>. >0 mro>z>44< «I‘llln'anl i} .‘ ”9 INIIP!’¢TCRNEI«LM£\" ‘u- A; 2’.“ ~_ ;___, 2"" -- rm; ~ J HHHHHHHH ‘.“ _CIIIIIIIII IIIIIEEEE {THESIS .7 ”H-l 1)-, . _. - ,1 / _-4 1’7)- 11— - 11-9- ”’1—.-.'.-.' V// 'l'. '5 52 it I. 0" $6"? 17’). f' rg—grr u .aWwfi%V 1:5 o/r,4,4.’v-,I.4 (64-6-3 h' {t .r--/ .9 c. ’4 _ (92/ r ',' «I ",f at ’9 9- 41/ 4‘; 0' - I-A‘é-flz’é/ffi' x’z/I} ' /9'»: ' Xv/Jéu 42:52,?57/2/4 vii-3.965;»? 3 “if left/ogrfirgéfrc . 7 "fa/.15 5- ”!” I” E '4}? $513}; 546143: 63328;?! 0 I i ’6. “I _____ ____ it t u an arc This is to certify that the dissertation entitled A descriptive and demographic analysis of educable mentally retarded graduates of the Mataria Center in Egypt and perceptions of competencies, knowledge, and skills required for independent living. A need assessment studlymsented by Abdul Ghaffar Abdul Hakim Eldamatty has been accepted towards fulfillment of the requirements for Ph.D. degree in Counseling, Educational Psychology and Special Education @Zw. L~\\ Kc. Major professor / 1 Dr. Charles V; Maég Date Qfimf C“, (957/ MS U is an Affirmative Action/Equal Opportunity Institution 0-12771 MSU LIBRARIES I.“ \- RETURNING MATERIALS: Place in book drop to remove this checkout from your record. FINES will be charged if book is returned after the date stamped below. A DESCRIPTIVE AND DEMOGRAPHIC ANALYSIS OF EDUCABLE MENTALLY RETARDED GRADUATES OF THE MATARIA CENTER IN EGYPT AND PERCEPTIONS OF COMPETENCIES, KNOWLEDGE. AND SKILLS REQUIRED FOR INDEPENDENT LIVING: A NEED-ASSESSMENT STUDY By Abdul Ghaffar Abdul Hakim Eldamatty A DISSERTATION Submitted to Michigan State University in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY Department of Counseling. Educational Psychology, and Special Education 1984 ABSTRACT A DESCRIPTIVE AND DEMOGRAPHIC ANALYSIS OF EDUCABLE MENTALLY RETARDED GRADUATES OF THE MATARIA CENTER IN EGYPT AND PERCEPTIONS OF COMPETENCIES. KNOWLEDGE. AND SKILLS REQUIRED FOR INDEPENDENT LIVING: A NEED-ASSESSMENT STUDY BY Abdul Ghaffar Abdul Hakim Eldamatty This study was conducted primarily to gather socio-demographic information regarding a selected group of educable retardates who graduated from the Mataria Center of Egypt between 1976 and 1980 and to describe their independent living status. It also attempted to deter- mine the independent living competencies needed by educable mentally retarded in Egypt and the impact the Mataria program had on developing these competencies in its "graduatesJ' Fifty "graduates" were randomly selected and equally divided into two groups. The subjects' parents represented them in interviews conducted for collecting data. The Mataria Center professionals also participated in this study. comprising a third group. A four-part instrument was used in this study. Parts I and II were used in collecting socio-demographic. vocational. marital. economic. and living data regarding the 50 subjects. Part One of the AAMD Adaptive Behavior Scale (ABS) comprised Part III and was used in Abdul Ghaffar Abdul Hakim Eldamatty rating independent competencies of group one of the subjects. Part IV consisted of two forms. A and B. on which both the parents of group two and Mataria professionals were asked to specify. on a six-point scale. the perceived importance of 78 competency statements for independent living. Also on Form A. parents of group two rated the Mataria programls impact on the development of these competencies in their children. Descriptive statistics were used in analyzing the data. The following major findings were reported: The "graduates" were primarily male. living in Cairo. mostly identified as mentally retarded during elementary education where special education was pro- vided for few of them. and came mostly from economically and education- ally deprived backgrounds. A very large majority of them were employed. earning a good income. single. and living with their parents. Their independent living competencies were mostly of high to above- average mastery and comparable to those of the American norm. Parents and professionals perceived independent living competencies. included in Part I of the AAMD-ABS. as important for educable retardatesfl inde- pendence in Egyptian society. The Mataria program had little impact on the development of these competencies. as perceived by parents. Recom- mendations to improve the effectiveness of Egyptian habilitative pro- grams for mentally retarded and implications for further research were reported. IN THE NM OF ALLAH THE MERCIFUL THE COMPASSIONATE This work is fully dedicated to Allah (God). glory be to Him. who has been. is. and will continue to be giving me strength and guidance through the light of His countenance. and to the soul of my father. who was destined to die at the very last moment of my completing this study. ACKNOWLEDGMENTS It is not possible to credit all who have contributed to the accomplishment of this study. In expressing appreciation and recog- nizing the contributions of many. I would like to give particular recognition to my wife. Zeinab. who has sacrificed her Job. personal convenience. and many precious things in her life to support me throughout my program at Michigan State University. and to my daughters. Suzanne and Eman. and my lovely son Waleed. who have patiently endured my long absence and separation from them while I was working on this study. I most gratefully acknowledge and appreciate the loyal support provided by Dr. Charles V. Mange. my major advisor and committee chair- man. without whose steady wisdom and valuable guidance my entire program at MSU would not have been possible. Dr. Linda A. Patriarca. a special professor. committee member. and friend. has provided me with confi- dence. inspiration. encouragement. knowledge. and guidance throughout my entire doctoral program at MSU. The other members of my committee. Dr. Donald A. Burke; Dr. William D. Frey; Dr. James E. Keller. who retired before the completion of this study; and Dr. Robert L. Ebel. may his soul rest in peace. who was destined to die before the comple- tion of this study. made unique contributions by their example. advice. and teaching throughout my program. The other faculty members of the Counseling. Educational Psychology. and Special Education Department. especially Dr. Ronald M. Wolthuis. Professor Vivian Stevenson. Dr. Harvey F. Clarizio. Dr. Stephen L. Yelon. and Dr. Richard Houang. are special people I have come to know as personifications of the "helping professionalsd‘ Special thanks and gratitude are extended to Dr. Jeanne E. Gullahorn. Associate Dean of the Graduate School. and Dr. Andrew Porter. Assistant Dean of the College of Education. for their valuable moral and financial support provided for the completion of this study. I take this opportunity to extend my thanks and appreciation to Dr. Mohamed Mohrous Mohamed. Assistant Professor and Former Director of th Egyptian Institute for Program Evaluation. for his great help in launching this project and facilitating the collection of its data by the Institute's research team. Thanks are due to the many people who took time to help in completing this study. especially Andrew Davidson and Steve Howard. who have assisted me in various ways. and Susan Cooley. who patiently and neatly typed my dissertation under very difficult time constraints. Above all. I am sincerely thankful to my parents. brothers. and sisters for the prayers. sacrifices. and patience with which they bore my very long absence from home. TABLE OF CONTENTS LIST OF TABLES . . . . . . . . . . . . . . . . . . . . . . . LIST OF FIGURES . . . . . . . . . . . . . . . . . . . . . . Chapter I. INTRODUCTION.................... The Educational and Rehabilitation Systems for the Mentally Retarded in Egypt . . . . . . . . Historical View . . . . . . . . . . . . . Current Services for the Mentally Retarded Need for the Study . . . . . . . . . . . . . Purposes of the Study . . . Research Questions . . . . . . Significance of the Study . . Limitations . . . . . . . . . Overview of the Remainder of the St II. REVIEW OF LITERATURE . . . . . . . . . . . . . . . . Introduction . . . . . . . . . . . . . . . . . . . Definition of Independent Living as the Highest Rehabilitation Goal . . . . . . . . . . . . . . Independent Living as a Goal in Training Mentally Retarded . . . . . . . . . . . . . . . . . . . Follow-Up Studies on Community Adjustment . . . . Importance of Follow-Up Studies to Program Evaluation . . . . . . . . . . . . . . . . . Types of Follow-Up Studies . . . . . . . . . . Post-Institutional Studies . . . . . . . . . . Studies of Noninstitutionalized Retardates . . Follow-Up Studies of Mentally Retarded in Egypt Discussion and Implications . . . . . . . . . . Adaptive Behavior Scale . . . . . . . . . . . . . The Concept of Adaptive Behavior . . . . . . . . Adaptive Behavior and Its Relationship to Independent Living . . . . . . . . . . . . . . Measures of Adaptive Behavior . . . . . . . . . Page viii xii 10 l4 l5 T7 18 19 19 20 24 28 28 31 34 44 53 54 56 56 59 62 Page Importance of Adaptive Behavior and Its Measurement to Rehabilitation Programs . . . . . . . . . . . . 64 Rationale for Selecting the ABS and Restricting Its Use to Part One . . . . . . . . . . . . . . . 66 Chapter Summary . . . . . . . . . . . . . . . . . . . 71 III. METHODS AND PROCEDURES . . . Population and Sample . . . . . . . . . . . . . . . . 72 Instrumentation . . . . . . . . . . . . . . . . . . . 76 Part One . . . . . . . . . . . . . . . . . . . . . . 78 Part Two . . . . . . . . . . . . . . . . . . . . . 78 Part Three . . . . . . . . . . . . . . . . . . . . . 79 Part Four . . . . . . . . . . . . . . . . . . . . . 80 Instrumentation Translatio and Pilot Test ng . . . . 83 Procedures of Data Collection . . . . . . . . . . . . 87 Treatment and Analysis of the Data . . . . . . . . . . 90 IV. PRESENTATION OF THE RESEARCH ANALYSIS . . . . . . . . . 95 Introduction . . . . . . . . . . . . . . . . . . . . . 95 Socio-demographic Characteristics of the "Graduates" . 96 General Information . . . . . . . . . . . . . . . . 96 History of Disability . . . . . . . . . . . . . . . 98 Socio~demographic Characteristics of the "Graduates'" Families . . . . . . . . . . . Educational History of the "Graduates“ . . . . . . . 108 Analysis of the Independent Living Status of the Mataria Center "Graduates" . . . . . . . . . . 111 General Overview . . . . . . . . . . . . . . . . . . 111 The "Graduates'" Vocational Status . . . . . . . . . 113 The "Graduates'" Income Status . . . . . . . . . . . 120 The "Graduates'" Ability to Handle Economic Activities . . . . . . . . . . . . . . . . . . . . 123 The "Graduates'" Marital Status . . . . . . . . . . 123 The "Graduates'" Living Status . . . . . . . . . . . 124 The "Graduates'" Independent Living Competencies . . 125 Comparison of the "Graduates'" Scores to the American Normative Sample . . . . . . . . . . . . 131 Skills and Competencies Perceived Important for Successful Independent Living . . . . . . . . . . . 133 Analysis of Parents' Perception . . . . . . . . . . 135 Analysis of Professionals' Perception . . . . . . . 143 Professionals' Perception . . . . . . . . . . . . . 147 Comparison Between Parents' Perception and Professionals' Perception . . . . . . . . . . . . 156 vi Parents' Opinion of the Impact the Mataria Program Had on Improving the "Graduates'" Independent LIVIng BehaVIOrs O O O O O O O O O O O O O O O O O 0 Chapter Summary . . . . . . . . . . . . . . . . . V. SUMMARY. DISCUSSION. AND RECOMMENDATIONS . . . . . . . . Summary . . . . . . . . Purpose . . . . . . . Review of Literature . Population and Sample Instrumentation . . . Summary of Major Findings . . . . . . . . . . The "Graduates'" Demographic Characteristics Socio-demographic Characteristics of the "Graduates'" Families . . . . . . . . . The "Graduates'" Educational History . . . The "Graduates'" Vocational Status . . . . The "Graduates'" Income Status . . . . . The "Graduates'" Ability to Handle Economic Activities . . . . . . . . . . . . . . . . . . The "Graduates'" Marital Status . . . . . . . . The "Graduates'" Living Status . . . . . . . The "Graduates'" Independent Living Competencies . Parents' Perception of Needs in All 78 Competencies. Professionals' Perception of Needs in All 78 Competencies . . . . . . . . . . . . . . . . . . . Comparison Between Parents' and Professionals' Perceptions . . . . . . . . . . . . . . . . . . . Parents' Opinion of Mataria's Impact on "Gradu- ates'" Competencies . . . . . . . . . . . . DISCUSSIO" O O O O O O O 0 O O O O O O O O 0 Recommendations for Possible Implementation Implications for Further Research . . . . . O O O O O O O O O O APPENDICES O O O O O O O O O O O O O O O O O O O O 0 O O O A. WE INSTRUMENT O O O O O O O O O O O 0 O O O O O O O O O B. THE STUDY SAMPLE BY GROUP. SEX. AGE. IQ. AND TEST USED, AS RANDOMLY DIVIDED o o o o o o o o o o o o o o o C. RAW DATA OF THE SAMPLE . . . . . . . . . . . . . . . . . D. FREQUENCY DISTRIBUTION FOR PARENTS' AND PROFES- SIONALS' PERCEPTIONS OF COMPETENCY STATEMENTS AND PARENTS' PERCEPTIONS OF PROGRAM IMPACT . . . . . . . BIBLIOGRAPHY . . . . ...................... vii Page 157 166 166 167 167 167 168 168 169 169 170 170 171 172 172 172 173 173 174 174 175 176 176 194 199 201 202 250 252 260 281 10. 11. 12. 13. 14. 15. 16. 17. LIST OF TABLES Total Population of the Mataria Center Graduates From 1976 to 1980 O O O 0 O O O O O O O O O O O O O O O 0 Distribution of Subjects by Sex . . . . . . . . . . . . Distribution of Subjects by Age . . . . . . . . . . . . Distribution of Subjects by Birth Place. Residency. and Number of Years Living in Present Residency . . Distribution of Subjects by Identification Age . . . . Distribution of Subjects by Method of Identification . Distribution of Subjects by Major Cause of Mental RetardatTOn 0 O O O O O O O O O O O O O O O O O 0 Distribution of Subjects by Parents' Kinship and Prevalence of Mental Retardation in the Parents' Offspr1ng O O O O O O O O O O O O O O O O O O O 0 Distribution of Subjects by Suffering From Other Disabling Conditions . . . . . . . . . . . . . . . . Distribution of Subjects by IQ . . . . . . . . . . . . Distribution of Subjects by Parents' Life or Death . . Distribution of the "Graduates" by Family Members . . . Distribution of Subjects by Birth Order . . . . . . . . Distribution of Subjects by Mother's Age at the Time of Subject's Birth . . . . . . . . . . . . . . . . . Distribution of Subjects by Parents' Educational Status Distribution of Subjects by Parental Vocational Status Distribution of Subjects by Parents' Income . . . . . . viii Page 73 97 97 98 99 100 100 101 102 103 104 104 105 105 106 107 108 F- --—..- 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. 33. 34. 35. Distribution of Subjects by Admission Age to the Mataria Center . . . . . . . . . . . . . . . . . . . Distribution of Subjects by Years of Graduation . . . Distribution of Subjects by Length of Training . . . . Distribution of Subjects by Years They Attended Special Education Before the Mataria Center . . . . . . . . . Distribution of Subjects Who Received Special Services Before the Center by Types of Services Received . . . Distribution of "Graduates" by Their Present Vocational Status . . . . . . . . . . . . . . . . . Distribution of "Graduates" by Types of Present Jobs . Employed Subjects by Years Present Jobs Had Been Held . Distribution of Employed Subjects by Type of Employer . Distribution of the Employed Subjects by the Types of Job Placement Efforts . . . . . . . . . . . . . . Distribution of Subjects by the Type of Vocational H91 p a a c o o o o o o I I o O o o O o I o o c I 0 Distribution of Reasons for Satisfaction of Employed subJeCts O O O C O I O I 0 l 0 O l O O 0 O I I 0 O O Reasons for Dissatisfaction of Employed Subjects . . . Reasons for Quitting Jobs . . . . . . . . . . . . . . . Distribution of Employed Subjects by Their Monthly Income From a Job . . . . . . . . . . . . . . . . Distribution of Employed Subjects by Monthly Income From Parental Support . . . . . . . . . . . . . . . . Distribution of Employed Subjects by Their Overall Montth Incane I 9 I O 0 C O O O O I O O I l l O I 0 Distribution of the "Graduates" by Their Marital Status I I l 0 O O O O D O O O I I O t O O I O Q Page 109 109 110 111 111 114 115 115 116 117 118 118 120 122 122 124 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51. 52. Distribution of "Graduates" by Living Status . . . . . . Descriptive Statistics of the Subjects' Raw Scores on theABSMajorDomains Order of the Converted Domain Scores by Mean and Standard Deviation . . . . . . . . . . . . . . . . . . Descriptive Statistics of the Subjects' Raw Scores on the ABS Subdomains . . . . . . . . . . . . . . . . . . Order of the Converted Subdomain Scores by Mean and Standard Deviation . . . . . . . . . . . . . . . . . . T-Test Results of the Mataria "Graduates" and the United States Normative Sample (Ages 19-29) . . . . . . Order of Importance by Mean Ratings for All 78 Statements as Perceived by Parents . . . . . . . . . . Rank Order by Mean Ratings for the Importance of the Ten ABS Domains as Perceived by the Parents . . . . . . Distribution of Mataria Center's Professionals by Age and sex 0 O O O O O O O O O O O O 0 O O O O O O O 0 Distribution of Mataria Staff Members by Job Titles . . . Distribution of Mataria Staff Members by Years of Experience Working With Retarded Persons . . . . . . . Distribution of Mataria Staff Members by Educational Leve] O O O O O O O O O O C O O O O O O O O O O O O O 0 Distribution of Mataria Staff Members by Category of Training Assignment . . . . . . . . . . . . Order of Importance by Mean Ratings for All 78 Statements as Perceived by Professionals . . . . . . . . . . . . . Rank Order by Mean Ratings for the Importance of the Ten ABS Domains as Perceived by Professionals . . . . . Comparison of Parents' Perception With Professionals' Perception O O O O O O O O 0 O O O O O O O O O O o o 0 Order of Competency Statements by Means and Standard Deviations of the Impact Rated . . . . . . . . . . . . Page 125 126 127 129 130 132 136 142 144 144 145 146 147 149 155 156 159 53. 0-10 0-2 0 0-3 0 C-5 0 D-10 D-Zo D-3 0 Parents' Opinion of Improvement Impact on the ABS Domains Ordered by Mean Ratings . . . . . . . . . . The Study Sample by Group. Sex. Age. IO. and Test Used) as Random1y DTV‘ided o o o o o o o a o o o o o 0 Summary Answer Sheet of the ABS Domain Scores Obtained by the Subjects of Group One . . . . . . . . . . . . Summary Answer Sheet of the ABS Subdomain Scores Obtained by the Subjects of Group One . . . . . . . . Frequency Distribution of the Individual Scores Obtained by the 25 Subjects on the ABS Domains . . . Frequency Distribution of the Individual Scores Obtained by the Subjects on Subdomains . . . . . . . ABS Raw Domain Scores of Group One by IO Level. Age Group; and sex o o a a o o o o o I I o o n o o 0 Observed FreQUency Distributions Regarding Both Perceived Importance of IL Competencies and Program Impact on Them by Parents . . . . . . . . . . . . . Observed Frequencies Regarding Perceived Importance of IL Competencies by Professionals . . . . . . . . . Comparison of Parents' Perception to Professionals' Perception Regarding All the Competency Statements . xi Page 165 251 253 254 256 257 259 261 270 279 LIST OF FIGURES Figure Page 1. Study Participants and Instrumentation Parts Used in Interviews and Data Collection . . . . . . . . . . . 77 xii CHAPTER I INTRODUCTION Mental retardation in its various degrees of severity is one of the most common disabilities for which special educational help is needed. Any teacher must have confronted pupils whose capacity to learn is well below that of average children. Most people know of some family in which there is a mentally handicapped child. Among children with physical and sensory handicaps. low intelligence is a common additional disability and many multi-handicapped children tend to be rather severely mentally retarded. The need to understand the nature of mental retardation and to evolve effective educational programs is an important one. There has been a considerable change in past attitudes toward the problem of mental retardation. While attention was given to deaf and blind children early in the history of special education. and while there was always an optimistic belief that special methods could contribute much to overcoming visual and hearing impairments. such was not the case for the mentally handicapped: it was thought that education and training were of limited worth in improving their condition. For the first half of the twentieth century. care for the mentally retarded tended to be custodial. and even special schooling was limited in goal and scope by the feeling that great improvement could not be expected (Perske. 1972; Gulliford. 1973; Scheerenberger. 1983; Bank—Mikkelsen. 1978). One result of this earlier philosophy was that. apart from a few devoted pioneers. there was a shortage of professionals interested in research and in experimental methods of treatment. The Second World War. however. reversed this unfortunate situation. A considerable amount of medical research into the causes of mental retardation has been conducted. and now some of the causes are better understood; in some instances. disability can be prevented. others can be treated. and the research for still more causes and treatment continues. Research by psychologists. furthermore. has contributed to improving the atti- tude toward the capacity of subnormal individuals to learn and to work. Their limitations of thinking. language. and learning have been researched. and tentative findings which have implications for methods of educating them have been established. The educational and social aims of teaching for the mentally retarded have become clearer (MacMillan. 1977; Ingalls. 1978; Scheerenberger. 