypredispositions),basedonwhichhereturnedhiscountryoforigin.

Fromtheinterview,severalkeycategories(C1-C5)wereidentified,whichareconnectedwithformingandreconstructingpersonalidentity(Table2).

Table 2 Description of identified categories

Category Description

C1 Home Perceptionofa placeorconceptwhere/whena personexperiencesa feelingofbelonging

C2 Language Knowledgeoflanguageofthetargetcountryasa meansofadapta-tion

C3 Work Changesinprofessionalorientationinfluencedbymigration

C4 Strategiesofadapta-tion

Strategiesofconductofbehaviorandprocessingofemotionswhenreconstructingone’sownidentity

C5 Culturalnegotiation Comparingcultureofthenewandtheoriginalcountryandefforttofindindividualbalance

Oneofthekeyquestionsofthestudywastodescribetheconceptofhome(C1).P1mentionedherownexperienceandcommentedonwhatotherparticipantsofthepublicdiscussionmentioned.Shesaidthathome,mainlyforolderpeoplewiththeexperienceofmigration,isnota particularplaceina certaincountry.However,itisa placewhere:a)peoplehavetheirfamily,b)peoplefeelwelcome,c)peopleknowitthere.Peopleneedtobesurroundedbylovingotherswhocreatea safeenvironmentandthisdoesnotdependona mutualculturalconsonance.Atfirst,homeisthecoun-tryoforigin.Aftera whileoflivinginthenewplace(andthelengthoftheperiodisveryindividual),homeisinthenewcountryandhomeisinthecountryoforigin.ForP1ittooktwotothreeyearstostartfeelinglikeathomeinthenewcountry(C1,C5).

Itisinterestingtoobservethereactionsofinhabitantsofthenewcountrywhentheyreacttothemigrants’statementsofthecountrybeingtheirhome.Theyaresurprisedthatpeoplecanconsiderhomea certainplaceeventhoughtheyarenotproficientinthelanguageorthecultureisvastlydifferent.Itistheunacceptanceoftheenvironmentthatmakespeoplewhomigratednottofeelathome.P1said:“When I was a teenager I did everything just to fit in. I did everything that Slovak teenagers did, but I did not feel fully accepted. And I do not think it is necessarily connected only with the Slovak culture … it is more based on age … as teenagers we are not sure about our identity anyways. We are not sure who we are and when we move it may or may not be even more confusing for us. For me it was confusing” (C5).


Peoplewholivedinseveral(ormany)placesarenotabletoanswerthequestionofwheretheyarefrom.Theanswerisnotsosimple,oractually,thequestionisnotcorrectlyposed.Itisnecessarytosubstituteitwithmorespecificquestionsdependingontherealinterest,suchas:Wherewereyouborn?Wheredo youlive?Wherehaveyoulived?Whatlanguagesdo youspeak?Whatcountrywasyourpassportissuedby?Wherewereyourparentsborn?Wheredidyougotoschool?EventhoughinmanynationalEuropeancountriestheanswerforallthesequestionisthesame,itisnotsoformanypeople.Thepressurethattheenvironmentcreatesandposesona persontoidentifytheconceptofhome(C1)asa fixedplacemayleadtofeelingsofdifferentnessandmayshakethedefinitionofone’spersonalidentity(C4,C5).

Thefeelingofbelonginginthenewcountrycanbesupportedbymomentsoffriendlycontactwiththelocalinhabitants.Thatispossiblewhenpeoplewhomigrat-edspeakthelocallanguage(C2).Accordingtotheresearchparticipants,learningthelanguagecontributestoraisingmutualrespectandunderstanding.Thus,itbelongstooneofthebasicadaptationstrategies(C4)andmeansofidentityreconstruction.

P2commentsonherprocessofmigrationandadaptation:“The decision to leave the country was very straightforward for me and was convinced from the first mo-ment. I knew that the beginning would not be easy. I was often visited by frustration, which sometimes lasted for days, or weeks; and even now it is still tuned in with ‘my office hours’. It became regular… The perceived identity crisis manifested because of the change in my social status (C3), I felt it that way. But later, cultural and language barriers climbed on the top (C4). I accept this challenge; change is life (C5) and I am determined to the essence of being and to take care of myself.”

Whenpeoplemovetoanothercountry,ononehand,theyaretryingtofindpositivesthere,butsuddenlytheystartrealizingalsothepositivesoftheircountryoforiginwhichtheywerenotawareofbeforeortheywereoverlookingbecausetheyconsideredthemnormal/naturalandtheyarenotpresentinthenewcountry,forexample.Ontheotherhand,theysenseaspectsthatweremissingintheircultureoforiginandtheywouldliketotransferthemthere(C5).Influencedbytheevaluationofprosandconsofbothcultures,reflectinguponthem,identityofa personchanges.Awarenessisraisedandvariouswaysoffunctioningandthinkingaredeveloped.

Thementionedresultsarebasedonexperiencesofmigrantswholefttheircoun-trieslegallyandaftercertaintimeofplanning,eventhoughtheirreasonsmighthavebeendifferent(economical,political,orpersonal).Migrationhappenedbasedona decisionofonefamilymemberorasa consensusofthewholefamily,ortheircom-promiseandsomemembershadtoadjust.Eventhoughthemigrationintoanothercountrywas“withoutmajorproblems”,theidentityoftheindividualswentthroughcertainshockandreconstruction.


Intheidealcase,migrationbringsenrichmentandhaspositiveinfluenceonidentitybuilding.However,migrationmaycausestrongdistress.Peoplemayfeelthedistressduringmigrationorduringtheadaptationperiodinthenewenviron-ment.Distresscanbecausedbythefeelingoflossofsafety,lossofhome,lossofroots,fearofchange,changeofsocialstatus,limitedsocialcontacts,orsuperficialrelationshipsinthenewenvironment.Thesituationofmigrationmayevenbecon-nectedwithtrauma,whichhappensmainlyincasesofillegalmigration(forcedtoleavehome,physicalandmentalstrain,orlifethreats),butmaybepresentincasesoflegalmigrationaswell.Distresscanleadtomentalandpsychosomaticproblems,suchasdepression,neuroticdisorders,evenpsychoses.

Supportingtheprocessofidentityreconstructioninthenewenvironmentseemstobeanimportantdemandtowardsprofessionalsinhelpingprofessionssuchassocialworkers,therapeuticpedagogues,psychologists,ortherapists).Thequestionremainingarethelanguageandculturalcompetenciesoftheseprofessionalsforworkingwithpeoplemigratingfromdifferentcountries.Fromthisregard,methodsofworkthatdo notrequirelanguageskills,suchasartornonverbaltechniquesusedinexpressivetherapies(arttherapy,dramatherapy,musictherapy,etc.)providespaceforexpressingtheneedsofindividuals,sharingexperienceandofferpsychosocialsupportintheperiodofadaptationtotheenvironment.Theresearchresultswillthereforebeimplementedincreatingsupportprogramsforpeoplewhoexperiencedmigration.

6 ConclusionsAsa resultoftheprocessesofmigrationandadaptationtothenewenvironment,variouschangesinperson’sidentityarecaused.Basedontheresearchinterviews,severalrelatingareaswereidentified.Theseareasincluded:theconceptofhome,over-cominglanguagebarriers,changesofsocialandprofessionalstatus,usingadaptationstrategiesandculturalnegotiation.Thegoalofthestudywasachievedbyprovidinginsightintothetopic.Theresultsofthestudywillbeappliedinplanningprogramsforsupportingtheprocessofadaptationandidentityreconstruction.

ReferencesAntonovsky,A.(1996).Thesalutogenicmodelasa theorytoguidehealthpromotion.Health Promotion

International, 11(1),11–18.https://doi.org/10.1093/heapro/11.1.11Ascher,C.(1989).SoutheastAsianAdolescents:IdentityandAdjustment.ERIC/CUEDigestNo.51.Satir,V.(Ed.).(1991).The Satir model: family therapy and beyond.PaloAlto,Calif:ScienceandBehavior

Books.Schwartz,S.J.,Kim,S.Y.,Whitbourne,S.K.,Zamboanga,B.L.,Weisskirch,R.S.,Forthun,L.F.,...

&Luyckx,K.(2013).Convergingidentities:Dimensionsofacculturationandpersonalidentity

https://doi.org/10.1093/heapro/11.1.11


statusamongimmigrantcollegestudents.Cultural diversity and ethnic minority psychology, 19(2),155–165.

Tartakovsky,E.(2009).Culturalidentitiesofadolescentimmigrants:A three-yearlongitudinalstudyincludingthepre-migrationperiod.Journal of Youth and Adolescence, 38(5),654-671.

Ting-Toomey,S.(2005).IdentityNegotiationTheory.InBerger,C.R.,Roloff,M.E.,Caughlin,J.,Dil-lard,J.P.,Wilson,S.R.,&Solomon,D.(Eds.).The international encyclopedia of interpersonal communication(Vol.1)(pp.1–10).Hoboken,NJ:JohnWiley&Sons.

ŤulákKrčmáriková,Z.,Kováčová,B.(2016).Evaluationofanarttherapyprogrammeforclientswithdifficultlifesituations.Review of Artistic Education (6), 11-12,277–283.

(reviewedtwice)

Mgr. IvanaLessnerLištiaková,PhD.ComeniusUniversityinBratislavaFacultyofEducationInstituteofSocialStudiesandTherapeuticEducationRačianska59813 34BratislavaSlovakia

Grant dedicationThestudywasconductedundertheprojectVEGA(1/0598/17)Evaluationoftheeffectivefactorsofmultisensoryapproachesintherapeuticeducation.


Selected dramatherapy techniques and their effect on addicted clients in detoxication ward

(scientific paper)

Kristýna Krahulcová, Bohdana Štěpánová

Abstract: The present paper describes the effect of selected dramatherapy techniques on addicted clients in a detoxication ward. The paper focuses on four specific techniques. The mask, the metaphor, the symbol, and the puppet. The authors of the paper investi-gated the patients’ feelings evoked by these techniques, what the patients were thinking, and whether they gained any deeper experiences. In the paper the authors reflect on the suitability of these techniques in the environment of a detoxication ward in Olomouc.

Keywords: Dramatherapy, addiction, detoxication ward, dramatherapy techniques, mask, puppet, metaphor, symbol

1 IntroductionIn2009theauthorswereofferedtojoina teamofvolunteersandtoattenda detoxica-tionwardinOlomouc.Inthewardthevolunteersdelivereddramatherapyinterven-tions(referredtoasDI).Theauthorsbecameinterestedinworkingwiththeclientsandstartedtoexploredramatherapyaimedataddictedpersons.Onthebasisoftheauthors’experiencegainedinthecourseofseveralyearsofactiveparticipationindramatherapysessionsina detoxicationward,theynoticeda lackofdramatherapytechniquesusingartisticmaterialsormasks.Thisfactmotivatedthemtocarryouta researchstudyaimedatthesetypesoftechniques.Aftereachdramatherapyin-terventiona feedbacksessiontookplacewiththeparticipants,butintheauthor’sopinion,thereflectionwasrarelysatisfactoryintermsoftheeffectofthetechniqueontheparticipants.Onthebasisofthesefindings,theauthorsdecidedtoexplorethetechniquesindetail.


2 Mask, symbol, metaphor and puppet in dramatherapyToachieveitsobjectives,dramatherapyusesvarioustheatricalanddramaticmeans.Thebasicdramatherapytechniqueisimprovisation.Thisisbecauseimprovisationre-flects(unlikestructuredplay)theclient’sinternalstate(Valenta,2011).AccordingtoMajzlanová(2004)othertechniquesincludemimic and speech exercises, dramatic play, verbal play, role play, scenario, myths, stories, working with a text, story-telling, make-up, masks, puppet or hand puppet play, movement, pantomime, playing with objects, and drawing. Thereisa greatvarietyofmeansandtechniques.Otherauthorssuggestdifferenttypesofclassification.

Masksareoftenassociatedwitha ritual.Theuseofmasks(andritual)indrama-therapyhasa prominentposition.Masksareusedfora widerangeofpurposes.Mostoften,theyareusedasa toolofdisassociationand‘anonymization’ofthecharacters(Valenta,2011).

Indramatherapy,thiscanbeachievedespeciallybymasksonthefaceandfacecolours.Themaskisdeliberatelyusedtosearchforexpressions,achievereflection ofthesoul,releasetension,orgainexperiences.Themaskcanbeusedasa relaxingoroccasionaltechniquetolivenupa dramatherapysession,sometimesaspartofdramatherapyintervention,orasa separatetechniquewithitsownstory,courseandgradation.(Majzlanová,2004)

Workingwiththemaskindramatherapyaimedataddictedpersonsisalsorefe-rredtobyBoháčová(2009),whoemphasisesthetherapeuticvalueofthemask.Inhistory,themaskwasusedfora completetransformation.Gradually,itmovedfromthesacralsphereintoplay(theatre).Themaskispartofplay,inwhichtheprincipleof‘asif ’isinduced,thankstowhichtheclientcanenterorexittheworldoffiction.Themaskhasa venturingandprotectivefunction.Itisa vehicleofnon-verbalcommu-nication.Inthefirstplace,themaskisnotwhatitrepresentsbutwhatittransforms.Indramatherapy,masksconcealsomethingbutatthesametimeexposesomething.

ThewordsymboloriginallycomesfromtheGreekword‘symbolon’,whichmeansa markthatpresentsvisiblesignsofinvisiblereality.Symbolicthinkingcanbeseenallaroundus.Inliterature,paintings,speech,fairytales,mythsandrituals.Thingsbecomesymbolswhentheyarelinkedwithanemotionandevokethisemotionwheneverthesethingsareseen(Wollschläger,2002).

Intherapy,symbolscanberepresented,forexample,bysymboloncards.Thesecardscanbeusedasa meansofexpressingemotions,situationsorrelationshipsthataredifficulttoshowfortheclient.Workingwithsymbolsisa processthatbringsnu-merousalternativesandways;eachtimethecourseoftheprocessisaffectedbythegroupanditsdominantenergy.Regardingthefactthatsymbolsopentopicsthataresometimesdifficulttoopen,thetherapist-clientrelationshipisofgreatimportance(Olejníčková,Růžička,2013)


Themetaphorisanapproachusedinmanytherapeuticsystems.ThesignificanceofthemetaphorindramatherapyisdescribedbyS.Jennings(1994)whoclaimsthatcreatinga distancewillbringuscloser.Byusingmetaphors,theclientscancircum-ventorovercometheirinternalblocksorbarriersandbehaveinanauthenticway.Polínek(2015)describestheuseofmetaphorsingestalttherapywithelementsofdramatherapyasa suitabletechniquewhentheclientsfindthemselvesina stalemateandareunabletodealwiththesituation.Themetaphorbringsendlessopportunities.

The puppethasitsmagicalsignificance.Theclientsspeakforthepuppetandatthesametimeforthemselves.Thepuppetprovidesa degreeofsafetyanddistancefromtheproblemandtheclients’ownvulnerability.Inthisway,theclientsaremoreacces-sibleandwillingtoreacttostimuli,acceptandmodifytheirapproachorbehaviour,andlearnempathyandtolerance(Majzlanová,2004).

AccordingtoMajzlanová(2004)puppetsorhandpuppetsindramatherapyservethepurposeofmotivation,establishingcontact,presentationofeducationalprin-ciples,rulesofdramaplay,playinga situationordialogue–aspartoranelementofa storyindifferentdramatherapytechniques.Shealsoemphasisesanimportantaspect–theclientschoosethepuppetsontheirown.Alreadyduringtheprocessofmanufactureofthepuppetstheircommunicationimprovedandtheclientsestab-lisheda certainrelationshipwiththepuppet,whichalsoimprovedtheirwillingnesstoplaywiththem.

Tomanová(2003) emphasisestheprocessofmanufactureofthepuppets.Shede-scribesoneofthepossibletechniquesofusingthepuppet.Accordingtotheauthor,thefirststageofthetechniqueispreparatory.Theclientsthinkabouttheirpuppets,choosematerialsandactuallyproducethepuppet.Thepuppethasitsownstory,characterandform.Theclientsoftenprojectsomethingoftheirownintothepuppet.Thenthesecondstageofthetechniquecomes.Theclientsintroducetheirpuppetsandsearchfora partnertocompletetheintroduction.Thefinalpartisanintroduc-tiontotheremainingclients.Inthethirdstagethecreationsareanalysedincludingsharingandreflectionofthemanufacturers.

Jennings(1994) referstousinglife-sizepuppetsmadeprimarilyofboxes,paper,cardboardandcloth.Theyareusuallyledbytwopersons.Thesepuppetsprovidetheirleaderswitha greaterdegreeofidentificationwiththepuppet.

3 Research objective and research questionsLongbeforetheresearch,theteamofauthorshadbeeninterestedintheeffectofdramatherapytechniquesinDIonthepatients’opinions.Ineachinterventiontheauthorsreceivedverbalfeedbackfromthepatients,butthisfeedbackwasneververi-fiedbyanadditionalmethod.Therefore,theauthorswerenotsureabouttheway


thepatientsperceivedtheinterventions.Theauthorsdefinedthemainandpartialobjectiveoftheresearch.

Main objective of the research: ‘To identify the reactions (behaviours) of patients in a detoxication ward in Olomouc to selected dramatherapy techniques.’

Partial objective of the research: ‘To identify how selected dramatherapy techniques affect the opinions of persons ad-dicted to alcohol and methamphetamine during their stay in a detoxication ward.’

Basedontheobjectivesmentionedabove,theauthordefinedthefollowingre-searchquestions:RQ1: Whatemotionswereevokedinthepatientsafterusingthetechniques?RQ2: WhatisthebenefitofDIforthepatientsina detoxicationward?RQ3: Whatisthechangeinthepatients’emotionsaftercompletionofDI?

RESEARCH TECHNIQUES

Technique No. 1 CARDSTheauthorusedDixitboardgamecards.Thesearecardsthatevokevariousassocia-tions.

Course of the technique:TheDixitcardsaredealtoutinfrontoftheclients.Thetaskofeachclientistopicka cardthatrepresentstheclient’scurrentstate,iscloseinsomeway,orisinterestingforsomereason.

Thisisfollowedbya shortimagination,duringwhichtheclientsmeetthecardintheirthoughts.Thetherapistleadsthisimaginationsessionina verbalway.Duringtheimaginationtheclientsfocusonhowtheyperceivethecardthoughthefivesenses.

Aftertheimaginationsessiontheywriteordrawthefollowingonthepaper:• Whattheyseeonthecard.(VISION)• Whattheysmellfromthecard.Doesitproducea smellornot?(SMELL)• Whattheyhearfromthecard.Isitjustsilence?(HEARING)• Whattheyfeelwhentheytouchthecard.(TOUCH)• Whattheircardtasteslike.(TASTE)Theclientsnamethecard.Eachclientshowsthecardtothegroupandsaysthenameofthecard.Thentheclientplacesthecardonthefloorinfrontofthetherapist.Thecardsforma ‘line’infrontofthetherapist.


Thislinedividestheroomintotheauditoriumandthestage.Theauditoriumisthetherapist’spart.Allclientsstandintheauditorium.Thetaskofeachclientistoplaytheircardbymeansofmovement.Theclientscometothestageoneafteranotherandperformthecardbymeansofmovement.Afterthattheyreturntotheaudito-rium.Theclientsreturntotheirplaces.Nowtheyhaveanopportunitytoredrawthecardtobehappywithit.(Addsomethingorredothecardcompletely).Thepurposeistofeelwellwiththecard.Iftheclientsarehappywiththecard,theyneednotredrawit.Thencomesthesharingandreflectionphase.

Technique No. 2 METAPHORES

Course of the technique:Thetherapistexplainstotheclientswhata metaphoris.Inthegrouptheyrecallfa-mousmetaphors.Forexample:‘Life is like a box of chocolates, you never know what you are going to get.’ (ForrestGump)Theclients’taskistothinkabouttheword‘LIFE’andmakeupfourmetaphors.

Thesemetaphorsmustbeginwith:Lifeislike…• Metaphor1–theclientscomparelifetofoodordrink.• Metaphor2–theclientscomparelifetoa geometricshape.• Metaphor3–theclientscomparelifetointeractionbetweenpeople(forexample:

jointbreakfast,arguing,etc.)• Metaphor4–theclientsmakeuptheirownmetaphoraboutlife.

Thenextstepisasfollows.Iftheclientsareinterested,theypresenttheirmeta-phorstothegroup.Inthewholetext,theclientsidentifyfourwordsthataremostimportant.Theclientsusethesewordstowritea story.Thestoriesarereadinfrontofthegroup.Sharingandreflection

Technique No. 3 MASKSInthistechniquetheauthorusedusualsturdypapermasks.Ina gentleway,theauthorindicatedtheeyes,noseandmouthnottoattributeanyemotionstothemask.Atthebeginningtheparticipantscolouredthemaskandwroteonitfrombothsidesaccordingtotheinstructionsandthenattacheda skewer.Someoftheclientsusedanadhesivetape,somedidnot.Intheresearch,thepurposeofthemaskwastoprovidea distance.Thetaskfortheparticipantswastothinkabouttheirownpersonality,theirqualities,skills,aboutwhattheylikeorwhattheydis-like.Thedevelopmentofthemaskwasprecededbyshortactivitiesthathelpedtheparticipantsgraspthetopicinvariousways.Thiswasthestatuetechniqueandsystematicclassificationofthoughts.


Course of the technique:TheclientsaregivenA4papersandpencils.Theclientsareaskedtodividethepapersintofourboxes.Thenthefollowingquestionsareaskedandanswered:Box 1–WhatI like,myinterests.Box 2–WhatI dislike,myfears.Box 3–WhatI valueaboutmyself.Box 4–WhatI wouldliketochangeaboutmyself.(Thistechniquewasusedfirsttomaketheparticipantsthinkaboutthemselves.Thesepeopleoftenneedanorderandstructure.)

Thiswasfollowedbythemainstatuetechnique.

Statue• Firsttheclientsareexplainedwhattoexpect.• Thentheyareaskedtowalkaroundtheroom.Firsttheclientsthinkaboutthe

firstbox.Theychooseonethingthatwaswritteninthefirstboxonthepaperandthinkaboutitsform.

• Onthetherapist’sclapofthehandstheclientsfreezeasa statuethatrepresentsthethingoremotion.Theyremainasa statuefor2seconds.Thetherapistclapsagainandtheclientsstartmoving.

• Inthisway,theclients‘sculpt’fourstatues.Onestatueforeachbox.

Theobjectiveofthetechniqueistotouchthetopicphysically.Toestablisha linkbetweenthethoughtsandthebody.

MaskThetherapistgivestheclientswhitemasksandinstructsthemtochoosetwothingsthatcharacterizethem(theycanchoosefroma list).Theclientsportrayonething(part)ononemask(drawingorwords),theotherthingontheothermask.Whetherthemasksaredifferent,bothpositiveorbothnegativeisuptotheclients.

AppearanceThisisthefinalpartofthetechnique.• Thetherapistdividesthespaceintothestageandtheauditorium.• Allclientsstandintheauditorium.• Eachclientgoes‘onstage’facingtheaudience.Thentheyputthemaskontheir

faceandsay:‘Thisisme’–theclientstaysinthepositionfor5seconds,thenturnsoverthemaskandsays:‘Thisisalsome’–andstaysforanother5seconds.

• Afterthattheclientreturnstotheauditorium.Thisisfollowedbythesharingandreflectionphase.


Technique No. 4 PUPPETS

Course of the techniqueTheclientsareprovidedwithvariousmaterialsandobjects:wire,paper,newspapers,scissors,adhesivetape,glue,skewers,waxcrayons,etc.

Theclientsmakea puppetthatrepresentsa thingora personthattheyarethink-ingabout.Ona pieceofpapertheclientswritethenameofthepuppet,whatitlikestoeat,whereitlives,whatitlikesdoing.Thentheypresenttheirpuppetstothegroup.Thisisfollowedbythereflectionphase.

4 Research methodologyTheauthorschosea qualitative approachbasedonspecificmethodsthattheywantedtouseintheresearch.Theyfocusedontheclients’opinionsandfeelingsduringDI,andonwhattheclientsthinkaboutDI.Theauthorsassumedthatinthecaseofa quantitativeapproachthequalityandaccuracyoftheresponsescouldvarycon-siderably.Therefore,theydecidedtoapproachthepatientsdirectly.

Thequalitativeapproachallowsa detailedanalysisofa researchproblem.Theresearchquestionsandresearchobjectivesmayberevisedandchanged.Inadditiontotheresearchquestions,theresearcheralsoformulateshypothesesandnewdeci-sions.Theresearchermeetsnewpeopleandworksinthefield.Variousnotesaremadeallthetime.Theresearchertriestotakeadvantageofeachpieceofinformation(Hendl,2016).

