RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, BANGALORE, KARNATAKA.

SYNOPSIS PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

Mr.MAILARI KARABEER1st YEAR M.Sc. NURSINGPSYCHIATRIC NURSING

YEAR 2011 – 2012

NATIONAL COLLEGE OF NURSINGHEGGANAHALLI CROSS, SUNKADAKATTE,

VISHWANIDAM POST,

BANGALORE - 560 091.

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RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES,

BANGALORE, KARNATAKA.

PROFORMA FOR REGISTRATION OF SUBJECT FOR DISSERTATION

1. NAME OF THE CANDIDATEAND ADDRESS

Mr. MAILARI KARABEER1st YEAR M. Sc. NURSING,

NATIONAL COLLEGE OF NURSING,

HEGGANAHALLI CROSS,

SUNKADAKATTE, VISHWANIDAM POST,

VIA, MAGADI ROAD

BANGALORE - 560 091.

2. NAME OF THE INSTITUTION NATIONAL COLLEGE OF NURSING,

HEGGANAHALLI CROSS,

SUNKADAKATTE, VISHWANIDAM POST,

VIA, MAGADI ROAD

BANGALORE - 560 091.

3. COURSE OF STUDY AND SUBJECT

M. Sc. NURSING

PSYCHIATRIC NURSING

4.DATE OF ADMISSION TO

THE COURSE

5. TITLE OF THE TOPIC

“KNOWLEDGE AND ATTITUDE ABOUT SPECIFIC LEARNING

DISABILITIES IN PRIMARY SCHOOL CHILDREN AMONG SCHOOL

TEACHERS IN SELECTED SCHOOLS AT BANGALORE, WITH A VIEW TO

DEVELOP AN INFORMATIONAL GUIDESHEET ON MANAGEMENT OF

SPECIFIC LEARNING DISABILITIES IN SCHOOLS.”

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6. BRIEF RESUME OF THE INTENDED WORK

6.1 INTRODUCTION

‘‘Today’s children are tomorrow’s citizens’’

-Mahatma Gandhi

Health is a common theme in most cultures; in fact all communities have their concepts

of health, as part of their culture. Among definitions still used, probably the oldest is that health

is the absence of disease. In some cultures, health and harmony are considered equivalent,

harmony being defined as being at peace with the self, the community, god and cosmos. The

ancient Indians and Greeks shared this concept and attributed disease to disturbances in bodily

equilibrium of what they called humors.

Health is a resource for life, not the object of living; it is a positive concept emphasizing

social and personal resources, as well as physical capacities. All communities have highly

variable, unique strengths and health needs; and is a common theme in most cultures. Health is

multidimensional and is the condition of being sound in body, mind or spirit especially freedom

from physical disease or pain. Health is the outcome of a large number of determinants. The list

of health determinants is quite long. The factors affecting health may be classified as agent, host

and environment. The presence and interaction of these factors initiate the disease process in

man.

Learning disability (LD) is a general term that describes specific kinds of learning

problems. A learning disability can cause a person to have trouble in learning and using certain

skills. The skills most often affected are reading, writing, listening, speaking, reasoning, and

doing maths. Learning disabilities vary from person to person, one person with Learning

disability may not have the same kind of learning problems as another person with Learning

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disability. One person may have trouble with reading and writing. Another person with Learning

Disabilities may have problems in understanding maths. Still another person may have trouble in

each of these areas, as well as with understanding what people are saying (National

Dissemination Center for Children and Youth with Disabilities [NICHCY], 2004.1

“Specific Learning Disabilities” is a generic term which refers to a group of learning

disorders with respective cognitive specific deficits.