1983). This progress has not come a moment too soon. Low mental ability necessarily entails social handicaps. Rapid development and changes in contemporary society increase the burden of disability. For a minimal adjustment to living and working in modern communities. the educational skills and degree of social competence required are greater than those of urban. and even more of rural. life 50 years ago. ‘There are fewer unskilled jobs. Many jobs that used to be thought suitable for the least intelligent now require skills and adaptability. For those who marry and raise a family. greater complexities ensue. especially when a large family and low income are combined. allowing no room for error or incompetence. The organization and methods of educating the mentally retarded in schools are matters that can neither be approached casually nor remedied without careful planning. A clear-cut assessment of the present educational potentialities of the mentally retarded and of their future social needs must be made. Technical and organizational changes in societies are inevitably accompanied by changes in attitudes which affect working with the mentally retarded. As society develops higher levels of education and progresses to more advanced stages. it is less willing to maintain customary methods of care as a long-term solution for the mentally retarded. and superior strategies for dealing with them need to be elaborated. In the meantime. more flexible attitudes toward human differences. greater optimism over the improvement of abilities. and greater awareness of social and group influences on learning lead society to challenge many customary methods of organizing education. From a variety of viewpoints. therefore. new directions in the policies and educational provisions for the mentally retarded are being forged. and the need to evaluate the efficiency as well as the effec- tiveness of current educational programs has become imperative. T e c o e bi io S s e s o e Me 9 r e 1 Historical View Under the influence of the ideals of modern scientific progress. many countries have radically revised their policies toward the men- tally retarded. As a new era began in the field of social rehabilita- tion and special education in Egypt. greater concern for the mentally retarded was shown. and the stereotypes about their potentialities underwent revision. The means of caring and providing for the mentally retarded in Egypt did not come all at once. At the National Conference on the Welfare for the Disabled held in 1956. a recommendation was issued that called for the establishment of a program for the care of the mentally retarded. Two years later the Ministry of Social Affairs initiated a very modest program at Kobbah in Cairo. This program was merely the first step toward a more sophisticated program. In 1965. the Depart- ment of Rehabilitation for the Handicapped addressed itself with vigor to the problem of mental retardation. 1. The following steps were taken: A comprehensive rehabilitation scheme was developed to face the problem of mental retardation. 2. The existing facilities were classified by function as elements in an integrated program. 3. Professionals in the field were called upon to contribute to the advancement of the services. 4. A sample survey to determine the size of the problem was designed. .) 5. A plan for the establishment of new facilities was prepared (E1 Hommossani & Mohamed. 1979). These steps led to an enlightened view of the problem and of the efficiency with which local and international resources could deal with it. In 1966. a cooperative research program was launched. funded by a grant from the Rehabilitation Services Administration of the United States Department of Health. Education and Welfare. with two principal tasks: 1. identifying the dimension of mental retardation as a social. economic. and educational problem; 2. identifying different aspects of the potential for the habili- tation and education of the mentally retarded. The research continued for five years and the results pointed to an urgent need for the establishment of a demonstration research and training rehabilitation center for the mentally retarded. It also determined that the mentally retarded can be more easily integrated into society if their needs for special education and rehabilitation are met on a regular basis. By the middle of 1972. these efforts culminated in the establishment of a comprehensive center for training and research. created by and put under the auspices of the Intellectual Development Association. The Mataria Center in Cairo was built. encompassing an area of 17.000 square meters. Opened and fully operational in 1973. it began a new era in the habilitation of the mentally retarded in Egypt (El Hommossani & Mohamad. 1979). In the meantime. a plan was devised to cover all the Governorates of Egypt with services for the training of mentally retarded within the next ten years. Since the establishment of the Mataria Center. rehabilitation legislation has been changed several times. resulting in the enactment of the Law of Rehabilitation of 1975. This law formalized the follow- ing innovations: l. A supreme council for rehabilitation on the national level with representatives from different concerned governmental bodies and interested individuals. 2. A 5% quota for the employment of the disabled in those enterprises that employ 25 workers or more. In addition. the same law established the right to rehabilitation for all disabled persons who meet the definition of disability. 1.3a any person who has had physical or mental limitation either since birth or acquired at any time through life and who has never been employed or who quit his job because of his limitation (Mohamad. 1982). e 9 cs Me Re e Services for the mentally retarded are provided through facilities affiliated with either the Ministry of Education or the Ministry of Social Affairs. 1. Special education is under the supervision of the Special Education Department in the Ministry of Education. The mildly retarded children who are identified at an early age are liable for compulsory schooling insofar as there are special education services in their locality. However. those who are identified at school age or during school years are referred for services according to the availability of either special classes or special schools in their locality as well. The identification process at the school age may occur as a result of a complete medical and psychological evaluation undertaken by the School Hygiene Department once a child is admitted to schoOL. During school years. the identification may occur as a result of a teacher's observa- tion or a school psychologist's evaluation of the student's abilities. However. children who are identified as trainable or severely impaired are not eligible for services offered by the Ministry of Education (E1- Hommossani & Mohamed. 1979). Hence. the most common models of special education services available in some localities are as follows: a. Special classes: Located within regular schools. programs are presented that address the unique educational characteristics of the educable mentally retarded. b. Special schools: Educational services form the pillars of such models. Schools are equipped and staffed to suit the educational needs of the educable mentally retarded under the title of Schools for Intellectual Development. At the present time. there are 33 schools throughout the country that provide primary education for the educable mentally retarded. These schools contain 335 classes with an enroll- ment of over 3.000 children with ages ranging from 5 to 13. The mentally retarded student can then proceed to a vocational preparatory school for a period of three years. Teachers needed for the educational processes are trained in a special institute in Cairo. Besides teachers. there are trained psychologists who work with the children to improve personal adjustment and readiness for independent living (E1 Hommossani & Mohamed. 1979A 2. The Ministry of Social Affairs. on the other hand. provides the bulk of noneducational services for the handicapped. For the mentally retarded. the Ministry has formulated policies to integrate the existing services and to create a new model for services. Hence eight centers have been established. in major cities for the most part in addition to the Mataria Center. to provide rehabilitation on a comprehensive basis for both trainable and educable mentally retarded persons from the age of 6 to 25. These services start with determining the individual's eligibility and the kinds of services needed for care. In order to define eligibility and the kind of service needed. a classification unit was established. The team working in this unit is composed of a medical practitioner. an internist. neurologist. psychia- trist. social worker. psychologist. and rehabilitation counselor. A complete evaluation is done for the case. including: 1. A complete history of the child. 2. Social evaluation. 3. Educational and vocational history. 4. Medical evaluation--general. 5. Medical evaluation--specific. 6. Psychiatric screening. 7. Psychological evaluation: General abilities--I.O. Aptitudes-—educational and vocational. Interests. Completing that full evaluation. the team can decide on the eligibility of the case. The person who meets the criteria for eligi- bility is admitted to the most appropriate center considering age. sex. Ill. and family residence and is provided with medical. psychiatric. educational. and vocational training. as well as psychological serv- ices (El Hommossani & Mohamed. 1979). The teachers who are involved in the rehabilitation program. however. are usually employed by the Ministry of Education. Upon completion of training. the mentally retarded are assisted in finding appropriate jobs in larger factories. firms. or the government. However. those who fail to find work or cannot compete in the labor market can be aided through social security funds so as to have a private business at home or be employed in sheltered workshops. It should be mentioned that the educational phase of the rehabili- tation program is different from its counterpart at the Ministry of Education in several ways: 1. It is run on a comprehensive basis (i.eu physical. social. vocational. and psychological services are provided). 2. It is vocationally oriented for adults. 10 3. It is prevocational in nature for those who are admitted at younger ages. 4. Once identified. the mentally retarded can be admitted at any age between 6 and 25. 5. It is available for both educable and trainable persons. It should also be noted that there is no indication in relevant literature of how these two types of services offered by the two Ministries are coordinated if they both are available within one locality. It seems from the literature that educable and trainable retarded students are not served if their localities lack such types of services. It also seems that the severely retarded are not served by any of these services. ee 0 e Mataria Center for the habilitation of the educable and trainable mentally retarded is regarded as a prominent and comprehensive center in Cairo. As previously indicated. it was established in 1972 by the Egyptian Society for Intellectual Development. It is the first concrete outgrowth of a cooperative research project supported by the Rehabilitation Services Administration of the United States Department of Health. Education and Welfare and carried out by the Ministry of Social Affairs of Egypt. The Center was established to serve as a prototype program for training/habilitation services for mentally retarded persons. Among the objectives announced for the establishment of this Center are the following (Provitt. 1981): 11 1. Providing needed assistance to the existing centers and insti- tutions that render services to mentally retarded persons in Egypt. 2. Establishing a technically sound program of habilitation services and a staff training program to serve as a model for the development of a national program of habilitation resources for mentally retarded persons and their families. In addition. it is a model that could have implications for other Arab countries in the region that may be interested in developing similar programs. 3. Training personnel to administer and provide services in new centers that will be established gradually throughout the 27 Governorates in Egypt. As far as the immediate objectives of the Center are concerned. the concept that has been adopted by the Mataria Center program in training of the mentally retarded is comprehensive habilitation. that is. a maximum development growth of the total individual to the highest level of independence his potential will permit. Vocational skills training and preparation is an important component of the habilitative programming of the mentally retarded persons served at the Mataria Center to produce the capability for employment. sheltered employment. or supervised activity. Personal care and skills training for self— help capability. educational training for activities of daily living development. and socialization training for acceptable social and work behaviors are given significant emphasis in the program. As its ultimate goal. the Mataria Center Program stresses the importance of independent living skills in the hope that its graduates 12 will eventually become fully independent and be able to live a more normal life. with normality here defined as the ability to participate actively in society and the capacity to meet mental and physical requirements of daily life. It is very apparent that the Mataria Center Program assumes a great role in the habilitation of mentally retarded persons in Egypt both as it encompasses a wide variety of provisions and as a central focus and model for assistance to other centers. However. since the Mataria Center was opened and fully operational in 1973. no attempt has been made to investigate its effect on its graduates and whether or not they are functioning competently in society. No study has attempted to determine the extent to which the current training program of the Center is suitable for meeting the needs of mentally retarded persons. To determine whether or not the Mataria Program is efficiently meeting the needs of mentally retarded individuals and training them for living in a way that would lead to adult behaviors adequate to social demands. it is necessary to determine specifically the skill and knowledge areas deemed important by professionals and the parents of its graduates for successful independent living in Egypt. It is equally important to determine to what extent these competencies. knowledge. and skills are present in the graduates as a result of being trained in the Mataria Program. We need to know how the graduates are functioning in society and to what extent they are capable of making a satisfactory adjustment vocationally. personally. and socially. Because the major purpose for which graduates of the habilitation 13 program at the Mataria Center of Egypt are prepared is that of inde— pendent living. the independent-living aspect of this program is stressed in this study. P r oses o e S In general. this study is intended to make an evaluation that can be used as feedback to modify ongoing programs. to increase effec— tiveness in developing skills needed for independent living. and to further the vocational competence of mentally retarded persons in Egypt. More specifically. the following objectives will help in clari— fying the extended purposes of this study: 1. To gather basic socio—demographic information regarding the graduates of the Mataria Center of Egypt. 2. To determine whether the areas of competency as listed in Part I of the AAMD Adaptive Behavior Scale (ABS) are indeed the spe- cific competencies needed by mentally retarded persons in Egypt. 3. To describe the adult-program graduates' independent living status. 4. To make an analysis of the strengths and weaknesses of the adult graduates as related to their vocational. personal. and social adjustment. 5. To examine the opinion of the parents related to the effect the Mataria Program had on improving the independent-living behaviors of the graduates. l4 6. To determine whether or not any significant differences exist in the perceptions of the parents and professionals of the adult- program graduates regarding competencies. knowledge. and skills of importance for successful independent living in Egypt. 7. To provide feedback for the training program so as to promote the independent-living behaviors of the mentally retarded in Egypt. es rc u 5 10 s This study is directed toward answering the following questions: 1. What are the demographic characteristics of a selected group of educable mentally retarded graduates of the Mataria Program? 2. What competencies. knowledge. and skills as measured by the AAMD Adaptive Behavior Scale (ABS). Part I. are acquired by the edu- cable mentally retarded graduates of the Mataria Program? 3. What are the areas of relative weakness of Mataria Program graduates in competencies. knowledge. and skills as measured by the ABS? 4. What competencies. knowledge. and skills measured by the ABS are perceived by the parents of educable graduates of the Mataria Program to be of importance for successful independent living in Egypt? 5. What competencies. knowledge. and skills measured by the ABS are perceived by professional staff members of the Mataria Program to be of importance for successful independent living in Egypt? 6. What effect do the parents believe the Mataria Program has had on improving competencies. knowledge. and skills of the graduates of the program? 15 7. What is the vocational status of the educable mentally retarded graduates of the Mataria Program? 8. Are there significant differences between perceptions of parents and perceptions of the professional staff members of the Mataria Program regarding the importance of the competencies. knowl- edge. and skills measured by the ABS for successful independent living in Egypt? 5 c ce 0 e S Although some progress has been made in both the educational and the training/habilitation provisions for the mentally retarded in Egypt since the establishment of the Mataria Center and a few other centers. there are still many retarded persons whose needs remain unidentified and who receive no special attention. especially in the areas outside the largest cities. Only the most populous communities have been able to provide habilitation services to any extent. In addition. resources within the country and the services they provide. relating to the problem of mental retardation. appear impressive when first reviewed. When explored in detail. however. we find that services provided are fragmented. uncoordinated. and do not extend adequate coverage to all areas and groups within a country with an ever-increasing population. Moreover. gaps in services are obvious in providing a continuum of services needed for optimum development of the mentally retarded. In many instances the services provided by existing facilities are meager due. for the most part. to lack of understanding of the special needs 16 of the mentally retarded. lack of serious focus on the problem. and inadequate funding. Consequently. the effects of these disabling conditions on children. which could be minimized. are allowed to become chronic. and the children grow up to become hopeless. heavily dependent on their families. and prevented from successfully using their remaining abili- ties in a productive manner. Hence. the present study was conducted in the hope that it would contribute to both the establishment of new educational programs and the advancement of the effectiveness of ongoing programs for mentally retarded persons. As mentioned before. it is obvious that identifying the competencies. knowledge. and skills required for successful inde- pendent living in Egypt and knowing which of these skill and knowledge areas are present in the graduates of the Mataria Program would help in identifying the needs of the mentally retarded and their areas of deficiency. By the same token. obtaining information in this respect would help policy makers and program developers in both making effective decisions and taking proper measures to meet the needs of the retarded population in Egypt. In the meantime. the Mataria Center Program has been under a very thorough revision through a project carried out with special funding assistance by the United Nations Development Programs in collaboration with the Ministry of Social Affairs of Egypt (Provitt. lQBl). The primary aim of this project is to examine all aspects of the organiza- tional and administrative structure of the Mataria Center as a pre- l7 requisite for establishing a program of facilities and services for mentally retarded persons in each of the 27 Governorates within ten years—-by l990. The initial emphasis of this project seems to be on internal program revision and validation. However. external validation of the Mataria Program seems to be de—emphasized at the first stages of the project. Consequently. a study of the graduates of the Mataria Program is a timely one. Its successful completion and subsequent review by the Ministry of Social Affairs of Egypt could have a direct influence on the education and habilitation of the mentally retarded population in Egypt. LJflflIQIiQflé Findings from this study should be viewed in light of the follow- ing limitations: 1. The paucity of literature relating to the education and/or rehabilitation of the handicapped in general and the mentally retarded in Egypt. This may Justify. at least in part. the need for the present study. 2. The difficulty of obtaining access to comprehensive informa- tion regarding the internal organization of the Mataria Center Program. The fact that the researcher was mostly viewed by the officials there as an outsider who was not sponsored by any official party put him in a position in which he otherwise would have found valuable research information that could support the study findings. Consequently. no attempt was made to analyze the actual habilitation process. curricu- lum. training methods. evaluation criteria. and the like. 3. The sample was restricted to the graduate population of the Mataria Center who completed their training programs in the years 1976 through l980. The sample as defined in this study may not have repre- sented other mentally retarded trained at some other centers in or outside Cairo. Hence the findings are limited to the graduates of this Center because the study dealt exclusively with its graduates. 