4.1 Triangulation

helpsimprovethevalidityoftheresults.Thisisa moredifficultprocedurefortheresearcherbutprovidesgreaterquality.Thereareseveraltypesoftriangulation.How-ever,thesetypesarefurtherclassified.A systemofclassificationispresentedbyHendl(2016),a differentsystembyMiovský(2006),anotheronebyŠvaříček,Šeďová(2014).Thesesystemsofclassificationaresimilar.

Forthepurposesofthepresentresearchthemethodological triangulation wasselected. Thistypeoftriangulationmaybecharacterizedasfollows:

‘The same phenomenon is analysed by different methods and the outcomes are compared.’(Chrastina,Ivanová,2010,p. 158,Table1)

TheimportanceofmethodologicaltriangulationisdescribedbyMiovský(2006). Thisapproachcanbeusedtoidentifyanydifferencesbetweenvariousmethods.Thewaysthattheycomplementeachother,overlaporcontradict.


4.2 Description of the research sample

Theresearchparticipantswererecruitedbymeansofdeliberate sampling.AccordingtoMiovský(2006) thisisthemostcommonsamplingmethod.A predefinedcriterionisusedtodeliberatelyrecruitindividualswhomeetthiscriterionora setofcriteriaandatthesametimearewillingtoparticipate.

Theresearchsampleconsistedofaddictedpatientsstayingina detoxicationwardinOlomouc.Inmostcases,thepatientswereaddictedtoalcoholandnon-alcoholicsubstances.Thegroupofparticipantsconsistedofbothmenandwomen.Specifically,theywerefourwomenandthreemenaged16to70years.Thelengthoftheirstayinthedetoxicationwardwasatleastfourweeks.

Theauthorsdefinedtheinclusioncriteriawithrespecttothemainandpartialresearchobjective.Thecriteriawereasfollows:• TheparticipantmustbepresentinallfourDIs;• Duringthetreatmentprocess,theparticipantmuststayinthedetoxicationward

inOlomouc;• Theparticipantmustagreewiththeresearchstudybysigninganinformedconsent

form,inthecaseofparticipantsyoungerthan18yeartheirparents’consentisrequired;

• Theparticipantmustbeaddictedtoalcohol,methamphetamineormarijuana.

4.3 Data collection methods

Thedatacollectionmethodwastheinterview,observationandanadditionalmethodusingtheparticipants’diary.

ObservationTheobservationwascarriedoutinthepatients’meetingroom.Thisroomisalsodesignedforalljointtherapies,sessionsandjointmeals.Forbetterclarityofinforma-tionandnotesduringobservation,theauthorsdevelopeda recordsheet,inwhichtheyimmediatelywrotetheresultsofobservation.Duringobservation,theauthorsfocusedonverbalandnon-verbalcommunicationandtheparticipants’behaviour.Thiswasparticipantobservation,whichmeansthattheinterventionswereinfactledbytheauthors.

InterviewThedatacollectionmethodwastheinterview.Thequestionsoftheinterviewwerederivedfromtheresearchquestions.Thequestionsweredividedintotwoparts.Thefirstpartincludedquestionsaimedattheinterventiontechniques.Thispartincludedfivebasicquestionsforeachtechnique.Theotherpartconsistedofadditionalques-tionsrelatingtoleadingDIsessionsanddramatherapyingeneral.Theadditional


questionswereincludedintheinterviewonpurpose.Theresearcherswantedtomakesurethattheparticipantsarenotinfluencedbythewaytheinterventionsareled.Theywereinterestedintheparticipants’opinionsaboutDIsinthedetoxicationward.Theinterviewstookplaceintheparticipants’rooms.Theinterviewswerealwaysattendedbythequestioner(author)andtheparticipant.Theinterviewstookplaceaftercompletionofallfourinterventions.Theinterviewslastedfor20to30minutes.

DiaryThethirddatacollectionmethodwasananalysisoftheparticipant’sdiary.Theau-thorsattendedthewardonlyoncea week.Inthiswaytheyusedthetimethattheparticipantshadbetweentheinterventions.

Thetechniquesinvestigatedbytheauthorscouldreveala personalmemoryoranimportantideathattheparticipantsdidnotwanttoshare.Someideasarebetterwrittenona pieceofpaperthanspokenabout.Fortheteamofauthors,thesediarieswereextremelyimportant.Thisisanothermethodbymeansofwhichtheauthorsconfirmedtheirassumptions.Thediarieshelpedunderstandtheparticipants’expe-riencing.

4.4 Data analysis methods

Forthepurposesoftheresearch,theopencodingmethodwasusedtoanalysetheinterviewsanddiaries.Thegeneralprincipleofthisapproachisa breakdown,classi-ficationandrearrangementoftheinformationobtained.Basically,thetextisbrokentounitsthatarenamedbytheresearcher.Afterthattheresearcherworksonlywiththenames(Švaříček,Šeďová,2014).

TheauthorsfollowedthemethoddescribedbyŠvaříček.Theauthorsreadthetextcarefullysentenceaftersentenceandgraduallyclassifiedthetextintounits.

Šeďová(2014)statesthata unitmightbea word,sentence,paragraphora se-quenceofwords.Eachunitisthenassigneda code. ‘In selecting the code one must ask what the sequence shows, what phenomenon or theme it represents.’(Švaříček,Šeďová,2014,p. 212).Thecodesareconstantlyreferredto,revisedandreworkedasnecessary.Anauthorwhousesthemethodofopencodingmustknowthemeaningthateachcodesignifies.

Aswrittenabove,there-writtentextisbrokentounits.Theseunitsareassignedcodes.TheauthorsusedtheMicrosoftWordprogramme.Inthisprogrammetheymadea commentforeachunitandspecifiedthecode.Thesecodesusuallytooktheformofa wordora sentence.

Afterthattheauthorsusedtheaxialcodingmethod,whichfollowsopencod-ing.Theaimofthismethodistogroupthecodesbytheirinternalphenomenaandmeanings.Thisisperformedbymeansofcomparing,searchingandidentifying


relationships(Miovský,2006).Theauthorsdevelopeda tableincludingcodesandexampleunitsforbetterclarity.

Theresultsweresummarizedusingthemethodofsecondaryinterpretation. Accordingtothismethod,theresearcheranalysesthematerialagain(Švaříček,Šeďová,2014).

Thedatacollectedbymeansofobservationwereincludedina singletablede-velopedintheMicrosoftExcelprogramme.

5 Data interpretation5.1 Secondary interpretation – interviews

Theresultssuggestedthattheparticipantsdidnotdescribespecificfeelings.Instead,theyexpressedtheirfeelingsbymeansofthoughts.Theauthorsaskedabouttheparticipants’feelings,someofthemansweredbutmostofthemdidnot.

Technique No. 1 CardsThistechniquehada differenteffectoneachparticipant.Someparticipantsbecameabsorbed,somefocusedsolelyonthecard,someweresurprisedbythetechnique.Thistechniquemadetheparticipantsthinkabouttheirlives,aboutthemselvesandtheiraddiction.Thepicturesonthecardsmadetheparticipantsexposetheirsouls.Onlyoneoftheparticipantsthoughtaboutthesignificanceofthecardassuch.Theparticipants’thoughtsduringthistechniquewerebasedontheirthemes.Inmostcases,theparticipantsthoughtabouttheirlives.Theirthoughtsduringthistechniquewerelinkedwiththeirlives.Someoftheparticipantsunderstoodthesignificanceofthepresent,someemphasisedtheirfuturewithoutaddiction,somethoughtaboutthepastandwhattheyhadlost.Oneoftheparticipantsdidnotmakeanassociation.Instead,theparticipantthoughtaboutthecardassuch.Formostoftheparticipantsthistechniquewasbeneficial.AfterthisDI,theparticipantsoftenreturnedtothethemestheyhadthoughtabout.Thesuccessofthetechniquewasconfirmedbythefactthatsomeoftheparticipantswereinterestedintryingthistechniquewithdif-ferentcards.

Technique No. 2 MetaphorsThistechniquefocusesmoreonthinkingandisnotasspontaneousasthecardtech-nique.Thisrequirementhadaneffectontheparticipants’feelings.Someofthemwerenervousanddidnotknowhowtocreatea metaphor.Forotherparticipantsthistechniquewasentertaining.Forsomeitwasa creativechallenge.Assuggestedbyoneoftheparticipants,a significantfactorwasthemoodoftheparticipantduringDI.Thistechniquespecificallyfocusesonthethemeoflife.Mostoftheparticipantsthoughtabouttheirlives.Aboutthepastorthepresent.Thistechniquesupported


groupdynamics.Inthegroup,theparticipantsreadtheirmetaphors/thoughtsaboutlife.Theparticipantshadanopportunitytothinkaboutwaysthatthereaderthinksaboutlife.Inmostcases,theparticipantswereenrichedwiththethoughtsofotherparticipantsaboutlife.Inthisway,thetechniquewasbeneficialalsoforthosewhofailedtocreatea metaphor.Forsomeoftheparticipantsthethoughtsweresostrongthattheyreturnedtothem.OtherparticipantsforgotabouttheirmetaphorsandthoughtsrightafterDI.Theparticipantssuggestedtryingthetechniquewitha dif-ferentword.Forexampleaddiction.

Technique No. 3 MasksThistechniqueevokedvariousemotionsintheparticipants.Someofthemthoughtthatthistechniquewasgreat.Ontheotherhand,someoftheparticipantswerenotsoexcited.Duringthistechniquetheparticipantsthoughtaboutthemselves,abouttheirlives,abouttheirfaces,andabouttheothers.Thethingsthattheparticipantsthoughtaboutincludedthemselvesandtheirfaces.Whattheirfaceslooklikeundertheinfluenceandwhentheyareclean.Thistechniquewasrathernon-verbal,whichwaswelcomedbysomeoftheparticipants.Theyhadanopportunitytodrawtheirqualities.Inthiswaytheyexposeda littleofthemselvestotheothers.Theparticipantsreturnedtothesethoughts.Attheendoftheinterviewtheypointedoutthatmoretimewouldhavebeenappropriate,andalsocomplainedaboutotherpatientswhodisturbedthetechniquebyloudconversation.

Technique No. 4 PuppetsInmostoftheparticipantsthistechniqueevokedpleasantfeelings.Theparticipantsdescribedtheiremotionssuchasitwasfine,I enjoyedit,I wasina goodmood.Theparticipants’puppetsusuallyrepresentedsomethingclose,inseveralcasesitwasdirectlythehabit-formingsubstance,somepuppetsrepresentedspecificproblems.Duringthistechniquetheparticipantsthoughtabouttheirowncreationsandthepuppetsofothers.Thethoughtassociatedwiththistechniquerelatedtolifeingen-eral,lifewithoutaddiction,theparticipants’personality.

Additional questionsFiveofthesevenparticipantshavenotexperienceddramatherapybefore.Thelead-ingroleofthetherapistwasassessedpositivelybyeverybody.Theparticipantsusedwordssuchas‘nice’,‘fine’or‘great’.Theylikedthefactthattheywerenotforcedtocarryoutactivities.Thateachactivitywasvoluntary.Theoverallassessmentofdrama-therapyinthewardwaspositive.Someoftheanswerssuggestedthatdramatherapywassomethingnewthatprovidedrelaxationandentertainment.(Laughterrelievestension).Thedramatherapytechniquessupportedgroupdynamics.Theparticipantsappreciatedthevoluntarynatureoftheactivitiesandjointagreementsthatcreated


a safeenvironment.Theyalsoassesseddramatherapyascreative,whichallowstheparticipantstofacetheirproblemsandthemselvesinaneasierway.

5.2 Answers to the research questions

What emotions were evoked in the patients after using the techniques?Theparticipantsdidnotnametheiremotionsandfeelings.Theyrathercomparedtheiremotionstotheirthoughts.Accordingtotherespondents,a crucialaspectisthemoodoftheparticipantsduringDI.Differentpeoplelikedifferentwaysofworking.Forthisreason,thetechniquesevokedvariousemotions.Someoftheparticipantsfeltjoyanddescribedtheiremotionswithentertainment.Otherswhodislikedrawingandusingmaterialsdidnotenjoythetechnique.Ineachtechniquetheparticipantsfeltdifferentemotions.

What is the benefit of DI for the patients in a detoxication ward?DIisbeneficialforthepatientsina detoxicationwardinmanyways.Firstly,itisa typeofactivitynotledbymedicalstaffina whitecoatbuta volunteer.Itisa typeoftherapyunknowntothepatients.Itispresentedina friendlyway,whichisnottypicalfora detoxicationward.InthecourseofDI,thepatientsarenotforcedintoactivities.Ifanyofthetechniquesisunpleasant,theymaydecidetoquit.Asa result,theyneednotbenervousandwaitforexamplefor15minutesbeforesomebodyelsefinishes(asisusualingrouptherapy–author’snote).Itisuptothepatientswhethertheywanttoexpressthemselves.

Dramatherapyusesgroupdynamics.However,groupdynamicsneedstobebuiltinsidethegroup.Bymeansofshortandentertaininggamesthepatientsrelax,forgetabouttheirproblemsfora whileandarethemselvesforthemoment.Thiswasap-preciatedbymanyoftheparticipants.Thepatientsinthegrouplookedateachotherfroma differentperspective.Theysawthemselvesassomebodywholikesfunandwhoiscreative.Theysawthemselvesassomebodywhohasgonethroughsomelifeandwhoisunique.Notjustasalcoholicsanddrugaddicts.

A safeenvironmentencourageseventhosewhoarelesstalkativetoopenup.Tospeakabouttheirlifeandaddiction.

What is the change in the patients’ emotions after completion of DI?MostoftheparticipantsconsiderDIpositive.Theyreflectontheirmoodasfollows:‘better mood, problems forgotten, laughter, releasing internal tension.’

5.3 Interpretation of results

Theobjectivesdefinedbytheauthorswereasfollows:


Main objective of the research: ‘To identify the reactions (behaviours) of patients in a detoxication ward in Olomouc to selected dramatherapy techniques.’

Theparticipants’responsestothesetechniquesweremostlypositive.Thepar-ticipantswererelaxedandlearnedsomethingnewaboutothergroupmembers.Ina playfulway,theyencounteredtheirproblemsandtheirlife.Thiswasalsoappreci-ated.Althoughthetechniquemightnotbeinterestingforeverybody,thebenefitoftheinterventioniswatchingothers.

Partial objective of the research: ‘To identify how selected dramatherapy techniques affect the opinions of persons ad-dicted to alcohol and methamphetamine during their stay in a detoxication ward.’

Thetechniquesinvestigatedbytheresearchstudyreallyhelptheparticipantsthinkaboutthemselves,theirlives,theirthoughts.Theformulationofthetaskitselfurgesreflection.Inmostcasestheparticipantsnamedtheirthoughts.Theythoughtabouttheiraddiction,theirlife,theirrelatives,andaboutthemselves.

Theresultsoftheresearchconfirmedthesuitabilityofapplicationofthesetech-niquesina detoxicationward.Volunteersshouldnotbeafraidtotryoutmorecrea-tiveDItechniques.A significantaspectistoincludesuitablewarm-uptechniques.Therearealwayssomepatientswhodislikethetechnique.Eveninsuchcase,however,itisbeneficialforthemtositandwatch.Observationssuggestthatpersonsaddictedtodrugsengagewitha greateramountofenergyandspontaneitythanpersonsad-dicted to alcohol and medicine.

6 Discussion

Inthispartofthetexttheauthorsconsiderthelimitationsoftheresearchstudy.Theyassesstheresultsoftheresearchandproposepracticalrecommendations.

6.1 Limitations of the study

Althoughtheaimoftheresearchwasachieved,theauthornoticedseverallimitationsofthestudythatcouldhaveaffectedtheresults.

ThemainlimitationistheinsufficientnumberofsimilarstudiesintheCzechRepublic.Researchstudiesonthisissueina similarenvironmentthattheauthorcompareshaveonlybeencarriedoutinthedetoxicationwardinOlomouc.

AnotherlimitationconsideredbytheauthoristhetimeofDIinthedetoxicationward.DIswerecarriedoutbetween4and5.30pm.Duringthistimeofthedaythepatientsaretired,oftenhungrybeforetheirdinner,andtheirmoodsvarydepending


onthepreviousprogramme.ThetimeofDIhasnotbeenchangedsofar.Thedetoxi-cationwardhasa strictdailyregimen.

Anotherlimitationmightbea negativeatmosphereinthegroup.Internalcon-flicts.Someoftheparticipantsmighthavebeenaffectedbytheproblemsofotherpatients.Oneresearchparticipantwassadbecausethemotherofoneofthepatientshaddied.Theparticipantsneednothaveconcentratedonthetechniqueduringtheimplementationoftheresearch.

Theresultsmighthavealsobeenaffectedbythemethodofobservation.Theau-thorsledDIpersonallyandwrotedownthefindingsaftercompletionofDI.

Lastbutnotleast,itisimportanttotakeintoconsiderationthattheresearchwascarriedoutonlyina singledetoxicationwardinOlomouc.Theresearchteambelievethatthisisa considerablelimitation.Theauthorswouldbeverymuchinterestedinpatients’reactionsinotherdetoxicationwardsintheCzechRepublic.

6.2 Practical recommendations

Duringtheimplementationoftheresearchtheauthorsthoughtaboutpossiblewaysofusingtheresultsina practicalenvironment.Thisprimarilyrelatestopracticalfindings.

Theresearchparticipantsappreciatedthecombinationofmovementtechniquesandquiettechniques(inthesittingposition).Theresearchteamrecommendthatvariousdramatherapytechniquesshouldbeused.

Dramatherapyusesvarioustypesofcards.Usuallytheyaresymboloncards.TheauthorpreferstheDixitboardgamecards,whichprovedtobea suitabletoolforuseindramatherapyinterventions.Theyrepresentobjectsintowhichpatientscaneasilyprojecttheircurrentstateandtheirownthoughts.Theauthorsrecommendthesecardsasa possiblemeansofdramatherapy.

Theclientsina detoxicationwardarediverse.Mostlytheyareolderpersonswithvariousdiagnoses.Thesepersonsneednotnecessarilyknowtermssuchas‘metaphor’.Theauthorsbelievethateachtherapistshouldtakethesedetailsintoaccount.

Inadditiontounknownterms,theclientsoftenaskedwhatthetechniquewasgoodforandwhatitsaimwas.Thetherapistshouldalsobereadyforthesetypesofquestions.Thepatientsareinterestedinthetechniquesbutsometimesdo notseethesenseofplayfulactivities.

Theauthorsalsobelievethatthepatientsshouldbeofferednotonlyartisticmeth-odsofexpressingtheirthoughtsandfeelings,butalsowriting.Forsomedrawingmaybestressful,whichmighthavea negativeeffectonotheractivities.Theresearchparticipantsappreciatedvariouspossibilitiesofexpression.

A positiveaspectwasthethematiclinkbetweenwarm-upandthemaintechnique.Inthisway,thepatientswerepreparedforthemaintechnique.Thiswasa commonthreadofDI.


7 ConclusionTheauthorstestedtheeffectivenessofselectedtechniqueswithpersonsaddictedtoalcoholandmethamphetamine.Theresearchteamconcludedthatthesetechniqueswereapplicableina detoxicationward.Itishoweverrecommendedtorevisethewarm-uptechniquesthatprecedethemaintechnique.Theresearchsuggestedwhatthepatientsthoughtaboutdramatherapy.Dramatherapyisanimportantelementoftreatmentina detoxicationward,introducesnewapproaches,groupdynamics,entertainment,andreleasestensioninthegroup.Themaindatacollectionmethodsincludedtheinterview,observationandanadditionalmethodusingtheparticipants’diary.Thiswasthebasisofthemethodologicaltriangulationapproach.Thedataachievedwereanalysedusingtheopencodingmethod,followedbyaxialcodingandsecondaryinterpretation.

Theauthorsbelievethatthepresentresearchstudyenrichesthetheoreticalback-groundoftheissue,improvesthepositionofdramatherapyinthehealthcaresectorandhighlightsthesignificanceofthisformoftherapyina detoxicationward.

TheauthorswouldliketothanktheCentreofsecondarypreventionandtreat-mentofaddictions,MilitaryHospitalOlomoucandtheirpatientsforgrantingtheirconsenttotheresearchstudyandtheirwillingnesstocooperate.

8 AcknowledgementsThepaperisdedicatedtotheGrantoftheDeanofFEPUinOlomouc2017entitledExpressive approaches within the competence of special education teachers aimed at persons with addiction in the context of a detoxication establishment – analysis and recommendations for special education theory and practice.

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zkoumání limitů životního stylu chronicky nemocných dle ošetřovatelských domén.PROFESEon--line.Vol.III,Issue3/2010,p. 151–164.

[4] Jennings,S.(1994).The handbook of Dramatherapy. London,NewYork:Routledge.[5] Majzlanová,K.(2004).Dramatoterapia v liečebnej pedagogike.2nded.Bratislava:Iris.[6] Miovský,M.(2006).Kvalitativní přístup a metody v psychologickém výzkumu.1sted.Praha.Grada

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[8] Polínek,M.(2015).Expresivní (kreativní) práce s metaforou v gestalt terapii. InProceedingsSpo-lečnýprostor/Commonspace2015.Olomouc: PalackýUniversity.pp.167–184.

[9] Švaříček,R.Šeďová,K.(2014).Kvalitativní výzkum v pedagogických vědách.2nded.Praha.Portál[10] Tomanová,M.(2003).Setkání mezi ploty. O šesti letech práce pracovního terapeuta v psychiatrické

léčebně na gerontopsychiatrickém odd. [Online].Retrievedfrom:<http://www.pvsps.cz/data/do-cument/20100505/ppf-zp-tomanova.pdf?id=270>

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dividuální, rodinné a skupinové terapii.Praha:Portál.Spektrum(Portál).

(reviewedtwice)Mgr. KristýnaKrahulcová,Ph.D.InstituteofSpecialEducationStudiesFacultyofEducation,PalackýUniversityinOlomoucŽižkovonám.5771 40OlomoucCzechRepublice-mail:[email protected]

Mgr. BohdanaŠtěpánováInstituteofSpecialEducationStudiesFacultyofEducation,PalackýUniversityinOlomoucŽižkovonám.5771 40OlomoucCzechRepublice-mail:[email protected]


Personality centered approach to education of children with emotional and behavioral disorders: intervention through the eyes of educational professionals from residential educational facilities

Karel Červenka

Abstract: This paper explores the role of personality-centered approach to education (Helus, 2009) in the intervention in children with emotional and behavioral disorders (EBD). Selected findings of the author’s qualitative research, the participants of which were educators from residential educational facilities, are also presented in the text. The author compares research findings concerning the so-called personality-holistic approach of educational professionals to these children with the personality centered approach to education defined by Helus. The research focused on their professional experience and their opinions regarding children with EBD. Keywords: Emotional and behavioral disorders; special needs education; children with EBD; child centered approach; intervention; educational needs.

1 IntroductionTheaimofthispaperistofindananswertothequestionofwhatrolecanpersonal-itycenteredapproachtoeducationplayininterventioninchildrenwithemotionalandbehavioraldisorders.

OurmainstartingpointswillbetheHelus’(2004,2009)definitionofpersonal-itycenteredapproachandselectedfindingsfromqualitativeresearch,whichshowpersonalityfocusedtendenciesinapproachesofeducationalprofessionalsfromedu-cationalfacilities.Thistextthereforefollowslooselytheconclusionsoftheresearchmonograph(Červenka,2016)inwhichthesefindingswereanalyzedandwherethespecificconceptofinterventioninchildrenwithemotionalandbehavioraldisorders(hereinafterreferredtoas«EBD»)describedintheinterviewsbyparticipants.


Helus’(2004,2009)bookChild in Personality Centered Approach1 isfarfromad-dressingtheissueofeducatingchildrenwithEBD.Onthecontrary,itisa generaleducationalbookorientedoneducationofallchildren.StudentsofspecialneedseducationfocusingonchildrenwithEBDtowhomwegivetheHelus’booktostudykeepaskingwhatistheuseorinspirationofhisbookintheirfield.

Theanswercanbeverysimple:simplybecausethey are primarily childrenwhosebehavioraldisordershinderproperdevelopment. Butevensucha simpleanswerdeservesa broaderexplanation,towhichthefollowingtextisdevoted.

2 Aim of children education and personality centered approach to education

Helus’(2004,2009)personalitycenteredapproachtoeducationappliestoall chil-dren.IfwewishtoapplythisconcepttothesituationofchildrenwithEBD,itisnecessarytofindareasofsharedinterestbetweentheapproachesofgeneraleduca-tionandspecialeducation.Thecommongoalisundoubtedlythegoalofeducation:maximizingtheindividual’sdevelopmentpotential.However,therearedifferencesin the means used.