Specific learning disabilities are still not universally recognized as conditions that cause

difficulties in children’s learning, indeed they have been often referred to as “hidden handicaps”

because of the lack of awareness by teachers, physicians and parents. There is also the erroneous

belief by many that these are rare and mild problems despite evidence to the contrary. Attempts

to achieve a universally accepted definition for specific learning disabilities have been plagued

by continuing and often bitter disagreements among the various professions who have legitimate

interest in this field. These disciplines include neuroscience, neurology, clinical,

neuropsychological and neuropsychiatry, Education professions including educational

psychology, teaching and education administration, and speech and language pathology and so

on. This fragmentation arises from differences in focus by individual professions on the various

aspects of specific learning disabilities, with each discipline often not being aware of practices

and advances in other fields.1

As the children with learning disability find it difficult to adjust in schools, teachers are

also challenged to find ways and provide them with the very best instruction possible. The best

sources of assistance and the most promising pool of resources are to be found right there in the

school. General and special educators working creatively, sharing ideas and strategies, tapping

related services providers and others including speech therapists, psychologists and occupational

therapists, implementing progress-monitoring activities and sharing responsibility adjustment in

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instruction. These are ways to ensure that students have the best opportunities to succeed and

these are the ways to help educators and administrators create learning communities, polling

resources and sharing expertise to the benefit of all.2

Early identification and interventions provided appropriately will bring about plenty of

changes. If parents and teachers are equipped with adequate knowledge and appropriate skills in

handling these children and there attitude of accepting the child with learning disabilities it will

help the child to improve in the future. To help the child with learning disability, it is not only

the responsibility of the teachers and parents; it is the responsibility of the mental health

professionals to march forward and reach the unreached people not only in the urban community

but also in rural community where the services are in scarce. 2

6.2 NEED FOR THE STUDY

"Safe and supportive environment helps children to emerge as responsible adults"

- Health Dialogue 2003

Children with learning disabilities should enjoy the same rights of access to healthcare

service entitled to general population. Children with severe learning disabilities may need

special schools and often have associated with mental disorders. Children with learning

disability are more vulnerable to the full range of mental health disorders and also have

additional psychosocial, physical and general health problems these include self injurious

behavior, significant behavioral difficulties, speech and language problems and difficulties with

sleep, eating and elimination.3

There are many reasons in children for school failure, but a common one is a specific

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learning disability, children with learning disabilities usually have a normal range of

intelligence. They try very hard to follow instructions, concentrate, and “be good” at home and

in school. Yet, despite this effort, he or she is not mastering school tasks and falls behind.

Learning disabilities affect at least 1 in 10 school children. A recent National Institutes of Health

study showed that 67 percent of young students who were at risk for reading difficulties became

average or above average readers after receiving help in the early grades 2.

According to Wagner et al. (2005) identification of learning disability begins when

parents or teachers suspect that student is having problem in coping with everyday school tasks

because it is always an educational one. The teachers rapport with a learning disabled child is

proved to be vital in helping the child succeed. According to learning disabilities services,

students can greatly benefit when the teacher takes a little time and thought to accommodate

these needs. These students may need accommodation in some class room activities,

assignments and exams. Making the child aware of a disability is a great service to the child.

Unless such children are identified and properly treated, they may develop secondary emotional,

social and family problems 2.

It is in this context that the importance of nurses becomes vital in safeguarding and

promoting the mental health of children and early identification of deviations from normal. The

school is one of the most organized and powerful systems in the society which presents

opportunity to work through it and to influence the health and well being of those who come in

contact with it. This is especially true in Indian setting where there is a considerable shortage in

mental health facility for children. Thus nurses will be a dynamic force, instrumental and

indispensable in assisting the teacher to learn, to recognize and to help children with learning

disability.2

The mental health needs of children with both learning disabilities and mental health

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problems have previously been neglected. The children concerned as well as their families and

careers have suffered from fragmented services and discrimination arising from their disability.

Across the United Kingdom, children with learning disabilities have historically faced both

geographical inequities in terms of access to and quality of National Health Services and

inequalities in comparison to those without learning disabilities.5

Nearly 4 million school-age children have learning disabilities, 7.7% of children have

ever been told they had learning disability. Prevalence of reading disability is conservatively

estimated to range between 4 percent and 10 percent in general among school-aged population in

the United States. In India, prevalence estimates of learning disability ranges from 9-39% and

the incidence of dyslexia in primary school children has been reported to be 2-18%, of

dysgraphia 14%, and of dyscalculia 5.5%.2

The National Joint Committee on Learning Disabilities (NJCLD, 1998) believes that

comprehensive interdisciplinary education programs are necessary for the preparation of all

education professionals. To serve the needs of students with learning disabilities most

effectively, all teacher trainees should have preparation that includes the competencies in the

area of learning disability. By doing a thorough review of teacher education, the researcher felt

that after the thorough analysis of the curricula and also the question papers of the teacher

education in India showed that there is only one unit on the childhood psychological problems.