4. Although efforts were made by the researcher to explain and clarify to the participants the purpose and importance of survey research in general and this study in particular. it should be kept in mind that the majority of the participants were not accustomed to survey research techniques. a factor that might have affected the accuracy of their responses. By the same token. some of the parents might naturally have denied their children's mental limitations or exaggerated their expectations of the children's competencies or skills. 0 e o R i o In Chapter II a review of the literature pertaining to the study is presented. Chapter III focuses on the methodology. the procedures followed in preparing the survey instrument. subjects and participants. and data collection. Chapter IV provides data analysis and findings. In Chapter V. the discussion and conclusions of the study are pre- sented. CHAPTER II REVIEW OF LITERATURE Introduction The purpose of this study is to describe the adult-program graduates' status related to functioning independently in society after graduating from the Mataria Center Program. The study also concerns itself with the assessment of competencies and skills thought to be of importance for the retardates' successful independent living. Research relating to the intellectual and social growth of men- tally retarded in the United States has been amply carried out in many areas. It is beyond the scope of this study to try to review all that has been written about social and vocational competence and its differ- ent components. However. the following areas are thought to be approp— riate for the purpose of this study and will be dealt with concisely: —-Definition of independent living as the highest goal of special and rehabilitation services for disabled people in general and mentally retarded in particular. --Follow—up studies that investigate the independent-functional status of formerly institutionalized retardates and "graduates" of special public school classes. 20 -—The Adaptive Behavior Scale of the American Association on Mental Deficiency as a tool for assessing the independent-functioning status of mentally retarded persons. Reviewing the literature on the definition of independent living (IL) revealed that any individual's definition of independent living is a matter of that individual's perception. As stated by Walls et al. (1979). If you ask "the man on the street" for definitions of independent living you are likely get responses such as. "It means being on your own. taking care of yourself. You can go places and do things without the help of other people. You do not need anybody else. You've moved away from your parents' control and are making it in the world. Ybu can maintain an apartment. do your own shopping. and generally get along independently." (p. i) It is evident from Walls et ale statement that IL is a relative concept that each perceives from his own perspective. based on his own situation and goals in life. However. a clear-cut independence does not seem practically existent. Almost everyone is dependent on others to a greater or lesser extent. Thus. dependence-independence is a continuum for us all. As Walls et al.'viewed this concept from a programmatic point of view. they pointed out that the objective of training for independent living is to move away from the former end of the continuum to a relatively more independent life style. Total dependence implies constant assistance and supervision. To the extent that an individual can begin to accomplish functions of everyday life such as mobility. home care. dressing. eating. and social communication without assistance and supervision. IL skills are gained. Although a 2] person may never achieve full mobility. progress in other life activities is attainable. (p. i) Although the preceding definition conforms to the goals that most rehabilitation programs aspire their clients will achieve. it is a narrow definition that does not consider the person's productivity in life beyond the level of independence. This definition seems to reflect the task-oriented/physical-skill viewpoint that penetrates most traditional rehabilitation programs. Despite the fact that the above definition does not take other aspects of IL into consideration. the task-oriented physical skills that the definition implies were seen by Cole (l983) as required to be mastered in order to attain independent functioning as far as mentally retarded persons are concerned. Cole viewed IL from a different perspective. As she explained skills training. she stated that Widely accepted definitions of IL have two predominant themes in common: self-direction and control over their own lives for handicapped individuals and full participation by handicapped people in the life of the community. including both the responsi- bilities and the benefits shared by all citizens.(p. l88) Of course. Cole's definition reflects the two central principles of the recent IL movement in the United States that profoundly shape the ways independent-living skills are conceptualized and taught. in contrast to skills historically taught under the rubric of activities of daily living skills. The fundamental difference. in her view. is that IL skills are skills for self—direction. rather than task-oriented behavioral capabilities. This distinction arises from the basic expectation within the IL movement that handicapped people are capable 22 of managing adult responsibilities as contrasted to the tacit expecta- tion of the recent past that has been that handicapped persons need to be taken care of as wards of their parents. appointed guardians. or public institutions. Heumann (l978). an IL-movement activist. viewed IL in a way that relates to Cole's definition. She stated. "to us. independent living does not mean doing things physically alone. It means being able to make independent decisions. It is a mind process not contingent upon a 'normal body.'" While Heumann's definition is not operational. other writers like Stoddard (l978) operationally defined IL in a way that is closer to the concept this study adopts. as will be indicted below. Stoddard com— mented on Heumann's definition. mentioned above. by stating that "when those active in the disabled movement use the term 'independent liv- ingfl they are referring to their ability to participate in society--to work. have a home. raise a family. and generally share in the joys and responsibilities of community life." The relativity of independence has made agreement on one defini- tion a difficult task. While some people define it as a state of mind. being able to make independent decisions. or the ability to share in the joys and responsibilities of community life. some other people define it to include the struggle for survival and fulfillment of basic needs (e4m. food and shelterL This would emphasize the point made earlier in this review--that IL is a relative concept and a function of oneks perception (Frieden. Noble. & Zola. l983L 23 Noble (l983) went further when he explained the universality of the independent-living concept. From a national view. Noble explained that the IL concept. stripped of its connotation as a social movement in the United States. is closely allied to the concept of handicap. as defined by the World Health Organization. For him. IL represents freedom from a handicap that may arise from an impairment or a dis- ability. This concept as being practiced in the United States varies drastically in its meaning. implication. and the means by which dis- abled groups achieve their independence in life. From an international view. Noble pointed out that a number of paradoxes exist between the American perspective on one hand. and the developed and developing countries' perspectives on the other. He stated that desperately poor families in other parts of the world maim their children so that their pitiful appeal as beggars will be enhanced. In still other places. . . . numerous instances can be cited where persons whose livelihood is threatened as a result of economic conditions are induced by public policy to declare themselves "disabled" in order to obtain income. (pp. 6-8) The researcher may conclude from the preceding review that looking at independent living as a social movement in the United States. one would find the concept more allied to civil rights and by far much more disabled-controlled and oriented (Heumann. l983). While disabled Americans practice their rights and seek control over them. the picture is very different for handicapped people in other parts of the world. As far as this researcher is concerned. the degree of control over their lives that may be attained by the handicapped is limited by the extent to which -all People's lives are controlled in that society. 24 That is not to suggest that disabled people in a country like Egypt should not aspire to live independently. What this researcher suggests is that independent living as the highest goal desired for disabled people should conform to the cultural values. the demands of the society. and the social. economic. and political trends that influence the rehabilitation and care services in a given country. Wining Wasted Substantial differences occur in the development of capabilities among various groups of handicapped persons. This fact necessitates that training a disabled person to achieve the goal of independent living should conform to the specific needs and characteristics of that person. Professionals in the field of mental retardation have long real- ized that the highest goal of any special program should be to help retarded persons to master the skills for independent living. However. from a programmatic perspective. the review of literature on the con- cept of independent living as the highest goal of any special program has been found to be broad. confusing. inconsistent. and difficult to interpret. a problem that makes researchers like Seltzer et al. (l98l) note. "Much of the research on post-institutional adjustment has been difficult to interpret because the comnuufity adjustment has been opera- tionalized in many different ways" (p. xiiL 25 Lakin et al. (1981) realized this inconsistency in using such terms and the problem it causes researchers in the field. These researchers pointed out that The notion of "adjustment." with its numerous definitions. is The breadth of every bit as problematic as the term "communityJ' conceptualization of "adjustment" has spanned from complete self- sufficiency to simply not being remanded to an institution within a specific period of time. While such a wide range of operational definitions of adjustment does not inherently lead to confusion (if the operations are made explicit). it does lead to problems in Furthermore. comparability and consistency of research findings. it does not recognize the fact that for all of us. adjustment is a matter of degree and of personal preference which may vary from time to time and from one area of life to another. (p. 383) Nevertheless. it seems obvious from the literature that there has been general agreement among the majority of professionals that inde- pendent living is based on oneksadaptation to the community. However. the differences seem to lie in the way the various authors perceive the process of adaptation. the environmental settings in which it occurs. the criteria by which they judge its success in the mentally Moreover. retarded. and the terms used to operationalize this process. the degree and the manner in which some professionals focus on particu- lar issues mostly reflects their area of professional expertise. work and interests. experience. we may find researchers who equate the term "independent Hence. living" to adaptability to environment. MacMillan (1977). for example. mentioned that the success of any special program should be measured in terms of whether or not it helps retarded individuals to master the He viewed the power of fending for skills for independent living. as "the (mums self in life. or an adaptability to the environment. 26 social competence that is the vital evidence of whether or not a person has adjusted to life and as the actual outcome of interest. not aca- demic achievement" (p. 309% In the same manner. Dingman (l973) believed that acquiring the skills crucial for independent living should be taught by programs designed for the retarded in order to attain "social competence)‘ As he stated. The really important question. then. is what is to be taught as The skills crucial for independent living-— "social competencefl' getting along with people and utilizing social abilities--are not attained in programs for the retarded designed to provide an I am afraid the current emphasis on academic academic education. achievement is not what is needed by the retarded to develop their lives. (p. 90) Retardates' adaptability to community consists of improvements in If we are to measure the range a variety of complex behavioral areas. of behaviors included. the measurement should be comprehensive. Seltzer et al. (198D suggested three dimensions of community adapta- tion that should be. at a minimum. considered when we measure oneus improvements in living independently. These are: l. Improvements in clients' performance of community living skills. such as self-help. housekeeping. cooking. shopping skills. Reductions in behavior problems should be seen as evidence 2. of community adaptation. The extent to which the individual is more satisfied with his 3. or her lifestyle in the community than in the institution with respect to many aspects. including the physical environ- ment. social relationships. degree of autonomy. Thus. an individual can be said to have adapted to the extent that he or she improves in performance. manifests fewer problems. and/or increases in satisfaction. (p. 82) 27 Since independent living as a rehabilitation goal has been viewed by many researchers as the retarded's ability to be socially competent and his adaptability to the environment. and since the concept of independent living as a goal has been found to be universal. relative. and varied from culture to culture. this study has adopted the definition of the International Labor Office (l978) that operationally defines independent living as follows: Before any assessment of competence or ability of the retarded is made. it is necessary to define the rehabilitation goal. The highest goal for the mentally retarded person is the same as that for any other person. 14%. a person who is totally independent. who is able to earn his or her own living. support himself and perhaps a family in his or her own community and have a happy. productive. and respected place in society. The skills required by a retarded to reach this goal through training and experience are as follows. --.Mgcatignal_skills (ability to do a job and earn a living); -- (social and self-help skills relating to all activities of daily living); -1Behayignal_§k111§ (ability to get along with workmates. people in the community and family. and to conform to accepted standards of behavior); -1ngmunicatign (ability to communicate with others both in understanding what is said and being able to respond); 3 -:Mgbility (ability to move around in the community) (International Labor Office. l978. ~1Litgnagy (where possible). p. l5) This definition of independent living as a goal conforms to the goal of the vocational rehabilitation services rendered to the mentally retarded person in Egypt. It also conforms to the cultural and eco- nomic values and environmental demands that are required of a retarded person to live independently in Egyptian society and to be socially competent. Moreover. it conforms to most of the definitions that have been reviewed in this part of the chapter. Furthermore. it helps this researcher to clearly identify the criteria for assessing the community-adjustment status of the subjects of this study and in pre- Later in this chapter. more will be presented senting the findings. about the evaluation and assessment of independent—living skills and their relationship to the retardate's adaptability and adjustment to the community. A fair amount of research has been devoted to studying the mentally retarded individual's adjustment to community. both before and after the move into community. However. there has not been much attention given to careful and systematic examination of community settings. Payne and Patton (l98l) pointed out that less research has been directed at inspecting what Rappaport (l977) called the "person- environmenfl'fit researchers have realized that the contribution Over the years. that studies of retarded adults' adjustment make to improving the effectiveness of rehabilitation and special education programs cannot be overemphasized. Windle (l962) recommended studies of adult adjustment as the scientific basis for establishing prognostic data. Diagnosis was viewed as a summary of the present. while prognosis was inference of future course. duration. and outcomes. Follow-up studies of adult adjustment were viewed by Windle as contributing to certain vital areas of decision making. These areas may be viewed as criteria that emphasize: l. Treatment. which involves cost factors of different treatments and the probability of outcomes following different treatments. 2. Identification of variables related to favorable outcomes. The isolation of data would enable practitioners to further augment their influence. Moreover. there remains the great need to identify those factors associated with social and vocational adjustment. 3. Admission and termination criteria. This area involves knowing the length of time required for various treatments. The intention would be to select those persons who genuinely reflect the condition so as to avoid misdiagnosis and so as not to retain persons unnecessarily. Also. if certain treatment approaches were firmly established as helpful. there would be implications for physical facilities and staffing patterns. 4. Program evaluation. The suggestion is made that eventual client attainments could be a basis for assessing program goals. Thus. the validity of approaches that purport to achieve vocational adjust- ment could be assessed with reference to that criterion. 5. Philosophy and/or theory of treatment. The validity of either the philosophy (value structure) and/or theoretical system (integrated explanation) must depend on its accuracy of prediction. The eventual validity of prognosis at time of diagnosis is that all variables concerning a person will account for an effective treatment plan. 6. Base-rate data. Windle noted that evaluation of program alternatives involves a comparison between what can be expected and the actual results Without a knowledge of the effects of either nontreatment or of previous treatments. it becomes difficult to attribute consequences to a "new" approach. 7. Individualized treatment. This area of knowledge would uncover the multiplicity of variables necessary for prediction. The current problem is that individuals similar in age. sex. and measured intelligence can differ dramatically in work adjustment. The objective of this area of inquiry would be to establish different outcomes and treatments dependent upon the implications of intervening variables between admission and graduation. While Windle recommended using these seven criteria for utilizing follow-up data in establishing. monitoring. and/or evaluating programs' outcomes. other researchers like Payne and Patton (l98l) have viewed providing follow-up services for students who have completed. or will complete. the preparation program as an important objective that should be included in all programs. Cown (l978) emphasized the importance of follow-up studies to community-program evaluation. He maintained that the purpose of follow-up is to insure that effects observed when a program ends accu- rately and stably mirror the program's effect. Follow-up data thus solidify generalizations about program effects over time. Such infor- mation is important for planning future programs. Without follow-up. we can underestimate program effects (p. 795% Furthermore. Rosen et al. (l977) refuted the suggestion made by Tizard that purely descriptive follow—up study has little further interest and should be replaced by predictive investigations. They 3] pointed out that "to reason this way . . . is to ignore the gaps that still exist in our understanding of those retarded persons who are capable of community adjustment" (p. l43). I E F 1] _“ 5| 1' Reviewing the literature revealed that follow-up studies that have been conducted on the retarded adultfls community adjustment by many investigators have followed different approaches that vary according to each investigator's objective and research design. Payne and Patton (l981) and Rosen et al. (l977) identified two techniques that have been established: 1. One is the use of follow-up studies of previously institution- alized people or of noninstitutionalized persons to investigate their general adjustment after a period of time in the community. This type is purely descriptive in nature and dates back to the early part of this century. 2. A second technique involves the attempts to predict successful community adjustment. Because this type of study is carried out with prognostic intent. it is sometimes called prognostic study. This classification of follow-up studies according to the researcherhs intent does not clearly reflect program evaluation as a potential purpose for which follow-ups would be conducted. Many researchers. particularly in recent years. have conducted follow-up studies in an attempt to determine the extent and quality of public residential facilities. Hence. McCarver and Craig (l974) discussed the different types of studies done over the years concerning 32 postinstitutional placement of mentally retarded in a more systematic manner than the other authors mentioned above. McCarver and Craig stated that all of these studies may be sub- sumed under one of three general categories that can be distinguished inainly on the basis of the experimenter's purpose. These categories are: l. Prognostic studies. which are done in an attempt to arrive at variables that would predict the success or failure of released retardates. Most of these studies have been retrospective. ld%. the data were collected at the time of the follow-up from available records. rather than before release. 