AccordingtotheSalamancadeclaration,educationistherightofeverychild.Similarly,itistheirrighttohave“theopportunitytoachieveandmaintainanac-ceptableleveloflearning”.Thestatementalsotakesintoaccountthat“everychildhasuniquecharacteristics,interests,abilitiesandlearningneeds”andthateducationsystemsandprogramsshouldallowfor“thewidediversityofthesecharacteristicsandneeds”(UNESCO,1994).

Thewide diversity of the characteristics and needs ofthechilddoesnotnecessarilyincludeonlythecharacteristicstypicallyassociatedwithchildhood(e.g.theidentitycrisis in adolescents2).Itmayalsoincludespecialcharacteristicsrelatedtoemotionalandbehavioraldisorders(e.g.fixedbehavioralpatterns,disturbedrelationshipswithpeersandteachers)3.Thesecharacteristicscarryspecificeducationalneedswiththem.

Thenotionofeducationmayrelatenotonlyto“knowledgeandlearning”,butalsoto“acquiringsocialandotherskills,spiritual,moralandaestheticvaluesanddesirablerelationshipstootherpeopleandtosocietyasa whole,toemotionalandotherdevelopment[…]”.Thus,educationfocusesonboththepersonallevelofde-velopmentandintegrationoftheindividualintosociety(Bílákniha,2001,p. 14-15).Understandingeducationas“justteachingknowledgeandlisteningtoorders”isanoversimplification:“Theteacherunderstandssocializationissuesandprovides

1 Therearetwoeditionsofthesamebook,thelatterhasbeenextendedandreworked.2 Cf. Erikson(1999).3 Cf. Bower(1981).


educationasa comprehensiveintegrationintosocietyandapplicationtoit.”(Helus,2015,p. 107)

Themeanstothisendshouldinclude,interalia,“ensuringa fairaccesstoeduca-tionalopportunities”inthesenseoffreechoiceofpathandinstitutionstoeducation,and“thecreationofadequateeducationalopportunitiesandformsforallbytheircapabilities,requirementsandneeds”(Bílákniha,2001,p. 17).Generaleducationandspecialneedseducationoftendifferinthewaysandmeansofensuringthisequitableapproach.EducationofchildrenwithEBDinwhich“thereissegregation(exclusionofanindividualfromhisorhernaturalsocialenvironmentandplacementina schoolfacilityforinstitutionalorprotectiveeducation4)usinganintervention”wouldbeanexample.Inotherspecialneedseducationdisciplines,interventionisdirectedprimarilyatmainstreamschools.(Vojtová,2008,p. 20)

Thepersonalitycenteredapproachisoneofthepathstotheeducationalgoal.ZdeněkHelusunderstandstheconceptofpersonalitycenteredapproachasanap-proachthattreatsthechild“asa personalityinitsemergenceanddevelopment”,whilethe“tendencytodevelopasa personality”isunderstoodasnaturalandessentialtoeverychild(Helus,2009,p. 259).

Advocatesofthepersonalitycenteredapproachunderstandthatallchildrenhavea tendencytodevelop;towardseverhigherstagesofdevelopment;tointegrateintointerpersonalrelationshipsandtobe(invariousways)inmutualtrustwithotherpeople;tobecomea manora woman;torealizeandupdatetheirpotentials;toshapetheirself-conceptandtoexpresstheiridentity;tohavecontrolovertheirlives,tobewhotheywanttobeandtoachievethegoalsthatgivetheirlifepurposeandbringthemjoy(Helus,2009,p. 259–260).

Inadditiontoenumeratingthechildren’sdevelopmentaltendencies,Helus(2009,p. 108)listsfourpersonalityqualitiesthatarespecifictothechildandrefertowhatis“animportantinternalprerequisitefora child’spersonaldevelopment”:a)open-mindedexperiencing(accompaniedbytheriskofvulnerability);b)reliance(ac-companiedbytheriskofdisappointmentinothers);c)developmentaldirection(accompaniedbytheriskofdeformation),andd)a wealthofdevelopmentoppor-tunities(accompaniedbythedangerofthemgettingwasted).

Withtheseprerequisitesofpersonaldevelopment“thechildturnstotheeducator”andtheeducatorsbasetheireducationalactivitiesonthem(Helus,2009,p. 123).This,however,requires“aneducatorwhounderstandsthistendency,takesitseriously,helpsitina properway,andprovidessupportandcounseling”–suchaneducatorappliesa personalitycenteredapproachtothechild(Helus,2009,p. 259-260).The

4 Itmayalsobeanotherfacility(notonlyfortheexerciseofinstitutionalorprotectiveeducation)–forexample,a centerforcounselingcare,whichisa preventiveeducationalfacility,anda two-monthstayinitsboardingdepartmentisbasedlargelyonformalvolunteeringofthechild.(seeZákon109/2002Sb.)


roleoftheeducatorliesinhelpingthechildtousehis/herpotentialtogrowtoadult-hood(Helus,2004,p.80).AsI willshowlater,similarattitudinaltendenciestowardsEBDchildrendo existamongeducators.

Thechildshouldbeapproachedwiththeawarenessoftheimportanceofthedevelopmentaspect.Thisishowweconcentratemoreonhowpersonal“qualitiesoriginateandevolve–whethertheyareinhibitedordeformedintheiroriginanddevelopment.”Fromthisperspective,“thechildisa personalityinthedynamismofitsconstitution(origin)”(Helus2004,p.86).

3 Emotional and behavioral disorders as a barrier in the child’s life path

Theissueofemotionalandbehavioraldisordersisprimarilyaddressedintermsofitsmanifestations(aggressivebehavior,conflicts,etc.),whichareperceivedasa negativedeviationfromsocial,age-relatedandothernorms(cf.Pokorná,1993).Commontrendsinapproachesto“problem”behaviorarewelldocumentedbythestatementthat“teachersoftenrespondtobehaviorratherthantheneedthechildexpressesintheirbehavior,whichmayleadtodeteriorationincaseofproblematicmanifesta-tions”(Ayers,Clarke&Murray,2000,p. 63).TheseapproachestoEBDhelpinbasicorientationinthesituation.However,inisolatedformtheydo notsaymuchaboutthechild’seducationalneeds(cf.Vojtová,2008),andtheydo notevenfocusourat-tentionontheseneeds.However,fromthepointofviewoftheeducationaleffectonthechild,itisnotenoughtobaseone’sresponseonlyonthephenomenalaspectoftheissue,fromthedescriptionalone.

Thisiswhyweunderstandemotionalandbehavioraldisordersasa specificbarriertothechild’slifepath(seeVojtová,2010;Kaufman&Landrum,2013)–asa factorthat inhibitsorevendeforms developmentofthepersonalityqualitiesofthechild.

ThisapproachtoEBDistakenintoaccount,forexample,inthedefinitionofemotionalandbehavioraldisordersoftheAmericanNationalMentalHealthandSpecialEducationCoalition(1992),which,inadditiontonormativecomparisonofthechild’smanifestations(differences)withexternalstandards,takesintoaccountthedimensionofa perspective,i.e.theconsequencesofthesituationforthechild’slifecareer:(i) Theterm“emotionalorbehavioraldisorder”meansa disabilitycharacterizedby

behavioraloremotionalresponsesinschoolsodifferentfromappropriateage,cultural,orethnicnormsthattheyadverselyaffecteducationalperformance.Theeducationalperformanceincludesacademic,social,vocational,andpersonalskills.Sucha disability


(A) ismorethana temporary,expectedresponsetostressfuleventsintheenviron-ment.

(B) isconsistentlyexhibitedintwodifferentsettings,atleastoneofwhichisschool-related; and

(C) isunresponsivetodirectinterventioningeneraleducationorthechild’sconditionissuchthatgeneraleducationinterventionswouldbeinsufficient.

(ii) Emotionalandbehavioraldisorderscanco-existwithotherdisabilities.(iii) Thiscategorymayincludechildrenoryouthwithschizophrenicdisorders,af-

fectivedisorders,anxietydisorders,orothersustaineddisordersofconductoradjustmentwhentheyadverselyaffecteducationalperformanceinaccordancewithsection(i).Fora deeperunderstandingofthesituationofa childwithemotionalandbehav-

ioraldisorders,wewilluseGoffman’s(1986)theoryofstigmatization.Theauthorseesitasa specialsocialprocessthatcanleadtotheexclusionofa stigmatizedpersonfrom full social acceptance.Inthiscase,thestigmatizedpersonis“reducedinourmindsfroma wholeanda normalpersontoa tainted,discountedone”(Goffman1986,p. 3).Thishasrealconsequences:forexample,peoplearelessfriendlytowardsthestigmatizedperson,reluctanttohelp,or,intheextremecase,theyseektophysi-callydestroyhim/her5.

A typicalreactiontoa stigmatizedpersonisdiscrediting,butGoffman(1986)pointstoothertypesofreactions.Oneofthemmaybethereactionofthe wise,whichhedividesintotwobasicgroups:1)personswhoarerelatedtothestigmatizedpersonthroughsocialstructures(relatives,friends);and2)personswhocomeintocontactwiththestigmatizedprofessionally(Goffman,1986).Reactionstothestigmatizedcanbeinterpretedasunderstandingorsupporting(Červenka,2013).

The wiseprofessionalsarekeytothispaper,because,forexample,educationalprofessionalsfromeducationalfacilities(specialeducators,educators)canplaysucha role.TheirprofessionalpositionandexperienceisanopportunitytogetacquaintedwiththesituationofEBDchildrenandtoadopta personalitycenteredapproachtotheinterventionprocess.Theiractionsmayprovidea counterbalancetodepersonal-izingeffects6thatemotionalandbehavioraldisordersbringtothechild.

5 Cf.Z.Bauman(2003)writingaboutholocaustthiscontext.6 Helus(2004,pp.153–158)presentsseveraldepersonalizing attitudes towards the child:a)the

childasa material,anobjectofmanipulation;b)thechildasa threat,a burden;c)thechildasa compensationforowneducationaldeficiencies;andd)beingblindedbythechild–protectionistreductionism.Inthecontextofemotionalandbehavioraldisorders,itisessentialtoemphasizethesecondofthedepersonalizingattitudes–thechildasa threatandburden.


4 MethodologyQualitativeresearch,thefindingsofwhichI relyuponinthispaper,wasfocusedontheexperienceofeducationalprofessionalsfromresidentialeducationalfacilitiesandtheirapproachtochildrenwithEBD.Theresearchwasconductedin2012-2015.TheprocessofinterventioninchildrenwithEBDconstitutedmyframeworkofinterest.

Themainthematicareaswererepresentedbythefollowingquestions:a)Whatimportancedo theeducationalprofessionalsattributetotheirrelationshipswiththechildrenwithwhomtheywork?b)Whataretheessentialcircumstancesoftheinterventionrelationship(sources,barriers)?c)WhateducationalneedsofchildrenwithEBDareconsideredbyeducationprofessionalstobeessential?

Inviewoftheresearchobjectives,a qualitativemethodwaschosenandthedomi-nanttechniqueofcollectingdatamaterialwasa deepsemi-structuredinterviewwitha totalof15participants–educationalprofessionals.Inordertoaddresstheethicaldimensionoftheresearch,informedconsentwasrequiredbeforetheinterviews.Participantswereselectedthrougha deliberateselection,itsmaincriteriaincludeddiversityoftheirprofessionalexperience.Thechoicetookintoaccountthecriterionof“generalizabilityofcasestotheoreticalassertionsratherthantopopulationsoruniverses”(BrymanbySilverman,2005,p. 118).Diversityofthedatawasensuredbythevarietyoffacilitiesinwhichtheparticipantswereactive(facilitiesforinstitutionalorprotectiveeducation:diagnosticinstitutions,children’shomeswithschools,edu-cationalinstitutions,counselingcarecenters).Inaddition,thisvarietywasensuredbya varietyofprofessionalpositionsandroles(facilitymanagers,specialeducationteachers–ethopedists,teachers,educators).Inadditiontotheinterviewtechnique,thedatawascollectedthroughthreepre-researchgroupinterviewsandfieldnotes.

Thecollecteddatamaterialwasanalyzedonanongoingbasisfromthepositionofanethnographicapproach(cf.withEmerson,FretzandShaw,1995)andwasconductedattwolevels–atthelevelofopen coding and focused coding. Mostofthetopicsandfindingsthatemergedfromtheanalysiswerepublishedintworesearchmonographs(Červenka,2014,2016).

5 Personality-holistic approach of educational professionalsI formulatedtheconceptofpersonality-holistic approach7whileanalyzingthedata(seeČervenka2016),whenI noticedinmanyparticipants’(educationalprofession-

7 Usingthisveryconceptratherthananestablishedconcept(personcenteredapproach–Rogers,thepersonalitydevelopingeducation–Jedlička)wasanefforttoemphasizethatI refertothetendencytowardsa certaininterventionalconceptthatwerecapturedinqualitativeresearchandwhichmaynotexactlycorrespondtovariousestablishedtheoreticalconcepts.Thenotionofpersonality-holisticapproachshouldalsounderlinethoseofitsfeaturesthatcanbecounter-balancedbytheeffectsofstigmatizationandlabeling,orbea counterbalancetothetendency


als)testimoniestheirattitudestowardschildrenaspersons who have problems rather than problem person.Itwasa manifestationoftheapproachthatwecouldrefertoasa holistic view of the personality.

Theseattitudesdidnotappeartobeofexplicitnatureinthedatamaterial.Similarly,thepersonality-holisticapproachcannotbeconsideredasanapproachinthetruesenseoftheword,butratherasattitudesorattitudinaltendencies,whichweretoa largeextentcommontomanyresearchparticipants.Theresearchfindingsarenotgeneralizablefortheentirepopulationofeducationalprofessionalsfromresi-dentialeducationalfacilities.Theyshow,however,thattheseattitudestendtooccurandthattheyattributedimportancetothemintheinterventionprocess(Červenka, 2016).

I shallbeginwithtwoexcerptsfrominterviewsinwhichtheparticipantsex-pressedtheirattitudebeyondthenarrowviewofchildrenbeingperceivedonlythroughtheirproblem:

Oneparticipant(P7)characterizedchildrenwithEBDasfollows:“they are not any different, it is just that they had a little different … they had a different regimen, different rules... They need to be treated a little differently...”(P7).Similarly,anotherparticipant(P6)characterizedthechildrenwithwhomsheworks(i.e.childrenwithEBD)asfollows:“What kind of children do we have here? Well, I’d rather say we have kids here. [...] They are not inmates to me, they are just children. To me, they’re like everybody else. .. I think they’re not much different from ordinary children. .. It’s just kids undergoing puberty.”(P6)

OneofthekeytopicsthatemergedfromtheanalysisofthedatamaterialwastherelationshipandtheroleitmayplayintheinterventionprocessinchildrenwithEBD.Forexample,theroleofa relationshipasaninstrumentandprerequisitefora successfulinterventionliesinpersonalrelationshipsbetweenteachersandchildren.Therelationshipsmustbefrequent,long-lasting,andoftenintense(“It is almost like we live here with the kids.”P6),whileexperiencesfromstressfulsituationsareoftenshared.Theserelationshipsareopportunitiesfortheeducatorstogetacquaintedwiththechildindifferentcontexts,withthechild’ssituationandperspective.Thisisinitselfanopportunityforeducatorstobecomethe wise(cf.Goffman,1986)andtoapproachthechildasa personalitywitha varietyofcharacteristics,includingthoseassociatedwith“problem”behavior(“They are little rascals, but we are still quite fond of them.”8).(Červenka,2016)

Thetendencytopersonalitycenteredapproachwasalsoapparentfromthepartner-likeandchild-respectingapproach,whichwasillustratedina statementby

toreducethepersonalityofa childwithEBDtothoseattributesassociatedwiththe“problem”.(Červenka,2016)

8 Thisisa reconstructionofthesentenceusedduringaninformalinterviewthatconcernededuca-tionofchildrenwithADHD.


participantP2a,whenheperceivedthefollowingsituationasa success:«when the child becomes our client”,definingasa clienta person“who actively enters into [in-tervention, counseling ] relationship”.

ParticipantP12spokeaboutrelationship,theessenceofwhichhedefinedasa partnership,notbetween aneducationalprofessionalanda client,butratherbe-tween human beings.Healsodescribedthisformofrelationshipexplicitlyasa needofchildrenwithEBD:“… although we do not really allow the children to call us by our first names, we actually do have that kind of relationship.[...]...that there is no institutional barrier, what I represent, I am simply a human being. Yes, I think this is what they need a lot. Being accepted perhaps as a partner, as an adult to adult, because I’m there for them, rather than they for me.”(P12)

ThestatementsoftheparticipantsthatI interpretedasa tendencytowardsa per-sonality-holisticapproach,suggestedtheexistenceofaninformal,althoughnotclearlyarticulated,sharednorm,whichI termedimperative to respect the child and help him/her(Červenka,2014).

6 Personality centered approach to education through the eyes of educational professionals

NowI willinterpretexcerptsfromresearchinterviewsthroughtheopticsoffourpre-requisitesforthepersonalitydevelopmentofthechild(open-mindedexperiencing,reliance,developmentaldirection,wealthofdevelopmentalpossibilities)asdefinedbyHelus(2009).Withtheirhelp(Červenka,2016)I describedthebasicparametersoftheaforementionedpersonalityandholisticapproach.9

6.1.Open-minded experiencing

Open-mindedexperiencingis“linkedtothedesiretohavesomethingcommonwithotherpeople,tobeinterested,toexplore,toaskandanswer,tolookforwardtowhatcomes,tolearnnewthingsandtoshowit”while“thedispositionofthechildtoopen-minded experiencingisessentialandtheprioritytaskinearlycareistobringabout,empowerandexploitedthisopen-mindedexperiencing”.Thechildshouldexperiencekindness,beauty,truth,orderandhumaninteractions(Helus,2009,p. 108).

Althoughthechildtendstowardsopen-mindedexperiencing, circumstances that willpresentobstaclesmayoccur.Anexamplemaybefloodingthechildwith“per-ceptionsandexperiencesthathe/shecannotprocesspsychologically.”(Helus,2009,

9 WeshouldkeepinmindthatthefourassumptionsformulatedbyHelus(2009)havecharacter-isticsofanalyticalcategoriesthatdo notexistinthereality,atleastnotinsuchanideal,pureform,butarerathermixedandintertwinedindifferentways.Similarly,theneedsofthechildwillinterweave,aseachofthemcanalsorespondtomultipledevelopmentalprerequisites.


p. 108-109).Thereisanapparentoverlaptothefieldofemotionalandbehavioraldisorders here.

Ifsomethingpreventsthechildfromexperiencingopen-mindedness,he/sheshouldhavecloserelativeswhohe/shetrustsunreservedly,providinghim/herwithprotectionandsupportandpreventinghis/hertraumatization(Helus,2009,p. 108-109).

Letussummarizetheabovebyaskingwhatneedsofthechildcanbeassociatedwiththeprerequisiteofopen-mindedexperiencing?Whatneeds to be doneifthenaturaltendencyofthechildtoanopenexperiencingisblocked?Whatdoesthechildneedforanopen-mindedexperiencing?

FromhowHelus(2009)definestheassumptionofopen-mindedexperiencing,wecandeduceforexamplethefollowingneeds:theneedfora secureandtrustworthyspace;theexperienceofgoodness;theneedtohavea senseofbelongingwithothers,toexperiencesocialacceptanceandthefeelingofbeingimportanttoothers,etc.

Foropen-mindedexperiencing,thechildneedsa secure and trustworthy space and unreserved trust(atleastinsome)otherpeople,itneedsto experience interest of another person in him/her.

A commontopicintheinterviewswastrustinthelivesofchildrenwithEBD,especiallywhenthechildlosttrustinotherpeopleaftera badexperienceofdisap-pointment.Theparticipantsthenspokeoftheneed to restore the child’s trust in other peopleand,sincetrustinothersislinkedwithself-confidence,toteachthechildtotrustothersandself.A relationshipbetweentheteacherandthechildbuiltontrustcanbea meanstorestorethetrustofthechildinothers:“...that the child will start perceiving, experiencing, believing and trusting that the care he/she receives can be fair.”(P8a)

Trustwasalsoseenbytheparticipantsasa prerequisitefortheinterventionrela-tionshipbetweentheteacherandthechildandtheopencommunicationinit:

“The trust allows me to play a clean game, so to speak. [...].. . we really can be straightforward with each other.[...] I believe it is essential in life, because as long as I trust myself, I trust others.” (P12)

Theparticipantsspokeofopportunitiesthattheyprovidetothechildrento let them express their emotions safely: “As soon as they engage in the life of the facility where they form relationships with the teachers and the wardens, and vice versa, this is when they start receiving emotional support, too.”(P4)

ParticipantP6consideredemotionalneedsanddescribedtheopportunitiesforthechildtoexpresstheiremotionsintherelationshipbetweentheteacherandthechild:“Many children [...] are emotionally deprived [...] Some kids come back from school and want to be fondled. [...] Some bigger kids come to shake hands. [...] Some just need to talk. Some nod to greet us. [...] This is what they miss. And what they need.


[...] Every child has someone, be it a teacher, a warden, no matter who, assistant teacher, who is a little closer to them.” (P6)

Toexperiencethedesiretohave something in common with other people, the child needstofeelpartofthecommunity,whichreferstotheneedforexperiencedsolidar-ity,theyneedanopportunitytofeelbeinga memberofthecommunity,toreceivesocialacceptance(incontrasttotheeffectsofstigmatization)andtheexperienceofpositiveself-perceptioninrelationships(cf.Vojtová,2010)10,whichiscloselyrelatedtotheinterestshownbyothersinthechild.

ParticipantP6hasspokenaboutaccepting the child for who he/she is:“I am interested in you and … I am not condemning you.”(P6)ParticipantP1stressedtheneed to be sensible and empathetic towards the childintheinterview:“It requires huge attention, huge empathy, to make the little person trust you. ..”(P1)

Helus(2009,p. 109)writesaboutthefiveexperiences(goodness,beauty,truth,order,human-to-humaninteractions)thatthechildneedstobeprovided.Forexam-ple, the need to experience goodnessthroughtheimportanceofa gooddeedshouldstrengthenthechild,“nomatterwhathappens”(ibid.)

Inthiscontext,itisworthmentioningtwoconceptsthatexplicitlyappearedintheinterviews:“a trace of a good man”and“a positive flash of light”.

ThefirstonewasusedbytheparticipantP3inconsideringtheeffectivenessandvisibilityoftheresultsofinterventionsinchildrenwithEBD:“… if we give it to the child … just that life can be different, [...] only a trace of a good person, just a trace of someone respecting them that exists in this world.”(P3)

TheotherconceptappearedinthestatementoftheparticipantP2a:“You know, we are still using such a starting point – that there was some kind of a positive flash … of them meeting people and being in an environment where they feel good. And we think that children can carry it on in their lives going forward.”(P2a)

6.2 Reliance

Inthepositivesenseoftheword,relianceis“basedontheabilityofa childtocommittoanotherperson,torely,totrust.”Theotherpersondoesnotabuse“thechild’sreli-ance,butonthecontrary,meetsithalfway,lovingly.”Thechildthenhasthechancetodraw“stimuliandstrengthtodeveloppersonally”fromtheotherperson(Helus,2009,p. 110).

Reliancelosesitspositivemeaningwhenthechildlosesitsrespecttoandtrustintheotherperson,andwhendisappointmentsetsin.Forthechild’sreliance,therisk

10 VěraVojtová(2010)focusesonseveraldimensionsofschoollifeinherquestionnaire,aimedatpreventingproblemstudent’sbehavior.Oneofthesedimensionsisthestudent’spositioninschool(schoolstatus)andtheassociatedissueofself-perceptionofthechildinrelationships,whichisanimportantfactorfortheresiliencetoordevelopmentoftheproblembehaviorofthestudent.


ofdisappointmentinothersisoneofthe“seriouslifelossesofchildhoodandyouth,withserious,lastingconsequences”.(ibid.p. 108-110)

Theassumptionofreliancerelatestoissuesofrelationship,trustandsafety,butalsototheneedtofeelsolidaritywithothersandfromothers,theneedtorelyonsomeone,withwhichtrustinothersiscloselyrelatedto,sothatthechildcanrelyonthem(seetheresting in trust above).Here,theareaofopenexperiencingmingleswiththeareaofreliance–theparticipants’actionscanofteninfluenceboth.