The teacher trainees hardly remember the utterance of the word learning disability during their

course period. Hence, learning disabilities is one such area where adequate knowledge in

handling these children in class room situation .6

Hence the researchers felt that it is important to understand knowledge and attitude of

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primary school teachers towards the child’s disabilities so they can manage learning disabilities

at school, therefore it is essential that they should have the knowledge regarding the specific

learning disabilities in children. Based on this, a specific content of information guide sheet can

be developed and it would enhance the knowledge of school teachers there by develop a very

positive attitude towards learning disabilities.

6.3 REVIEW OF LITERATURE

Review of literature is considered as an essential step of research process. It involves

systematic identification, location, scrutiny and summary of written materials that contain

information on a research problem (Polit and Hungler 1995).13

The overall process of review of literature is to develop a strong knowledge base to carry

out research and other scholarly educational and clinical practice activities. It helps to determine

the gaps, consistencies and inconsistencies in the literature about the particular subject under

study. Review literature guides the investigator to design the proposed study in the scientific

manner so as to achieve the desired results.

Every person has different knowledge, attitudes, a person’s knowledge and attitudes have

a strong influence on his or her attitudes and behaviors.

A quasi experimental study was conducted on Impact of an education program on

parental knowledge of specific learning disability at Lokmanya Tilak Municipal Medical

College and General Hospital Mumbai with the aim to investigate parental knowledge of

special learning disability (SpLD) and to evaluate the impact of an educational intervention on

it. The study result shown that after the intervention, there was significant improvement in

parental knowledge on meaning of the term specific learning disabilities the researcher

concluded that Parental knowledge of their child's specific learning disabilities significantly

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improved by a single-session educational program 5.

A Prospective observational study was conducted on Clinical and psycho educational

profile of children with specific learning disability (SpLD) and co-occurring attention-deficit

hyperactivity disorder at Lokmanya Tilak Municipal Medical College and General Hospital,

Mumbai with the aim to document the clinical profile and academic history of children with

specific learning disabilities and co-occurring Attention Deficit Hyperkinetic Disorder. The study

results shown mean age of children was 11.4 years. 30% children had a significant perinatal history,

24% had delayed walking, 22% had delayed talking, 10% had microcephaly, 54% displayed soft

neurological signs and 20% had primary nocturnal enuresis. Their academic problems were

difficulties in writing (96%), inattentiveness (96%), and difficulties in mathematics (74%),

hyperactivity (68%) and difficulties in reading (60%). The researcher concluded that Children

with specific learning disabilities and co-occurring Attention Deficit Hyperkinetic Disorder

need to be identified at an early age to prevent poor school performance and behavioral

problems 6.

A study was conducted on Specific learning disabilities in children: deficits and

neuropsychological profile at Postgraduate Institute of Medical Education and Research,

Chandigarh. The study involved 35 children in the age range of 7-14 years (both boys and girls) who

were diagnosed clinically and assessed using the battery of tests for SLDs and neuropsychological tests

consisting of the PGIMER memory scale for children, the Wisconsin card sorting test, the Bender

visuo-motor gestalt test and Malin's intelligence scale for Indian children. The study results

revealed that deficits in language and writing skills and impairments in specific areas of

memory, executive functions and perceptuo-motor tasks 8.

A study conducted on Expressive versus receptive language skills in specific reading

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disorder in United Kingdom igated the difference between expressive and receptive language

skills in a sample of 17 children with specific reading difficulty aged between 7 and 12 years.

The study samples were administered a battery of two receptive and two expressive language

measures. The results of the study shown that as the neuro-anatomical model would predict, the

children scored significantly lower on tests of receptive than on tests of expressive language skills 7.