2. Simple follow-up studies. in which no attempt was made by some investigators to isolate predictor variables. In this type. investi- gators have merely followed up discharges to see how they were faring in the outside world. 3. Comparative studies. This type of study is distinguished by some attempt to compare the retardates'achievement in the community to some other relevant group. According to McCarver and Craig. this type of study is relatively rare because what constitutes a relevant control group is a complicated issue. McCarver and Craig viewed that most of the follow-up programs employed by public residential facilities fall into either the second or third category in an attempt to determine the extent and quality of these programs. However. they asserted that using the third type is 33 mandatory if one seriously wants to evaluate a residential-facility program. However. the type of purely descriptive study is the concern of this part of the literature review. It will mainly concern itself with studies done on the mildly retarded who are supposedly the major beneficiaries of educational and rehabilitation services for the retarded. As research in education and rehabilitation of the mentally retarded has been competently reviewed by others in several sources (Eagle. 1967; Goldstein. 1964; McCarver & Craig. 1974; Rosen et at” 1977; MacMillan. 1977; Seltzer et aL» 1982; Gollay. l982; Bell. 1982) that are well known. this part of the chapter will not repeat existing reviews. Rather. it will comment briefly upon the general direction which previous work has taken and review. relatively in detail. only leading representative studies that ought to have major implication for understanding the adjustment of the mentally retarded dealt with in the present study and for planning future directions for programs and research in Egypt. By the same token. this review will deal with studies performed with formerly institutionalized individuals as well as with graduates of special schools or special classes in the public schools. Following this approach conforms to the approach most investigators have tradi- tionally followed in reviewing studies performed with these two popu- lations. 3h .E9stzlnstitutignal_§tud1e§ Attempts at following up the careers of the former residents of institutions for the mentally retarded can be traced back to Fernald (1919). His study is considered a classic in the establishment of procedures that have been used. with some variations. in succeeding studies. It involved individuals discharged from the Waverly Institution over a 25-year period. Information was gathered by a social worker who visited former patients' families. pastors. local officials and agencies. and the police with the aim of learning all we can of our former pupils--whether they are now living. where they are now living. how they have occupied themselves. whether they have been useful and helpful at home. or for wages. whether they have been able to look out for themselves. their problems. trials. experiences. etc. (Fernald. 1919. p. 2) Of the 1.537 individuals released by the institution during the period of the study. information was available on only 646. or less than half the original subjects. Fernald found that 612 were in other institutions for the retarded. while 279 could not be located. Of the 646 available subjects. 176 were females and 470 were males. Many of the female subjects appeared to make a satisfactory adjustment to community living. Of the 90 females who were located in the community. 11 were married and were housewives. 8 were self-supporting and independent. 20 worked at home. and 13 were living totally dependent at their parents' home. Thirty-eight of the females had negative or antisocial records. Feur of these had been committed to correctional institutions. The one factor that differentiated the adjusted from the 35 maladjusted was that the former group typically had someone who had taken an interest in them. The male subjects appeared to make a better adjustment to commu- nity life than their female counterparts. Twenty-eight were self- supporting and living independently. 86 were employed and living at home. 77 worked at home. and 59 lived dependently at home with their families. The majority of the dependent group were lower-grade retarded. while those holding jobs tended to come from higher functioning levels. Goldstein (1964) noted that release of most of the patients Fernald followed had not been recommended by the institution. These patients. however. functioned fairly well in the community. We can ‘ only speculate as to how well more capable patients might have done. Fernald's study was important both in terms of the methodology it introduced. and also in its administrative implications. As Goldstein (1964) pointed out. "The results of this study were diametrically opposed to the commonly held expectations of administrators. including Fernald" (p. 222). Moreover. Fernal d's data were so in conflict with the prevailing view that for two years he delayed publication of his findings which showed that some retardates could. indeed. adjust to the:"outside world)‘ It should be noted that Fernahrs results are widely interpreted today as supportive of deinstitutionalization policies. Rosen et al. (1977) described Fernal d's study as original and conducted with a sophisticated research goal. As they reported. ?7——i ’ Fernaldts original study was undertaken to help future generations of mentally retarded persons passing through his institution. There is a good reason to believe that on the basis of his results he was able to modify his earlier endorsement of ideas concerning the menace of retardation and. we may assume. he was able to modify administrative policies at Waverly State School and within the American Association on Mental Deficiency. where he served as president. Fernald's study stimulated a series of studies of retarded persons who had been released from institutions. a series which has carried through to the present time (Foly. 1929; Matthews. 1922; Storrs. 1924). These early studies refuted the notion that all retardates were incapable of a satisfactory adjustment in the cxmnmunity. Another finding was that. aside from severe retardation. the level of measured intelligence did not appear to have a great relationship either to success on the job or the amount earned. and further. that the institution. at least in terms of length of residence. had little to do with outside adjustment. However. MacMillan (1977) contended that such follow-up studies usually con- tained serious methodological flaws that make conclusions hazardous. Heber and Dever (1970) mentioned some other studies conducted by other researchers (e4;. Abel & Kinder. 1942; Bigelow. 1921; Duncan. 1942; Kinder. Chase. & Buck. 1941; Little & Johnson. 1932; Thomas. 1943; Town & Hill. 1930). ‘These researchers looked at the nature of the adjustment of adult retardates who were discharged from the institution. Their reports usually contained information on one or A -e-ni. . 37 more of the following variables: occupational status. income. police records. and marital status. Heber and Dever criticized the findings of these studies on the grounds that they cannot be compared with each other because they differed in the extent to which they evaluated the adjustment outcomes. Furthermore. the studies varied in terms of what constitutes adjustment. the sampling procedures. the length of time subjects were institutionalized. and the length of time since release. On the other hand. Rosen et al. (1977) reviewed follow-up studies conducted by researchers who were inspired by Fernald to follow up previously institutionalized retardates. These studies include. but are not limited to. Hegge (1944). Coakley (1945). Wardell (1946). Wolfson (1956). and Windle. Stewart. and Brown (1961). These studies have. in general. used such criteria of community "success" or "fail- ure" as employment. avoidance of arrest or antisocial behavior. and the ability to remain out of an institution of any sort After summarizing the findings of these studies. Rosen et al. reached a conclusion similar to Heber and Devefls mentioned above. They pointed out that it is obvious that every investigator interprets the "success" and "failure" of previously institutionalized retardates depending on his choice of criteria. his individual value or moral judgment about what to accept as a high or low success ratio. Rosen et al. (1977) reviewed conclusions made by Eagle (1967) and Goldstein (1964) regarding these criteria and concluded that the absence of uniform and consistent criteria from study to study. differences in the samples being followed. in the type of community placement. the length of time in the community. and the 38 economic conditions during the years studied make comparison of the various follow-up investigations quite difficult. Rosen et al. also explained the inadequacy of these follow-up studies in dealing with the question of how to evaluate success or failure rates. They further indicated that none of the studies reviewed has dealt specifically with the effect of the community as it influences the mentally retarded graduate of the institution. The studies performed by Windle (1962) and Edgerton (1967) have been cited by many authors as two of the most sophisticated studies on discharged institutionalized patients (Heber & Dever. 1970; Rosen et al.. 1977; MacMillan. l977; Payne & Patton. 1981). Heber and Dever viewed the results reported by Windle and Edgerton as a challenge to some of the conclusions based on earlier work. Windle studied three groups of patients released from Pacific State Hospital on different types of leave: vocational placement. home placement. and family—care placement. These groups of residents had spent time in the community. However. they could not be discharged from the institution. Consequently. Windle set forth the purpose of his study as to determine why patients failed to remain in the community. Each person was followed for a four-year period. and reasons for community failure were analyzed. Windle found that persons on vocational leave failed most often because of their inadequacy in performing work and in interpersonal relations. Persons on home leave failed because of lack of environmental support or because of intolerable behavior. However. while the reasons for failures 39 differed. the percentages of failure were about the same-—50% for all three groups. MacMillan (1977) reported that several conclusions can be drawn from Windlewsfindings: the results run counter to the optimism noted in the writings before 1960; they are consistent with them only in the finding that factors independent of IQ appear to determine success and failure; the reasons for individual failure seem to vary as a function of the type of leave granted. Moreover. Windle's study is also consistent with the earlier studies in its inability to deal specifically with the effect of the community as it influences the mentally retarded dischargees of the institution. Edgerton's (1967) monumental study. however. addressed this problem. Because Edgerton's study is regarded by many investi- gators as a leading one in explaining the effect of the community on the mentally retarded's adjustment. the study and its findings will be briefly preSented. Elaboration will be made only on the investigators' perceptions of the overall findings and their implications for research and programs. Edgerton's study was performed during the early 19605 of 53 mentally retarded who were released from Pacific State Hospital between 1949 and 1958 because they had been successfully rehabilitated. All were diagnosed as mildly retarded and were considered to have social competence and emotional stability. The original sample of 110 had a mean IQ of 65 and a mean CA of 35 years. but for practical purposes 53 people were selected to be contacted personally. Edgertoms study was #0 designed to gain a greater appreciation of the everyday lives of mentally retarded who had been released from an institution. The areas of focus that Edgerton and his colleagues believed to be factors in community adjustment were: . Where and how the ex-patients lived. Making a living. Relation with others in the community. Sex. marriage. and children. "Spare time" activities. Their reactions to the stigma associated with retardation. and . Their practical problems in maintaining themselves in the community. (Edgerton. 1967. pp. 16-17) \lOlU'l«bU)N._a 0 By interviewing the subjects and other people associated with them. Edgerton and his colleagues gained a great amount of interesting information on the everyday lives of the subjects. The subjects were found to be coping with life in the community and spending their lives trying to conceal the stigma of retardation and incompetence. "which never can truly be hidden" (Rosen et al.. 1977). Major areas in the everyday lives that were problematic for the subjects centered on (a) making a living; (b) managing sex. marriage. and reproduction; and (c) using leisure-time activities. To cope with these problems and to help pass as normal. many of the subjects developed relationships with "benefactorsfl' These benefactors-- frequently spouses--were typically of normal intelligence and were of assistance in carrying out those activities requiring literacy or the use of numbers and symbols. The frequency of such dependency made Edgerton estimate that only three of the subjects could be judged as independent and that without the support of their benefactors 20 subjects would be returned immediately to the institution. bl Heber and Dever (1970) viewed the support provided by benefactors for the subjects' survival in the community as substitutes for the protective environment of the institution. They also speculated that the possible reason for the failures of these same individuals on earlier releases may have been the lack of a benefactor rather than any real differences in skills or attitudes. Nonetheless. Rosen et a1. (1977) pointed out that Edgerton's description of the thin and transparent "cloak of competence" of the mentally retarded has been influential in shaping professional atti- tudes toward the potential of the mentally retarded for independent community living. Twelve years after the original study. Edgerton and Bercovici (1976) were able to locate 30 of the original 53 subjects. As these two investigators attempted to determine the effects of time and changes in life situations on the subjects' social adaptation. their findings of that follow—up do not conclusively support the idea that the passage of a considerable period of time improves the social adaptation of the retarded persons (MacMillan. 1977). Some subjects had improved. others had not changed. and others seemed to have regressed. While Edgerton and Bercovici indicated their inability to predict very well from their original data how a person was to be doing at a later date. some general remarks could be made. As length of time in the community increased for the subjects. there seemed to be fewer feelings of stigmatization. less concern with trying to deny their retardation. and less need for benefactors. Furthermore. while the 42 incidence of unemployment was higher. quality of life was heightened. The subjects' increased gratification with life was not a function of employment; subjects regarded themselves as normal despite their vocational failures. Payne and Patton (1981) reported a number of points raised by Edgerton and Bercovici as noteworthy: 1. Adjustment is a complex and multi-dimensional concept. 2. Social adjustment . . . may fluctuate markedly. not only from year to year. but from month to month or even from week to week. 3. Perhaps what constitutes good social acceptance from the mentally retarded person's viewpoint may differ signifi- cantly from the criteria used by professionals. Payne and Patton quoted Edgerton and Bercovici's statement that reflects the third point just mentioned: After many years of community living. persons once institution- alized as mentally retarded could .. . develop their own collec- tive and individual views of what constitutes good social adjust- ment. If. as we suspect. our criteria of adjustment will continue to emphasize competence and independence while retarded persons themselves emphasize personal satisfaction. then our dilemma is even worse than we had all previously recognized. (Edgerton & Bercovici. 1976. p. 495) Hence. as larger changes occur in the retardates' lives. it is difficult to determine whether these changes occur as a result of increased time spent within independent—living arrangements in the community or as a reflection of more general changes in society and the demands of all workers for improved quality of life. Edgerton and Bercovici's findings are largely subjective judgments derived from their interviews. Nevertheless. it is still most important that within each of these categories (better adjustment. worse adjustment. same adjustment) there 43 was diversity. For example. one person judged to be very competent in 1960 was found to be even better adjusted in 1976; however. so were some cases considered highly dependent in 1960 (MacMillan. 1977). Investigators who reviewed Edgerton's study compared its findings and criteria used for investigating community adjustment to other findings of studies conducted before 1960. Heber and Dever (1970) pointed out that Edgerton's report did not conform to the optimism engendered by previous studies which used superficial occupational and social indices of adjustment. They also indicated that the Windle (1962) and Edgerton studies showed that "melting into society never to be heard from again" may have been an illusion of earlier studies (p. 402). However. MacMillan (1977) described the picture Edgerton and Bercovici drew of their subjects as vivid and anything but optimistic. It is a very different portrayal of the quality of life enjoyed by patients released from institutions than emerged from the follow-up studies conducted before 1960. The Edgerton subjects were the most qualified patients and were sent into the community in a period of unparalleled prosperity in the United States. yet they survived only marginally and apparently largely because of the support of bene- factors. On the other hand. the findings of Edgerton seem pertinent to any efforts to normalize moderately and severely retarded persons. To the extent that the benefactors determine success or failure. it might be Lu. helpful to involve professionals or paraprofessionals in a benefactor- like role. at least in the early periods following a retarded person's release from an institution. Rosen et al. (1977) concluded their discussion of Edgerton's study by pointing out that it is of interest that Edgerton's suggestion for greater concern of professionals in mental retardation with the more subjective side of life is precisely what some researchers are recently attempting to explore. SI I' E H 'n |.| Ii _ £111§Q_BQI§£Q§I§§ The characteristics of patients in institutions have been changing in the last two decades as community-based special education programs have expanded. As Heber and Dever (1970) indicated. undoubtedly associated physical and behavioral impairments are important precipitants of institutionalization. Hence one might expect a superior adjustment from the graduates of special education classes. Follow—up studies of subjects who have been identified as retarded by community agencies or the public schools. but who have not been institutionalized. have focused almost exclusively on educable mentally retarded (EMR) as opposed to trainable mentally retarded (TMR) (MacMillan. 1977). The occupational level achieved by the graduates of special education classes seems to have been cited in the literature in support of the merits of special education. and in advocacy of its expansion. However. there have been few comparisons to determine whether the 45 adaptive level of the adult retardates who have not had the benefit of the special class is. in fact. inferior to that of the special class beneficiary (Heber & Dever. 1970). At any rate. researchers as well as investigators of this type of research seem to have reached a near agreement that the vast majority of former mildly retarded who have been in special schools or classes disappear into society and escape identification as mentally retarded beyond their training careers (MacMillan. 1977; Rosen et al.. 1977; Ingalls. 1978; Chinn et al.. 1979; Payne & Patton. 1981; Peterson & Smith. 1960; Dinger. 1961; Goldstein. 1964; Kirk & Johnson. 1951; Sarason. 1943; Wallin. 1955). Sparks and Younie (1969). for example. concluded from a review of the literature that mildly retarded persons have demonstrated capability and competence as adults. In the same manner. Goldstein (1964) drew several generalizations concerning the mildly retarded. First. most of the mildly retarded will make an adjustment to their communities as adults. Second. these mildly retarded persons are more often adversely affected by economic depressions than are nonretarded persons. Third. prevailing economic conditions largely determine whether or not retarded persons are able to join the ranks of home- owners and acquire other of the usual material assets of families. Fourth. the occupations held by the mildly retarded as adults tend to be on the lower end of the occupational scale. Heber and Dever (1970) commented that these conclusions made by Goldstein are identical to 46 those drawn from the early studies on persons discharged from institu— tions. However. while investigators agreed on the retarded adultfls capability to adapt successfully to community living. they differed sharply in interpreting and evaluating the quality of success reported by follow-up studies conducted on this population. On the other hand. researchers who reviewed follow-up studies differed in estimating the optimism inferred from the results of such studies. Three of the classic follow=up studies done before 1960 compared the community adjustment of the mildly retarded graduates to control groups of normals who were in school at the same time. These include studies of Fairbanks in Baltimore (1983). Baller in Lincoln. Nebraska (1936). and Kennedy in Connecticut (1948). As Baller conducted his study at a time of severe economic depression that resulted in the lower employment rates reported. he generally drew a bleaker picture of the lives of the retarded adults studied than did Fairbanks or Kennedy. who con- ducted their studies during periods when economic conditions were generally favorable (Goldstein. 