Moreimportantly,thereisa needtobe able to draw from the personality of the other person,whichaffectstheresearchtopicoftherelationshipbetweenthechildandtheteacherasa meansofintervention.ThistopicwasmentionedbytheparticipantP2a:“The only educational … and effective educational method is the personality of the educator. [...] And we need [...] to convince them that the person, the educator or the personality they met with, somehow addressed them, enriched them, has given them some impulse to their future life.”(P2a)

ParticipantP12consideredmutualreliancewiththechild(theabilityoftheteachertorevealhis/herownvulnerability)asa waytoshowthechildhis/hergoodintentionsandofferthechildanopportunityforopencommunication.Atthesametime,thisattitudepointstotheteacher’sdesiretodefinetherelationshipasa partner,andthewillingnessto riskreferstotheteacher’ssenseofprofessionalresponsibility:“... that you believe [the child-client] and he can hurt you … but on the other hand, I let him hurt me rather than his parents later. Let him try it, see what it results in in this institution, when I can teach him, because I’m less emotionally involved, rather than letting him do it, with all consequences, in the world outside. Yeah, if he needs to go through it, it better … happen in this environment.” (P12)

6.3 Developmental direction

Thechild’sdemandsdirection,whichisevidentinthefactthat“italwayswantssomething,strivesforsomething,evolves,goessomewherewithhiswholelife”,andwhichis“a basisof[...]everything.”Theyheadtowardsadolescenceandadulthood–towardsbiological,psychologicalandsocialmaturity;toself-conceptandauthenticself-expression;toindependence–lookingforwaystocopewithrelianceandhowtogetridofit,theylearntotakeresponsibilityandtoliveanautonomouslife(self-discipline,education)(Helus,2009,p. 112).

Fromtheabove,variousneedscanbededuced,suchastheneedtohavetheop-portunitytolearnautonomy,todevelopautonomy,independenceandaccountability.

Forexample,theparticipantP8aspokeofthefactthatthepersonalityandexperi-enceofthechildareatthecenteroftheinterventionprocessandthedevelopmentofthechildisperceivedasa success:“For me, the first priority is how they feel here[...]for me, the success is that the child begins to experience, to perceive and begins to appreciate self.[...]To me, the stage when the child begins to flourish, become


self-confident and listen and work on self-development, is the significant phase, a priority.”(P8a)

ImplicittargetingfordevelopmenthasalsobeenmentionedbytheparticipantP3whenshetalkedabouttryingtotoughen up the child,insteadoftryingtoadaptthechildtohisenvironment,breakthem:“And we do not want to break anyone at this age, right? These are immature children. [...] We want to toughen them up. And we can only toughen them up positively.” (P3)

6.4 Wealth of development opportunities

Thewealthofthechild’spotentialitiesmeansthefollowingpersonalityqualities:“tobehappy;tofeeltheloveandsympathyofothersandtorespondtothemwithownmanifestationsofaffectionandsympathy;toemancipateoneselffromthenarrowedviewofthingsandtotrytoseewideranddeeperconnections;tomakeanefforttocultivateone’sownself-esteemandtobeoneselfina noblerway;toacceptthechal-lengesofopenfutureandtopursueone’sgoals;totakeresponsibilityandtocopewithdifficulties.”(Helus,2009,p. 113)

Intermsofthewealthofthechild’spotentialtodevelop,thereisalwaysa riskofitbeingwasted(Helus,2009).Thisdevelopmentalpremiseisassociatedprimarilywiththeneedofthechildtohaveanopenperspectiveofthefutureanda qualityoflifeinadulthood(cf.Vojtová,2008).ManychildrenwithEBDarenottryingtochangetheirlifesituation,althoughtheywouldwantit(thewill to change)becausetheyhavenoideaofanopenfutureanddo notbelieveinchange(belief in change)(Červenka,2017).

TheneedforopenperspectiveswasoneoftheresultingtopicsoftheresearchI referencedhere.Inadditiontotheneedfor(positive)settingofboundaries,theneedforopenperspectivesandidentitieswasidentifiedinthedatamaterialasa needthattheparticipants–educationprofessionals–perceivedasessential.Theneedtosetboundariesandopenupperspectivesisrelatedtotheneedtohavea rolemodel.Itcanbetherolemodelwhogivesthechilda conceptionofboundaries(whatshouldorshouldnotbedone)andalsosuggeststhedirectionforthefuture(Červenka,2016).

Anexampleofthinkingaboutfutureperspectivesisa snippetofaninterviewwiththeparticipantP6whospokeaboutmakinga cleanbreak,turningovera newleafasa waytohelpthechildoutofpastproblemsandasanopportunityfora newbeginning:“I will punish him and that’s the end of the story. [...] And I mean I do not just punish [...] we speak about it, we discuss it to take some lessons from it, but then we make a clean break and we start all over again. I cannot tell him in two months … something like: I do not want to talk to you, I don’t trust you because two months ago you disappointed me. Bang on about it and throw it back in his face, what was … and what actually is no more. Because our children have a lot of problems here and they would never get rid of them.”(P6)


7 ConclusionIntheveryconclusiontothispaper,weshouldanswertheintroductoryquestion–What can be the role of personality centered approach to children with emotional and behavioral disorders?

Theeducationalprocessreliesonthecharacteristicsofthechild,itderivesfromthemtheeducationalneedsofthechild,andtheeducatorplansthechild’seducationaccordingly.11Forexample,needssuchasopen-mindedexperiencing,emancipa-tiontoadulthood,opportunitytodeveloptowardsadulthoodorthefulfillmentofindividualpotentialsstemfromdevelopmentalcharacteristics(cognitive,emotional,social)(cf.Helus,2009).Inaddition,childrenwithEBDshouldalsotakeintoaccountthecharacteristicsassociatedwithbehavioraldisordersthatactasa barriertotheirpersonalitydevelopment(Vojtová&Červenka,2015).ThisisrelatedtothespecificeducationalneedsofthechildwhichtheeducatorshouldrespectandaimtofulfilintheinterventioninchildrenwithEBD.

Theconceptofthepersonalitycenteredapproachtoeducationisa beneficialstimulusnotonlyforthetheory,butalsoforthepracticeofeducatingchildrenwithEBD.Thisisanapproachthathighlightsfactorsessentialtothedevelopmentofthepersonalityofthechildandshowsthedirectionsgoingforward.Atthesametime,however,itpreventsus(notonlyspecial-education)educators(anditisessentialinthecontextofemotionalandbehavioraldisorders)fromforgettingthatchildrenwithemotionalandbehavioraldisordersaremainlychildren.Children,whosebehaviorisalsosubjecttoproblematicmanifestationswithcomplicatedconsequencesforthemandpeoplearoundthem.WhileHelus’conceptofpersonalitycenteredapproachputsthechildatthefocusofinterest,theindividualdevelopmentassumptionsarealwaysdefinedinthecontextofthechild’senvironment–thereforesomuchemphasisisputonsocialization,relationshipswithothers,theroleoftrustinothers,reciprocityandotherneeds.Perhapsthisisbecause,inmanycases,thesechildrenarenodifferentfromotherchildrenotherthantheyhavenotbeengivenopportunitiesandsupportforproperpersonalitydevelopmentintheirlives.

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(reviewedtwice)

Mgr. etMgr. KarelČervenka,PhD.DepartmentofSpecialandInclusiveEducationFacultyofEducation,MasarykUniversityPoříčí9630 00BrnoCzechRepublicemail:[email protected]


Movement and orthopedic problems based on postural instability in visually and hearing impaired people

(overview essay)

Kristína Tománková, Hana Majerová, Veronika Švecová, Vojtech Regec

Abstract: This article proposes a literature review about the movement and orthopedic problems based on postural instability in visually and hearing impaired people. Visually and hearing impaired people are a potentially weakened target group with regard to the genesis of various orthopedic problems as well as morphological and structural foot deformities. The foot has an important functional relation within the lower limb and body. The paper clarifies the causes, mechanism of development and results of these problems. The article is supplemented by personal statements of the impaired on the occurrences and manifestations of specific pathologies in their daily lives.

Keywords: visual impairment, hearing impairment, posture, stability, balance, foot

1 IntroductionPosturalstabilityistheactiveholdingofthebodysegmentagainsttheactionofex-ternalforcestomaintainanuprightposture(Winter,1995).Itisactivelymanagedandcontrolledbytheinternalforces,throughthecentralnervoussystem(Vařeka,2002).Posturecanbeaffectedbyvariousfactors.Theneurophysiologicaleffectsbe-longamongpsychologicalfactorsandeffectsoftheinternalenvironment(differentdiseases)(Véle,1995).Ageaffectsposturalstability;forexample,a studyshowsthatolderfootballers,aged25yearsandover,havea betterposturalcontrolcomparedtoyoungerfootballers,agedunder25years(Gosselin&Maltby,2011).Holdingthebalanceisachievedandmaintainedthrougha comprehensivesetofsensorimotorsystemcontrolthatincludessensoryinputfromtheeyes,proprioceptionandthevestibularapparatus.Thesethreesourcesofinformationtobesenttothebrainasa nerveimpulsefromspecialnerveendingsarecalledsensoryreceptors.Thebalanceistheabilitytomaintainthecenterofgravityofthebase.A properlyfunctioning


systemofbalanceallowspeopletodeterminetheorientationwithrespecttograv-ity,determinethedirectionandspeedofmovementandperformautomaticsetuppostureandstabilityindifferentactivitiesandunderdifferentconditions(Shumway-Cook&Woollacott,2001).Thefoothasanimportantfunctionalrelationwithinthelowerlimbandbody.Itconstitutesanimportantsuppositionformaintainingthebalancewhilestanding,walkingandinotherderivedmovements(Votava,2002).Thefunctionofthefootisstatic(bearing)anddynamic.Thefootisillustratedasa “trippedmodel”,whenthehealthyfootwithwell-developedarchesissupportedonlyin3points(calcanealprotuberance,1stmetatarsalheadand5thmetatarsalhead).A healthyfoothasa metatarsalheadwhenlaidonthematandcontributesroughlyequallytotransferbodyweight.Plantarscrolling(unwinding)inhealthyfeetisthetransferofthepressure(centerofpressure)throughthelateralbeam,fromthe5thmetatarsalheadtowardthe1stmetatarsalhead(Riegerová,Přidalová,&Ulbrichová,2006).Theprimaryfunctionofthefootistocreatea solidbaseandanequaldistribu-tionofexcessiveburdensofthelowerlimbwhilewalking,andtoreducetheenergyintensityofwalkingwhilemovingthebodyforward(Gross,2002).Thefunctionofthefootisconditionedbyitsanatomicalstructure,whichiscontingentontheorganizationofthebonesintotwofootarches(longitudinalandtransverse).Longi-tudinalvaultiscontingentonthehighermedialarchwhichiscreatedbythreemedialbeamsconnectingtalus,ossacuneiformia,the1stto3rdmetatarsusandphalangesofthefirsttothirdtoes;itisemployedduringdynamicloading.Transversevaultisconditionedbytheshapeandorganizationofosacuneiformia(cuneiformbones)andproximalmetatarsals.Itsroleistoprovideprotectiontosoftstructuresinthesoleofthefootandpartiallyabsorbforcescreatedwhenbodyweightistransferred.Fromthephylogeneticpointofview,similarlytoverticalpater,thevaultisa youngstructure,andthereforelabileandrelativelyeasilyvulnerable.Itsdisordersbelongtothemostcommonorthopedicdefectsingeneral.Staticdefectsoftheforefoot(halluxvalgus,digitusquintusvarus,halluxvarus,halluxrigidus,digitimalei,digitihamate,digitiHippocratici)occurmostfrequently.Painoccursfrequentlyintheheelandinmetatarsals.Thetypicaldefectsofthefootvaultareflatlongitudinalvault(pesplanovalgus),transverseflatfoot(pestransversoplanus),andhollowfoot(pescavus;pesexcavatus)(Riegerová,Přidalová,&Ulbrichová,2006).Thestructureandfunctionofthefootareadjustedtoanappropriatedistributionofbodyweightwhilestandingandwhenmovingina gravitationalfield,theflexibilityandshockabsorp-tionduringmovement,aswellasa hugesourceofreceptorsnecessaryforthepropermanagementofpostureandmotorontheprincipleofcybernetics(theprincipleofbiological„locomotivecomputer“)(Müller,2011).Thecausesofstaticdeformitiesarelong-termanomalouspositionofthefoot,permanentlyappliedtension,pressureona certainpartofthefoot,ordisproportionbetweentheloadandtheresistanceofthebody(Matějovský,2002).Thefootisa shockabsorberandsensoryequipment.


Theweightofthebodyisbornemainlybytheinnerhalfofthefoot,whiletheouterhalfmaintainsstability(Riegerová,Přidalová,&Ulbrichová,2006).Balancedisordersoftenmanifestthemselvesasuncertaintywhenwalking.Uncertaintyisexpressedbya widestep,uncertainfeelingswhilewalking,rigidityandclumping.Thesymptomsareenhancedbyfingerparesthesia,sensorydisturbanceoflowerlimbs,andatacticmovementduetotheincreasedmuscletoneoflowerlimb(Mumenthaler,2008).

2 Visual impairment Visualimpairmenthasbeendescribedina varietyofcontexts,intheconceptsoffunctionalblindness,partialblindness,lowvision,andexpressionssuchasvisuallydefective,visuallyhandicapped,visuallyimpaired(visuallydisabled),orvisuallylimited.Inrecentdecades,thediversityofterminologicalexpressionshasreflecteda tendencytousethetermimpairment(FlorianandMcLaughlin,2013).Definitionsofvisualimpairmentmayvaryacrossagenciesandprograms.Somedefinitionsfocusonthemeasuresofacuity,whileothersfocusonmorefunctionaldescriptions(Ran-dalletal.,2000).Thereisnounifiedconsensusconcerningtheterminologyofvisualimpairment,itispracticallydefinedbytheexpertswhouseit(Sardegnaetal.,2002).

2.1 Categorization of visual impairments

WorldHealthOrganization(WHO)defines4levelsofvisualfunction,accordingtotheInternationalClassificationofDiseases–10:normalvision,moderatevisualimpairment,severevisualimpairmentandblindness.Butinfact,moderatevisualim-pairmentcombinedwithseverevisualimpairmentaregroupedundertheterm“lowvision”(WHO,2017).Thus,wecandefinethefollowingcategories:Normalvision:isdefinedasa decimalacuityequaltoorbetterthan1.0(Valberg,2008).Lowvision(moderatevisualimpairment,severevisualimpairment):Alberta(1998)specifieslowvisionasthevisualfunctioningofsomeoneforwhomeyeglasses,contactlenses,medicaltreatment,orsurgerycannotcorrectvisiontothenormalrange.Thepersonwithlowvisionmayexperiencemoretypesofvisionproblemsasoverallblurredvi-sion(diabeticretinopathy),lossofcentralorcentervision(maculardegeneration),lossofperipheralorsidevision(glaucoma,stroke).Blindness:referstototalblind-ness(inwhichthereisa totallossofvision),tonolightperception,ortoparticularvisuallimitations(Jones,2013).InadditiontotheclassificationofWHO,wementionthefollowingcategoriesusedinCzechandcentralEuropeanliterature:lowvision,partialsightedness,blindnessandbinocularvisionimpairment.Thecategoryofpartialsightednessislocatedontheboundarybetweenlowvisionandblindness.Binocularvisionimpairmentsoftenmeanpartialortotallossofstereoscopicvisionandbinoculardepthperception(Kosikowski&Czyzewski,2010).


Thefollowingtextwillcontinuewithorientationandmobilityinthecontextofvisualimpairment.Wewillalsofocusonthestructural,morphologicalandpressurefootchangesbasedonposturalinstabilityinvisuallyimpairedpersons.

2.2 Contemporary research on movement and orthopedic problems

Orientationcanbeunderstoodastheabilitytouseone’sremainingsensestoun-derstandlocationintheenvironmentatanygiventime,andmobilityisthefacilityofmovement.Orientationandmobilitymaybedefinedastheteachingofconcepts,skills,andtechniquesnecessaryfora personwitha visualimpairmenttotravelsafelyandefficientlythroughanyenvironmentandunderallenvironmentalconditionsandsituations(Jacobson,1993).Fora blindperson,everymovementwhichdemandsspatialorientation,andeveryinadvertentmovement,isa targetedandconsciousmotion.Thetransferinspacerequiresconstantconcentrationonandconfrontationwiththeformsimaginedwiththeperceivedexperience.Manyactivitiesinthetrain-ingofspatialorientationandindependentmovementarenecessarytofixatthelevelofperfectlymasteredskills,orevenhabits.Whenanindividuallosestheireyesight,theyexperiencefeelingsoffear,usuallyinthespaceoftheunknown.Animpairedpersonistryingtoovercomethefearofspaceduringthetrainingbyconductinganindependentmovement.Somelearnedmovementpatternsmaynotbedesirable(incorrectposture,tiltingforward,etc.)(Wiener,1986).

A personwitha visualimpairmentusestheentirebodytoreceiveinformationofvariouskinds(compensationfactors:tactility,hearing,smell,echolocationability).Insubjects,thesenseduringthetouchofthefootallowsthemtocheckthequalityofthesurface,changesintheterrain,andothereffects(Jesenský,2007).Theuseofneuromuscularmechanismsofmemorythencontinueswithmultisensoryconnec-tionsbetweenthesenses,theabilitytoformanideaoftheirbodyina movementinspace,andthealreadymentionedroleofthetouchofthefoot.Anexhaustiveconstantfocusonanyactivityisconnectedwitha separateindependentmotion.Thelossofvi-sionandtheresponsetochangesinperceptionarealsoanintegralpartofthehumanbrainplasticity.Anabilitytorespondtothestateoftransformation,itisassociatedwitha numberofotherareas,andaffectstheoverallperceptionofindividualswithvisualimpairmentinthecontextofthespecificsoftheimagination(Majerová,2016).

Thefootchangesandtheposturalinstabilityinvisuallyimpairedpersonscanbeseenfromthecontextsoforientationandmobility,thereceivinginformation,theroleofthetouchofthefoot,theplasticityofthebrain,etc.Letuscontinuewithcurrentresearch.Duetothetheoretical-criticalresourceanalysis,wefoundvariousstudiesaimedatourtopic.TheobjectiveofthestudyofHallemans,Ortibus,Meire,&Aerts(2010)wastodemonstratespecificdifferencesingaitpatternsbetweenthosewithandwithouta visualimpairment.Theyperformeda biomechanicalanalysisofthe


gaitpatternofyoungadults(27±13yearsold)witha visualimpairment(n=10)inanunclutteredenvironmentandcomparedittothegaitpatternofagematchedcontrols(n=20).Theresultsshowedthateveninanunclutteredenvironment,visionisimportantforlocomotioncontrol.Thedifferencesbetweenthosewithandwithouta visualimpairment,andbetweenthefullvisionandnovisionconditions,mayreflecta morecautiouswalkingstrategyandadaptivechangesemployedtousethefoottoprobethegroundforhapticexploration.Thedevelopmentofnormalposturalreac-tionsthatopposetheforceofgravityandmaintainthebody’sbalanceduringexerciseandrestispossibleduetostimulationofthelabyrinthandthelabyrinth’scoopera-tionwithproprioception,vision,touch,andhearing(Nakajima,Kaga,Takekoshi,&Sakuraba,2012).Vestibularreceptorsreceiveimpulsesrelatedtothepositionoftheheadinspaceandgeneratereflexesthatplaya keyroleinbasicmotorresponses;forexample,maintainingheadandbodyposture.Duetothiscomplexprocess,wehave,interalia,a senseofcontroloverthemovingbodyanditsorientationinspace(GreenwaldandGurley,2013).

2.3 Personal statement of the visually impaired

A 21-year-oldrespondentwithcongenitalvisualimpairment(practicallyblind)re-portssufferingfromvertigosporadically.Shewasdiagnosedwithglaucomaandaphakiaandshealsoundergoestreatmentatallergology,cardiologyandendocrinol-ogy(thyroidgland).Whendescribingherlifestyle,shementionsnotusingcoffeeandnicotineatallandusingalcoholoccasionally.Sheregularlyusesimmunosuppres-sivedrugsandeyedrops,othertypesofmedicineratheroccasionally.Shedoesnotperformanysportactivityofa moreintensivenature;sheperformsonlycommoneverydaymovements(e.g.walkingfromwork,walkingupthestairs,housework,andphysicalactivityupto30minutesperday).Therespondentsubjectivelyevaluateshermotorcoordinationasnormal.Overcomingdifferencesinelevationrepresentsa problemforher,forexample,whenwalkingdownthestairsoronanunevensur-face,assheexperiencesinstabilityandevena guide’sassistancedoesnotimprovethesituation.Withrespecttothesenseofdirection,shementionsbeingabletomoveonherown(witha stick)ina familiarenvironment;inanunfamiliarenvironment,witha guide’sassistanceora classmate’shelp.Spatialvision(stereoscopy)isnotinvolved,duetoresidualvisionconsiderablyoutoffocus,andcompensatedbytheprocessingofhearingstimuli.Shefeelsthatherpostureisgettingworse,shestartsfeelingdiscomfortaswellasmuscletensionandstiffness,whichisaccompaniedbytirednessandoccasionalpain.Amongorthopaedicdefects,shesuffersfromscoliosis.


3 Personal statement of the hearing impairedA hearingimpairmentisveryvariable.Hearingimpairmentscanbedividedac-cordingtothetimeofthebeginningofhearingloss,thelevelofspokenspeechorthedegreeofhearingloss.Peoplewitha hearingimpairmentcanbecalledthedeaf,personswithresidualhearingandhardofhearing.

3.1 The classification of hearing loss according to the time of beginning of hearing loss

Hearinglossmaybecongenitaloracquired.Congenitalhearinglossisa hearinglosswhichdevelopsinthetimeofpregnancy.Thechildisborndeaforhardofhearing.Mostchildrenwithhearinglossarehardofhearing.Childrenwhoarehardofhear-ingcommunicatebyspokenspeechandusehearingaids.Somechildrenwithseverehearinglosshavea cochlearimplant.Deafchildrencommunicateinsignlanguagebecausetheydo nothearspokenspeech(AmericaSpeech-Language-HearingAs-sociation,online).Thecausesofcongenitalhearinglosscanbegeneticandnon-genetic.Non-geneticfactorsare,forexample,infectiousdiseases,lowbirthweightormaternalintoxicationduringpregnancy(AmericaSpeech-Language-HearingAssociation,online).

2.2 The classification of hearing loss according to the level of spoken speech

Accordingtothelevelofspokenspeech,hearinglosscanbeprelingual,perilin-gualandpostlingual.Prelingualhearinglossbeginsduringpregnancyorinthefirstmonthsofthechild´slife.Childrenwithprelingualhearinglossdo nothearspokenspeechandtheycannotlearnspokenspeechnaturally.Thesechildrendo nothavepsychicalproblemsthatmaybecausedbyhearingimpairment.Perilingualhearinglossbeginsinthetimeoflearningspokenspeech.Thisisa periodbetween3and5yearsoflife.Postlingualhearinglossoccursatthetimewhenthechildcanusespokenlanguage.Thischilddoesnothaveanyproblemswithcommunicationbyspokenspeech(Tarcsiová,2010).

3.3 The classification of hearing loss according to the degree of hearing loss

Whenwesearchdegreesofhearinglosswecanfindmedicaltermssuchasnorma-cusis,hypacusisandsurditas.Lejskadescribesnormacusisasa degreewhena persondoesnothaveanyproblemswithcommunicationandtheirauditorythresholdatanaudiometricexaminationdoesnotexceedtheintensitylevel20dB(Lejska,1994).Hypacusis(hardofhearing)canbedividedintohypacusisconductive,hypacusissenzorineuralis,hypacusismixtaandhypacusiscentralis(Lejska,1994).Hypacusisconductivameansa hearinglosswhentheouterandmiddleeararedamaged.Poten-tialcausesofconductivahearinglossarewaxbuildup,earinfection,a foreignobject


lodgedintheear,rupturedeardrum,andstructuralmalformationofpartsoftheear(Betterhearing,online).Hypacusissensorineuralismeansa hearinglosswhentheinnerearisdamaged(Lejska,1994).Sensorineuralhearinglossincludestraumatothehead,ototoxis,genetics,illnessandaging(Betterhearing,online).Surditas(deaf-ness)isthemostseverecaseofhearingloss.Surditasmeansthatthepersoncannothearvoicesandcannotlearnspokenspeechnaturally(Lejska,1994).

3.4 The classification of hearing loss according to the type of hearing impairment

Inspecialeducationresults,wecanfinda descriptionofpeoplewithdifferentcasesofhearingloss.Wecantermthesepeopleasdeaf,hardofhearing,thosewithresidualhearingandthosewithprofoundhearingloss.A deafpersoncannothearandun-derstandspokenspeech(Potměšil,2011).Hearinglossbeginsinthepre-,peri-,orpostnatalperiod.Thechildeithercannotusespokenlanguageorspokenlanguageisverydifficultforthem.Theycommunicateinsignlanguage(Tarcsiová,2010).Peoplewhoarehardofhearinghavesubstantialdifficultieswithhearingspokenlanguage.Thesepeopleusehearingaidsorcochlearimplants(Tarcsiova,2010).Wecanclassifythosehardofhearingbyusingthecategoriesofmild,moderate,severeandprofoundhearingloss.Peoplewithmildhearinglosscanhearsoundslouderthan40dB:“Someonewithmildhearinglossmayhaveminimalornoissuescommunicatinginquiet,inone-on-onesettings,orwithonlya coupleofpeople.Buttheytendtohavedifficultyhearingsofterenvironmentalsoundsaswellassomeconversations,especiallyinnoisierenvironments,ata distance,inlarger-groupsettings,oroverthephone.“(Betterhearing,online).Peoplewithmoderateandseverehearinglosshavesubstantialdifficultieswithhearingspokenlanguage.Thesepeoplemayusehearingaidsorlisteningadvices(Betterhearing,online).Peoplewithprofoundhearinglossprobablycannothearanyspeechorsomeloudsounds.Theyoftenusehearingaidsorcochlearimplants.Theycommunicateinsignlanguage(Betterhearing,online).