A qualitative exploratory study was conducted on Clinical experiences of students with

dyslexia with the aim to explore the clinical experiences of student nurses with dyslexia and its

potential influence on their practice. The investigation involved tape-recorded interviews with a

convenience sample of 18 nursing students with a formal dyslexia diagnosis. Data was collected

between 2003-2004 and were analyzed using thematic analysis. The study findings shown that

participants of the study expressed number of personalized approaches in managing their

difficulties in practice. Some participants contended with discrimination and ridicule, often

choosing not to disclose their disability. Positive aspects of dyslexia were never raised or

acknowledged by participants. The researcher concluded that greater awareness of the practice-

specific needs of dyslexic students is required to ensure appropriate support and public safety 9.

A cross-sectional study was conducted on cognitive abilities between groups of children

with specific learning disability having average, bright normal and superior nonverbal

intelligence to assess whether cognition abilities vary in children with specific learning

disabilities having different grades of nonverbal intelligence. For this study 95 children with

specific learning disabilities (aged 9-14 years) were assessed. A battery of 13 Cognition Function

tests (CFTs) devised by Jnana Prabodhini's Institute of Psychology, Pune based on Guilford's

Structure of Intellect Model was administered individually on each child in the four areas of

information viz. figural, symbolic, semantic and behavioral. The study revealed there

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were no statistically significant differences between their mean CFTs scores in any of the four

areas of information. The researcher concluded that Cognition abilities are similar in children

with specific learning disabilities having average, bright-normal and superior nonverbal

intelligence 10.

A descriptive study was conducted on Attitude and knowledge of attention deficit

hyperactivity disorder and learning disability among high school teachers. The study involved

Forty-six high school teachers and they were divided into two groups 25 teachers taught at an

academic school (School 1); and 21 teachers taught at special education school (School 2) and

dealt with Attention Deficit Hyperkinetic Disorder/Learning Disability cases regularly. The

study results revealed that general knowledge about Attention Deficit Hyperkinetic Disorder

(71%) and about Learning Disability (74%) was relatively low among both groups. Thirteen

percent of all teachers considered Learning Disability to be the result of parental attitudes,

namely ‘spoiling’ the children. In relation to Learning Disability cases, the overall scoring for

positive attitude was 75%. However, this score was higher for Group B teachers. Three-quarters

of the teachers favored increasing peer awareness and comprehension as to the problems

Learning Disability kids encounter at school. Ninety-five percent believed Learning Disability

patients should enjoy a more lenient school education. There was no correlation between

teachers, knowledge of Attention Deficit Hyperkinetic Disorder and Learning Disability and

their attitude 11.

A study was conducted on Learning disability in rural primary school children at

varanasi. The study revealed that 12.97 per cent of those having Intelligent Quotient greater than

or equal to 90 were found to have poor achievement in arithmetic test and teacher's assessment

and learning disabled children had impaired perceptual maturity and conceptual grasp as

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observed on MISIC (Indian modification of WISC), Bender Gestalt test and Piaget's test 12.

STATEMENT OF THE PROBLEM

A study to assess the knowledge and attitude about specific learning disabilities in

primary school children among school teachers in selected schools at Bangalore, with a view to

develop informational guide sheet on management of specific learning disabilities in schools.

6.4 OBJECTIVES OF THE STUDY

1. To assess the knowledge about, specific learning disabilities among primary school

teachers in selected primary schools in Bangalore.

2. To assess the attitude about, specific learning disabilities among primary school teachers

in selected primary schools in Bangalore.

3. To correlate the knowledge and attitude about, specific learning disabilities among

primary school teachers in selected primary schools in Bangalore.

4. To associate the knowledge and attitude with selected demographic variables about,

specific learning disabilities among primary school teachers in selected primary schools

in Bangalore.

5. To develop an informational guide sheet on management of specific learning disabilities

in primary schools.

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6.5 OPERATIONAL DEFINITIONS

1. KNOWLEDGE: refers to the correct response of primary school teachers to the

structured questionnaire on specific learning disabilities. It also refers to the awareness

and understanding of primary school teachers regarding specific learning disabilities,

which covers the general information on reasons, causes, effects, prevention and

management.

2. ATTITUDE: refers to the response of primary school teachers to the items in attitude

scale stating their opinion regarding specific learning disabilities.

3. SPECIFIC LEARNING DISABILITIES: refers to the group of learning disorders viz.

(Dyslexia, Dysgraphia and Dyscalculia) characterized by varying degree of difficulty in

achieving school task resulting in under achievement in school performance.