1964L Besides different economic conditions. the three studies differ in the types of communities they surveyed and the types of jobs the formerly retarded could find in the face of increasing mechanization. But despite differences between the three studies. they indicated that the marital status of the retarded subjects as well as their home ownership appeared to be somewhat comparable to the nonretarded control subjects who came from the same background. 47 Comparisons with the control group revealed that retarded subjects in all three studies showed a higher evidence of dependency and reli- ance on support provided by either family or agencies. more involvement with the police. poorer living conditions. and a higher incidence of broken marriages. When Charles (1953) followed up the 206 retarded Baller subjects later. he found that at the ages of 36 to 49 years. a lower proportion of them had married than the norm for the population of Lincoln. Nebraska. as a whole. Of those who were married. about 80% had one or more children. and the majority of these children were progressing normally in school. The group as a whole was found to be still func- tioning at a marginal level. However. Charles optimistically con- cluded his report with the following statement: The studies of social adjustment of persons judged to be mentally deficient present a fairly bright picture. suggesting that many. if not most such persons. can find a happy and successful life in the community. if given understanding and guidance. (p. 19) As Heber and Dever (1970) examined studies completed since 1960 (Patreson & Smith. 1960; Dinger. 1961; Eddy. 1963; Lindenblatt & M011. 1963; Keller. 1964; Miller. 1965; Strickland & Arrell. 1967; Baller. Charles. & Miller. 1967). they challenged Charles's optimistic outlook implied in the above statement. Heber and Dever contended that former EMRs do not do as well as nonretarded persons from the same socioeconomic background. Most of these studies. particularly Strick— land & Arrill's (1967). have set forth the unskilled and service— occupation nature of the employment of retardates. whereas occupations held by nonretarded persons from the same diverse economic background 48 are primarily characterized as clerical. semiskilled. or skilled. Payne and Patton (1981) presented a synopsis of information derived from reviews and studies of mildly retarded workers that supported Heber and DeveNs viewpoint. In addition. the wages of the persons studied in both the Dinger (1961) and Peterson and Smith (1960) studies show that nonretarded females outearn former EMR males by over $1.000 per year in median annual incomes. Comparing the median annual income of former EMRs (females. $1.002; males. $2.837) to the poverty figure adopted by the President's Council of Economic Advisors in 1963 ($3.000). Heber and Dever concluded that the validity of Charles's statement is question- able. They maintained that in judging whether or not the retardates' economic life was bright as compared to the nonretardatesu a distinc- tion should be made between the percentage of subjects who are employed full time or are self-supporting and income derived from that employ- ment. Such a distinction would show the economic life of the retardate as either bright or marginal. Moreover. Peterson and Smith went on to state that fully 93% of their retarded population resided in homes that were substantially below standard. Hence. Heber and Dever said. "It is difficult to see how these persons could be considered to present a 'fairly bright'picture"(p.404). Heber and Dever summarized their views in a general fashion by stating that: The picture portrayed by [the 19605] analysis of the status of graduates of special classes. as well as of persons discharged from institutions. is not a bright one at all. They appear to be 49 at the lowest points on the scales of social and occupational adjustment. They do not. as often is stated. adjust as well in adult life as do their nonretarded age peers who live in comparable neighborhoods.. . . Clearly. [these studies] do not suggest that institutional or special education habilitation renders most retarded persons capable of an adjustment which we would set as minimally adequate. (pp. 404-405) Heber and Dever"s conclusions were also supported by another follow-up study conducted by Gozali (1972). As he could locate 56 of 218 male EMR who had participated in a work-study program from 1964 to 1966. he found the average income of those employed ($3.145) was still sub— standard. Nonetheless. after Charles followed up Baller's original (1936) study. the same subjects were contacted some years later by Miller (1965) and again by Baller. Charles. and Miller (1967). At the time of the third follow-up. the majority of the retarded subjects were found to be self-supporting (MacMillan. 1977). A serious criticism of these studies is the lack of similarity between the retarded and control groups on dimensions other than IO. Goldstein (1964) pointed out the problems in comparing groups of unequal socioeconomic levels. He suggested that researchers should compare the retarded with a nonretarded sample "drawn from a common and contemporary socio-physical milieu" (Rosen et al.. 1977). An attempt to correct this deficiency was included in two studies conducted by Kennedy (1984. 1966) on the social adjustment of a mildly retarded group in a Connecticut city. Kennedy's study is worth men— tioning here. somewhat in detail. because her investigations covered a broad range of criteria. many of which have been used in subsequent foll 50 follow—up studies (Rosen et al.. 1977). In her study. 256 mentally deficient persons were matched with 129 normal controls in a way that would make both groups so comparable in all socioeconomic aspects that the major difference between them would be their intelligence levels. The purpose of the study was to examine adjustment of both groups according to five broad criteria: Employment record. Economic status. Marital and family patterns. Academic progress of offspring. and Social functioning as reflected in antisocial behaviors and community participation. U'IAWN—l on. When Kennedy replicated the earlier study 12 years later. she was able to locate approximately 70% of the original sample. In general. Kennedy's findings showed both similarities and differences between the two groups in terms of getting married. number of children. children's IQ. self-support. living arrangements. material belongings. money sav- ing. work performance. court records. and recreational activities. In defining personal. social. and economic adjustment in terms of the criteria of her study. Kennedy was quite optimistic in her conclu- sions: Adjustment in each area of behavior may and does range from a minimal to an extremely high level with. however. the "norm of expectancy" still being attained because two important criteria have been: to care adequately (even though minimally) for themselves and those dependent upon them; and to be law-abiding. . . . The overwhelming majority of both subjects and controls have made acceptable and remarkably similar adjustment to all three areas: personal. social and economic. The main differences are in degree rather than in kind. (p. 51) While Kennedy's study is laudable for its completeness. investi— gators have differed in evaluating its findings. Rosen et a1. (1977). for 51 m the: whe ret def of 501 (10' ad for example. stated that the question can be raised regarding the similarities of adjustment between the subjects and the controls as they were equalized on all variables but IO. One would then wonder whether the similarities reported are due to the achievement of the retardates. or merely to the initial socioeconomic and intelligence deficits of the controls. Although Rosen et al. admitted that the use of control groups in follow-up studies allows for more precise compari- sons between retardates and nonretardates. they indicated that it does not answer all questions that require answering. Nor does it provide information regarding factors that determine successful or unsuccessful adjustment. Ingalls (1978) viewed Kennedy's findings from a different perspec- tive. According to him. the results of this type of research suggest that many children who are considered mentally retarded by the schools and indeed. many people who are institutionalized. are capable of independent living. and thus probably ought not to be considered mentally retarded. Several other studies investigating the socioeconomic status of the EMR graduates were conducted in more recent years. Most of these studies followed. in one way or another. the leading representative studies. mentioned already. regarding the variables studied. criteria of adjustment. whether or not a control group was used. and findings reported. Crain's (1980) study is worth indicating here because it suggests some explanations for the discrepancies noted between its findings and prev stat grad was clas tiou Per C011 52 previously reported findings concerning unemployment and poverty-level status of EMR adults. In Crain's study. the economic status of 130 EMR graduates of the Special School District. St. Louis County. Missouri. was investigated. The graduates were randomly selected from the classes of 1962. 1965. 1968. 1971. 1974. and 1977. Current occupa- tional data were collected and recorded from occupational records. Personal telephone interviews with each of the 130 individuals were conducted. Results showed that 68% of the individuals were in the civilian labor force. Of individuals in the labor force. only 7.9% were unemployed and the majority were earning a yearly income of approxi- mately $7.000. Only one individual of the employed category was earn- ing an income at poverty level. Sixty-three percent had unskilled and semiskilled jobs. Of the variables age. sex. race. IO. and vocational training. age was the only variable found to be related to wage; i.e" the older the individual. the higher the wage. Crain justified the unskilled and semiskilled jobs held by her subjects as the only jobs open to them and for which they qualified. Moreover. because EMR adults are of lower ability than others. they hold lower-paid and less—prestigious jobs. Although her justifications conformed to the general findings of previous studies. Crain reported that previously reported findings concerning unemployment and poverty-level status of EMR adults were not true of her population. One of the explanations she suggested for these discrepancies was that the definition of unemployment used in E9121 53 other studies was nebulous. According to the U.S. Department of Labor definition of unemployment. which is the definition Crain used in her study. a person (16 years or older) must be "laid off" and/or actively seeking employment in order to be considered as unemployed. As she reported. it appears that Keeler (1964). Tobias (1970). Dinger (1961). Kidd. Cross. and Higginbotham (1967). and Peterson and Smith (1960) subtracted the percentage of those not working from the employed group and considered those individuals as being unemployed. She added that the issue was further confounded when Kidd et al. included as employed those who were homemakers. in the military. and working in sheltered workshops. Dinger (1961) included individuals who were in further training and full-time homemakers in his emplOyed group. EQllQW:UR.§IuQiQ§_Qf_MQflI§ll¥ Betanded_in.Eg¥RI Conducting follow-up studies has. in general. been stressed within a frame of reference to evaluating rehabilitation programs in Egypt. Mohamed (1982) indicated that rehabilitation program evaluation in Egypt has been stressed since 1966. when the Ministry of Social Affairs _conducted the "Study on the Effectiveness of Rehabilitation ProgramsJ' He pointed out that the study was in the form of a follow-up survey of those who were rehabilitated in the preceding five years (1960-1965L The population was stratified according to type of disability and a random sample taken out of each stratum. The results of this study were very helpful in program development in subsequent years. It 54 is not clear from the only source available on this matter whether or not this study included the mentally retarded population. The absence of a complete explanation of the status of retarded adult graduates in Egypt may be attributed to several factors. the most important of which are: the recent development of the special educa- tion and rehabilitation programs for mentally retarded persons and the fact that the existing scarce literature is of an uncritical nature. consisting merely of official reports. In fact. a serious follow-up study of the retarded adult graduates in Egypt has not been undertaken as far as this author has discovered. However. in 1977 an Institute for Program Evaluation in the field of rehabilitation was established in collaboration with the United States National Institute of Handicapped Research. The institute has a plan to train professionals. conduct research. and apply evaluation strategies in the field. The present study was conducted with the help of a research team provided by the Egyptian Institute mentioned above. Discussion and Impljcatjons Follow—up studies of graduates are plentiful for two types of programs: special classes for EMR children and institutions. In some instances studies have focused upon the individual's occupational adjustment (e4;. Does he have a job? How long has he held it? Is he on public assistance?) and his personal adjustment in the society (e4j. Is he married? Can he care for his own needs? Does he avoid trouble with the lawlh 55 In general. the review of leading representative follow-ups sug- gests thatindividuals who were either deinstitutionalized or "gradu- ated" from school settings were able to adapt successfully to community living. However. while some investigators were optimistic in their future outlook for these individuals. others were pessimistic and pointed out that their quality of life is very poor. This difference between investigators may have resulted from the inconsistency of follow-up studies in selecting and defining clearly the criteria for what constitutes successful adjustment to community life. As reported by Payne and Patton (1981). Think for a moment. what criteria do you believe to be signifi- cant? While many studies have used similar criteria. there has been no effort to standardize a set of general criteria. Of course. some specific criteria may need to vary from one community setting to another if we are truly to consider the idea of "person-environment fitJ'(p. 318) Most of the studies reviewed have used IO as the sole criterion for defining the subject groups. Rosen et a1. (1977) pointed out that subjects were usually identified from past records without benefit of comprehensive diagnostic procedures. Ranges of IQ of retarded subjects have differed widely from study to study. with few attempts to differ- entiate borderline or near-normal subjects from those with more severe deficits. However. McCarver and Craig (1974) identified eight major criteria by which to gauge community adjustment. Within each of these major categories. more specific variables may be considered. Rosen. Clark. and Kinitz (l977) summarized the adjustment variables identified by McCarver and Craig as follows: 56 1. Living environment (type of residence. amount of rent or mortgage payments. residential stability. satisfaction with living quarters); 2. Type of employment (place of work. skill level. job require- ments); 3. Job changes (general stability. mobility up or down); 4. Savings and money management (debts. bank accounts. budgeting. installment buying); 5. Sexual problems (venereal disease. promiscuity. prostitution. homosexuality. illegitimacies. marital adjustment. exploita- tion); 6. Antisocial behavior (legal problems. arrests. delinquency. acts of violence); 7. Marriage and children (sexual adjustment. contraception. parental responsibility. health of children); 8. Use of leisure time (social contacts. recreational activi- ties. hobbies. reading. travel). (pp. 142-43) The literature on follow-up research has been very helpful to the present study both from a theoretical and an operational point of view. The preceding review of follow-up studies on the capability of both formerly institutionalized retardates and "graduates" of special public school classes of independent functioning in the community has helped in identifying the need for the study. conceptualizing and devising the procedures. methodology of investigation. and selection of its vari— ables. Adaptixe_8ebaxign_§cale IhQ_QQnQQRI_Qi_Ad§QIi¥§_Bth119£ In 1973 the American Association on Mental Deficiency (AAMD) adopted a definition of mental retardation that included the criterion of deficit in adaptive behavior. According to this definition. professionals were able to find three criteria that had to be met before an individual was considered to be retarded. These were (1) subaverage 57 intellectual functioning. (2) origins during the developmental period. and (3) an impairment in adaptive behavior. which indicates impaired adjustment (MacMillan. 1977). However. professionals could not clearly determine whether or not a person was impaired in adaptive behavior according to the third criterion of the AAMD. Consequently. guidelines had to be developed by which one could judge adaptive behavior. First. a definition of adaptive behavior was developed. It has undergone several revisions. The current Manual on Terminology and Classification in Mental Retardation describes adaptive behavior as: "the effectiveness or degree with which the individual meets the standards of personal independence and social responsibility expected of his age and cultural group" (Grossman. 1977). The term "adaptive behavior" as defined by the AAMD is also called "social competence" (Cain et al.. 1963). "social maturity" (Doll. 1953). "adaptive capacity" (Fullan & Loubser. 1972). and "adaptive fitting" (Cassel. 1976). The second step involved the development of a standardized scale by which one could judge adaptive behavior. Before we examine the Adaptive Behavior Scale. it is appropriate to examine adaptive behavior and to explore some of its characteristics as relating to the concept of independence. Leland (1978) defined adaptive ability as involving three Components: 1. . defined as the ability of the indi- vidual to successfully accomplish those tasks or activities demanded of him by the general community. both in terms of 58 critical survival demands for that community and in terms of the typical expectations for specific ages. 2. Personal responsibility. defined as both the willingness of the individual to accomplish those critical tasks he is able to accomplish (generally under some supervision) and his ability to assume individual responsibility for his personal behavior. This ability is reflected in decision-making and choice of behavior. 3. Social responsibility. defined as the ability of the individual to accept responsibility as a member of a community group and to carry out appropriate behaviors in terms of these group expectations. This is reflected in levels of conform- ity. social positive creativity. social adjustment and emotional maturity. (p. 40) This definition emphasizes the individual's ability to respond to the demands of his environment and community. The demands obviously change radically as the individual develops. As far as this definition is concerned. adaptive ability of the adult is primarily assessed by the capacity to function independently in the community. hold a job. effectively use money. and so forth (Maloney & Ward. 1981L A second feature of adaptive ability is that these behaviors vary from society to society and even from community to community. depending on the demands made on a given individual. MacMillan (l977) explained that an individual's success or failure can only be measured in terms of that environment. Hence. what is demanded from a child living in an urban community is not the same as that demanded from a child living in a rural community. Moreover. Havighurst (1972) emphasized that expectations differ for boys and girls and by social classes. He also pointed out the need to allow subgroups to establish individual priorities in defining what is normal. 59 Payne and Patton (1981) went a step further to indicate that it is necessary to remember that very few people behave. or are expected to Jehave. in the same manner in all places at all times. Most individ- uals have a number of different roles they are expected to fulfill that vary according to the different social contexts in which they find themselves (p. 191). Moreover. Payne and Patton declared that the pluralism in a society. such as American society. the diversity of ethnic. cultural. religious. and social groups that thrive autonomously within the con- fines of a common culture. create endless possibilities for different values to dictate dissimilar degrees of acceptability for comnmwibehav- iors. Wis WWW It is apparently evident from the previous explanation that we can make no absolute statement as to what constitutes adaptive behavior. Interestingly. as we have seen in reviewing the literature in the first section of this chapter that independent living is a relative concept that varies from one culture to another. so is the concept of adaptive behavior. It is a relative and variable phenomenon (Maloney & Ward. 1979). It is not surprising to find that the majority of researchers see the concept of independent living as intertwined with the retard- ate's adaptability to his environment. Klein et a1. (1979) indicated that Coulter and Morrow (1977) report at least nine definitions of adaptive behavior currently found in the literature. Yet a review 60 of these definitions indicates several "themes"touc_ c_ tom: magma co_uwucoE:cumc~ use mucma_u_uuma >uaum--._ ou:m_u )H .d N P. J . 