3.5 Contemporary research on movement and orthopedic problems

Thedevelopmentofnormalposturalreactionsthatopposetheforceofgravityandmaintainthebody’sbalanceduringexerciseandrestispossibleduetostimulationofthelabyrinthandthelabyrinth’scooperationwithproprioception,vision,touch,andhearing(Nakajima,Kaga,Takekoshi&Sakuraba,2012).Vestibularreceptorsreceiveimpulsesrelatedtothepositionoftheheadinspaceandgeneratereflexesthatplaya keyroleinbasicmotorresponses;forexample,maintainingheadandbodyposture.Duetothiscomplexprocess,wehave,interalia,a senseofcontroloverthemov-ingbodyanditsorientationinspace(Greenwald&Gurley,2013).Researchresultsbetweennormallyhearingchildrenandseverelytoprofoundlyhearingimpaired


childrenattheageof6to10yearsshoweda significantdifferenceintwostaticbal-anceskills.Therewasa significantdifferenceinstaticbalanceskillsofstandingononelegona lineandstandingononelegona balanceteamwitheyesclosed(Jafari,Malayeri&Rezazadeh,2011).ThestaticanddynamicbalanceperformanceofdeafchildrenwithandwithoutcochlearimplantswasstudiedbyEbrahim,Movallali&Jamshidi(2016).Theystudied85childrenwithcongenitalandearlyacquiredbilat-eralprofoundsensorineuralhearinglossandnormallyhearingchildrenattheageof7–12years.TheyusedthebalancesubtestofBruininks-OseretskyTestofMotorProficiency.Theresultsshowedthetotalscore,especiallythetotalscoreofchildrenwithcochlearimplant,wassignificantlylowerthanthatofthecontrolgroup.Thecontrolgrouphada betterbalanceperformancethantheimplantgroupinalloftheitems.Thefindingssuggestedthatdeafchildren,especiallythosewithcochlearimplants,areatriskfrommotorandbalancedeficits.LivingstoneandMcPhillips(2011)conducteda similarsurvey,whichexaminedmotorskilldeficitsinchildrenwithpartialhearing.Theystudiedthreegroupsofchildren:1)a partiallyhearinggroup;2)a non-verbalIQ-matchedgroup;3)anage-matchedgroup.Childrenwithhearingimpairmenthada bilateralhearingloss>60dB.TheresultsshowedthattheMABCscore(MovementAssessmentBatteryforChildrenScore)ofthefirstgroupwassignificantlylowerthanthoseofbothcomparisongroups;thechildreninthefirstgrouphadparticulardifficultieswithbalance.Kegel,Maes&Baetens(2012)dealtwiththeinfluenceofvestibulardysfunctiononthemotordevelopmentofhearing-impairedchildren.Theytestedchildrenwithunilateralorbilateralhear-ingimpairment>40dBattheageof3–12years.TheyusedMABC–secondeditionandVEMP(vestibularevokedmyogenicpotential).Theresultsshowedthat“balanceperformanceonMABC-2,clinicalbalancetests,aswellastheswayvelocityassessedbyposturographyinbipedalstanceona cushionwitheyesclosedandinunilateralstancedifferedsignificantlybetweenbothgroups.Wilson,Garner&Loprinzi(2016)pointedouttherelationshipbetweenhearingimpairmentandbalance.Theyusedthedatafromthe2003-2004NationalHealthandNutritionExaminationSurveyanddetectedthatsensoryimpairmentwasassociatedwithperceiveddifficultyoffallsandfunctionalbalance,becauseparticipantswitha singlesensoryimpairmenthad29%reducedoddsofhavingfunctionalbalanceandtheirreporteddifficultywithfallsincreasedby61%.Wolter,Cushing&Madrigal(2016)implementeda pilotstudyaboutrelationshipsbetweenhearingimpairmentandbalance.Theirresearchgroupincludedchildrenwithunilateralsensorineuralhearinglossandchildrenwithnormalhearing.TheyweretestedbyBruininks–Oseretsky(BOT-2).TheBOT-2testscoreshowedthatbalanceabilitywassignificantlyworseinchildrenwithunilateralsensorineuralhearingloss.


3.6 Personal witness of hearing impairment

A 30-year-oldrespondentwithcongenitalhearingimpairmentofperceptionaltype(residualhearing)reportssufferingfromvertigoseveraltimesa day.Whendescrib-ingherlifestyle,shementionsnotusingcoffeeandnicotineatall,usingalcoholoccasionallyinsmallamount,andusingmedicineirregularly,ratheroccasionally.Twicea week,sheperformsa ratherintensive(maximumheartrateof65-80%)ac-tivesportactivityformorethan30minutes.Inhercase,vertigooccursinrelationtoa specificsituation,namelythechangeofbodyposition.Therespondentalsomen-tionssufferingfromfeelingsofuncertaintyanddeviatingfromherbody’sbalanceseveraltimesa day.Therespondenthasdifficultywithovercomingdifferencesinelevation;inparticular,shesuffersfromvertigowhenrisingup.Inspiteofthat,sheconsidershermotorcoordinationnormalandproblem-free.However,shedescribesherposturalhabitsasbad,andfurtherspecifieshereverydayproblemsasa feelingofdiscomfort,muscletensionandstiffness,oftenevenmusclefever,overalltirednessandpain.Amongorthopedicdefects,shesuffersfromcervicalkyphosisandlumbarlordosisrelatedtoa mildpelvicdeviation.

4 ConclusionVisuallyandhearingimpairedpeoplearea potentiallyweakenedtargetgroupwithregardtothegenesisoflight,mediumorhardmorphologicalandstructuralfootdeformities.Thefoothasanimportantfunctionalrelationwithinthelowerlimbandbody.Thefunctionofthefootisstaticanddynamic.Inaddition,stabilityproblemsinpeoplewithhearingimpairmentsarenotrare,asadequateposturalstabilityrequirestheintegrationandevaluationofvisual,vestibularandsomatosensoryinformation.Researchshowsthat30%-70%ofpeoplewithhearingimpairmenthaveproblemswithbalance.Thefootrequiresincreasedattentionnotonlyasthefinallinkinaffectmechanismchainofdailyload,butespeciallyastheexecutivebodyapparatandanimportantinputfeedbackfactor.Thisfeedbackshouldperforma supportfunction,nota limitfunction,forall-purposeandoptimaldevelopmentoftheimpairedperson.Thegenesisofdeformitiesissupposedonthebaseofposturalinstability,whichissubsequentlyreflectedinthechangeofthecenterofpressure.Themovementofthecenterisreflectedinplantarpressureredistributionandconsequently,dependingontheduration,causesthegenesisoffootdeformities.Surprisingly,thisproblemisnotthoroughlyexaminedandprocessedinCzechorforeignliterature.Healthybodypostureandgaithaveunimaginableimportanceinthetermsofqualityoflifeandsocialintegrationoftheindividuals.Throughoutthelivesofimpairedpersons,spatialorientationandmovementinspaceaswellasuprightbodyposturetraining


requiretobetakencareof.Theeffectofhealthrestrictionsextendstoallspheresofhumanexistence,makingitratherdifficult,especiallyintheeducationprocess.

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factsheets/fs282/en/[34] WIENER,P. 1986.Prostorová orientace a samostatný pohyb zrakově postižených.Praha:Avicenum.[35] WILSON,S.J.,GARNER,J.C.&LOPRINZI,PD.,2016.Theinfluenceofmultiplesensoryimpair-

mentsonfunctionalbalanceanddifficultywithfallsamongU.S.adults.Preventive medicine,87,p. 41–46.

[36] WINTER,D.A.1995.Humanbalanceandposturecontrolduringstandingandwalking.Gait & posture,3(4),p. 193–214.

[37] WOLTER,N.E,CUSHING,S.L&MADRIGAL,L.D.,2016.Unilateralhearinglossisassociatedwithimpairedbalanceinchildren:a pilotstudy.Otology&Neurotology,37(10),p. 1589–1595.

(reviewedtwice)

KristínaTománková,Ph.D.PalackýUniversityŽižkovonám.577140,OlomoucCzechRepublice-mail:[email protected]


HanaMajerová,Ph.D.PalackýUniversityŽižkovonám.577140,OlomoucCzechRepublice-mail:[email protected]

VeronikaŠvecová,Ph.D.CzechNationalDisabilityCouncilŽižkovonám.577140,OlomoucCzechRepublice-mail: [email protected]

VojtechRegec,Ph.D.PalackýUniversityŽižkovonám.577140,OlomoucCzechRepublice-mail:[email protected]


A case analysis on the curriculum development of adaptive functional education for children with mental retardation in mainland China

(overview essay)

Xu Bo

Abstract: The cultivation of social adaptability is an important part of education for children with mental retardation. The curriculum of adaptive functional education is guided by the relevant theories of social adaptation, it is an extremely important part of the curriculum of education for children with mental retardation, its basic idea and operation flow are suitable for curriculum development in a wide range of fields. Taking a specific case as the basic starting point, this paper introduces a common method of developing this kind of curriculum for special educators in mainland China. The specific steps include the definition of curriculum concept and scope; the formation, analysis and evaluation of the curriculum objectives; the formulation of teaching objectives; the design of relevant teaching materials and supporting schemes, and so on.

Keywords: Curriculum development, adaptive functional education, activity analysis, teaching materials

1 IntroductionThementalretardationisa disorderwithonsetduringthedevelopmentalperiodthatincludesbothintellectualandadaptivefunctioningdeficitsinconceptual,social,andpracticaldomains.Threecriteriamustbemet:deficitsinintellectualfunctions;deficitsinadaptivefunctioningthatresultinfailuretomeetdevelopmentalandsocio-culturalstandardsforpersonalindependenceandsocialresponsibility;onsetofintellectualandadaptivedeficitsduringthedevelopmentalperiod.Amongthethreecriteria“intellectualfunction”isrelativelystable.Whilethe“adaptivefunction”hasa considerabledegreeofplasticity,withoutongoingsupport,theadaptivedeficitslimitfunctioninginoneormoreactivitiesofdailylife,suchascommunication,socialparticipation,andindependentliving,acrossmultipleenvironments,suchashome,


school,work,andcommunity(AmericanPsychiatricAssociation,2013),soitistheemphasisofeducation.

Ina broadsensesocialadaptabilityisaboutthesameasadaptivebehaviors,whileitreferstointerpersonalorsocialskillsina narrowsense.Socialadaptabilityhasalwaysplayedanimportantroleinthedefinitionofmentalretardationandintheprocessofeducation.Itandacademicdevelopmentarethetwomainlinesinthedesignofcurriculumforchildrenwithmentalretardation(DengMeng,LeiJianghua,2006).Itincludesa seriesofconceptual,socialandpracticalskills.Theassessmentandeducationofsocialadaptivebehaviorsmusttakeintoaccountthenaturalandsocialecologicalenvironmentofstudentswithmentalretardationandthelimita-tionsofcognitivedevelopmentlevelandindividualagecharacteristics,andcollectinformationthroughmultiplechannels(WeiXiaoman,WangPeimei2004).

Adaptabilityreferstotheharmoniousrelationshipbetweenchildrenwithmentalretardationintherealsocietyandtheenvironment,andthiskindofcoordinationisachievedthrougheducationtoimproveitsfunction.Theadaptivefunctionaleduca-tionreferstothecultivationoftheabilitytoadapttotheenvironmentforchildrenwithmentalretardationinsomeplannedandstep-by-stepprocesses(ZhangWenjing,XuJiacheng,2002).Itisthespecialeducationtheoryandoperationmodethattakesthesocialadaptationskillsofchildrenwithmentalretardationastheeducationalcontents,aimstocultivatetheirabilitiestoadaptandparticipateinnormalsociallife.

2 The meaning and characteristics of the curriculum of adaptive functional education

Thereisa lotofliteratureonthe“curriculum”,andmanydifferentopinionsonthedefinitionofthecurriculum.Thediversityofcurriculumdefinitionscanbebroad-lygroupedintothefollowingthreecategories:makingthecurriculumasa disci-pline,a kindofactivity,orallthedisciplines,alltheactivitiesthatconductedbytheteachers(Fiona,Tracey,Barbara,Junghwa,2017);makingthecurriculumasanobjec-tiveora plan(Oliva,P,2005);makingthecurriculumasa learner’sexperience(Foshay,2000).Thecurriculumofadaptivefunctionaleducationisanimportanttypeofcur-riculuminthefieldofeducationforchildrenwithmentalretardation.

2.1 Meaning of this type of curriculum

Thecurriculumofadaptivefunctionaleducationisguidedbytherelevanttheoriesofsocialadaptation,itaimstopromoteindividualadaptation,familyadaptation,schooladaptation,communityadaptationoroccupationaladaptation.Itscurriculumformisoftena life-based,ecologicalcomprehensivecurriculum.


2.2 The core ideas and characteristics of this type of curriculum

Thecurriculumofadaptivefunctionaleducationpaysattentiontothepracticalcontentinthestudents’learningandlife.Itscoreideasandcharacteristicsareasfollows(ZhangWenjing,1998):

Thepurposeoftheadaptiveeducation:topromotetheindividualadaptation,socialadaptation,occupationadaptationofthechildrenwithmentalretardation;

Takingfunctionaleducationasthemeans:toteachthemthemostusefulthings,themosteffectivethings,andtopromotetheabilityofadaptingtothefunctionalthings;

Takingindividualizededucationasitsprinciple:todevelopindividualizededuca-tionandteachingplan,toimplementindividualizededucationservices;

Takingnormalchildren‘sphysicalandmentaldevelopmentastheclues:withtheorderandruleofphysicalandmentalgrowthofordinarychildrenasthestandard;

Providingsupportandassistance:theestablishmentofsupportsystem,thissystemwillpromotetheimplementationofeducationandteaching,operation,andmaketheeffectivenessofeducation;

Makinguseoflifeinnaturenormalenvironmenttocreatetheenvironmentfortheneedsofchildrenwithmentalretardation:teachingactivitiesplacedinthechil-dren‘snatural,normallife;

Promotingtheintegrationofteachingactivities:tochoosethetypesofcorecur-riculums,toenhancestudents‘learningoflife,toemphasizetherealityoflearningproblem.

Thecurriculumofadaptivefunctionaleducationhasmanyformsofexpression,amongthemtheevaluatingtypescanbeusedasthecontentandbasisofeducationaldiagnosisandevaluation,theycanprovideguidancefortheformulationofindividualeducationprogrammes,andrevealthedegreeorcontentofthesupportassistanceforstudentsandtheteachingcontent.ThedevelopmentofadaptivefunctionaleducationcurriculumisintheascendantinmainlandChina.Undertheguidanceoftherelevanttheoriesoftheadaptivefunctionaleducationandthecurriculumdevelopment,theauthortakesthecasechild’s„elevatorusing„astheobject,andintroducesindetaila commonoperatingmethodforthedevelopmentofthistypeofcurriculumbyspecialeducatorsinmainlandChina.

3 The basic information of the case childWangX,male,bornin1999,withmoderatementalretardation.Hissensorypercep-tionabilityisgood;coarseandfinemovementabilitydevelopswell;hecancarryonsimpleoralcommunication,canusethebodylanguagecommonlyusedinhisdailylife;generallyspeaking,hismoodisrelativelygood,whenthemoodisnotvery


stable,likestoclaphandstoexpresshisanxiety;cognitiveskillssuchasmemory,classification,problem-solving,etc.arepoor;interpersonalskills,familyskills,com-munityuse,leisureskills,etc.arealsobad.Helivesinthedowntownareaofa liftapartment，hisparents'culturallevelisveryhigh,therelationshipofthefamilymembersisveryharmonious,andtheyattachgreatimportanceofthedetailsinlifetoeducatetheirchild.WangXcouldidentifyelevennumbersfrom0to10;num-bers11to20cansometimesbeidentifiedcorrectly;waiting,observationandcolorrecognitionabilityaregood.Heisconsciousoftakinganelevator,buthecannotbecarriedoutindependently,inmanycases,verbaladvicesorphysicalassistancesarerequired.Hisparentsarealsoverymuchinthehopeofmakinghimhavetheabilityundertheguidanceoftheschoolteacherandothers.

4 MethodologyThisstudymainlyadoptsthemethodofcasestudy,mainlythroughobservation,interview,evaluationandotherspecificmethodstocollectdata.Firstofall,defin-ingtheideaandscopeofuseofthecurriculum.Secondly,byusingactivityanalysismethodandtakingcommonchildrenofthesameageasreference,thetargetbehav-iorisanalyzedindetail,andtheactivityanalysistableofindividualgoalbehaviorisobtained.Thenwiththebehavioractivityanalysistableasthebasicclue,theparents,theschoolteachers(especiallytheteacherinchargeoftheclass),thelifeteacher,theclassmateswereinterviewed.Atthesametime,theauthorevaluatedthecasechildhimselfandanalyzesthevariousfactorsandtheirinteractioninhiselevatorusingenvironment.Finally,accordingtotheinformationcollectedtorefinetheindividualeducationalobjectivesofthecase,analyzehiseducationalneeds,andonthesebasis,designrelatedcoursesandsupportstrategiesforthecasechildtoforma systematicadaptivefunctionaleducationcurriculumfortargetbehavior.

Inordertoprotecttheindividualprivacy,thisarticledoesnotcontainanyspe-cificnames,anypicturesornamesaboutschoolsorinstitutionsrelatedtotheboy.Furthermorethemostsalientfeatureofthecasestudyapproachisthetruestorythatdescribestheobjectiveworld,andmostofthemuseinductivemethodsina ob-jectivemanner.Therefore,thematerialsobtainedbythecasemethodcanalsobescientificandaccurate,andhavehighliteraturevalue.Toa largeextenttheresearchofeducationisa processthatcannotbereplicatedaccurately.Soifthetypicalcasesthatoccurringinthisprocessareanalyzedandstudieddeeplyandmeticulously,includingcollectingthebackgroundofthecase,specificmaterials,theresultsoftheinvestigationandinterviews,andtheassessmentandreflectionofthepersonscon-cerned,describingtruthfullythe“story”thathappenedintheprocess.Theprocessandtheresultsthemselveshavegreatliteraturevalue,sowecanusethemtocomparethesimilarcases(Maňák,Švec,Švec,2005).


5 The idea and scope of this curriculumCurriculumdevelopmentcanbedefinedasthesystematicplanningofwhatistaughtandlearnedinschoolsasreflectedincoursesofstudyandschoolprograms.Thesecurriculaareembodiedinofficialdocuments(typicallycurriculum“guides”forteachers)andmademandatorybyprovincialandterritorialdepartmentsofeduca-tion.Theprimaryfocusofa curriculumisonwhatistobetaughtandwhen,leav-ingtotheteachingprofessiondecisionsastohowthisshouldbedone(LimonE.Kattington,2010).Itcontainsseriesofsteps,suchasmakingsurewhateducationalpurposesshouldtheschoolseektoattain,judgingwhateducationalexperiencescanbeprovidedthatarelikelytoattainthesepurposes,thinkingabouthowcantheseeducationalexperiencesbeeffectivelyorganized,decidinghowcanwedeterminewhetherthesepurposesarebeingattained(RalphW.Tyler,1988).Therearea lotofmodelsaboutthecurriculumdevelopment,inthisarticletheobjective-orientedmodel is the main one.

5.1 Basic idea

Thecurriculumideaisaboutthebasicperceptionandcoreconceptofcurriculum,itisthesoulandsupportofallthelinksthatfollowthecourseoperation.Itwillprofoundlyaffectthebreadthanddepthaswellaspresentationofthecurriculumobjectives,curriculumcontent,curriculumorganizationandimplementationorthedevelopmentandutilizationofcurriculumresources.Thiscurriculumintendstoadoptthetheoryofadaptivefunctionaleducation,thatis,tomakethechildrentoadapttotheenvironment，andtoenhancehisfunctioninadaptingtothesociallife,accordingtothecharacteristics,thebasicideasofthiscurriculumareasfollows:

Thiscurriculummustbeabletomeettheindividualneedsofthestudent;Thiscurriculummustbeabletodeveloptheabilityofthestudenttoimprovehis

abilitytoadapttotheenvironment;Thiscurriculummustimprovethelifequalityofthestudent..

5.2 Definition of the application scope of the curriculum

Theapplicationscopeofcurriculummainlyreferstothelimitationoftime,place,situation,objectandsoon.Itisoneoftheimportantviewpointsofcurriculumdevelopmentandapplication.Theterrainwherethecasechildlivesismainlythemountain,theurbanpopulationisverylarge;thebuildingsaregenerallyveryhigh;residentsmainlytakeelevatorsupanddownthefloor.Thecorrectuseofelevatorsisoneofthebasicabilitiestomeettheneedsoflocalurbanlife,toimprovethequalityoflifeandmeettheirneedsoftraveling.

Thiscourseisonlydesignedforthestudenttotaketheelevator.Inhislife,allthemajorfieldsoftakingtheelevatorinvolved:hishome,hisgrandfatherandaunt’s


community,thehospitalandlargeshoppingmallsandsupermarketsnearhishome.Theelevatorsintheseplacesarenotthesamestyle,butthebasicabilitiestousetheelevatorsfora personarethesame.Soinordertoavoidrepeateddiscussion,inthiscourse,wedo notconsiderthedifferentplaces,theyarediscussedina unifiedman-ner.

6 Analysis and evaluation of the behavior objectives of the curriculum

Theobjective-orientedmodelofcurriculumdevelopmentmakesthegoalasthefoundationandcoreofwholeprocess,itbasesonthedetermination,realizationandevaluationofthecurriculumobjectives.Itplacesparticularemphasisonbehavioralobjectives.Thatis,statingthecurriculumandteachingobjectivesintheformofconcrete,actionablebehaviortopointoutthebehaviorchangesofthestudentsaftertheendofthecourseandteachingprocess.Itsbasiccharacteristicistheaccuracy,concretenessandmaneuverabilityoftheobjectives(ZhangHua,2000).

Fora normal8yearsoldchild,whowasborninthecity,throughdailyobserva-tionandlearning,hehaslearnedtousetheelevator.Butduetotheirinherentob-stacles,thechildrenwithmentalretardationoftenhavea lotofdifficultiesincolordiscrimination,digitalidentification,handeyecoordination,patientlywaiting,andcannotuseoftheelevatorsindependently.Therefore,itisnecessarytomakedetailedanalysisoftherelativeactivities,inordertohelpthemcompletetheactivitythroughsomesmallsteps.Thespecificanalysiswayisasfollow:

Thefirststep:accordingtotheprocessoftheactivityitself,“usingelevator“issubdividedintothreesubactivities:„gettingintotheelevator“,„takingtheelevator“and„gettingoutoftheelevator“.

Thesecondstep:observingtheactivitiesandproceduresoftheelevatorusingforordinarychildrenofthesameage.Sumuptheabovethreesub-activitiestotheirtypicalbehaviorrequirements,anddescribethemwithspecificbehaviors.

Thethirdstep:checkeverybehaviorinthedescriptionlistandjudgeifitisnec-essaryforWangX,anddeterminesthenecessityofaction.Inthecaseofhavingnoinfluencesontheadaptivefactionaloutcome,thendeletetheitemsthatirrel-evant,beyondhispresentabilitylevelornotsourgent.Thedetailsareasfollows(LiBaozhen,1997):


Table 1: Activities analysis of the case child’s elevator using

Activities analyses Necessity check remarksnecessary unnecessary

Find the elevator entrance √Move quickly to the elevator entrance × NoturgentNotice the arrow symbol of “↑” “↓” √Press the arrow symbol of “↑” “↓”” with the right posture and strength

♀ Aslongashecanachievethegoal

Wait quietly at the elevator entrance √Walk into the elevator quietly and quickly ♀ Needs

promptNotice the digital keystroke screen √Press the number key for the right floor with the right posture and strength

♀ Reducedif-ficulty

Find the right place to stand √Identify the hazards in the elevator × Beyondpre-

sentcapacityWait quietly in the elevator √Use the alarm button × Beyondpre-

sentcapacityKeep an eye on the current floor number √Notice the floor indicator number he wants to reach √Friendly interact with other people in the elevator × NoturgentWaiting for the elevator door to open √Help others as much as he can × Beyondpre-

sentcapacityLine up and quiet to walk out of the elevator √Immediately leave the elevator, do not look back ♀ Needs

promptIf doesn’t get out in time, press the button “Open the door” quickly

♀ Needs prompt

＊instructions：1.“√”indicatesthebehaviorsthattheyarenecessarytobereserveddirectly.2.“♀”indicatesthebehaviorsthattheyarenecessarytoberetained,buttobeadjusted.3.“×”indicatesthebehaviorsthattheyareexceedingcurrentcapacityornoturgent.