4. PRIMARY SCHOOL CHILDREN: refers to students who are studying Ist standard to

IVth standard in selected primary schools and are aged between 6-9 years.

5. PRIMARY SCHOOL TEACHERS: refers to teachers who are teaching to students

who are studying Ist standard to IVth standard at primary schools.

6. PRIMARY SCHOOLS: refers to schools who offer education to Ist standard-IVth

standard students.

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7. INFORMATIONAL GUIDE SHEET: refers to learning materials prepared by the

researcher based on the knowledge and attitude response given by the primary school teachers

regarding specific learning disabilities and this will serve as a reference guide for primary school

teachers.

6.6 HYPOTHESES

1. H01: There is significant relationship between the knowledge and attitude among primary

school teachers.

2. H02: There is significant association between selected demographic variables with the

knowledge and attitude among primary school teachers.

6.7 ASSUMPTIONS

1. The primary school children may experience some level of specific learning disabilities.

2. Knowledge of primary school teachers regarding specific learning disability among primary

school children is measurable.

3. Primary school teacher’s knowledge can be enhanced through informational guide sheet.

4. Primary school teachers can realize the importance of knowledge regarding specific learning

disabilities among children.

5. Primary school teachers may have some knowledge about specific learning disabilities.

6. There will be association between the knowledge and attitude with selected demographic

variables among primary school teachers.

7. Primary school teachers may have positive or negative attitude about specific learning

disabilities.

8. Adequate knowledge improves favorable attitude.

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9. Favorable attitude encourages gain of knowledge.

10. Informational guide sheet about specific learning disabilities may help Primary school

teachers to update their knowledge about specific learning disabilities.

6.8 DELIMITATION

The study is delimited to Primary school teachers who are working in selected Primary

schools at Bangalore.

7. MATERIAL AND METHODS

7.1 SOURCE OF DATA

Data will be collected from the Primary school teachers who are working in selected

Primary schools at Bangalore.

7.2 METHOD OF COLLECTION OF DATA

Structured interview schedule method will be used to collect the data.

VARIABLES

Dependent (study) variable refers to : Knowledge and Attitude of Primary school

teachers.

Extraneous variable refers to : Demographic variables viz. age, gender,

religion, educational status, occupation, class handled by

the teacher, residential area, source of information

regarding specific learning disabilities.

7.2.1 RESEARCH APPROACH

Descriptive survey approach will be used to carry out the study.

7.2.2 RESEARCH DESIGN

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Descriptive design will be used.

7.2.3 SETTING

Selected primary schools at Bangalore.

7.2.4 POPULATION

The population of the present study consists of primary schools teachers who are working in

selected Primary schools at Bangalore.

7.2.5 SAMPLE SIZE

The sample size of the present study comprises of 60 numbers.

7.2.6 SAMPLING TECHNIQUE

Non-probability, purposive sampling technique will be adopted to select the sample.

7.2.7 SAMPLING CRITERIA

Inclusion criteria:

1. The primary schools teachers who are willing to participate in the study.

2. The primary schools teachers who are available during the period of data collection.

3. The primary schools teachers who can able to communicate either in Kannada or

English.

4. The primary schools teachers who gave consent to participate in the study.

Exclusion criteria:

1. The primary schools teachers who are not willing to participate in the study.

2. The primary schools teachers who are absent during the period of data collection.

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7.2.8 TOOL FOR DATA COLLECTION

The tool for the data collection consists of three sections:

Section A: Socio-demographic Performa of the study participants.

Section B: Structured questionnaire to assess the knowledge of primary schools teachers about

specific learning disabilities.

Section C: Structured questionnaire to assess the attitude of primary schools teachers about

specific learning disabilities.

7.2.9 DURATION OF THE STUDY

Duration of the study will be 6 weeks.

7.2.10 METHOD OF DATA ANALYSIS AND PRESENTATION

Data analysis will be through descriptive and inferential statistics.

Descriptive Statistics:

Frequencies, percentage, mean, median and standard deviation will be used to explain

demographic variables and to compute the knowledge and attitude.

The Correlation Coefficient will be used to find out the correlation between the

knowledge and attitude.