1 0 (C 9. I3 0 J 9 Aoc_mcco.u (\I.s . . D. 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M A S J m.coce__:o c_o;u unsm 0;» ._w . i. e 9 3m. 95 95.5 “.0 3:0qu 05 coucou 05 an w W muzw m. mvcoooc .muoomnam ._ 7.9 e 1.9 we mucocme m:_ mc_30~>c0uc_ c. 1.9 1 o>mz >n nouuo_ >9 weave. sot» (\ J w ._00 ecu: memo :_00 use: mama wouuo_.oo use: mama mucoucoqe_ Humae_qumcm0cm oocmucoae_ mmm__emw can mm<-az<< ego moooessm to muuoanam *0 m aged < shod e0 oco acme co magnum oEOoc_ mo.um.couumcm u mo_ucouoa50u 4. new .m:0_umoo> o. mchOEo o.mo mucoEoumum >ocouon50u 4. mm .5 u- . m Quota cowum_:a0¢ H>_ h¢03 —l 206 The subject's 1.0. upon admission to the Center: 54-50 59—55 64-60 70—65 What test was used? Binet Wechsler Both Other Unknown Does the subject suffer from some other disability? Yes No If yes, specify Socioeconomic Status 3. Family Structure: Both parents are alive Only father Only mother Both parents are not alive Number of siblings Brothers Sisters Total kw 207 Order of the subject among siblings 1 2 3 4 5 6 7 8 9 10 Age of the mother at the birth of the subject below 20 between 20-30 between 30-40 over 40 4. Family Educational Background: Did father receive any education? Yes No If yes, what is the highest level? Elementary Preparatory Some secondary school Completed secondary school Some college education Bachelor (or equivalent) Master Doctorate Did mother receive any education? Yes No 208 If yes, what is the highest level? Elementary Preparatory Some secondary school Completed secondary school Some college education Bachelor (or equivalent) Master Doctorate 5. Parents'Income Status (Per month) less than $25 $25-49 $50-74 $75—99 $100-124 $125-199 more than $200.00 Parent's occupation 6. Educational History of the Subject: Age of the subject when first admitted to Mataria Center years N #00 209 Year in which the subject graduated from the Center: 1976 1977 1978 1979 1980 Period spent at Mataria Center (in months) Did the subject attend any special education before admission to Mataria Center? Yes No If yes, how many years did the subject spend in that education? (Circle the appropriate number) Primary 1 2 3 4 5 6 7 8 Preparatory 9 10 11 Vocational 12 l3 14 15 What type of special education did he receive before being admitted to the Mataria Center? Special classes in regular school Special school for the mentally retarded Rehabilitation center for the mentally retarded Other (specify) .p-w 210 7. Marital Status of the Subject: Single Married with children Married without children Divorced Widow 8. Living Status of the Subject Lives with his wife and children (if any) Lives by self Lives with friends, unrelated persons, and/or siblings Lives with parents and with spouse and/or children Lives with relatives other than spouse, parents or siblings (i.e., grandparents, uncles, aunts, or children) Lives with parents or with parents and siblings Lives in an institution (e.g. nursing home, chronic care, hospital, rehabilitation facility) #00 211 Part 11 Vocational Status (For all the subjects) 1. Does the subject have a job at the present time? Yes No 2. If yes, what type of work? 3. Since when has the subject started it? One year Two years Three years Four years Five years and until now 4. Is work being with Government? Public sector? Private sector? Working for the family against payment? Self-employed in his home? Self-employed outside his home? 5. Did he obtain his job through the effort of The Center Director? The Center Counselor? Placement Officer? Labor Force Office? His parents? U'l-hOON 0301-500 7. 8. 9. 212 Another relative? His own effort? Others (specify) 6. Do you think the Mataria Program could If no help him acquire his job skills? help him acquire work habits? help him to choose a permanent job? other help (specify) Has he been satisfied with his job? Yes No If yes, why is s/he satisfied? job is suitable job place is near to his home job is in public sector job is governmental job gives him a high payment has good friends there co-workers are good it is the only job available other reasons (please specify) , why is s/he dissatisfied? work is not suitable for him time of work is not convenient place of job is far from his home nongovernmental job —I (.0 #014.) 10. 213 payment is low has problems dealing with supervisor has problems dealing with co—workers Source of Income (per month) From work Parent support Support from others Total earning per month if employed If s/he is not employed at the time of interview, was s/he ever employed? If yes, why did s/he quit the previous job? (check all reasons which apply) Yes No Job type and/or skills were below his competency Work was hard Time of work was inconvenient Place of work was far from home Lack of skills needed for performing the job Job was not permanent Low payment Could not get along with co-workers Could not get along with supervisors Other (explain) —-l 0101-wa 214 13, If he was never employed, what do you think the reasons were? (Check all reasons which apply) Work opportunities are generally rare in the community Jobs offered are not suitable for him/her Type of work s/he can do is not wanted in the community Employers do not generally like to hire disabled persons Employers do not like to hire mentally retarded Other (specify) 215 A A M D ADAPTIVE BEHAVIOR SCALE For Children and Adults ' 1974 Revision Special Name identification (last) (first) Date Sex)! Date of Birth (m0) (day) (year) (m0) (day) (year) Name of person filling out Scale Source of information and relationship to person being evaluated (such as ”John Doe - Parent,” or “Self - Physician") Additional information: This Scale consists of a number of statements which describe some of the ways people act in different situations. There are several ways of administering the Scale; these, and detailed scoring instructions, appear. in the accompanying-Manual. Instructions for the second part of the Scale immediately precede the second half of this booklet. INSTRUCTIONS FOR PART ONE There are two kinds of items in the first part of the Scale. The first requires that you select only ONE of the several possible responses. For example: [2] Eating in Public (Circle only m) Orders complete meals in restuarants s Orders simple meals like hamburgers or hot dogs ® Orders soft drinks at soda fountain or canteen 1 Does not order at public eating places 0 Notice that the statements are arranged in order of difficulty: 3,2,1,0. Circle the one statement which best describes the most difficult task the person can usually manage. In this example, the individual being observed can order simple meals like hamburgers or hot dogs (2), but cannot order a complete dinner (3). Therefore, (2) is circled in the example above. In scoring, 2 is entered in the circle to the right. @1969, 1974, 1975 American Association on Mental. Deficiency 2l6 The second type of item asks you to check ALL statements which apply to the person. For example: [4] Table Manners (Check ALL statements which apply) B-number Swallows food without chewing checked = Chews food with mouth open Drops food on table or floor Uses napkin incorrectly or not at all Talks with mouth full Takes food off others’ plates Eats too fast or too slow Plays in food with fingers None of the above .— Does not apply. e.g., because he or she IS completely dependent on others. (If checked. enter "0" in the circle to the right.) llllklkl I“ ”'9 e"il'l‘llile above, the second and fourth items are checked to indicate that the person "chews food with s subtracted from 8, and mouth open" and “uses napkin incorrectly.” ln scoring, the number of items checked, 2, i . . .0 the item score, 6,is entered in the circle to the right. Most items do not, however, requrre this subtraction. instead, the number checked can be directly entered as the score. The statement “None of the above.' Which.“ mduded for administrative purposes only, is not to be counted in scoring here. Some items may deal with behaviors that are clearly against local regulations, (e.g., use of the telephone), or behaviors that'are not possible for a person to perform because the opportunity does not exist, (e.g., eating in ese instances, you must still complete your rating. restaurants is not possible for someone who is bedridden). In th . Give the person credit for the item if you feel absolutely certain that he or she can and would perform the behavior without additional training had he or she the Opportunity to do so. Write “AR" for “Against. Regulations 0' “HNO” for “Has No Opportunity” next to the rating made in these cases. These notations will not affect the eventual scoring of that item, but will contribute to the understanding and interpretation 0f me person 5 “339““ behavior and environment. Please observe the following general rules in completing the Scale: I. In items which specify “with help" or “with assistance" for completion of task, these mean with direct physical ads-ance. rson credit for an item even if he or she needs verbal prompting or reminding to complete the task 've the . . n 2. Gt 9° ”wimout prompting" or “without remmder. unless the item definitely states neral use. Therefore, some of the items may not be appropriate for your specific ' e is e ared for ge Th5 Scal pr p lete all of them. setting, but please d0 "Y to ”mp A. Eating [1) Use of Table Utensils (Circle only ONE) Uses kniie and iork correctly and neatlv Uses table (mile (or cutting or spreading Feeds sell with spoon and fork - neatlv Feeds sell with spoon and fork - considerable spilling Feeds sell with spoon . neatly Feeds sell with spoon - considerable spilling Feeds self with lingers or must be led (2| Eating in Public (Circle only ONI'I Orders complete meals in restaurants Orders simple meals like hamburgers or hot dogs Orders soft drinks at soda fountain or canteen Does not order at public eating places [3) Drinking (Circle only ONE) Drinks without spilling. holding glass in one hand ' Drinks from cup or glass unassisted . neatlv Drinks from cop or glass unassisted considerable spilling Uni-s not drink lroiii tut) or glass unassisted I‘I Table Manna-s (Check ALL statements which apply) Swallows food without dictating Chews food with mouth open Drops food on table or floor Uses napkin incorrectly or not at all Talks with mouth full Takes lood oil others' plates Eats too fast or too slow Plays in food with lingers None ol the above __ Does not apply, e.g.. because he or she is bedlast, and/or has liquid (and only. (If checked. enter "0“ in the Circle to the right.) 217 PART ONE . 1. INDEPENDENT FUNCTIONINC > O O d'Ju-J a. A v 0;... O O O - ' ll-numlier Lhi'tki'tl = O A. Eating B. Toilet Use (5) Toilet Trailing (Circle only me) Never has tailet “(idents Never has toilet accidents during the day Ouasiuiiallv has toilet at‘t'idents during the day Frequently has toilet accidents during the day Is n0! toilet trained at all A L '-.i—£- Q d [ti . (6| Sell-Care at Toilet (Check ALL statements which apply) Lowers pants at the tuilet without help Sits on tailet seat without help Uses toolet tissue appropriately Flushes tailet alter use Puts on clothes with0ut help Washt's hands without help None oi the above 8. Toilet Use ”DO C. Cleanliness j [7] Washing Hands and Face (Check ALL statements which apply) Washes hands with soap Washes face with soap Washes hands and lace with water Dries hands and lace None of the above I.) Bathing (Circle only ONE) l’ri-pari-s .iiitl iiinipIi-tvs bathing iiii.iiili-il i, \N‘nsIIi-s .iiiil iliii's si-II ii-iiitiIi-tt-ly Williiiut trunipting or helping Washi's Jntl tlrii-s sell reasonably well With prompting Washes and dries sell with help Attempts to soap and wash sell Cocoa-rates when being washed and dried by others ‘ Makes no attempt to wash or dry sell tl b 0 [9| Personal Hvsiene (Check ALL statements which apply) Has strong underarm odor Does not change underwear regularly by self Skin is often dirty it not assisted Does not keep nails clean by self None ol the above __ Does not apply, e g . because he or __ she is cornpletely dependent on others (It checked. enter "0" in the Circle to the right ) ~l tIllllllN'f t llt’t lit‘tl —" . (l0) Tooth finishing (Circle only ONE) Applies toothpaste and brushes teeth with up and down motion 3 Amilii-s toothpaste and lirtishi-s Ii-i-th 4 Illuslies teeth without help. but Lannol apply toothpaste l IlIuslii-s twth with sutii-rvmiiii .' I Cooperate: in haying teeth brushed Makes no attempt to brush teeth ii (11) Menstruation (Circle only ONE) (l or males. Circle "no menstruation") No menstruation S t'ariis tor sell completely for menstruation without 5 assistance or rerninder t’ariis tor sell reasonably well during menstruation 4 Helps in changing pads during menstruation 3 lndii ates pad needs changing during menstrua tion 2 indicates that menstruation had begun 1 will not care for self or seek help during menstruation 0 C. Cleanliness 7% ADD t 7.11 D. Appearance In) Posture (Check A_LL statements which apply) Mouth hangs open Head hangs Mn Stomach sticks out because ol posture ShOulders slumped forward and bark bent Walks with toes Out or toes in Walks with leet lar apart Shuttles, drags, or stamps feet when walkinlt Walks on tiptnes None of the above __ Din-s not apply. e g , because he or she is bedfast or non-ambulatory (lf checked. enter "0" in the Circle to the right ) ll-number checked == [13) Clothing (Chi-tit All statements which apply) Clothes do not fit properly if not assisted Wears torn or unpressed clothing if net prompted .— Rewears dirty or sailed clothing if not prompted Wt‘d" clashing color combinations if not 7'0“"‘59’ prompted checked =: Does not know the difference between work shoes and dress shoes — Does not choose different clothing for formal and informal occasions Does not wear special clothing for different weather conditions (raincoat. overshoes, etc.) _. None of the above _ Does not apply, eg.. because he or she is __ tompletely dependent on others (If checked. enter “0" in the circle to the right ) ADD 0. Appearance {- 12°13 E. Care of Clothing (14) CareolClothing lt'heck ALl statements which apply) wipes and polishes shoes when needed __ Puts clothes in drawer or chest neatly __ sends t lothes to laundry without being remmded _.... Hangs up clothes without being remmded —— None of the above — ENTER E. (are of CIozhing m: M F. Dressing and Undressing [15] Dressing (Circle only CNE) Completely dresses sell r. Completely tlri-ssi-s self with verbal prompting only 4 Dresses sell by pulling or putting on all clothes with verbal prompting and by fastening (zipping, buttoning, snapping) them with help 3 Dresses self with help in pulling or putting on most clothes and fastening them 2 Cooperates when dressed by extending arms or legs 1 0 Must be dressed completely [16) Mg at Appropriate Times (Circle only ONE) Completely undresses self . Completely undresses self with verbal prompting only Undresses self by unfastening (unaipping, unbuttoning, unsnapping) clothes with help and pulling or taking them off with verbal prompting J Untlresses sell with help in unlastening and pulling or taking iilf most clothes (”innit-rates when umlri-ssi-il liy i-ati-niliiis: arms or lt-us Must be tompletely undressed O C [17] Shoes (Check ALL statements with apply) Puts on shoes Lorrec‘tly without assistance Ties shoe laces without assistance Untii-s shin- lines without assistance Removes shoes without assistance Noneottheabove .— F. Dressing and Undressing—£22.. 15-17 C. Travel (to) Sense of Direction (Circle only ONE) COt's a tow blocks from hospital or school ground, or several blocks from home without getting lost 3 Goes arOond hospital ground or a few blocks trom home without getting lost 2 Goes around cottage, ward. or home alone 1 Gets lost whenever leaving own livmg area (i 219 II’I Public lranspoflalion II. PHYSICAL DEVELOPMENT “Wu-(Iv. All statements whtch apply) Ruth". am lmm, lam: tltslamt- Inn on "Law A. St‘IlMNY [)1’Vt'l0pllll‘lll uuMu-mkmlv — (Observable lunctioning ability) thes tn tau mdewndenlly — Rides subway or (“Y bus for unlamtliar .Ourneys l22| Vision (wlth glaw-s, ll mull mth-tu-mlt-ntly _ ((‘lttlt- mtly fl) Rules subway or (tly bus for lomnluar pourneys mtla-pentlently _. No tltlltculty tn set-mg ‘ Some dtlltcultv m set-mg (Ln-at tltllICttlty m swung No Vtston at all Noneoltbeabove_ ADD C. Travel 47 1‘19 [23] Hearing (thh hearing and. Il used) (Ctrcle only M) H. Other Independent Functioning 5 No (ltltttulty tn hearing 2 [20] “W (Check ALL statements which We‘ll‘l'W'W'“ hem“ 1 ' Great dllltcultv tn hearmg app v) u Nu III'.II’IH|.: .1! .III UV" lt'k'tslsone durectory . ADD Uses pay telephone Al Sensory Development 22-23 Makes telephone calls from prwate telephone Answers telephone approprtately Takes telephone messages None ol the above __ .21, W | I I F . . . 8. Motor Development (Check ISLE statements which apply) [24] Body Balance ((‘lrrle only .0_Nl:) Stands on "ttptOe" ior ten semnds If asked Stands on one loot for two seconds ll asked Stands Without suppon Stands wuth support Stts wuthom Support (Tan do none at the above Prepares own bed at ntght Goes to bed unassisted, e.g.. getttng in bed, cow-rung wulh blanket, etc. Has ordnnary control at appetite, eats moderately Knows postage rates. buys stamps lrom Post Olltte Looks alter personal health, 1: 3., changes wet clothmg _ [25] Walking and Running Deals wtth snmpletnturles, 13.; ,cuts, burns (Chest All state-ments whtth .tmllvl Knows how and where to obtatn .t donor‘s or — tlt-ttllst's lwlp Walks alum- Kms about weltare faculnttes tn the commumty want, up gndtlown sldlf) alone Noneol the above _ Walks down st.urs bv alterndltng feet Runs wulhoul lullmll ullt'n Hops, ships or lumps H. Other Independent Functioning._A£2E—p Noneolthe above __ 20- 1 [26] Control 0‘ Hands (Check al.-l; statements whlch apply) I. INDEPENDENT FUNCTIONINCJ‘BL—p ' (Iatchesaball "“ANGLES A’H Throws a ball Overhand Ltlts (up or glass Crasps wtth thumb and ttnger None ol the above _ uwuum A ‘ Hill 0 O O $0'O 220 [27: Limb Function tCheclt ALL statements which apply) tins etiei lth' use ol right arm Has ent-(tive use at lelt arm Has ettective use ol right leg Has eilective use ol lelt leg None ot the above __ B. Mator Development ll PHYSICAL DEVELOPMENT A” TRIANGLES A-B lll. ECONOMIC ACTIVITY A. Money Handling and Budgeting [2|] Money Handling (Circle only ONE) Uses banking facilities independently Makes change correctly but does not use banlufls t'acilities Adds coins at various denormnations. up to one dollar 2 Uses money. but does not make change correctly 1 Does not use money 0 lnl Budgeting (Check ALL statements which apply) Saves money or tokens for a partiCular purpose Budgets lares. meals, etc. Spends money with some planning Controls own maior expenditures None ol the above __ [lll A. Money Handling and Budgeting 8. Shopping Skills 1101 Email: (Circle only 95g) Goes to several shops and specilies different items 4 Goes to one shop and speCilies one item 3 Goes on errands for simple purchasing without a note 2 Goes on errands for simple purchasing with a note 1 0 Cannot be sent on errands [31] Purchasing [(firtlt- only ()Nl [ lluys all own thithing '~'. [luvs tivvii t Itilliing .it't t-ssurit-s -l Makes muiur purchases without llt'lp (candy, solt drinks, etc ) 3 Does shopping With slight superwsion 2 Does shopping with clase supervision ‘I 0 Does no shapping 3. Shopping 5km; . ADD —A III. LCONOMIC ACTIVITY ' tRiANCLes A-B IV. LANGUAGE DEVELOPMENT A. Expression [III Writing [Circle only ONE) Writes sensible and understandable letters Writes short notes and memos Writes or prints lorty words Writes or prints ten words Writes or prints own name Cannot write or print any words O-tha-ui [33] Preverbal Expression (Check ALL statements which apply) Nods head or smiles to express happiness Indicates hunger indicates wants by pomting or vocal nOises Chuckles or laughs when happy Expresses pleasure or anger by vocal houses Is able to say at least a lew words (Enter "6" il checked, regardless at other items ) Noneoltheabove __ Hill I [341 Articulation (Check ALL statements which apply-«l no speech. check ' None" and enter "0" in the circle) Speech is low. weak. whispered or difficult to hear Speech is smed. deliberate. or labored Speech is hurried. accelerated. or pushed Speaks with blocking, halting, or other Irregular interruptions Noneol the above __ ”0‘1: 30-31 ' 4-number Checked = IJS] Sentences (l'irtlt' ufllv UNI l' Sometimes uses complex sentences containing "because," "but." etc. Asks questions using words such as "why," "how," "what." etc Spt-ith in simple sentences Six-alts in primitive phrases only, or is iiiiit yt-rlml (36] Word Usage (Circle only ONE) liillss about at tion wlti-ii tlt'scribinu pit Itiri-s Naini-s people or obiects when describing pictures Names lamiliar obIects Asks t'or things by their appropriate names ls niin~verbal or nearly non-verbal A. Expression 8. Commehension (37] Reading (Circle only ONE) Reads boolts suitable for children nine years or older Ri-ails books suitable for children seven years old Reads simple stories or cornics Reads various signs. e 3., "NO PARKING." "ONE WAY,""MEN," WOMEN," etc Recognizes ten or more words by sight Recognizes lewer than ten words or none at all (3.] Complex instructions ltfhi-clt ALL statements which apply) Understands instructions containing pro-positions. e3. ”30" "under," etc at Understands instructions referring to the order in which things must be done, e.g.. "lirst 60° then do-” Understands instructions requiring a decision ”ll—, dothis. but it not. do-" None ol the above _ 8. Comprehension in," "behind,” Jz-Js ' w CA.