Thefourthstep:adjusttheselectedbehavioritemstomeettherequirementsofWang.

Thelaststep:summarizethebehaviorsnecessaryforWanginthethreekindsofactivities,andevaluatehisabilitytouseelevatorsinnormallifesituationsinmany


timesanddifferentsituations.Theresultsareshowninthefollowingtable:SummaryandevaluationofWangelevator’sbehavioralobjectives.

Table 2: Evaluation and result summary of the case child’s elevator using

Proper behaviors Date and result of assessment Actual behaviors Instructional strate-gies12.6 12.7 12.8 12.9

Find the elevator entrance

3/3 3/3 3/3 3/3 ☆ ♂

Notice the arrow symbol of “↑” “↓”

3/3 3/3 33 3/3 ☆ ♂

Press the arrow symbol of “↑” “↓”

3/3 1/3 1/3 2/3 conductswrongly4timesin12testsfornotenoughconcen-

tration

Oralcues;picturedescription

Wait quietly at the elevator entrance

1/3 1/3 1/3 1/3 Frequentlyclapshands hard, and runs withthenoise“e,e,

e,e…”

Verbal cues; limb assistance

Walk into the el-evator quietly and quickly

3/3 3/3 3/3 3/3 ☆ ♂

Notice the digital keystroke screen

3/3 3/3 3/3 3/3 ☆ ♂

Press the number key for the right floor

1/3 2/3 3/3 1/3 Oftenpressesother numbers ，forex-

ample: 4、5、6

Accurateidentifica-tionofthenumbers

0to9

Find the right place to stand

3/3 3/3 3/3 3/3 ☆ ♂

Wait quietly in the elevator

1/3 0/3 0/3 1/3 Sometimes claps his hands or touches

otherswiththenoise“e,e,e…”


Keep an eye on the current floor num-ber

0/3 1/3 0/3 0/3 Oftenlooksaround Verbalcues;digitalidentification

Notice the floor in-dicator number that he want to reach

0/3 0/3 0/3 1/3 Oftendoesn’tlookorhasnoresponseafter

seeingit

Colorperception;verbalcue

Waiting for the el-evator door to open

3/3 1/3 3/3 1/3 Sometimeswantstobreakoffthedoorby

hands



Line up and quiet to walk out of the elevator

3/3 3/3 3/3 3/3 ☆ ♂

Immediately leave the elevator, do not look back

1/3 2/3 0/3 1/3 Aftergettingoutoftheelevator,he

likestoturnbacktoseethedoorbefore

leaving

Physicalassistance;verbaltips

If does not get out in time, press the but-ton “Open the door” quickly

0/3 0/3 0/3 0/3 Totallycannot Createsomescenes;verbalcues;body

assistance

＊instructions：1.“☆”meanstheactualbehaviorsareconsistentwiththeproperbehaviors;2.“♂”meansconductingindependentlywithoutanyassistance.3.“Properbehavior"referstothebehaviorsrequiredbytheenvironmentandthereferenceframearethechildrenatthesameage;"actualbehavior"referstothecasechild’srealbehaviorsinthedailylife.4.Thedenominatorofthescoreinthetableindicatesthenumberoftimestheevaluationsaremade,andmoleculemeansthetimesthattheactualbehaviorsareinconformitywiththeproperbehaviors.Forexample:“1/3”meansthatWangconductssuccessfullyonetimeinthreetests.

7 Developing teaching objectivesThedevelopmentofteachingobjectivesisanimportantstepaftereducationaldiag-nosisandevaluation.Objectivesexistinmanyforms,rangingfromhighlyspecifictoglobalandfromexplicittoimplicit.Thereisdebateoverthemeritsandliabilitiesofobjectivesintheirvariedforms.Thoseobjectivesthattheyaremostusefulforidentifyingtheintendedcognitiveoutcomesofschooling,forguidingtheselectionofeffectiveinstructionalactivitiesandforselectingordesigningappropriateassess-ments.Othertypesandformsofobjectivesmaybeusefulindifferentways(LorinW.Anderson,DavidR.Krathwohletc.,2001).

TheanalysisandevaluationofbehaviorobjectivesforWang‘s elevatorusingisdevotedtofindthestartingpointoftheteaching,andlaya foundationforthefu-tureteaching.Accordingtotheaboveassessmenttable,itisnotdifficulttofindthatthefollowingaspectsshouldbefurtherimproved,sotheseaspectsareextractedasteachingobjectives:

Beingabletoclickthebuttonsof“↓”、“↑”exactly;Beingabletowaitatleast3minutesquietlyattheelevatorentranceandinside

theelevator;Beingabletoaccuratelypointouttherightfigurefrom1to10;Beingabletogazeatdisplayscreenforatleastoneminute;Beingabletogooutafterthedooroftheelevatorisopen;


Beingabletopresstheopeningbuttonaccurately;Beingabletoquicklyleavetheelevatoranddonotlookback.

8 Design corresponding teaching materials and related support8.1 The corresponding teaching materials

Thedirectpurposeofdesigningteachingmaterialsistobetterachievetheintendedteachingobjectives.Afterthecasestudent’sindividualeducationprogramaboutusingtheelevatorwasdetermined,wecandesigncorrespondingtextmaterialsforusebyrelevantpersonnel,besidescarryonteachingarounda givenobjectiveinrealsituationswhereelevatorsareactuallyused.Forexample,wecandesigntextbooksforstudenttouseelevators,designteachers’manualsforteaching,designexercisebooksthathelpthestudentunderstandandmastertheimportantanddifficultaspectsofthetextbook,ordevelopauxiliarymaterialsrepresentedbypictures,audio,video,etc.

Alleducationalmaterialsmustbedesignedinaccordancewiththerelevantnorms.Intheaspectofdevelopingcontentandprocedure,wemustconsidertheabilityofthecasestudent,theconditionsandlimitationsprovidedbytheenvironment,andtheestablishedteachingideaandgoal.Takethecompilationofstudent’stextbooksasanexample,weshouldpayattentiontotheintegrityandreasonablenessofitsstructure,considerthelogicalorderofarrangement,payattentiontotheconsistencybetweenconcepts,takeintoaccountthereadabilityandscience.Atthesametime,theprevi-ousstudyandlifeexperienceofthecasestudentshouldalsobeconsidered(WangBinhua,2000).

Assomeresearchershavepointedout“thespecialeducationcurriculumshavethefunctionofthesoulandthecommanderintheteaching,andtheyaregenerallyusedforeducationaldiagnosticevaluation,individualizededucationplanformulation,designandimplementationofteachingactivities,teachingevaluation,curriculumsgothroughthewholeprocessofteaching.”(ZhangWenjing,2008).Aftera periodofteaching,thecurriculumtableabovecanbeusedagaintoassessthesituationofWang,totesttheeffectofteachingandrevisetheteaching,ortoprovidethebasisforthefollow-upteachingandassessment.

8.2 The related support

The“support”isoneoftheimportantconceptsofeducationforchildrenwithmentalretardation.Itisa resourceandstrategytoenhancepersonaldevelopment,education,interest,andwell-being,andtostrengthentheindividual’sfunction.Thedevelop-mentofadaptivebehavioristheresultoftheinteractionsbetweentheindividualandtheenvironment.Thecultivationofindividualadaptivebehaviorscannotbeseparatedfromthesupportsandassistancesfromtheenvironment,itneedsforthe


relatedpeopleandthingstocooperate.AccordingtotheactualsituationofWang,theauthordevelopsthefollowingsupportedprogram:

Teachingstaff:mainlycontainfather,mother,aunt,grandfather,grandmother,class teachers and other related persons;

Teachingplaces:ItismainlythecommunityelevatorroomsthatWangoftengoesthroughbeforeandafterschool;

Cooperationamongthepersons:themajoreducatorsneedtocloselycooperate,implementthelifeorientedteachingprinciples,andsomeactivitieslikenumbersidentificationcanalsobeusedinmathorgamesclasses.

9 Reflection about the studyThisarticlemainlyadoptscasestudy,becauseofthiskindofresearchdoesnotusetheprobabilitysamplingmethod,thestudyofa typicalcaseisnottoinfertheresultstothepopulationsampledfromthem,buttoillustratewhata casemightlooklikeinsucha phenomenon.Sothepurposeofthestudyistoshowandexplain,sothatpeoplewhohavesimilarexperiencesachievethepurposeofpromotionthroughidentification,ratherthanconfirmationandinference.Althoughtheinvestigation,descriptionandanalysisofcaseadaptivefunctionaleducationcurriculumisonlya concreteexample,theauthenticityofthisarticleisonlyfora case,indifferenttimeandspacebackground,allteachershavedifferencesinthepreparationofadaptivefunctionalcurriculum,butalsohavesomecommonality.Inthecaseoffollowingtherelevantresearchnorms,theresultsofthestudycanmakepeoplewithsimilarexperiencesachievethepurposeofpromotionthroughreading,experiencethereso-nanceofcommonproblemsoridentity.Soevenifpersonalexperienceisdifferent,thesimilarpurposecanbeachievedaslongasheagreeswiththeauthenticityofthecaseI present.

10 ConclusionDevelopedtothispoint,theauthorprovidesa relativelycompleteexampleofdevel-opingthecurriculumsforadaptivefunctionaleducationforthecasechildrenwithmentalretardation.Infact,inthefieldofsocialadaptation,suchasself-care,familylife,self-guidance,etc;ortheteachingfieldofdailylanguage,dailymathematicsandothersubjects;ora widerangeofareassuchaslanguagerehabilitation,motorrehabilitation,artisticrehabilitation,etc.Wecandrawupverydetailedcurriculumplansforcasestudents,caseclasses,caseschools,andevenschoolsina widerareabyreferencetothesimilarideaandoperatingproceduresabove.

Thegeneralprinciplesofcurriculumdevelopmentforadaptivefunctionaledu-cationareasfollowings:individualization,designingcoursesbasedonindividual


children-basedneeds;functionality,facilitatingthedevelopmentofadaptivefunc-tionalabilitiesintheprocessofchildren-environmentinteraction;dynamic,basingontheabilityofthechildrenwithmentalretardationtodevelopconstantly;ecology,thepreparationandimplementationofcoursesinthenormalnaturalandsocialecologicalenvironment.

Thegeneralstepsofcurriculumdevelopmentforadaptivefunctionaleducationareasfollowings:determiningtheideaofcurriculum;analyzingtheenvironmentandtargetactivities;analyzingthebehaviorsrequiredintheenvironment;assessingstudents‘currentabilities;drawingupteachingobjectives;formingteachingstrate-giesandprocedures.

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(reviewedtwice)

Xu BoFacultyofSpecialEducationLeshanNormalUniversity614004,Leshan,SichuanChinae-mail:[email protected]


The awareness and visual diagnosis of women with severe visual impairment as a main factor in the choice of delivery methods in childbirth

(overview essay)

Mgr. Daniela Kilduff, Ph.D.

Abstract: This article is focused on factors which influence the choice of delivery op-tions of women with visual impairment (VI), investigating the connection between the information women have and how prepared they feel, as well as their attitudes (direct or indirect) to delivery methods. This article emphasizes the necessity of sexual education, adequately modified for pupils with visual impairment from preschool to age 18/19. Sexual education, containing all necessary elements combined with education within the family is the cornerstone of an expectant mother‘s awareness, and her feeling of competancy in parenthood. This emphasizes a respectful attitude to women with visual impairment. The author points out the possible connections between recommending C-sections to these women (from the expectation of progressing the visual impairment during childbirth), and ongoing unsuitable delivery techniques. The article includes international studies showing that there are women with visual impairment who can give physiological birth without any changes in their visual diagnosis (if certain condi-tions are met). The practical part of this article includes the case-study of a woman who was able to deliver naturally even after two previous C-sections with no change in her visual diagnosis.

Keywords: Woman, Visual Impairment (VI), Pregnancy, Awareness, Competence of Women, Childbirth Preparation, Physiological Childbrith, Natural Childbirth, C-section, Respect, Maternity, Parenting

Motto: “Childbirth plays an important role in the life of a woman. It is the one fundamental moment that a woman will always come back to in her thoughts. The way it happens will be projected into her relationship to herself, to her baby, partner and to the whole society. Childbirth is not only a physical matter that the woman should survive, and it should not be a painful sacrifice. Instead, childbirth should


carve deeply and positively into the soul of each woman and child. During the birth, not only the child is born, but a mother is born and a new family is created. Birth can be a strong and happy experience for the woman, that will stay in her heart forever. This is why it is the oblilgation of society to create the conditions for woman and child so that the new mother would feel supported in her maternity role, and that the child would get a dignified and loving welcome.“

Anna Kohutová

1 IntroductionToconcievea childwithherlifepartnerispartofthenaturalinstinctofthewo-man.Thisisthesameforwomenwithvisualimpairment(VI),theyneedanopenfutureanda strongemotionalbondthroughtheparentingrole.Afteranalysingthecurrentinformationresourcesaccessible,weseethattheareaofpregnacy,deliverypreparation,deliveryandmaternityofwomenwith VIisstillnotnotdedicatedenoughattentioninCzechia.Thesituationisnothelpedby themythsthatstillexistaboutthesexualityofpeoplewithVI,andprejudicesagainstthesewomen’scompetencytogivebirthandbea parent.Simultaneously,amongthesewomen(and womenin general)thefeelingsofincompetencytodelivera babyarerising,especiallydueto a lackofinformation,andtheimpactofthewoman’ssurroundings.Thewholedeliveryprocessandbondinghasa hugeeffectonthewoman’spsyche.Buta tendencytowards C-sectionsisrisinginmodernsociety.ApartfrompossiblecomplicationsforwomanandchildduringtheC-section,anotherconsequenceisseparationofthechildfromthe mother,whichcancausepost-nataldepressionanddisruptthenaturallactationprocess.WomenwithVIareprimarilyrecommendedtodeliverthroughC-section,andinfollowingpre-gnanciesC-sectionsarestronglyrecommended.Meanwhile,incurrentresearchandpracticeitisshownthattherearewomenwithsomevisualdiagnosesexistingwhoare abletogivephysiologicalchildbirthwithoutanysubsequentchangesintheirvisualdiagnoses,evenwhengivingbirthafterpreviousC-sections.A widerangeoffactorsmustbeconsidered,the essentialbeing;visualdiagnosis,physical/psychologicalreadiness,andtheprovidedexternalconditions.

2 Definitions of the terms used Itisimportanttodefinetheessentialtechnicaltermswhichused.Firstly,“a personwithvisualimpairment“,issomeonewithlowvision(moderate,orseverewhichmeansbeingableto countfingersatsixmetersorless)orblindness(profound:


countingfingersatlessthan3 meters,near-total:at1meterorless,ortotal:nolightperception)accordingtoWHO.1

Next,physiologicalandnaturalchildbirth:physiological,alsocalled“normal“is,accordingto WHO,definedas, „spontaneousinonset,low-riskatthestartoflaborandremainingso throughoutlaboranddelivery.Theinfantisbornspontaneouslyinthevertexpositionbetween37and42completedweeksofpregnancy.Afterbirth,motherandinfantareingoodcondition.»2ICM3callnormalchildbirtha uniquedynamicprocess,whenthephysiologyofthefetusisreactingreciprocallywiththemother(withthegoalofmotherandbabytobesafeand healthy).

Naturalchildbirthisdefinedas“a childbirthwhichstartsandisgoingsponta-neouslywithoutanyexternalintervention.Itisaccordingtothewoman‘sinstincts.Itishappeningathomelikeenvironment.Thestaffinterfereminimallyandkeepanintimateatmosphere,respectingher intuitiveattitude.Theyareopentoherwishesanddemands,whichsupportthepositiveemotionsandcontributestothechildbirthwithoutanystressorfear“.(Štromerová)4

3 Information resources accessible to women with low vision or blindness

“Childbirth is a natural female ability, and the right of the woman is to be informed about this ability.“

Anna Kohutová

A womanwithlowvisionorblindness,aswellasa womanwhoisabletosee,createsher imaginationaboutherchildbirthstep-by-stepbasedontheobtainedinformation.

3.1 Media

Fromresearch(Paulíková2013,Kilduff&Kohutová2017,Kilduff2018,Kavalírová,Liškaa Vondráčková2015)weseethemaininformationresourcesforpeoplewithlowvision/blindnessareinternetandTV.Easyandgreateraccesstospecificinforma-tionmeansinternetprevailsagainstTV.However,thereisa riskoffindingincom-pleteinformationor misinformation,andofbeinginfluencedbytraumaticlabourstoriesthatleavewomanuncertainorscaredfromchildbirth.Itisalsodifficulttosearchspecificsifoneisunawareof theirexistance,e.g.informationaboutpossiblewaysofdelivery,thedeliverywish,prenatalcoursesetc.Manyblindwomenjoinnet

1 InternationalClassificationsofDiseasesWHO,2006[online].2 Definitionofnaturalbirth.[online].3 InternationalConfederationofMidwifes:Keepingbirthnormal.[online]4 Štromerová,Z.Přirozenýporod[online].


conferences,like“MaminaMimina“,toshareexperiencesandrecommendationsonmaternityandparenting.

Printedpublications exist on this topic5; a brochure from theOkamžikAssociation,a fewtechnicalarticles(Kilduff&Kohutová2017)aswellasincludinga fewtheses(accessibleonline).Apartfromthis,womenwithVIarelefttorelyonmainstreamliteraturewhichdoesnotcaterforthespecificaspectsofdeliveryprepa-rationanddeliveryitself,norforparentingasa womanwithVI.

3.2 Family

SomewomenwithVIobtainedtheaforementionedinformationfromtheirfamilies.However,questionsaboutthistopic,includingsexualityareusuallynotansweredenough(Škutová,2008,Kubátová2013).Inextremes,theyaretaboo,inspiteofthenaturalinterestofchildrenwithVI.

3.3 Sexual education of children with VI at schools

Therehavebeena fewresearchesmappingtherealizationofsexualeducationinschoolsandthesubjectivepreparationofchildrenforrelationshipsandfuturefa-milylifeinthelast15yearsorso.Škutová(2008),engagedinresearchaboutsexu-aleducationatpreschoolandprimaryschoolages,andshedlightonthelimitedunderstandingofsexualeducationamongteachers,and thetendencytoleavethisresponsibiltyonparents.

Míka(2015)discoveredthatmorethan80%from64childrenwithVIwithanaverageage17.5,considersexualed.asveryimportantandhelpful.Paulíková(2013)pointsoutthatalmost30%ofherrespondantswithaverageage14.65recievedthisinformationtoolate.Sometopicsgirlswereinterestedin,likecaringfora newborn,werecompletelyneglected.Sodo younggirlswithVIgetthefull,correctandcurrentinformationaboutdeliverypreparation,and possibilitiesconnectedtotheirvisualdiagnosis?

Thereisa noticableshiftinthisarea,withpregraduatefuturesexualed.teachers.Wecanexpectthatthequalityofsexualed.inschoolisincreasingasteachers‘inter-estincreases.Childrenareleadtoopencommunication,andexpresstheiropinionsandinterests.In addition,spreadingtheinformationaboutthelifeofpeoplewithVIhelpstobustthemythsaboutthesepeopleandtheirneeds.

3.4 Prenatal courses

Specialprenatalcourses,aswellasinformationaboutmaternityandbreastfeedingisstillverylimited.SpecializedcoursesdedicateddirectlytocoupleswithVI,areof-feredbyTyfloservis,butonlyoccassionally(Kavalírová,LiškaetVondráčková,2015).

5 Inenlargedprintoraudioformat


3.5 The Department of Health

Therighttogivebirthnaturally,orphysiologicallyshouldnotbepossibletotakeaway.The onlyreasonstodo sowouldbemedicalcomplications,orcontraindi-cations.WomenwithVIareprimarilyrecommendedC-sectionsinCzechia.Asmentionedabove,thisshouldbe recommededbyanopthalmologistwhennormalchildbirthcouldhaveanadverseeffectonvisualacuity.Opthalmologistsworryabouttheexpulsionphaseofdelivery,whenduringineffectivepushingthepressureinsidethewoman’sheadcouldcausea progressionofher VI.6ThisisnotrecommendedbyWHObecauseoftheirstudies,andthereasonsforma listof harmfuleffectsforallwomen,especiallyforwomenwithVI(BosomworthetBettany-Saltikov,2006;Kopas2014). A womanshouldfollowherownfeelings7.Controlledforcefulpushinginstructedbythemedicalprofessionalsisnotrecommended.Itisadvisedtogivebirthinanintuitiveandverticalposition,andwhiletheheadiscrownedthewomanshouldbelet toexhaledeeplyandcalmly,tobreatheandnottopush.Itisquestionable,whethertheopthalmologistwhorecommendC-sectionsareinformedaboutWHOrecommendations,andhowmuchtheirC-sectiontendencyiseffectedbytheirownawarenessofpractisesinmanyCzechhospitals.Towhatextentdo opthalmologistsexpecta passiveattitudetochildbirthfroma womanwithVI?Howmuchdo theyexpectthatshewillnotbeinformedaboutthephysiologyofthedeliveryprocess?Howisittakenforgrantedthatthewomanisafraidof childbirth?Itistrulyneces-sarytoalwaysrecommenda womanwithVI/blindness(havingthusfarexperienceda naturallydevelopinghealthypregnancy)a C-section?

“I don’t remember already if my gynecologist informed me about the possibility to deliver the baby normally, nobody else was informing me about this possibility or of a natural childbirth.“ (A blindrespondantfromKilduff&Kohutová,2017)Let‘sconsidertheconnectionbetweenmarkingpregnancyasa high-riskone

a priori,basedonVIalone,and(withotherfactorsmentionedabove)theC-sectionrecommendation:

“My pregnancy was labelled as high-risk, even though it was going completely nor-mally.“ (Kavalírová,Liška&Vondráčková,2015,p. 18)

“Me... my pregnancy was called “high-risk“, and there was no other reason, just my visual impairment.“ (inViktorová,2014,p. 40)

6 InCzechiaitisstillcommoninmanyplacestopracticecontrolledforcefulpushing:Valsalva‘smaneuver.The expectantmotherhastoputherchinonherchest,inhaledeeplyandpushforupto20secondswhileholdingherbreathandclosinghereyes.Thenshemustquicklyinhaleandrepeatthis3timesconsecutively.

7 AccordingtotheNationalInstituteforHealthandCare Excellence.[online]


“Put simply, there are two worlds existing – the world of pregnant women where the women are naturally trusting, naive, merry, scared, uncertain and, desiring a healthy baby. Aside from this world is the world of doctors, based on medical knowledge, the cool-headed application of methods, a desire to help, the fear of a wrong diagnosis, pressure from legal responsibilty, and time-pressure. The core of consultation is how to connect these two worlds and aim for meaningful, clear and effective communica-tion.“ (OdentinLabusová)8

“A patient has the right to obtain all information from their doctor, to be able to decide if he/she agrees with the course of action or not. If there are more alterna-tives, or if the patient asks for alternatives, they have the right to be informed about them.“ (Haškovcováin Zobancová,2006,p. 18-19)

Every expecting mother should recieve all the information about the process and possible risks about the C-section, to be able to sign the consent. (Kavalírová,LiškaetVondráčková,2015).