Inferential Statistics:

Chi-square test will be used to find out association between selected demographic

variables with the knowledge and attitude among primary school teachers.

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PROJECTED OUTCOME

The findings of the study would reveal:

1. The existing knowledge of primary school teachers regarding specific learning

disabilities.

2. The attitude of primary school teachers regarding specific learning disabilities.

7.3 DOES THE STUDY REQUIRE ANY INVESTIGATION OR INTERVENTIONS TO

BE CONDUCTED ON PATIENTS OR OTHER HUMANS OR ANIMALS? IF SO,

PLEASE DESCRIBE BRIEFLY.

No

7.4 HAS ETHICAL CLEARANCE BEEN OBTAINED FROM YOUR INSTITUTION?

YES, copy enclosed.

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8. LIST OF REFERENCES:

1. Catherine Lam. Child Assessment service. Hongkong, Vol.06 No.03 (May-2001).

2. Padmavati. D. and K. Lalitha. Effectiveness of Structured Teaching Programme for

teachers towards learning disabilities. Nightingale Nursing Times. Vol.05 No.04 July

2009 .Pp (14-17)

3. Tim Mcdougall, Nursing children and young people with learning disabilities and

mental health problems. 3rd edition. Blackwell publishing; 151.

4. Robert E. Hales; Stuart G. Yudofsky. Text Book of Cliical Psychiatry. 4 th edition.

American Psychiatric publishing; Pp – 843-54.

5. Karande S, Mehta V, Kulkarni M. Impact of an education program on parental

knowledge of specific learning disability. Indian Journal Medical Science: 379-80. 6.

Karande S, Satam N, Kulkarni M, Sholapurwala R, Chitre A, Shah N. Clinical and

psychoeducational profile of children with specific learning disability and co-occurring

attention-deficit hyperactivity disorder. Indian Journal Medical Science 2007 Dec;

61(12):637-8.

7. Stojanovik V and Riddell P.Expressive versus receptive language skills in specific

reading disorder. Indian Journal Medical Science 2005 Dec; 61(12):538-43.

8. Kohli A, Malhotra S, Mohanty M, Khehra N, Kaur M. Specific learning disabilities in

children: deficits and neuropsychological profile. Indian Journal Medical Science. 2007

Jul; 61(7):398-406.

9. Morris David and Turnbull Patricia (2008) conducted qualitative exploratory study on

Clinical experiences of students with dyslexia Journal of advanced nursing;

2006, vol. 54, (2):238-247.

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10.Karande S, Sawant S, Kulkarni M, Galvankar P, Sholapurwala R. Comparison of

cognition abilities between groups of children with specific learning disability having

average, bright normal and superior nonverbal intelligence. Indian Journal Medical

Science. 2005 Mar; 59(3):95-103.

11. Uzi Brook, Nathan Watember, and Diklah Gev. Attitude and knowledge of attention

deficit hyperactivity disorder and learning disability among high school teachers. Jl of

patient education and counseling 2000 Jun; 40 (23): 247-252.

12. Agarwal KN, Agarwal DK, Upadhyay SK and Singh M. Learning disability in rural

primary school children. Indian Journal Medical Research.1991 Apr; 94:89-95.

13. Polit D F, Hungler B P. Nursing Research. Principles and methods. 5th Ed.

Philadelphia. J B. Lippincot Co, 1999.

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9. SIGNATURE OF THE CANDIDATE

10.REMARKS OF THE GUIDE

11. NAME AND DESIGNATION

11.1 GUIDE Mr. P.K .PRASAD

PROFESSOR CUM HEAD OF

DEPT. OF PSYCHIATRIC NURSING,

NATIONAL COLLEGE OF NURSING,

BANGALORE.

11.2 SIGNATURE

11.3 CO-GUIDE

11.4 SIGNATURE

11.5 HEAD OF DEPARTMENT Mr. P.K. PRASAD

PROFESSOR CUM HEAD OF DEPT. OF

PSYCHIATRIC NURSING,

NATIONAL COLLEGE OF NURSING,

BANGALORE.

11.6 SIGNATURE

12.

12.1

REMARKS OF THE

CHAIRMAN AND PRINCIPAL

12.2 SIGNATURE

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