- 22] C. Social Language DeveIOpment (39] Conversation ((Ihi-tlt ALL statements which apply) Uses phrases such as ”please." and “thank YOU, Is socmbli' and talks during meals l.tllss lii iilltt-rs .iliiitil spurts. l.iiitily, gi'iiiip dCllVlllt‘s‘ i-tc Noneol the above _'- (40] Miscellaneous Language Development (Check ALL statements whith apply) Can be reasoned with Obwnusly responds when talked to Talks st-tisilily Reads books. newspapers, magazines tor enioyment ' g ' ' Repeats a story with little or no dillii‘tilty l ills iii "to main itt'iiis tiii applit atiiiii liiiiii reasonably well None ot the above C. Social Language Development ADD 39-40 IV. LANGUAGE DEVELOPMENT ‘00 YRIANGLES A-C V. NUMBERS AND TIME (41] Numbers (Circle only ONt'l Does simple addition and subtraction Counts ten or more obit-(ts M-t hanitally taunts tii lt‘tt Counts two obiects by saying "one two" Discriminates between "Oflt‘" and "mans " "a lot" Has no understanding ot numbers 0f ..d-‘3J‘ O O A [:3 (41] time ((ilit-iL All statt h-lls time by clock or watch correctly to the tmnute Understands time intervals. e. "3:30”and”4:30" g. , between «tienls whit li apply) Understands time equivalents, e.g.. "9:15" is the same as ”quarter past nine" Assot‘iates time on (lock wttl'i and events Noneol the above __ (43] time Caicept le’lOUS JClIOflS (Chi-tit All, statements which apply) Names the days at the week Relers correctly to "morning" and ”afternoon” Understands difference between day-week, minute—hour, month-year, etc. Noneoltheahove V. NUMBERS AND TIME VI. DOMESTIC ACTIVITY A. Cleaning I44| Rootn Cleaning (Circle only ONE) Cleans room well, e.g.. sweepintt. dUSU‘W .ititl IIdVIIH: 2 ("lo-alts mu bu‘ m ‘Wuhly I Does not clean room at all 0 "5| Laundry (Chi-(k Al I statements whith apply) Washes clothing Dries clothing l’ olds clothing "0‘” C‘O‘hmt “the" appropriate _ None oi the above .-\ (leaning ‘00 v. “45 8. Kitchen (“I table Setting (Circle only ONE) Places all eating utensils. as well as napkins, salt. pepper. suaar. etc.. in positions learned 3 Places plates, glasses, and utensils in positions lea 2 P‘a(p, "Iver, Wits, Cups. “Cw m "u' table 1 0 Does not sel table at all 222 |47| Food Preparation (Circle only UNI.) Prepares an adequate complete nieal (may use cannedor trozen lood) l Mixes and cooks simple food. e.g.. tries eggs, makes pancakes, cooks TV dinners, etc. 2 Prepares simple toads requiring no mixing or cooking, e. 3., sandwiches, cold cereal, etc 1 Does not prepare food at all (a) mile Clearing (Circle only one; Clears table ol breakable dishes and glassware 2 Clears table at unbreakable dishes and silverware Does not clear table at all . ADD 8. Kitchen A . as.“ DE) 0. C. Other Domestic Activities (‘91 General Domestic Activity . (Check ALL statements which apply) Washes dishes well Makes bed neatly Helps with household chores when asked Does household taslis routinely None ol the above C. Other Domestic Activities ___|=_N"'-R ’A to w. DOMESTIC Acnwrv___:’£_. ‘RIANGLES A-C Illl O VII. VOCA TIONAL ACTIVITY ISOI lob Complexity ((Iirtle only ()Nl l l’t-rlttrms a lull requmnu use ol tuttls iir machinery, e 3., shop work. settling, t-tt' l’t-rtornis simple work, e l: , simple gardening mowing tloors, emptying trash. etc. . Pertorms no work at all 1 0.. 223 (51) )ob W (Check .C‘EL statements which apply) (ll ”0" is circled in item 50, check "None at the above" and enter ”0” in the circle). Endangers others because oi carelessness Does not take care at tools ls a very slow worker Does sloppy, inaccurate work Noneoltheabove __ 4-number ._ checked: [52] Work Habits (Check by; statements which apply) (ll "0" is circled in item 50, check "None at the above" and enter "0" in the Circle.) ts ldlt‘ lrom work without good reason 'i'numher ts olten absent from work : Check“ = Does not complete iobs without constant encowagement _. Leaves work station without permission —— Crumbles or gripes about work .— Noneottheabove __ VII. VOCATIONAL ACTIVITY _‘°_°.[:] 50-52 VIII. SELF-DIRECTION A. Initiative ($3) initiative (Circle only ONE) Initiates most ot own activities. e.g.. tasks. games. etc. Asks il there is something to do, or espliires surroundings, e 3., home, yuril, etc Will engage in activities only il assigned or directed ' Will not engage in assigned activities, e.g.. putting away toys. etc. w _D O [54] Passivity (Check ALL statements which apply) Has to be madt' to do things ti-ntiuilii-r Has no ambition d“ L". Scents to have no interest in things Finishes task last because at wasted time ls unnecessarily dependent on others for help Movement is slow and sluggish None ol the above __ Does not apply, e.g . because he or she is tatally dependent on others (ll checked. enter "0" in the Circle to the right 1 . ADD A, IHIUOUVC s 5‘ V B. Perseverance [55) Attention (Circle only ONE) Will pay attention to purposeful activities lor more than lilteen minutes. e g.. playing games, reading, cleaning up will pay attention to purposelul activities lor at least lilteen niinutes Will pay attention to ptirpiiselul activuies (or at least ten minutes Will pity .tlti-nliiin tti purptiselul M'IIVIIMN ltir at lt'dsl live Minutes Will not pay attention to purDOselul activates for as long as live minutes A. * N —6 O I“) Persist' ence (Check AM statements which apply) twirl?" ‘ N" I" .. lit-comes easily discouraged Fails to carry out tasks lumps from one actiyity to another . Needs constant encouragement tocomplete task None oi the above __ Does not apply, i- g _ because he or she is _. liit.illy mi .ipnlili- .il .iiiy organized at twttws (It checked. enter "0" in the Circle to the' right ) 8. Perseverance ‘00—; 5566 C. Leisure Iirne (57) Leisure Yirne Activity (Check All. statements which apply) Organizes leisure time on a lairly complex level, e.g.. plays billiards, fishes. etc. Has hobby. e g , painting, embmidery, collecting stamps or coins __ Organizes leisure time adequately on .1 simple 'I'VI"_ i- k‘ , wahlitng li'li-wsititi. listening to pliiitiiiginplt, railin, r'tL None ol the above _ C. Leisure Time vm. SELF-DIRECUON A00 . tittAiiCtES A-C' IX. RESPONSIBILITY ISO) Personl Belongings (Circle only ONE) Very dependableualways takes care ot personal belongings Usually dependable-usual! 3 v takes ' U pezsonal belongings care ot nre iable-oseldorn takes 2 belongings core 0' personal Not responsible at all-does not take care i . 1 0 personal belong...” [59) General Responsibility (Circle only Q§_) Very conscientious and assumes much re- sponsibility—malies a special ellort; the assigned activities are always perlormed 3 Usually dependable-makes an effort to carry out responsibility; one can be reasonably certain that the assigned activity will be performed 2 Unreliable-makes little effort to carry out responsibility; one is uncertain that the assigned activity will be performed 1 Not given responsibility; is unable to carry out responsibility at all 0 ADD SCI-$9 Ix. RESPONSIBILITY #1 221i [63) Heraction With'Others (Circle only_ ONE) interacts with others in group games or activity lnti-racts with others Im at least a short iii-rind oi time. e.g.. showmg or oliering toys, clothing or objects Interacts with Others imitatively with little interaction Does not respond to others in a soaally acceptable manner . Participation in Group Activities (Circle only QN_E_) l“! X. SOCIALIZA TION [60) Cooperation (Circle only ONE) Otters assistance to others 2 Is willing to help if asked 1 Never helps others 0 lb!) Consideration lor Others (Check ALL statements which apply) Shows interest in the affairs oi others Takes care oi others' belongings Directs or manages the allairs oi others when needed Shows consideration for others' leelings None of the above _._ O O O [62] Awareness ol Others (Check ALL statements which apply) Recognizes own family Recognizes people other than family Has iiilormation about others, e.g.. job, address, relation to self Knows the names oi people close to him, e.g.. classmates, neighbors Knows the names oi people not regularly en. countered Noneoitheabove __ _.J Initiates group aCtivities (leader and organizer) Participates in group activities spontaneously and eagerly I.“ live partii iiiaiil) Participates in group activities il encouraged to do so (passive partiCipant) ‘ ’ Does not participate in group activities [65) Seliishness (Check fig statements which apply) Reiuses to take turns Does not share with others Gets mad II he does not get his way interrupts aide or teacher who is helping another person None ol the above __ l“l $0M Maturity (Check g; statements which apply) ls too lamiliar with strangers ls afraid of strangers Does anything to make Iriends Likes to hold hands with everyone Is at someone's elbow constantly Noneottheabove _ 0005 not apply. e3 . because he or she has no social interaction or is proloiindly withdrawn (ll checked. enter "0" in the circle to the right ) X. SOCIALIZA TION aoo Does not apply, e.g.. because he or she has no social interaction or is proloundly withdrawn (ll checked, enter "0" in the Circle to the right) 4-number checked = S-nuniber Che-(ltt‘d :- lllll 6046 l, Part IV Form A (For Parents) The following is a list of skills and activities. In column A, please indicate how important you think each skill or activity is for your son/daughter's independent living. In column 8, indicate the degree to which you think the Mataria Program has contributed to the development of your son's/daughter's personal independence in daily living. Skill area/activity . How important is this skill or activity for B. What effect has this Program had on this skill or activit ? ____ Average Importance «H c U +’ LO 44 to U O-r- U “- Cl a.) m to- s) M— cru te— Lu U ‘i— OE +9 ‘i- d) UJ rr-L- U U Q) Hi.- co a: U “- g -r-%— H- m “3 “J QC: “— e— S- E 00-! Lu P Q) a: 'P 49 TD 05 X 00 O - O '- ‘0 22 Z —1 Z I 2 Very Important Totally Unimportant Vital No Opinion or No Information Not Very Important I. INDEPENDENT FUNCTIONING Eating Independence in using table utensils cor- rectly and neatly Ability to order s eat meals at resturants when necessary Independence in properly drinking beverages Knowing table . manners a applylng them neatly Toilet Use Controlling bowel & bladder without having accidents Independence in using toilet & urinal properly when needed & taking care of himself after having done . Cleanliness Independence in washing hands & face with soap & drying them Independence in preparing & com— pleting bathing Independence in grooming self regularly & pr0perly Independence in pr0perly brushing teeth with tooth- paste Ability to properly handle feminine hygiene pinion or nformation Totally Unimportant Not Very Important Average Importance Very Important Vital No Opinion or No Information No Effect Little Effect Moderate Effect High Effect Maximum Effect No No fi— 227' 0 opinion or No Information Totally Unimportant Not Very Important Average Importance Very Important Vital No Information No Opinion or No Effect Little Effect Moderate Effect High Effect Maximum Effect 12. 13. D. Appearance Maintains an accept- able posture Independence in wearing clean & neat clothes properly for different situations & conditions 0 l4. . Care of Clothing Independence in taking care of shoes & clothing & sending clothes to laundry 15. 16. I7. . Dressing & Un- m Independence in dressing self Independence in undressing self at appropriate times Independence in wearing shoes, tying laces, & removing them correctly 228 No Opinion or No Information Totally Unimportant Not Very Important Average Importance Very Important Vital No Information No Opinion or No Effect Little Effect Moderate Effect High Effect Maximum Effect I8. 19. 6. Travel Independence in going a few blocks from home or work without getting lost Independence in riding public transportation (auto, cab, train, plane) for familiar & unfamiliar journeys 20. 21. 22. 23. . Other Independent Functioning Ability to use telephone direct- ory, private or pay telephone & to answer them or take messages correctly Ability to pre- pare own bed inde- pendently at night Ability to go to bed a cover self with blanket independently Ability to control appetite ordinarily and to eat moder- ately .229 Very Important No Opinion or No Information No Effect Little Effect Moderate Effect High Effect Maximum Effect Vital .5 (’1 -_J N w h 4.) r: +4 a) ‘0 C U «P a: C: L H «5 I: O S. +4 LO D. O S- O'r- E O. O +4 'I- E a. can : H E CE 3 0—0 w-S- >, .54? 3? 8 3% C.C r- > M or :2 .. a: 00 O O > 22 I— Z < 24. Know postage rates and buys stamps from Post Office 0 l 2 3 25. Ability to look after personal health 0 l 2 3 26. Ability to treat simple injuries 0 l 2 3 27. Know whom and how to contact when medical/dental help is required 0 l 2 3 II. PHYSICAL DEVELOPMENT A. Sensory Develop- ment 28. Ability to see well . even with glasses 0 l 2 3 29. Ability to hear well even with hearing aid 0 l 2 3 B. MOTOR DEVELOPMENT 30. Ability to keep body balanced upon request (i.e. stand on "tip- toe" for ID seconds) 0 l 2 3 230 No Information No Opinion or Totally Unimportant Not Very Important Average Importance Very Important Vital 0 Opinion or No Information No Effect Little Effect Moderate Effect High Effect aximum Effect 31. 32. 33. Ability to indepen- dently perform dif- ferent activities requiring walking, going up & down stairs, running, skipping or jumping Ability to control hands when perform- ing different activities Ability to use both right & left limbs effectively III. 34. 35. ECONOMIC ACTIVITY A. Money Handling and Budgeting Ability to use banking facilities independently Ability to budget, save, & spend money properly & with planning 36. B.SMmMngSth Independence in doing shopping & other errands (food, clothes, etc.) 23] .p C 4H 0) (U C U +3 a: C c 3 t :3 .4 c: ti LO O. O S- : LO +4 m .8 0"“ E D. O In O-r- U ‘6- Q) 44 -.~ E c2. 44 «p a) 9- +: 9— CM C H E S- cm H— Lu U H- OE D H 0 CE 44 Q- 0) Lu *PL >, D. ‘r-L U LU OJ ‘6- CO >5 5- a) E :0 OJ H ‘6— E CL: r- > M l— 0.: 9- r— S— E OH "3 ‘- >z 0 OH Lu 44 a) .c «- ...) 4.: cu L «p +4 "o 01 x 00 O O > 0) '0' OO O 'I- O -r- I!) 22 t— z < > > 22 z .1 z I z 37. Independence in buying all own clothing 0 l 2 3 4 2 3 IV. LANGUAGE DEVELOPMENT A. Expression 38. Ability to write sensible & under- standable letters 0 l 2 3 4 39. Ability to express his feelings verbally and non-verbally (i.e. nods, laughs, etc.) 0 l 2 3 4 40. Ability to arti- culate clearly & properly 0 l 2 3 4 4l. Ability to use com- plex sentence in speech 0 l 2 3 4 42. Ability to talk about action when describing pictures 0 l 2 3 4 B. Comprehension 43. Ability to read books suitable for children nine years or older 0 l 2 3 4 232 No Information No Opinion or Totally Unimportant Not Very Important Average Importance Very Important Vital No Information No Opinion or No Effect Little Effect Moderate Effect High Effect Maximum Effect 44. Ability to under- stand complex instructions con- taining prepositions, requiring a decision & done in order 45. 46. 47. 48. 49. C. Social Language Development Using “Yes", "No", "Please", “Thank you” appropriately & con— versing with others (peers, vistors) about sports, family, group activities, etc. Ability to be reasoned with, talk sensibly & to respond obviously when talked to Ability to read books, papers, magazines for enjoyment Ability to repeat a story with little or no difficulty Ability to fill in main items on application form reasonably well 233 No Opinion or No Information Totally Unimportant Not Very Important Average Importance Very Important Vital No Opinion or No Information No Effect Little Effect Moderate Effect High Effect Maximum Effect V. NUMBERS AND TIME 50. 5]. 52. 53. 54. 55. Ability to do simple addition and sub- traction Ability to tell time by clock or watch correctly Understanding time intervals Understanding time equivalents Associating time on clock with various actions & events Naming the days of the week, referring correctly to "morning & "afternoon", & understanding dif- ference between day- week, minute-hour, month-year, etc. VI. 56. 57. DOMESTIC ACTIVITY III-Mia Cleaning room well Washing, drying, folding & ironing clothing 23h No Information No opinion or Totally Unimportant Not Very Important Average Importance Very Important Vital No Opinion or No Information No Effect Little Effect Moderate Effect High Effect Maximum Effect 58. 59. 60. B. Kitchen Ability to properly set table using required items Ability to prepare an adequate complete meal Ability to clear table of breakable dishes & glassware 61. C. Other Domestic Activities Washing dishes well, making bed neatly, helping with house- hold chores upon request, & doing household tasks routinely VII. 62. 63. VOCATIONAL ACTIVITY Ability to perform a job requiring use of tools or machinery, e.g. shopwork, sewing etc. Performing job safely, punctually, and satisfactorily 235 No Information No Opinion or Totally Unimportant Not Very Important Average Importance Very Important Vital No Opinion or No Information No Effect Little Effect Moderate Effect High Effect Maximum Effect 64. Coming on time for work & is seldom absent, leaving it without permission or encouraged to complete jobs VIII. SELF-DIRECTION 65. 66. A. Initiation Initiating most of own activities or tasks Having ambition & interest in doing things punctually & independently 67. 68. B. Perseverance Paying attention to purposeful activities for more than l5 minutes (cleaning up, & putting things away, etc.) Persistence in doing tasks without being encouraged 69. C. Leisure Time Organizing leisure time adequately on a complex or a simple level, e.g. watching television, listening to radio, doing a hobby etc. 2365 pumwwm Eaewxmz pooccm now: pomwwm muoemuoz oooccw o_oowo Comet“ oz cowumecowcH oz go cowcwoo oz Pouw> acoucoosm xgo> mucougoosH mmocm>< “cougooEH zeo> uoz acoucooswcz zppouoh comumELowcH oz Lo comcwoo oz 0 77. others by taking turns & sharing Cooperation with I Not familiar with or 78. afraid of strangers & does not like to have friendship with others whom he does not know 237 COVER LETTER for Professionals Questionnaire August 15, I984 Dear Mataria Staff Members: As you surely know, training educable mentally retarded is a process by which their independent living skills and competencies could be improved. However, training educable retarded for living independently can be best accomplished if it is geared to their needs as perceived by professionals who are directly involved with their training. Because of their daily contact with those individuals, professionals are in a good position to identify their needs and competencies necessary for independent living. Hence, the attached questionnaire is designed for a study which intends to identify independent living competencies and skills by requesting the professionals' perception regarding whether or not selected varieties of skills and com- petencies are important for making the educable retarded able to live independently. The study for which this questionnaire is designed, also intends to help the rehabilitation authorities establish a framework for a better understanding of the educables' needs and, subsequently, for planning and/or improving rehabilitation programs in Egypt. . The questionnaire consists of two parts: first part includes questions designed to solicit some personal and demographic data about you and your professional experiences. The second part includes 78 statements which represent varieties of competencies and skills considered important for educable retarded persons to successfully live independent in society. Please answer all questions in both parts as truly and accurately . as you can. There is no need for you to write your name on the questionnaire. The information you give is intended to be used exclusively for the purpose of this research specified above. Your participation and cooperation are greatly appreciated. Truly yours, Abdul Ghaffar A. Eldamatty Ph.D. Candidate at Michigan State University, U.S.A. A. 238 Part IV (Form B: For Professionals) Please check the following items: 1. Sex Male Female Age Year Type of position at Mataria Center (Circle number(s) next -to your position(s)) Teacher Social worker Speech therapist Physiotherapist Psychologist Rehabilitation counselor Physician Psychotherapist Director of the Center Years of experience working with mentally retarded Educational level Do you work exclusively or predominantly with: Educable mentally retarded Trainable mentally retarded Severely mentally retarded l 2 N 0501-500 239 The following is a list of skills and activities. Please circle the number that indicates how important you think each skill or activity is for the independent living of the educable mentally retarded persons trained in the Materia Center Program. Importance of skill or activity Skill or activity statement +, C +> a) (U C U +4 (D C L H as C O L 4—> 44 LO D. O S- C O"- E D. O CD +3 °I— E D. +9 CCU C ‘l— E L CE 3 'l- O .,_ >3 Q CO >5 5- CI) E 'I-H- v- 0) U) '1- 0.: l—' > (5 ,._ o"— S +-> ES 5).” 3 OO O O > G) 'r- 22 I— 2 <1: > > 1. INDEPENDENT FUNCTIONING A. Eating 1. Independence in using table utensils cor- rectly and neatly O l 2 3 4 5 2. Ability to order & eat meals at resturants when necessary 0 l 2 3 4 5 3. Independence in properly drinking beverages O l 2 3 4 5 4. Knowing table manners & applying them neatly O l 2 3 4 5 B. Toilet Use 5. Controlling bowel & bladder without having accidents 0 l 2 3 4 5 6. Independence in using toilet & urinal properly when needed & taking care of himself after haVing done 0 l 2 3 4 5 240 4..) C -|-’ a) (O C U +3 ft! C L H rd : o 5.. +> 4.: LO D. O L C O‘v- E Q 0 (U +3 'l" E C. H CfU C 'l— E L CE 3 'I- O 'l-L >5 O. CO >5 5- 0) E 'F'Q- 1—- 0.) U? «- Q—C !— > (U .—- o-:— a: s. >, as +-> +> (I) s.