“It is essential for all expecting mothers to be informed about the benefits of the natu-ral childbirth and complications of C-sections.“ (Dr. Yap-SengChong,SingaporeStateUniversity.9)

4 Other factors effecting the feeling of competence and towards childbirth for women with VI

Thenaturaldesireandrightofa womanwithVItodeliverasnaturallyaspossible,isveryoftenstronglyconfrontedwiththeexperiencedorsharedreality.AccordingtoMáslová(inLabusová2011)childbirthnowadaysistraumaticformanywomeningeneral“whichleadstofearaboutotherchildbirths,aswellasleadingtoa feelingoftheft,melancholia,andnightmares.All of thishasa strongnegativeimpactonbreastfeeding.Rigidmaternitywardatmosphere,andobtrusivnessoftheinvasivestyleofdirectingchildbirth,arefeltlikea rapeofthesewomenaswellastheauto-maticseparationofmotherandnewbornafterchildbirth“.10

Forwomenwithlowvision/blindness,itisevenmoredifficultbecauseofotherfactors,whichare;lowaccesstoinformation,a lackofqualityinformativeresourcesaboutthistopic,and alsoa limitedunderstandingofthecontentofsexualeducationinfamilyandschool(compareŠkutová2008,Paulíková2013,Míka2015).Thelack

8 Labusová,E.Prenatální diagnostika: Dojít k vlastnímu rozhodnutí.[online]9 Thiscomment,whiledirectlyaboutvoluntaryC-sectionsinmanycountriesandnotinCzechia,

isfullyapplicabletoourdiscussionasitbringstolightnotonlythetrendtowardsC-sectionsworldwide,butalsotherisks.C-sectionsarethreetimesriskierthannormalbirth[online]

10 Labusová,E.Poporodnídeprese:Duševníporucha,nebopřirozenáreakce?[online]


ofinformationaboutthe physiologicalchildbirthprocesses,plusthetransformingofsexualthemesintotaboos,causesa lowerfeelingofconfidenceregardingchildbirthandmaternityandthereforecreatesa feartotrustthewomen’sownbodyduringbirth.(ICM,2014).11Womenwithlowvision,and womenwithblindness,canalsofeelscaredduetotheirpreviousnegativememoriesassociatedwithhospitalsandthosesharedbyotherwomenwithVI,andaswellfrom prejudicesagainstthewo-man’sabilitytocareforthenewborn.Thewomancanfeeldistance,disrespect,anddisapproval,shecanfacemanyuncomfortablequestions,andevenprejudicesagainstherlegalcapacitycansometimesmanifest(seeKavalírová,Liška& Vondráčková2015,Kilduff&Kohutová2017,Viktorová2014).Morefactorsinclude,orientationina newenvironmentnegativelyinfluencedbyVI(Zobancová2006),plusstressanda lackofemotionalsupportfroma personalmidwifeorfamilymemberswhoperhapscouldnotarriveintimetomakesurethewoman’sbirthwishesarefollowedandthatsheis experiencinga respectfulattitudeduringthatchallengingtime.

5 Delivery of women with VI who have already experienced C-sections

ItiscommonpracticethatwomenwhohavegivenbirthalreadybyC-sectionare rec-ommendedagainC-sectionsforthenextbirths.However,accordingtosomestud-ies(Neri,A –Grausbord,R–Kremer,I –Ovadia,J–Treister,G.1985;Landau,D.–Seelenfreund,M.H.–Tadmor,O.–Silverstone,B.Z.–Diamant,Y.1995;Prost1996)aswellasconcretecasesofwomenwithVI(seefurther)thefactisshownthatwomenwithVIareabletodeliverphysiologicallyeven aftertheC-sectionbefore,iftheinnerandouterconditionsaremet.Theyareabletogivethenormalbirthevenwithout changesintheirvisualdiagnosis.

5.1 A case-study of a woman with severe low vision

Thecasestudybelowiswrittenasa childbirthstory,whichisshortened(duetocapacity)and thefullversionisavailablefromtheauthor(whohasbeengiventherespondant’spermissiontoshareit).

5.1.1 Goals of the qualitative researchThemaingoalwastodescribethethirddeliveryofonewomanwithseverelowvision.Partial goal 1: Findoutabouttheconditionsandtheprocessofthethird(andphysiological)delivery,whichoccuredaftertwopreviousC-sections,andwhichwasrecommendedagainby theopthalmologisttobedonebyC-section.

11 InternationalConfederationofMidwifes:Keepingbirthnormal[online].[online]


Partial goal 2: FindoutthestateofVIprogressionpossibilycausedbyphysiologi-caldelivery.Partial goal 3: Findoutthesubjectivefeelingsofthewomanfromthestartofthedeliveryto theendofthepostnatalperiod.

5.1.2 Characteristics of the research sampleTheresearchsamplewaschosenintentionallybasedonrelevantattributes,whichwereVIandchildbirthbyC-sectionandsubsequentlythephysiologicalchildbirth.Therespondantwas one womanwithVIgivingbirthforthethirdtimeatage35.

Thevisualdiagnosis:lefteyetotalretinaldetachmentatage6months,sincethenamaurosis,andtherighteye,myopiagravis.Afterthefirstchildbirthshehad15dioptresandduringthe thirdpregnancyitwasmuchmore,12 in addition, cataracts had appeared.

Therespondantisa two-timemotherafterC-sectionsandthethirdpregnancywas recommendedtobealsobyC-sectionbytheopthalmologist,eachofwhomstateda differentlevelofriskoftheprogressionoftheVItowardsblindness.

5.1.3 Data collection Thedatawascollectedthroughinterviewandbyobtainingthedeliverystory.

5.1.4 The delivery story called: VBA2C Miracle – spontaneous childbirth after two C- sections (shortened version)

“I didn’thaveanyimaginationabouthavingkidsyet,butI knewalreadythatI won’tbeabletodeliverspontaneously.Alreadyatsecondaryschool,I gottheinformationfrommydoctorsandparentsthatpushingduringchildbirthwillprobablymakemeblind,andsincethenI heardthisinformationaboutblindnesscausedbyphysiolo-gicalchildbirth,andI hearditsomanytimesthatwhenI becamepregnantI didn’tdoubtthewordsofmyeyedoctor,thattheC-sectionisthebestchoice.Theriskwastoobig.So,afterthefirstdeliverybyC-section,andthenanotherone,andthethirdonewassupposedtobethesame.WhenI wasinthesixthmonthofthethirdpregnancy,I visiteda lectureofthedeliveryassistant,AnnaKohutová,calledKind and Gentle Delivery by Operation.There,mybeliefthattodeliverphysiologicallyishigh-riskforme,developeditsfirstcrack.I camehomeandI readontheinternettonnesof studies,Czechandforeigndiscussions,andpersonalstoriesofmotherswhoweregivingtheirbirthspontaneously,eventhoughhavingmyopiagravis,orretinaldetachment.I surprisinglyfoundoutthatI’mnotabletofindevenonestudy,oronestoryaboutretinaldetachmentafterphysiologicalchildbirth.Itdoesn’tmeanthatitdoesn’texist,butI wasn’tabletofindit.I realizedthatI havetomakea decision

12 Subjectivelyfelt,thewomandidnotknowtheexactamountofdioptres.


aboutwhatI wanttobelievein,becauseafterconsultationwiththreeeyedoctors,I gotthreedifferentopinionsabouttheamountof riskaboutmyvisualimpairmentprogression.I decidedtobelievethatthephysiologicalchildbirthissafeformyeyesandthatI amabletoprepareforitinthreemonths.“

5.1.4 Evalution of the partial goalsEvalution of goal 1: Basedonstudyingtheresearchfindings,investigatingtheexperiencesof womenwithVI,consultinga potentialvisualdiagnosisprogressionwiththreeopthalmologistswheneachofthemstipulateda differentdegreeofriskofblindness,the respondantdecidedtodeliveryphysiologically,vaginally.Therapiddeliverywhichhadbeenplannedtotakeplaceinthematernityhospital,happenedspontaneouslyathome.Evalution of goal 2: TheprogressionoftheVItowardsblindnessdidnotoccurthanksto the naturalchildbirth(unlikethecontrolledtype).Therespondantdidnotfeelanychangeofthevisualacuity,evenaftera manymonthsanduptothewritingofthisarticle.Evalution of goal 3: Therespondantdescribedherimmediatefeelingsasfollows:

“I am a mommy of three wonderful children. A fresh, three-time mother. Now I’m holding my son in my arms, we experienced a beautiful natural childbirth. Maybe I’m so taken away by it all and enthusiastic because I know how childbirth can be, and so I’m even more grateful that I could experience a natural childbirth.“

6 ConclusionTheaimofthisarticlewastomakea viewintothisissueofwomenwithVI,thedeli-verypreparationincluded,accessible.Thearticleacquaintsthereaderwithdifferentwaysof deliveryandpointsoutpossiblerisksassociatedwithC-sections.Theauthorofthisarticleisrealizingfullythateachcaseisindividualandspecificandnowayofchildbirthisidealforallwomen,inviewof;thewoman‘suniqueness,possiblecomplicationsduring pregnancy,VIdiagnosis,andarrangmentofinnerandouterconditions.Thecasestudyprovesthatevena womanwithsevereVIisabletodelivernotonlyphysiologically,but completely naturally,withnosubsequentprogressionofhervisualdiagnosis,evenafterpreviousC-sections.

But,themainrequirementsare:• a higherlevelofinformationavailableincludingalltopicswithinsexualeducation• a sufficientawarenessoftheexpectantmotheraboutthephysiologyofthedeliv-

ery,the phases,andpossiblerecommendedwaysofchildbirth• thementalandphysicalpreparationoftheexpectantmother,andherpro-active

attitudetothedelivery


• supportoftheenvironment,thepartner,family,deliveryassistantsordula,re-spectfulandkindstaffinthegynecologydepartment,inthematernityhospital,staffwhoknowtheneedsofwomenwithVI,includingthewaystocommunicatewiththem

• organisingtheidealouterconditions,asmuchaspossible,forphysiologicalornaturalchildbirth–supportofthenaturalpositionusinggravitation,notime-pressure,and providingintimitesurroundings(softlights,etc)

• theabscenceofsimultaneoushealthcomplications.Inthecasethatphysiologicalchildbirthisnotpossible,itisimportanttosupport

the bondingofmotherandbabyasmuchaspossible,whichisthenecessaryprequisiteforactivationand continuationoflactationandpreventionofpostnataldepression.

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Usedandrecommededinternetresources:22. Birth Options for Mothers Who Are Blind or Visually Impaired [online].[cit.2017-09-12].Accessible

at:https://www.visionaware.org/blog/visually-impaired-now-what/birth-options-for-mothers-who-are-blind-or-visually-impaired/12

23. International Classifications of Diseases.WHO,2006[online].[cit.2018-09-02].Accessibleat:http://www.who.int/classifications/icd/en/

24. International Confederation of Midwifes: Keeping birth normal.[online].[cit.2017-09-08].Acces-sibleat: http://internationalmidwives.org/assets/uploads/documents/Position%20Statements%20%20English/Reviewed%20PS%20in%202014/PS2008_007%20V2014%20Keeping%20Birth%20Normal%20ENG.pdf

25. Pět zrození–dokument[online].Dostupnýna https://www.youtube.com/watch?v=f-CZgwTC5bk26. Preparing for Pregnancy: A Blind Mother Checklist. Part 1. Am I ready? [online].[cit. 2017-09-

12].Accessibleat:https://www.visionaware.org/blog/visually-impaired-now-what/preparing-for-pregnancy-a-blind-mother%27s-checklist-part-1-am-i-ready/12

https://www.ncbi.nlm.nih.gov/pubmed/8543212



https://www.visionaware.org/blog/visually-impaired-now-what/birth-options-for-mothers-who-are-blind-or-visually-impaired/12

https://www.visionaware.org/blog/visually-impaired-now-what/birth-options-for-mothers-who-are-blind-or-visually-impaired/12

https://www.youtube.com/watch?v=f-CZgwTC5bk

https://www.visionaware.org/blog/visually-impaired-now-what/preparing-for-pregnancy-a-blind-mother%27s-checklist-part-1-am-i-ready/12

https://www.visionaware.org/blog/visually-impaired-now-what/preparing-for-pregnancy-a-blind-mother%27s-checklist-part-1-am-i-ready/12


27. Porod císařským řezem je až třikrát rizikovější než přirozený [online].[cit.2018-03-02].Accessibleat:https://www.novinky.cz/zena/deti/189082-porod-cisarskym-rezem-je-az-trikrat-rizikovej-si-nez-prirozeny.html

28. http://normalniporod.cz29. www.annakohutova.cz

(reviewedtwice)

Mgr. DanielaKilduff,Ph.D.DepartmentofSpecialEducationFacultyofEducation,UniversityofOstravaCzechRepublice-mail:[email protected]

https://www.novinky.cz/zena/deti/189082-porod-cisarskym-rezem-je-az-trikrat-rizikovejsi-nez-prirozeny.html

https://www.novinky.cz/zena/deti/189082-porod-cisarskym-rezem-je-az-trikrat-rizikovejsi-nez-prirozeny.html

http://normalniporod.cz/

http://www.annakohutova.cz/


Survey on Physical Education Student Teachers’ Attitudes toward Teaching Students with Special Needs

(overview essay)

Li Yun, Zhang Guodong

Abstract: With the implement of revised Regulations on Education for Persons with Disabilities on May 1. 2017, more and more students with special needs will be educated in general schools in China. As a psychological tendency, attitude affects the behavior to a certain degree (Zhang Hong-tao & Wang Er-ping. 2007). As physical education teach-ers in the future, PE student teachers’ attitude toward individuals with special needs will affects their behaviors to some extent. In order to predict the reserve of primary and secondary school PE teachers, it is necessary to investigate the attitudes of PE student teachers toward students with special needs. The survey was carried in three universi-ties, Beijing Normal University, Shaanxi Normal University, and Southwest University, and the participants are freshmen and senior students majored in physical education. Out of the 485 participants that responded, only 2 (0.004%) had taken special educa-tion courses, and none had taken adapted physical education courses. However, out of the 470 participants that responded, 173 (36.8%) have been around or studied with individuals with special needs. Results indicate that PE student teachers have more positive attitude to teach students with obesity, which followed by physical disabili-ties and other health impairments; the female had more positive attitudes than male. Especially, a statistically significant difference was found that attitudes toward obesity between genders, p＜.05; freshmen had a more positive attitude to teaching students with special needs in general PE class. A statistically significant different (p＜.05) was found between the PE freshmen and senior student teachers in attitude toward teaching students with obesity and students with other health impairments. A very high statisti-cally significant different (p＜.01) was found between PE freshmen and senior student teachers in outcomes of teaching students with obesity in regular classes.

Keywords: student physical education teachers, students with special needs, attitudes, general school


1 IntroductionAtpresent,thepopulationofindividualswithdisabilitiesisabout85millioninChina.Theeducationalsituationremainsatlowlevelformanyyears.Withthedevelopmentofsocietyandeconomy,thisissueattractsmoreandmoreattentionrecently(HuangZhi-cheng,2003;ChenShu,LuoYong-hua,&HuangYi-zhu,2012).Equalrightsforindividualswithdisabilitieshavebecomea focusinChina(Deng&Manset,2000).AccordingtoDengandManset,atleast210,000newspecialschoolsarerequiredtoestablishformeetingseparateeducationofnearly5millionchildrenwithdisabilities.Currently,enrollingstudentswithdisabilitiesingeneralschoolsmaybeanenforce-ableapproach.Inaddition,theStateCouncilofChinarecentlyannouncedtherevisedRegulationsonEducationforPersonswithDisabilities,whichwillbeimplementedonMay1,2017(REPD-2017:therevisedRegulationsonEducationforPersonswithDisabilities,2017).Itisa soundsupportforindividualswithspecialneedstoreceiveeducationandimprovetheireducationallevelinmainstreamingschools.Article17inREPD-2017stipulatesthat,inaccordancewiththeprovisionsoftheCompulsoryEducationLawofthePeople’sRepublicofChina,iftheindividualswithdisabilitiescanadapttotheordinaryschoolslifeorcanbeeducatedinordinaryschools,theyshouldenterthegeneralschooltoacceptcompulsoryeducation.

Inclusionconfersmanybenefitsintermsofsocializationandcurricularaccess,whilebringschallengesforteacherswhomaynotbeadequatelypreparedtoteachstudentswithspecialneeds.Article58inREPD-2017stipulatesthat“inclusionedu-cationreferstointegratetheeducationofstudentswithdisabilitiestothegreatestdegreeintogeneraleducation.”In《ATeacher’sGuidetoIncludingStudentswithDisabilitiesinRegularPhysicalEducation》byMartinE.Block(1994),wecanalsofindtheverylikestatement:“inclusionisthepracticeofeducatingallstudents,in-cludingstudentswithdisabilities,inregulareducationandregularclasses”(p19–20).However,inclusionisa longtimeneededprocess.Itisgenerallyacceptedthatstudy-ingtogetherinregulareducationandregularclassesbenefitsforindividualswithandwithoutspecialneeds.

ForPEstudentteachers,theattitudesformedduringtrainingandeducationarelikelytoaffecttheirbehaviorduringtheirteachingcareers(Hastings&Oakford,2003).Anotherresearcharguedthatinadequatetrainingregardingstudentswithdisabilitiescausedteacherstoexhibitnegativeattitudestowardstudentswithdis-abilitiesandtowardthepracticeofinclusion(Subban&Sharma,2005).Inaddition,Antonak&Larrivee(1995)thinkthatteachers’negativeattitudestowardstudentswithdisabilitiescreatedanexpectationforlowachievementforthosestudents,aswellasloweredsocialstatusforthosestudents.


PE student teachers’ attitude toward individuals with special needs Physicaleducationisimportanttopromotehealth-relatedlifestyleofindividualswithandwithoutspecialneeds.A qualityschoolphysicaleducationprogramcanplaya keyroleinindividuals’healthsinceitprovidesopportunitiesforparticipationinphysicalactivity.Butmanystudentswithspecialneedsarenotactiveincludeddur-ingphysicaleducationclasses.Withtheincreasinglyincludedsituationofstudentswithspecialneedsingeneralphysicaleducationclasses,theroleofPEteachersisveryimportantinthedevelopmentofPEprogramsforstudentswithspecialneedsingeneralphysicaleducation.

ShelleyE.Taylor,LetitiaAnnePeplau,andDavidO.Sears(1994)pointthathav-ingdirectpersonalexperiencewithanissuegetsustothinkandtalkaboutitmorethanifitisremotetous.Soattitude-behaviorconsistencywillbegreaterwhenwehavedirectexperiencewiththeattitudeobjectthanwhenweonlyhearaboutitfromsomeone else or read about it.

ThePEstudentteachers’attitudeswillhaveanimpactonthefutureeducationalprocesswhatevertheyarenegativeorpositive.Especiallytheirattitudestowardteach-ingstudentswithspecialneedsappeartoeffectonstudents.Usually,thesestudentshavelittleornoexperienceinworkingwithindividualswithdisabilities(Rizzo &Vispoel,1992).Ajzen,theAmericaresearcher,inhistheoryofPlannedBehaviorstatesthatanindividual’sexperiencesinfluenceandmoldsone’sattitudeandactionstowardsothers(IcekAjzen,1991).RizzoandVispoel(1992)alsosuggestedthatteacherswithmoreexperienceworkingwithstudentswithspecialneedsseemtohavemorefavorableattitudestowardthestudentswithspecialneedsthandidteacherswithlessrelatedexperience.

Asfutureteachers,PEstudentteachers’attitudetowardindividualswithspecialneedswillaffecttheirbehaviorstosomeextent.ResearchontheirattitudeswasforpreparingfuturePEteacherstosuccessfullyintegratestudentswithspecialneedsintoappropriateeducationalenvironments.Inordertopredictthereserveofpri-maryandsecondaryschoolPEteachers,itisnecessarytoinvestigatetheattitudesofPEstudentteacherstowardstudentswithspecialneeds.Basedonthese,thisstudycarriedoutformeasuretheattitudesthatPEstudentteachersholdtowardteachingstudentswithspecialneeds.

2 MethodologyParticipantsTheparticipantsofthecurrentstudywerepurposivesampling,includingfreshmenandseniorsattheSouthwestUniversity,ShanxiNormalUniversity,andBeijingNor-malUniversityinChina.PEstudentteachersparticipationinthestudywasvoluntary.


EachPEstudentteachersignedanddatedtheinformedconsentformattachedtothesurvey.Alltheparticipantswerepreparingtobemainstreamingteachersinalloverthecountry.A totalof485PEstudentteachersparticipatedinthisstudy,80%(n=393)weremaleand20%(n=92)werefemale(seeTable1).Thereare8.9%(n=43)fromBeijingNormalUniversity,45.6%(n=221)fromShanxiNormalUniversity,and45.6%(n=221)fromSouthwestUniversity.

Table 1: Demographic information of the questionnaire sample (n = 485)

Variables Category Frequency %

Gender Male 393 81.0Female 92 19.0

Grade Freshman 239 49.3Senior student 246 50.7

University BeijingNormalUniversity 43 8.9ShaanxiNormalUniversity 221 45.6

SouthwestUniversity 221 45.6

Survey InstrumentDatawerecollectedusingthePEATID-III(SherryL.Folsom-Meek&TerryL.Riz-zo,2002).ForreflectingthecompositionofstudentswithspecialneedsingeneralschoolsofChina,thelabelsofdisablingconditionsanddemographicsectionweremodified.TheinstrumentwastranslatedintoChineseandvalidatedbeforedatacollection.Accordingtoexpertcomments,theoriginaltypesofdisabilitieswereadjustedtothreetypesofspecialneedsinthisstudy(i.e.,obesity,physicaldisability,andotherhealthimpairments).

ThePEATIDIIIquestionnairewascomposedof12itemsansweredona five-pointLikert-typescale(i.e.,1=stronglydisagree,2=disagree,3=undecided,4=agree,5=stronglyagree).Itmeasuredthreeareas:(a)outcomesofteachingstudentswithspecialneedsinregularclasses(6items);(b)effectsonstudentlearning(4items);and(c)needformoreacademicpreparationtoteachstudentswithspecialneeds (2items).Sixitemsarepositivelyphrasedandsixarenegativelyphrased.Thenega-tivelywordedquestionswereconvertedtopositivescoresinthestatisticalanaly-ses.Scalemeanscoresarebasedonthesumoftheitemscores.Toderiveproperscalemeans,thescoresforstatementsthatarenegativelyphrasedarereversed(i.e.,5,6,7,8,9,and10).

Theoutcomesofteachingstudentswithspecialneedsinregularclasseswascom-posedof:(5)wouldnotbeacceptedbypeers,(6)woulddisruptharmonyoftheclass,(7)wouldcauseunfairburdenonteachers,(9)wouldcausemoreworkfortheteacher,(10)shouldnotbetaughtinregularclassesasrequiretoomuchteacher


time,and(12)shouldbetaughtina regularclasswheneverpossible(Folsom-Meek&Rizzo,2002).Ifrespondentsscoredlowonthisarea,itwouldindicatethattheoutcomeofteachingstudentswithspecialneedsintheregularclassroomwasnotviewedtobeideal.Ifrespondentsscoredhigh,itwouldindicatethatteachingstu-dentswithspecialneedsintheregularclassroomwasviewedasidealfortheteacherorforthestudents.Thatis,respondentsbelievedstudentswithspecialneedsshouldbetaughtintheregularclassroom.

Theeffectsonstudentlearningrepresentedstudentswithvaryingabilitieslearningtogetherinphysicaleducation(Folsom-Meek&Rizzo,2002).Thesefouritemswere:(1)bothgroupsofstudentsworktogether,(2)workingtogethermotivatesstudentswithoutspecialneeds,(3)studentswithspecialneedswilllearnmorerapidlyinclasseswithpeers,and(4)studentswithspecialneedswillhavemorepositiveself-conceptasa resultofstudentsbeingsuccessfulinregularclasses.Higherscoreswouldindicatethatrespondentsviewedstudentswithvaryingabilitiesasbenefittingfromlearningtogetherinphysicaleducation.A lowscorewouldindicatethatrespond-entsviewedstudentswithspecialneedsinregularclasseswithtypicalstudentsasnotbenefittingfromlearningtogether(i.e.lowpositiveself-concept,studentsnotworkingtogether).

Theneedformoreacademicpreparationtoteachstudentswithspecialneedsin-cludestwoitemstoidentifytheneedformoreadditionalcourseworkandacademicpreparation.Thesetwoitemswere:(8)do nothavesufficienttrainingnecessarytoteachstudentswithspecialneeds,and(11)needmorecourseworkandtrainingbe-forefeelcomfortableteachingbothstudentswithandwithoutspecialneeds.Higherscoreswouldindicatethatteachersfeeltheydo notneedmoreacademicpreparationinordertoteachstudentswithspecialneedseffectively.Ifrespondentshadlowerscoresonthisarea,thiswouldindicatethatteachersfelttheyneedmoreacademicpreparationinordertoteachstudentswithspecialneedseffectively.

Definition of TermsPEstudentteachers.Inordertoencouragemoreyoungpeopletobeinga teacher,theChinesegovernmentimplementedtheFee-WaiverPolicyforteachertrainingprogramsinsixnormaluniversitiesthataresupervisedbytheMinistryofEduca-tion,includingBeijingNormalUniversity,ShanxiNormalUniversity,SouthwestUniversity,EastChinaNormalUniversity,CentralChinaNormalUniversityandNortheastNormalUniversityfromtheyearof2007.ThePEstudentteachersinthisstudyarestudentswhoenrolledinPhysicalEducationundergraduateacademicdegreeprogramsinthreeofthesesixuniversitiesforprofessionaleducatorswhosetrainingandeducationpreparesthemtoteach.


3 ResultsItisimportantthatscalesarereliablewhenselectingscalestoincludeinthestudy.Therearea numberofdifferentaspectstoreliability.OneofthemostcommonlyusedindicatorsofinternalconsistencyisCronbach’salphacoefficient.Ideally,theCronbach’salphacoefficientofa scaleshouldbeabove.7.(JuliePallant,2001).TheCronbach’salphacoefficientinthiscaseis.906,sothescalecanbeconsideredreliable.

The influence of experience with and without studying with individuals with special needsTheparticipantshavepositiveattitudestowardteachingstudentswithspecialneedsinthisstudy.TheaveragescoreofthethreecategoriesofspecialneedsishigherthantheaveragescoreofPEATIDIII(36).Themeantoobesityis42.03,whichisthehigh-estscore,followedbythemeantophysicaldisability(40.25)andthemeantootherhealthimpairment(39.92)(seetable2).Outofthe485participantsthatresponded,only2(0.004%)hadtakenspecialeducationcourses,andnonehadtakenadaptedphysicaleducationcourses.However,outofthe470participantsthatresponded,173(36.8%)havebeenaroundorstudiedwithindividualswithspecialneeds.A t-testwasconductedtolookatthedifferencesbetweentheindependentvariablebearoundorstudywithindividualswithspecialneeds(beandnotbearoundorstudytogether)andthedependentvariablePEATIDIIItowardthreecategoriesofspecialneeds.Theresultshowsnostatisticallysignificant.

Table 2: Mean, Standard Deviation and T-test for categories according to experience

Categories of special needs

Experience N Mean Std. Deviation Std.Error Mean

T

Obesity no 302 42.08 5.609 .323 .277yes 168 41.93 6.074 .469

total 470 42.03 5.768Other health impairments no 302 39.87 5.128 .295 -.335

yes 168 40.04 5.091 .393total 470 39.92 5.115

Physical disability no 302 40.23 5.057 .291 -.147yes 168 40.30 5.236 .404

total 470 40.25 5.111

The differences between gendersThedifferencesbetweengender(maleandfemale)werefoundinallthreeareasofPEATIDIIIbyt-test.Thefemaleattitudescoreshigherthanmaleingeneralwhat-


evertowardteachingstudentswithobesity,physicaldisabilitiesandotherhealthimpairments(seetable3).Itmeansthefemalehadmorepositiveattitudesthanmale.Especially,a statisticallysignificantdifferencewasfoundinattitudestowardobesitybetweengender(p＜.05).Theattitudeoffemalewassignificantlybetterthanmale.Themeanoftheattitudestowardtypesofspecialneedsfromhightolowwere:obe-sity(male,41.64;female43.10),physicaldisabilities(male,39.96;female,40.87),andotherhealthimpairments(male,39.71;female,40.37).ThismeansthatPEstudentteachers,includingmaleandfemale,havemorepositiveattitudetoteachstudentswithobesity,whichfollowedbyphysicaldisabilitiesandotherhealthimpairments.

Table 3: Mean, Standard Deviation and T-Test for variables according to genders

Variables Gender N Mean Std. Deviation Std. Error Mean TOutcomes1 male 393 22.10 3.846 .194 -1.541

female 92 22.77 3.235 .337Effects1 male 393 13.00 3.161 .159 -1.604

female 92 13.58 2.829 .295Need1 male 393 6.53 1.212 .061 -1.553

female 92 6.75 1.219 .127Total 1 male 393 41.64 5.828 .294 -2.206*

female 92 43.10 5.233 .546Outcomes2 male 393 20.64 3.391 .171 -1.034

female 92 21.04 3.224 .336Effects2 male 393 12.54 2.907 .147 -.322

female 92 12.65 2.771 .289Need2 male 393 6.52 1.182 .060 -1.102

female 92 6.67 1.130 .118Total 2 male 393 39.71 5.198 .262 -1.121

female 92 40.37 4.530 .472Outcomes3 male 393 20.68 3.463 .175 -1.366

female 92 21.22 3.116 .325Effects3 male 393 12.77 2.839 .143 -.426

female 92 12.91 2.768 .289Need3 male 393 6.51 1.111 .056 -1.796

female 92 6.74 1.088 .113Total 3 male 393 39.96 5.221 .263 -1.540

female 92 40.87 4.478 .467

Note.Outcomes=outcomesofteachingstudentswithspecialneedsinregularclasses;effects=effectsonstudentlearning;need=needformoreacademicpreparationtoteachstudentswithspecialneeds.1=obesity;2=otherhealthimpairments;3=physicaldisability,*p＜.05


The difference between freshmen and seniorTheaveragescoreinPEATIDIIIofPEfreshmenishigherthantheaveragescoreofPEseniorstudentteachers.Itindicatedthatfreshmenhada morepositiveattitudetoteachingstudentswithspecialneedsingeneralPEclass.Froma gradeperspective,theparticipants,includingfreshmenandseniors,havea morepositiveattitudetoteachstudentswithobesity,whichfollowedbyphysicaldisabilitiesandotherhealthimpairments(seetable4).A statisticallysignificantdifference(p＜.05)wasfoundbetweenthePEfreshmenandseniorstudentteachersinattitudetowardteachingstudentswithobesityandstudentswithotherhealthimpairments.A veryhighsta-tisticallysignificantdifference(p＜.01)wasfoundbetweenPEfreshmenandseniorstudentteachersinoutcomesofteachingstudentswithobesityinregularclasses.

Table 4: Mean, Standard Deviation and T-Test for variables according to grades

variables Grade N Mean Std. Deviation Std.Error Mean TOutcomes1 freshman 239 22.94 3.369 .218 4.173**

senior 246 21.54 3.963 .253Effects1 freshman 239 13.39 2.762 .179 1.996*

senior 246 12.83 3.392 .216Need1 freshman 239 6.45 1.136 .073 -2.179*

senior 246 6.69 1.279 .082Total1 freshman 239 42.78 5.37

senior 246 41.07 5.975Outcomes2 freshman 239 21.04 3.056 .198 2.080*

senior 246 20.41 3.610 .230Effects2 freshman 239 12.71 2.588 .167 1.075

senior 246 12.43 3.136 .200Need2 freshman 239 6.47 1.129 .073 -1.556


senior 246 39.47 5.390Outcomes3 freshman 239 21.05 3.036 .196 1.749

senior 246 20.52 3.713 .237Effects3 freshman 239 12.96 2.603 .168 1.252

senior 246 12.64 3.019 .192Need3 freshman 239 6.56 1.071 .069 .158


senior 246 39.70 5.562


Note.Outcomes=outcomesofteachingstudentswithspecialneedsinregularclasses;effects=ef-fectsonstudentlearning;need=needformoreacademicpreparationtoteachstudentswithspecialneeds. 1=obesity;2=otherhealthimpairments;3=physicaldisability,*p＜.05;**p＜.01.

4 DiscussionArticle44and45inREPD-2017stipulatethatNormalUniversitiesandcomprehen-siveuniversitieswitha disciplineofteachereducationshouldsetspecialeducationcourses,sothatstudentshavethebasicknowledgeandskillsofspecialeducationtomeettheneedsoftheattendanceofstudentswithdisabilities.Inaddition,itshouldincreasetheproportionofspecialeducationcontentandknowledgerelatedintheordinaryteachertraining,andimprovethegeneralteachers’specialeducationalabil-ity.Whileatpresent,collegiatephysicaleducationprogramsinmostofuniversitiesofChinahavenotsupportedintroductoryadaptedphysicaleducationcoursestopromotecompetencieswithregardtoteachingstudentswithspecialneeds.

Althoughattitudestowardpersonswithdisabilitieshaveimprovedinrecentyears,negativeattitudessuchassocialrejectionandgreatersocialdistancestillexist,andarerecognizedasbarrierstosuccessforpeoplewithspecialneedsinsocial,educational,andvocationalcontexts.MostPEstudentteachersinthestudyagreedwithinclud-ingstudentswithspecialneedsingeneralphysicaleducationclasses,butwereonlywillingtoacceptstudentswithmildspecialneedsintheirownclasses.

PEstudentteachers’attitudesreflectsomestereotypeaboutindividualswithspe-cialneedsinsocialcontext.Differencesbetweensubgroupsbecomemoreimportantthandifferencesamongindividualswithincategoriesasthebasisofimpressionfor-mation(MarilynnB.Brewer,1996).Affectedbythesocialenvironment,inclusiveeducationstillneeda longtimeinChina.

ReferencesAntonak&Larrivee.(1995).PsychometricAnalysisandRevisionoftheOpinionsRelativetoMain-

streamingScale,Exceptional Children,62(2):101–110.ChenShu,LuoYong-hua&HuangYi-zhu.(2012).StudyontheIntegratedSportsTeachingunderthe

InclusiveEducationVision.Journal of Beijing Sport University,35(7):96–101.DengMeng&MansetGenevieve.(2000).Analysisofthe“learninginregularclassrooms”movement

inChina,Mental Retardation,38(2):124–130.HuangZhi-cheng.(2003).FromLife-longEducationandEducationforAlltotheInclusiveEducation:

AnalysisoftheDevelopmentoftheInternationalEducationalThoughts.Journal of Hebei Normal University (Educational Science Edition),5(2):27–30.

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JuliePallant.(2001).SPSSSurvivalManual:A Step-by-stepGuidetoDataAnalysisUsingSPSSforWindows(Version10),McPherson’sPrintingGroup,Maryborough,Victoria:85–86.


Li,Yun&Růžička,Michal.(2015)University´scareandcounselingforstudentswithspecialneedsinspecialphysivcaleducatiuoninChina.JournalofExceptionalPeople UP:Olomouc.6(1),31–49.

MarilynnB.Brewer.(1996).When Stereotypes Lead to Stereotyping: The Use of Stereotypes in Person Perception. TheGuilfordPress,NewYork:262.

MartinE.Block.(1994).A Teacher’s Guide to Including Students with Disabilities in Regular Physical Education, PaulH.BrookesPublishingCo.Inc.Baltimore,Maryland:19–20.

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SherryL.Folsom-Meek&TerryL.Rizzo.(2002).ValidatingthePhysicalEducators’AttitudetowardTeachingIndividualswithDisabilitiesIII(PEATIDIII)SurveyforFutureProfessionals,Adapted Physical Activity Quarterly,19(2):141–154.

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(reviewedtwice)

LiYunTheSchoolofPhysicalEducationSouthwestUniversity400715ChongqingChina

ZhangGuodongTheInstituteofChongqingPhysicalEducationStudiesSouthwestUniversity400715ChongqingChina

http://www.dsq-sds.org/article/view/545/722

http://www.dsq-sds.org/article/view/545/722

http://www.cdpf.org.cn/yw/201702/t20170224_583151.shtml

http://www.cdpf.org.cn/yw/201702/t20170224_583151.shtml

JournalofExceptionalPeople,Volume1,Number12,2018 Bookreviews 125

Structured teaching in practice: Applying the principles of structured teaching in standard school environment

TUCKERMANN, A., HÄUβLER, A., LAUSMANN, E. Strukturované učení v praxi: Uplatnění principů Strukturovaného učení v prostředí běžné školy. Praha: Pasparta, 2014.

Reviewed by Lucie Schwarzová

Thepublicationpresentsoneofthemethodsfortheeducationandteachingofindi-vidualswiththeautismspectrumdisorder–StructuredTeaching.Themethodology,accordingtoČadilová, Žampachová(2008),isbasedontheTEACHprogramandLovaas’interventiontheoryandthusonthelearningtheoriesandbehavioraltheo-riesbasedonbehavioralintervention(focusingonthemodificationoftheexternalconditionsoflearningandconductoftheindividual)andcognitive-behavioralin-tervention(focusingonthechangeoftheperson’swayofthinking).

CottiniandVivanti(2017,p. 21)providethedefinitionofautismasfollows:“Autismisanorganicdisordercausedbygeneticpredisposition,whichtogetherwiththeriskfactorsintheenvironmentresultinmodifieddevelopmentofthebrainthatmanifestsitselflateronindisturbedcognitivedevelopmentofvariouslevelsandconsequentlyabnormalbehavior.”Říhová,UrbanovskáandPastieriková(2011)de-scribetheautismspectrumdisorderasa life-longdisorderwhichcriticallyimpactsthewholedevelopmentofa child.Čadilováatal.(2012)addsthatthepresenceofthedisordersubstantiallychangesthelifeofnotonlythepersonwithautismbuthisorherwholefamily.Theautismsymptomsmayvary,however,theytendtobeperma-nent.Incasesofappropriateeducationalinterventionitispossibletoobservesomereductionofthesymptomsinseveralareasofdevelopment.Thespecificsymptoms,thesocalleddiagnostictriad,includeanimpairmentofimagination,socialinterac-tion,andcommunication.ThemethodofstructuredteachingisgroundedinthedevelopmentofstrongfeaturesoftheindividualswithPASaswellasineliminatingthedeficienciescausedbythediagnosis.

126 Bookreviews JournalofExceptionalPeople,Volume1,Number12,2018

Thepublicationmaybeviewedasa collectionoftoolsforteachersandteachingassistantsworkingwithchildrenwithautismspectrumdisorderwhoareeducatedinthemainstreamschools.Inconnectionwiththeamendmentoftheeducationlawwhichbroughtaboutsomeprincipalchangestotheareaofeducationofspecialneedsstudents,thereemergedtheneedtoreactpromptlytothemethodologicalsupportwhenapplyingthesupportivemeasuresspecifiedintheregulationno.27/2016oftheCode.Oneofthepossiblesupportivemeasuresisthemodificationofmethodsandformsoftheteachingprocesswhereitispossibletoincludetheuseofstructuredteaching.

TheteamofauthorsofGermannationalityhaslongtimeexperienceacquiredthroughtheirtherapeuticworkwithpeoplewithautismspectrumdisorderaswellasthroughtheprovisionofcounselingservicestotheirteachers,closerelatives,andfriends.Thisfactrunsthroughoutthewholeworkwhichcanbepracticallyutilizedandappliedbyelementaryschoolteacherswhoshouldbeabletopreparevariousmaterialsaccordingtotheinstructionsinthepublicationforeducatingchildrenwithautism.TheoriginalGermaneditionoftheworktitled„Praxis TEACCH – heraus-forderung Regelschule“ wastranslatedtoCzechbyJitkaHakenová.

Thepublicationislogicallysegmentedintoseveralchapters.Thefirstonecom-prisesthefundamentalideasofstructuredteachinganditsuseintheconditionsofthe main stream education.

Thesecondchaptercontainsthetheoreticalanchoringofthestructuredteachingandtakesa closerlookatspecificareasofthestructureatschool,i.e.structuralizingthespace,time,tasks,andinstructions.Thispartalsoincludesnumerouspicturesdepictingspecifictipshowthecomponentsofstructuremaybeutilizedintheclassandwhenpreparingvarioustasks.Thestructuredassignmentsthatareincludedrespectthebasicrulewhichsetsthesystemofworkmovingfromlefttorightandfromtoptobottom.A sub-chaptercanbealsofoundherethatpresentstheaidsfortimeorganizationandindividualwork.

Intheintroductiontothethirdchapter,theauthorsexplainthetermofa hiddencurriculumwhichtheyviewasa pitfallina standardschool.Furthermore,theyfo-cusonthegeneraldefinitionofthequalificationandtasksoftheteachingassistant.Theyalsopresenta time-testedteachingaid,thesocalled“boxthateveryoneneedstohave”.Itcontainssomefundamentalmaterialsforanimmediatemodificationofteachingmaterials.

Thefourthchaptertargetstheareaofcommunicationwitha studentwithautismspectrumdisorder.Thepracticalrecommendationsandillustrationsdepicttheactofaskingforhelp,makingdecisions,andaccessingcommunication.

Chapternumberfivesuggestsseveralwayshowtoannouncethediagnosisandexplainautismtotheclass.Itincludesa powerpointpresentationofa studentwithAsperger’s,Max,whopresentshimselftotheclassthroughsuchpresentation.


Thelastthreechaptersofthebookexplainthenecessityofmotivationintheteaching-educationalprocessandthestrategiesofcopingwithchangesduringthedayatschool.Theconclusionofthepublicationprovidesvariousreferencestospe-cializedliteratureandinformationsources.

I wouldliketorecommendthisbooktoallteachingandcounselingstaffwhoworkwithchildrenandstudentswithautismspectrumdisordersinceitoffersa num-berofusefulandspecificrecommendationshowtoworkwiththesestudentsusingthemethodologyofthestructuredteaching.Thepublicationmayberegardedasa collectionofpracticalinspirationhelpingachievethefundamentalprioritiesofeducation,i.e.toprovidethestudentwithsufficientsupportforthedevelopmentofallpartsofhisorherpersonality.

References1. Cottini,L.&Vivanti,G.(2017).Autismus: Jak pracovat s dětmi a dospívajícími s poruchami auti-

stického spektra. Průvodce.Praha:Logos.2. Čadilová,V.,Žampachová,Z.(2008).Strukturované učení: Vzdělávání dětí s autismem a jinými

vývojovými poruchami.Praha:Portál.3. Čadilová,V.Thorová,K.&Žampachová,Z.(2012).Katalog posuzování míry speciálních vzdělá-

vacích potřeb: Diagnostické domény pro žáky s poruchami autistického spektra.Olomouc:UniverzitaPalackého.

4. Říhová,A.,Urbanovská,E.&Pastieriková,L.(2011).Poruchy autistického spektra (Pomoc pro rodiče dětí s PAS).Olomouc:UniverzitaPalackého.

Mgr. LucieSchwarzováInstituteofSpecialEducationStudiesFacultyofEducationPalackýUniversityOlomoucŽižkovonáměstí5771 40OlomoucCzechRepublice-mail:[email protected]


Sensory perceptual issues in Autism and Asperger Syndrome

BOGDASHINA, Ol‘ga. Specifika smyslového vnímání u autis mu a As-pergerova syndromu. Přeložila Helena ČÍŽKOVÁ. V Praze: Pasparta, 2017. ISBN 978-80-88163-06-0.

Reviewed by Monika Smolíková

Authorofthepublication,OlgaBogdashina,MA,PhD,isaco-founder,programmeleaderandlecturerattheUKbranchoftheInternationalAutismInstituteandassoci-ateconsultant(Autism)totheEuropeanInstituteofChildEducationandPsychol-ogy(ICEPEurope).Since1994,shehasbeenthedirectorofthefirstdaycentreforchildrenwithautisminUkraineandthepresidentoftheAutismSocietyofUkraine.Inherresearchandpractise,shedealswithsensory-perceptualandcommunicationproblems.

In2017a translationofthepublicationof2003,byOlgaBogdashina,hasemergedintheCzechmarket,whichhasinspired,byitsconcept,twodifferentworlds;thatwithautismandthatwithout.Autismrepresentsa wayofexistenceofa stillgrowingpercentageofpeoplearoundus.Thispublicationexplainssomebasicissuesconcern-ingmanifestationsofbehaviourofpeoplewithautismandmay,atleasttoa certainextent,acquaintpeoplewitheverydaysituationsfacedbypeoplewithautism.

Expertsinvolvedintheissuesofautismspectrumdisordersanalyzemanifesta-tionsofbehaviourtheycanseeandareabletoevaluatethem,buttheydo notfocusontheexperienceofautisticpeoplethemselves.OlgaBogdashinahasgathereda lotofinformationfrompeoplewithhigh-functioningautismandAsperger’ssyndromeandhasproduceda veryimpressivepublicationthatgivesinsightintotheissueofsensoryperception“fromtheinside”.Sheusesresearchbyleadingprofessionalsinvolvedinautismresearch,aswellasthosewhoarethebestautisticprofessionalsandscientistsinthefieldofautism–i.e.thepeoplewithautismthemselves(suchasTempleGrandin,DonnaWilliams,LianeWilleyandJimSinclair).Bylinkingthisresearchalongwithherownstudiesandusingpersonalpracticalexperience,shepursuespracticalimpactofdeviationsinsensoryperceptionofpeoplewithautism.

Shesucceedsinmotivatingreaderstothinkabouthowtousethestrengthsofsen-soryperceptioninpeoplewithautismandhowtostimulatethosethatareweakened.

130 Bookreviews JournalofExceptionalPeople,Volume1,Number12,2018

Thus,thequestionistowhatextentthesensoryperceptionisthecauseofdeviationsinbehaviour.Thisquestionisanalyzedbytheauthorinthepublicationandissup-portedbyauthentictestimonialsandexamplesfromthelifeofpeoplewithautism,whichappropriatelybalancestheexpertfocusofthetext.

Thepublicationisdividedtoninechapters.Intheintroductorypart,theauthoracquaintsthereaderwiththegeneraltermsandwithmeaningsofindividualtermsassheunderstandsthem,despitethefactthesetermsareseldomusedinpracticeforthetimebeing,ordifferenttermsareusedinpractice.

Thefirstchapterfocusesonthecontroversybetweendysfunctionandatypicalsensoryexperience.Thiswaysheestablishesa uniqueviewofthefactthatwhatworksotherwise(formostpeople),canbeanadvantageanda positivephenomenonina personwithautism.Throughexamplesfrompractice,theauthordeclaresthatthecauseofsocialandemotionalproblemshasa perceptualnature.

Thesecondchapterdealswiththegeneralconceptofperception.Evaluatedisthemeaningofsensoryexperiences,describedistherelationshipandtheprocessbetweenthesensorystimulusandtheresultinterpretedbyourbrain.Theillustrationsaccompanyingthetextarefully“functional”;theycanbeusedtocheckhowvisualillusionsworkorhowtofinda “blindspot”onourretina.

Inthethirdchapteraredefinedsensoryexperiencesthatrelatetoautism.De-terminedphenomenaarethenevaluatedina complexwaywiththeeffortofmaxi-muminterconnectioninindividualareasofsensoryperceptionandtheirimpactinreallife.

Thefourthchapterdealswiththeperceptualstylesofpeoplewithautism.Thischapter,alongwiththefollowing,fifthchapteroncognitivestyles,providesthereaderwitha descriptionofnonstandardsensoryperceptionanditsinfluenceonthecogni-tiveprocessanditsownwayofthinking.

Thesixthchapterfollowssensorydifferences.Here,characterizedareatypical,butinpeoplewithautismcommonsituationsassociatedwithsensoryperception.

Theseventhchapterevaluatesthepossibilitiesoftherapeuticintervention.Itdealswithbasictherapeuticapproachesthatcanbeutilizedwithinthedevelopmentofsensoryperceptionofpeoplewithautism.

Theeighthchapterdealswiththesensoryperceptionprofileandcontainsa table,theso-calledspectralgraph,whichservestorecordthestrengthsandweaknessesofsensoryperception.Itisgroupedinto20categoriesthatevaluateall7sensorysys-tems(sight,smell,hearing,taste,proprioception,vestibularperception).Intheend,thepublicationcontainsa freetranslationoftheSensoryProfileChecklistRevised(SPCR,whichincludes232questionsthatserveasa complementarymaterialtode-velopa sensoryperceptionprofile),a recordsheetanda keytoevaluatethemethod.


Thechaptersaresupplementedwithsubsectionswiththetitle„WhattoNote“,thepurposeofwhichistoidentifyandinterpretsomebehaviouralmanifestationsofpeoplewithautismaffectedbyperceptualdifficulties.

Thelastchapterevaluatesthepracticalimpactofsensoryperceptiononthelifeofpeoplewithautism.Theauthoremphasizesthat,inordertocreatetherightin-terventionmethod,itisnecessaryfirsttoevaluatetheperceptualdeviationsofeachindividualandtoseehowthepersonperceivesthesurroundingworld;forexample,howa personevaluateswhathe/sheseesorhears.Ifwewouldbeabletounderstandthatoursensoryperceptionwouldbedifferentfromthatwhichpeoplewithautismdo haveitwouldbea basicprerequisiteforthesuccessofmutualco-operationofourperceptualworlds.

I amverypleasedtorecommendtoreadersa publicationthatexaminestheissuefromseveraldifferentanglesand,byitsnature,statesthatpeoplewithautismarethebestprofessionalsintheproblemsofautism.AlthoughI wouldrecommendthepublicationtoa professionalaudience,eventheparentsofautisticchildren(especiallyinthemoresevereformsofautismspectrumdisorders)willsurelycomeintotheirowninit,andeventhosewhohaveaninterestanddesiretogetintothelifeofpeoplewithautismatleasttoa certainextent.

Mgr. MonikaSmolíkováInstituteofSpecialEducationstudiesFacultyofEducationPalackýUniversityŽižkovonáměstí5771 40OlomoucCzechRepublice-mail:[email protected]

Information for authors

Basic information about the JEPJournal of Exceptional People (JEP)isbebasedontwicea yearpublishingperiodinbothelectronicandtraditional–printedform.ToguaranteeprofessionalstandardsoftheJournalwehavechosenspecialneedsteachers,psychologists,therapistsandotherprofessionalsfromtheU.S.,Finland,Spain,Slovakia,Hungary,China,Russia,Polandandothercountries.Abovementionedthescientificjournalaspirestoberegisteredintotheinternationaldatabaseofimpactedperiodicals(JournalCitationReports).

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