— 44 OO O O > a) -r- 22 I— Z < > > C. Cleanliness 7. Independence in washing hands & face with soap & drying them 0 l 2 3 4 5 8. Independence in preparing & completing bathing O l 2 3 4 5 9. Independence in grooming self regularly & properly 0 l 2 3 4 5 TO. Independence in properly brushing teeth with toothpaste O l 2 3 4 5 ll. Ability to properly handle feminine hygiene O l 2 3 4 5 D. Appearance 12. Maintains an acceptable posture O l 2 3 4 5 l3. Independence in wearing clean & neat clothes properly for different situations & conditions 0 l 2 3 4 5 E. Care of Clothigg_ l4. Independence in taking care of shoes & clothing & 5 di clothes to en ng O l 2 3 4 5 laundry 241 No opinion or No information Totally unimportant Not very important Average importance Very important Vital 15. l6. l7. F. Dressing & Un— dressing Independence in dressing self Independence in undressing self at appropriate times Independence in wearing shoes, .tying laces, & removing them correctly l8. l9. G. Travel Independence in going a few blocks from home or work without getting lost Independence in riding public transportation (auto, cab, train, plane) for familiar & unfamiliar journeys 20. 2l. H. Other Independent Functionigg Ability to use telephone directory, private or pay telephone & to answer them or take messages correctly Ability to prepare own bed independently at night 22. 23. 24. 25. 26. 27. Ability to go to bed & cover self with blanket independently Ability to control appetite ordinarily & to eat moderately Know postage rates & buys stamps from Post Office Ability to look after personal health Ability to treat simple injuries Know whom and how to contact when medical/ dental help is required II. 28. 29. PHYSICAL DEVELOPMENT A. Sensory Development Ability to see well even with glasses Ability to hear well even with hearing aid 30. B. Motor Development Ability to keep body . balanced upon request (i.e. stand on "tiptoe“ for 10 seconds) Totally unimportant Not very important No opinion or No information Average importance Very important Vital N 243 No opinion or No information Totally unimportant Not very important Average importance Very important Vital 3T. 32. 33. Ability to independently perform different activities requiring walking, going up &. down stairs, running, skipping or jumping Ability to control hands when performing different activities Ability to use both right & left limbs effectively III. 34. 35. ECONOMIC ACTIVITY A. Money Handling and Budgeting Ability to use banking facilities independently Ability to budget, save, & spend money properly & with planning 36. 37. B. Shopping Skills Independence in doing shopping & other errands (food, clothes, etc.) Independence in buying all own clothing 244 4.) C +3 (D (O C U +3 (U C L +3 r6 : o L +4 44 LO D. O L C O: s e a :3 Em : --— E 5. CE 3 '1- 0 PL >5 Q 5.? :2 5;, g. .E Q: r—- > (U '— r— O'F -S -H E 3’ .3 00 o o > a.) ..— 22 I— Z <: > > IV. LANGUAGE DEVELOPMENT A. Expression 38. Ability to write sensible & understandable letters 0 l 2 3 4 5 39. Ability to express his feelings verbally and non-verbally (i.e. nods, laughs, etc.) 0 l 2 3 4 5 40. Ability to articulate clearly & properly 0 l 2 3 4 5 4l. Ability to use complex sentence in speech 0 l 2 3 4 5 42. Ability to talk about action when describing pictures 0 l 2 3 4 5 B. Comprehension 43. Ability to read books suitable for children nine years or older 0 l 2 3 4 5 44. Ability to understand complex instructions containing prepositions, requiring a decision & done in order 0 l 2 3 4 5 7' Totally unimportant 245 No opinion or No information Not very important Average importance Very important Vital 45. 46. 47. 48. 49. C. Social Language Development Using ”Yes“, ”No“, ”Please”, “Thank you” appropriately & con- versing with others (peers, vistors) about sports, family, group activities, etc. Ability to be reasoned with, talk sensibly & to respond obviously when talked to Ability to read books, papers, magazines for enjoyment Ability to repeat a story with little or no difficulty Ability to fill in main items on application form reasonably well V. NUMBERS AND TIME 50. 5l. Ability to do simple addition and sub— traction Ability to tell time by clock or watch correctly 246 No opinion or No information Totally unimportant Not very important Average importance Very important Vital 52. 53. 54. 55. Understanding time intervals Understanding time equivalents Associating time on clock with various actions & events Naming the days of the week, referring correctly to "morning" & ”after— noon", & understanding difference between day- week, minute-hour, month- year, etc. _I w 4:. 01 VI. 56. 57. DOMESTIC ACTIVITY A. Cleaning Cleaning room well Washing, drying, folding & ironing clothing 58. 59. 60. B. Kitchen Ability to properly set table using required items Ability to prepare an adequate complete meal Ability to clear table of breakable dishes & glassware O 247 No opinion or No information Totally unimportant Not very important Average importance Very important Vital C. Other Domestic Activities 6l. Washing dishes well, making bed neatly, helping with household chores upon request, & doing household tasks routinely VII. VOCATIONAL ACTIVITY 62. Ability to perform a job requiringuseof tools or machinery, e.g. shopwork, sewing,etc. 63. Performing job safely, punctually, and satisfactorily 64. Coming on time for work & is seldom absent, leaving it without permission or encouraged to complete jobs VIII. SELF-DIRECTION A. Initiation 65. Initiating most of own activities or tasks 248 No opinion or No information Totally unimportant Not very important Average importance Very important Vital 66. Having ambition & interest in doing things punctually & independently O l 2 (A) .5 B. Perseverance 67. Paying attention to purposeful activities for more than l5 minutes (cleaning up, & putting things away, etc.) 0 l 2 3 4 5 68. Persistence in doing tasks without being encouraged 0 l 2 3 4 5 C. Leisure Time 69. Organizing leisure time adequately on a complex or a simple level, e.g. watching television, listening to radio, doing a hobby,etc. O l 2 3 4 5 H X. RESPONSIBILITY 70. Very dependable; always takes care of personal belongings O l 2 3 4 5 71. Very conscientious & assumes much responsibility; makes a special effort; & always performs the assigned activities 0 l 2 3 4 5 249 4.) C 4-’ a) (O C U +3 n: C L -i-> to c o L 4» 44 LO D. O L C O'!‘ E D. 0 rd 4.) -.— E o. 44 cm : -.— E L CE 3 ‘l_ O -r-L >, D. :0 >s $- OJ E °I-‘4— r— CIJ 05 -r- Q: r-- > (O r— o-r- as L >, n: +> +4 a) L +4 OO O O > a) .,... 22 I'— Z < > > X. SOCIALIZATION 72. Offering assistance to others 0 l 2 3 4 5 73. Showing consideration for others' affairs, belongings, & feelings O l 2 3 4 5 74. Awareness of own family & others by knowing their names, jobs, relation to selfi etc. 0 l 2 3 4 5 75. Interaction with others in group games or social activities 0 l 2 3 4 5 76. Active participation in social collective activities (church, mosque, sports, etc.) 0 l 2 3 4 5 77. Cooperation with others by taking turns & sharing 0 l 2 3 4 5 78. Not familiar with or afraid of strangers & does not like to have friendship with others whom he does not know 0 l 2 3 4 5 APPENDIX B THE STUDY SAMPLE BY GROUP, SEX, AGE, IQ, AND TEST USED, AS RANDOMLY DIVIDED 250 251 Table B-l.--The study sample by group. sex. agea, IOb, and test used, as randomly divided. Group I Group II No. Sex Age IQ Test Used No. Sex Age 10 Test Used 1 M 27 52 soC i F 23 65 so 2 F 26 55 so 2 M 26 55 so 3 M 15 7o WISCd 3 F 24 58 so 4 M 18 70 WISC 4 M 20 52 so 5 M i9 59 so 5 M 18 50 WISC 6 M 32 69 so 6 M i7 68 WISC 7 M 22 53 so 7 M 23 70 so a M 22 66 so 8 F 24 67 so 9 M 24 52 so 9 F 23 55 so 10 M 28 53 so 10 F 25 6i so 11 M 25 64 so 11 M 23 65 so 12 M 29 60 so i2 M 23 63 so i3 M 23 56 so i3 M 30 66 so 14 M 32 68 so i4 M 15 56 w1sc 15 M 24 64 so 15 F 20 7o WISC i6 M 27 67 so i6 M 2i 69 so 17 M 2i 6i so 17 M 26 57 so TO M 25 52 so l8 F 23 62 so 19 M 29 65 so i9 M 27 55 so 20 M 20 59 so 20 F 21 63 so 2i M 24 56 so 21 M 19 51 so 22 F 19 7o WISC 22 M 23 53 so 23 M 19 67 so 23 M 23 53 so 24 M 26 57 so 24 M 26 54 so 25 M 27 54 so 25 F 25 70 so aAge listed here was taken at the time of interview. bMean IQ = 60.5. CSB = Stanford-Binet. dWISC = Wechsler Intelligence Scale for Children. APPENDIX C RAW DATA OF THE SAMPLE 252 2253 .oLOUm E:E_me n mzm 665m cozmcm Nemesom .N.m. 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APPENDIX D FREQUENCY DISTRIBUTION FOR PARENTS' AND PROFESSIONALS' PERCEPTIONS 0F COMPETENCY STATEMENTS AND PARENTS' PERCEPTIONS OF PROGRAM IMPACT 260 261 1e D-1.--Observed frequency distributions regarding both perceived importance of IL competencies and program impact on them by parents. Perceived Importance Perceived Impact 0 1 2 3 4 5 o 1 2 3 4 5 1ND..EUNQI. hiatus: Statement 1 N O 6 1 6 10 2 3 11 5 4 2 O % O 24 4O 24 4O 8 12 44 20 16 8 0 Statement 2 N O 2 1 8 11 3 3 9 7 5 1 O % O 8 4 32 44 12 12 36 28 20 4 0 Statement 3 N O 1 O 1 15 8 2 10 6 6 1 O % 0 4 O 4 60 32 8 40 24 24 4 0 Statement 4 N O O O 6 14 5 2 11 6 3 3 O % 0 O 0 24 56 20 8 44 24 12 12 O B..IQil§I.D§§ Statement 5 N 0 0 O O 10 15 2 11 4 4 4 0 % O 0 0 O 40 6O 8 44 16 16 16 0 Statement 6 N O O O O 11 14 2 11 5 3 4 0 % o o o o 44 56 8 44 20 12 16 o C-meanlmgss Statement 7 N O 0 0 0 14 11 1 13 4 3 4 0 % o o o o 56 44 4 52 16 12 16 o Statement8 N o o o 1 16 8 2 13 6 2 2 g % o o o 4 64 32 8 52 24 8 8 262 b1e D-1.--Continued. Perceived Importance Perceived Impact 0 1 2 3 4 5 O 1 2 3 4 5 Statement 9 N O O O O 17 8 2 12 7 1 3 0 % O O O 0 68 32 8 48 28 4 12 0 Statement 10 N O 1 1 2 14 7 2 12 4 3 4 O % 0 4 4 8 56 28 8 48 16 12 16 0 Statement 11 N 14 O 0 O 6 5 15 7 1 1 1 0 % 56 0 O 0 24 20 60 28 4 4 4 0 D. Appearance Statement 12 N O O 1 7 13 4 1 13 4 5 2 0 % O O 4 28 52 16 4 52 16 20 8 0 Statenent 13 N O 0 O 6 15 4 1 11 4 6 3 O % O 0 0 24 6O 16 4 44 16 24 12 0 Statement 14 N 0 O 1 7 14 3 4 10 6 4 1 O % O 0 4 28 56 12 16 4O 24 16 4 0 F. W Mnessjm Statement 15 N O 0 O 2 18 5 3 10 5 4 3 0 % 0 0 O 8 72 20 12 4O 20 16 12 0 Statement 16 N 0 0 O 1 19 5 3 11 5 4 2 0 % 0 O O 4 76 20 12 44 20 16 8 0 Statement 17 N 0 O 0 1 19 5 3 11 5 3 3 0 % O 0 0 4 76 20 12 44 20 12 12 0 263 Tab1e D-1.--Continued. Perceived Importance Perceived Impact 0 1 2 3 4 5 0 1 2 3 4 Statement 18 N 0 O 0 2 14 9 4 2 6 9 4 0 % 0 0 O 8 56 36 16 8 24 36 16 0 Statement 19 N 1 2 0 7 11 4 4 4 6 8 2 O % 4 8 O 28 44 16 16 16 28 32 8 0 H. mm. m Statement 20 N 1 2 5 9 6 2 4 13 2 5 1 O % 4 8 20 36 24 8 16 52 8 20 4 0 Statement 21 N 0 O O 4 15 6 4 8 4 7 2 0 % 0 O 0 16 6O 24 16 32 16 28 8 0 Statement 22 N O 1 O 3 14 7 3 8 6 6 2 O % 0 4 O 12 56 28 12 32 24 24 8 0 Statement 23 N 0 O 1 4 14 6 3 8 8 4 2 0 % O O 4 16 56 24 12 32 32 16 8 0 Statement 24 N O 2 9 6 4 4 3 13 1 7 0 1 % 0 8 36 24 16 16 12 52 4 28 O 4 Statement 25 N O 0 O 3 14 8 3 1O 4 5 3 0 % 0 0 O 12 56 32 12 40 16 20 12 0 Statement 26 N O O 0 4 18 3 1 8 8 4 3 1 % O 0 0 16 72 12 4 32 32 16 12 4 w 26h Tab1e D—1.-—Continued. Perceived Importance Perceived Impact % 0 1 2 3 4 5 O 1 2 3 4 5 Statement 27 N O 0 O 5 15 5 2 7 5 6 3 2 % 0 O O 20 6O 20 8 28 20 24 12 8 II. PH D A. Seneca n Statement 28 N 0 1 3 13 6 6 14 3 2 O O % 8 0 4 12 52 24 24 56 12 8 O 0 Statement 29 N 3 O 1 0 12 9 7 14 3 1 0 O % 12 0 4 O 48 36 28 56 12 4 O 0 B. MQIQL Momma Statement 30 N 1 1 2 8 9 4 4 7 5 9 O 0 % 4 4 8 32 36 16 16 28 20 36 0 0 Statement 31 N O 2 1 9 10 3 3 5 5 10 2 O % 0 8 4 36 4O 12 12 20 20 4O 8 0 Statement 32 N O 0 0 6 13 6 2 4 6 10 3 O % O 0 O 24 52 24 8 16 24 4O 12 0 Statement 33 N 0 O 3 3 14 5 3 3 6 9 4 O % O 0 12 12 56 20 12 12 24 36 16 0 A. Money Hand]. é Budgeting Statement 34 O O 3 8 8 6 3 3 9 8 2 0 0 0 12 12 36 32 8 0 265 Tab1e D-1.-—Continued. Perceived importance Perceived Impact 0 1 2 3 4 5 0 1 2 3 4 5 Statement 35 N 0 0 2 6 14 3 2 7 6 7 3 0 % O O 8 24 56 12 8 28 24 28 12 O B..§hQRQiflQ £31115 Statement 36 N O 0 1 2 12 10 3 4 6 6 S 1 % O 0 4 8 48 4O 12 16 24 24 20 4 Statement 37 N O O 1 4 12 8 6 7 4 5 2 1 % 0 0 4 16 48 32 24 28 16 20 8 4 V. LANG. 95y. AW Statement 38 N 1 2 6 12 4 0 3 1O 6 5 1 0 % 4 8 24 48 16 O 12 40 24 20 4 0 Statement 39 N 1 1 1 7 13 2 3 9 4 7 2 O % 4 4 4 28 52 8 12 36 16 28 8 0 Statement 40 N 0 0 0 3 21 1 4 4 3 11 3 0 % 0 O O 12 84 4 16 16 12 44 12 0 Statement 41 N O 0 O 10 12 3 4 4 5 8 4 0 % O O O 40 48 12 16 16 20 32 16 0 Statement 42 N O 0 1 14 8 2 4 5 3 12 1 O % O O 4 56 32 8 16 20 12 48 4 0 RW Statement 43 N 3 4 9 4 3 5 6 5 8 1 0 9° 8 12 16 36 16 12 20 211 20 32 1+ 0 266 b1e D-1.--Continued. Perceived Importance Perceived Impact 0 1 2 3 4 5 0 1 2 3 4 5 Statement 44 N 1 1 4 12 5 2 4 5 6 9 1 O % 4 4 16 48 20 8 16 20 24 36 40 O Went Statement 45 N 0 2 2 7 11 3 4 4 3 1O 4 O % 0 8 8 28 44 12 16 16 12 40 16 0 Statement 46 N O 1 3 11 10 0 4 5 6 9 1 O % O 4 12 44 40 0 16 20 24 36 4 0 Statement 47 N 1 4 6 9 4 1 5 9 2 8 1 0 % 4 16 24 36 16 4 20 36 8 32 4 0 Statement 48 N 2 2 4 11 4 2 6 7 3 8 1 0 % 8 8 16 44 16 8 24 28 12 32 4 0 Statement 49 N 1 4 7 1O 3 0 7 8 5 5 O 0 % 4 16 28 4O 12 O 28 32 20 20 0 0 NUMBEB§_& IIME Statement 50 N 0 1 3 3 16 2 2 4 7 7 5 0 % 0 4 12 12 64 8 8 16 28 28 20 0 Statement 51 N 0 2 0 5 16 2 2 4 7 7 5 0 % O 8 0 20 64 8 8 16 28 28 20 0 Statement 52 N 0 2 1 5 15 2 3 5 4 9 4 0 % 0 8 4 20 6O 8 12 20 16 36 16 0 267 b1e D—1.—-Cont1nued. Perceived Importance Perceived Impact 0 1 2 3 4 5 O 1 2 3 4 5 Statement 53 N 0 2 3 11 7 2 5 6 2 10 2 O % O 8 12 44 28 8 20 24 8 40 8 0 Statement 54 N O 1 O 12 1O 2 4 2 6 9 4 O % O 4 O 48 40 8 16 8 24 36 16 0 Statement 55 N 0 1 1 0 20 3 1 1 8 10 5 0 % 0 4 4 O 80 8 4 4 32 4O 20 O DQMEfiIlQ_AQIL A. gleanjng Statement 56 N 1 2 3 2 12 5 4 9 7 3 2 O % 4 8 12 8 48 20 16 36 28 12 8 0 Statement 57 N O 4 6 0 11 4 5 12 4 3 1 0 % O 16 24 0 44 16 20 48 16 12 4 O B. Kitchen Statement 58 N 0 1 2 1O 9 3 4 9 6 6 0 0 % O 4 8 4O 36 12 16 36 24 24 0 0 Statement 59 N O 4 5 5 11 0 5 12 4 4 O 0 % 0 16 20 20 44 O 20 48 16 16 0 0 Statement 60 N O 2 2 6 14 1 5 9 7 3 1 O % 0 8 8 24 56 4 20 36 28 12 4 0 0mm AQIiliIiQS Statement 61 O 3 2 4 14 2 5 11 4 5 O 0 0 12 8 16 56 8 20 44 16 20 0 O % 268 Tab1e D-1.--Continued. Perceived Importance Perceived Impact 0 1 2 3 4 5 0 1 2 3 4 5 Statement 62 N O 2 0 5 15 3 1 3 2 10 9 O % 0 8 O 20 60 12 4 12 8 40 36 0 Statement 63 N O 0 1 2 18 4 1 3 3 7 11 0 % O 0 4 8 72 18 4 12 12 28 44 0 Statement 64 N 0 0 O 1 20 4 1 2 4 8 9 1 % 0 0 0 4 80 16 4 8 16 32 36 4 I. SELF-Q1359], A. I 'I' l' Statement 65 N 0 1 2 5 13 4 2 6 3 11 3 0 % O 4 8 20 52 16 8 24 12 44 12 0 Statement 66 N 0 1 1 10 11 2 2 5 5 11 2 0 % O 4 4 4O 44 8 8 20 20 44 8 0 B. W Statement 67 N O 2 5 12 4 2 3 10 1 10 1 0 % 0 8 20 48 16 8 12 4O 4 4O 4 0 Statement 68 N O 0 3 9 10 3 2 8 2 9 4 0 % O 0 12 36 40 12 8 32 8 36 16 O C. Leismze lime Statement 69 N 0 1 4 8 8 4 2 5 5 1O 3 0 % 0 4 16 32 32 16 8 20 20 4O 12 0 rab1e D-1.——Continued. 269 Perceived importance Perceived Impact 0 1 2 3 4 5 0 1 2 3 4 5 Law Statement 70 N O 2 O 4 16 3 2 4 3 10 6 0 % O 8 O 16 64 12 8 16 12 40 24 0 Statement 71 N 0 O 0 5 16 4 1 4 O 16 3 1 % O O O 20 64 16 4 16 O 64 12 4 K-SQQIALLZAILQN Statement 72 N 1 0 1 8 9 6 2 4 3 10 6 0 % 4 O 4 32 36 24 8 16 12 4O 24 0 Statement 73 N O 1 2 9 8 5 3 4 4 9 5 0 % O 4 8 36 32 20 12 16 16 36 20 0 Statement 74 N 0 0 2 1 17 5 2 7 6 9 1 0 % 0 0 8 4 68 20 8 28 24 36 4 0 Statement 75 N 2 3 9 6 1 4 6 4 7 8 0 0 % 8 12 36 24 4 16 24 16 28 32 O 0 Statement 76 N O 1 6 9 4 5 5 5 6 8 1 0 % 0 4 24 36 16 20 20 20 24 32 4 0 Statement 77 N O 2 1 9 1O 3 5 5 4 7 4 0 % 0 8 4 36 40 12 20 20 16 28 16 0 Statement 78 N 0 0 1 6 14 4 3 4 3 11 4 0 % 0 O 4 24 56 16 12 16 12 44 16 0 270 b1e D-2.—-Observed frequencies regarding perceived importance of IL competencies by professiona1s. Perceived Importance 0 1 2 3 4 5 INQEPENQ. FUNQI. mating Statement 1 N 0 0 2 18 6 4 % 0 0 6.7 60.0 20.0 13.3 Statement 2 N 0 4 6 12 6 2 % O 13.3 20.0 40.0 20.0 6.7 Statement 3 N O 0 1 4 13 12 % O 0 3.3 13.3 43.3 40.0 Statement 4 N 0 0 0 6 17 7 % 0 0 0 20.0 56.7 23.3 B. Ileet Uge Statement 5 N 0 0 0 2 6 22 % 0 0 0 6.7 20.0 73.3 Statement 6 N 0 0 0 2 8 20 % 0 0 0 6.7 26.7 66.7 C. QIeanljnegg Statement 7 N 0 0 0 1 8 21 % 0 0 0 3.3 26.7 70.0 Statement 8 N 0 0 0 4 18 8 % 0 0 0 13.3 60.0 26.7 Statement 9 N 0 O 1 2 18 9 % 0 0 3 3 6.7 60.0 30.0 1b1e D-2.-—Continued. 271 Perceived Importance 2 3 4 5 Statement 10 N 0 0 1 4 17 8 % 0 0 3.3 13.3 56.7 26.7 Statement 11 N 0 0 0 1 12 17 % 0 0 0 3.3 40.0 56.7 RAW Statement 12 N O 0 3 4 17 6 % 0 O 10.0 13.3 56.7 20.0 Statement 13 N 0 0 1 5 19 5 % 0 0 3.3 16.7 63.3 16.7 awning Statement 14 N 0 O 2 4 17 7 % 0 0 6.7 13.3 56.7 23.3 KW Liam Statement 15 N 0 0 0 3 14 13 % 0 O 0 10.0 46.7 43.3 Statement 16 N 0 0 0 3 13 14 % 0 0 0 10.0 43.3 46.7 Statement 17 N 0 0 0 4 15 11 % 0 0 0 13.3 50.0 36.7 6.1mm Statement 18 N 0 0 4 12 6 8 0 0 13.3 40.0 20.0 26.7 % 1b1e D—2.--Continued. Perceived Importance 0 1 2 3 4 5 Statement 19 N 10 3 6 6.7 30.0 33.3 16.0 20.0 00 N SO % H. chet_lndepend. 131391129319 Statement 20 N 0 4 6 12 5 3 % O 13.3 20.0 40.0 16.7 10.0 Statement 21 N 0 0 0 8 18 4 % 0 0 0 26.7 60.0 13.3 Statement 22 N 0 0 0 4 22 4 % 0 0 0 13.3 73.3 13.3 Statement 23 N 0 1 0 9 14 6 % 0 3.3 0 30.0 46.7 20.0 Statement 24 N 1 1 12 9 5 2 % 3.3 3.3 40.0 30.0 16.7 6.7 Statement 25 N 0 0 1 4 19 6 % O 0 3.3 13.3 63.3 20.0 Statement 26 N 0 1 1 12 14 2 % O 3.3 3.3 40.0 46.7 6.7 Statement 27 N 0 O 2 5 18 5 % 0 0 6.7 16.7 60.0 16.7 273 ab1e D-2.--Continued. Perceived Importance 0 1 2 3 4 5 . PH P AW Statement 28 N 0 0 1 9 20 0 % 0 O 3.3 30.0 66.7 0 Statement 29 N 1 0 2 10 15 2 % 3.3 0 6.7 33.3 50.0 6.7 B-Mptqtiexelga. Statement 30 N 0 4 4 17 3 2 % 0 13.3 13.3 56.7 10.0 6.7 Statement 31 N 0 1 2 6 14 7 % 0 3.3 6.7 20.0 46.7 23.3 Statement 32 N O O 1 4 17 8 % 0 0 3.3 13.3 56.7 26.7 Statement 33 N 0 0 3 6 12 9 % 0 0 10.0 20.0 40.0 30.0 W AW 8.8udgeting Statement 34 N 0 2 6 13 7 2 % 0 6.7 20.0 43.3 23.3 6.7 Statement 35 N 2 4 13 9 2 OO % 6.7 13.3 43.3 30.0 5.7 27h ab1e D-2.--Continued. Perceived Importance 0 1 2 3 4 B.Shsmjmiiflflé Statement 36 N 0 1 2 7 12 8 % 0 3.3 6.7 23.3 40.0 26.7 Statement 37 N 0 1 3 15 9 2 % 0 3.3 10.0 50.0 30.0 6.7 . LANQUA§E_QE¥ELQEL AW Statement 38 N 1 4 3 11 6 5 % 3. 13.3 10.0 36.7 20.0 16.7 Statement 39 N 0 0 1 5 16 8 % 0 0 3.3 16.7 53.3 26.7 Statement 40 N O 1 1 5 18 5 % 0 3.3 3.3 16.7 60.0 16.7 Statement 41 N 0 1 3 9 11 6 % 0 3.3 10 30.0 36.7 20.0 Statement 42 N O 1 7 12 6 4 % 0 3.3 23.3 40.0 20.0 13.3 8W Statement 43 N 1 1 4 10 10 4 % 3. 3.3 13.3 33.3 33.3 13.3 Statement 44 N 0 1 6 8 10 5 % 0 3.3 20.0 26.7 33.3 16.7 275 Tab1e D-2.--Continued. Perceived Importance 0 1 2 3 4 5 C. Sggjal Language Went Statement 45 N 0 0 0 1O 15 5 % O 0 0 33.3 50.0 16.7 Statement 46 N O 0 5 12 12 1 % O O 16.7 40.0 40.0 3.3 Statement 47 N 2 3 5 15 3 2 % 6.7 10 16.7 50.0 10.0 6.7 Statement 48 N O 1 6 14 8 1 ‘ % O 3.3 20.0 46.7 26.7 3.3 Statement 49 N 0 3 7 12 5 3 % 0 10.0 23.3 40.0 16.7 10.0 - NHMBEBS_&_IIME Statement 50 N O 0 1 6 18 5 % 0 0 3.3 20.0 60.0 16.7 Statement 51 N 0 1 1 8 17 3 % 0 3.3 3.3 26.7 56.7 10.0 Statement 52 N 1 11 14 4 36.7 46.7 13.3 00 DO U) O U) % 13 7 4 Statement 53 N 20.0 43.3 23.3 13.3 00 OO O1 % 276 ab1e D—2.--Continued. Perceived Importance O 1 2 3 4 5 Statement 54 N O 0 1 12 13 4 % 0 0 3.3 40.0 43.3 13.3 Statement 55 N o o o 4 19 7 % 0 0 0 13.3 63.3 23.3 . DQMESIIQ.AQILMLII A. meaning Statement 56 N 0 O 2 9 16 3 % 0 0 6.7 30.0 53.3 10.0 Statement 57 N 0 O 6 15 8 1 % O 0 20.0 50.0 26.7 3.3 B. 511913921 Statement 58 N 0 O 7 11 11 1 % 0 O 23.3 36.7 36.7 3.3 Statement 59 N 0 3 7 11 7 2 % O 10.0 23.3 36.7 23.3 6.7 Statenent 60 N 0 1 4 10 14 1 % O 3.3 13.3 33.3 46.7 3.3 C. W E I' '11 Statement 61 N 1 0 3 1O 14 2 % 3.3 0 10.0 33.3 46.7 6.7 1b1e D-2.--Continued. 277 Perceived Importance 0 1 2 3 4 5 199AIlQNAL.AQIl¥lII Statement 62 N 1 0 3 6 18 2 % 3.3 O 10.0 20.0 60.0 6.7 Statement 63 N 0 0 0 2 20 8 % 0 0 0 6.7 66.7 26.7 Statement 64 N 0 1 0 4 17 8 % 0 3.3 0 13.3 56.7 26.7 F- N A. Injtjatjgn Statement 65 N 0 0 2 13 11 4 % 0 0 6.7 43.3 36.7 13.3 Statement 66 N 0 1 2 18 7 2 % 0 3.3 6.7 60.0 23.3 6.7 B. Persayacange Statement 67 N O 1 O 8 18 3 % 0 3.3 0 26.7 60.0 10.0 Statement 68 N 0 0 2 11 14 3 % 0 0 6.7 36.7 46.7 10.0 Statement 69 N 0 2 2 11 11 4 % 0 6.7 6.7 36.7 36.7 13.3 278 1b1e D—2.—-Continued. Perceived Importance 0 1 2 3 4 5 1 BLSEQNSIBLLLH Statement 70 N 1 O 0 8 19 2 % 3.3 0 0 26.7 63.3 6.7 Statement 71 N 0 1 2 4 18 5 % 0 3.3 6.7 13.3 60.0 16.7 . SQQlALlZAIlQN Statement 72 N 0 0 1 11 14 14 % 0 0 3.3 36.7 46.7 13.3 Statement 73 N O 1 3 13 12 1 % O 3.3 10.0 43.3 40.0 3.3 Statement 74 N 0 1 3 8 13 5 % 0 3.3 10.0 26.7 43.3 16.7 Statement 75 N 1 0 1 6 18 4 % 3.3 0 3.3 20 60.0 13.3 Statement 76 N 0 0 1 9 15 5 % 0 0 3.3 30.0 50.0 16.7 Statement 77 N 1 0 1 7 16 5 % 3.3 0 3.3 23.3 53.3 16.7 Statement 78 N 0 1 1 7 17 4 % 0 3.3 3.3 23.3 56.7 13.3 ab1e D-3.-—Comparison of parents' perception to professiona1s' perception regarding a11 the competency statements. ten No. Parents Professionals t Mean SD Mean SD 1 3.0400 1.338 3.4000 0.814 .247 2 3.4800 1.046 2.8667 1.106 .040* 3 4.1600 0.050 4.2000 0.805 .860 4 3.9600 0.676 4.0333 0.669 .689 5 4.6000 0.500 4.6667 0.606 657 6 4.5600 0.507 4.6000 0.621 .794 7 4.4400 0.507 4.6667 0.547 .117 8 4.2800 0.542 4.1333 0.629 .357 9 4.3200 0.476 4.1667 0.699 .340 10 4.0000 0.957 4.0667 0.740 .777 11 4.4545 0.522 4.5333 0.571 .681 12 3.8000 0.764 3.8667 0.860 .762 13 3.9200 0.640 3.9333 0.691 .941 14 3.7600 0.723 3.9667 0.808 .322 15 4.1200 0.526 4.3333 0.661 .188 16 4.1600 0.473 4.3667 0.669 187 17 4.1600 0.473 4.2333 0.679 .640 18 4.2800 0.614 3.6000 1.037 .004* 19 3.6250 1.056 3.0667 1.230 .079 20 3.0417 1.083 2.9000 1.155 .645 21 4.0800 0.640 3.8667 0.629 .221 22 4.0400 0.889 4.0000 0.525 .844 23 4.0000 0.764 3.8000 0.887 .373 24 2.9600 1.241 2.8276 1.002 .672 25 4.2000 0.645 4.0000 0.695 .274 26 3.9600 0.539 3.5000 0.820 .016* 27 4.0000 0.645 3.8667 0.776 .490 28 4.0435 0.767 3.6333 0.556 .037* 29 4.3182 0.716 3.5862 0.733 .001* 30 3.5417 1.021 2.8333 1.020 .014* 31 3.4400 1.044 3.8000 0.997 .200 32 4.0000 0.707 4.0667 0.740 .735 33 3.8400 0.898 3.9000 0.960 .812 34 3.6800 0.988 3.0333 0.999 .020* 35 3.7200 0.792 3.1667 0.986 .025* 36 4.2400 0.779 3.8000 1.031 .077 37 4.0800 0.812 3.2667 0.868 .001* 38 2.7500 0.847 3.1724 1.256 .152 39 3.5833 0.881 4.0333 0.765 .054 40 3.9200 0.400 3.8333 0.874 .630 41 3.7200 0.678 3.6000 1.037 .609 42 3.4400 0.712 3.1667 1.053 .259 1b1e D-3.--Continued. No. Parents 280 Professionals tem t Mean SD Mean SD 43 3.0000 1.206 3.4138 1.018 .195 44 3.1250 0.947 3.4000 1.102 .329 45 3.4400 1.083 3.8333 0.699 126 46 3.2000 0.816 3.3000 0.794 .649 47 2.6667 1.090 2.8571 1.008 .519 48 3.0000 1.044 3.0667 0.868 .806 49 2.5000 0.933 2.9333 1.112 126 50 3.6000 0.957 3.9000 0.712 .202 51 3.6400 0.952 3.6667 0.844 .914 52 3.5600 1.003 3.7000 0.750 .567 53 3.1600 1.028 3.3000 0.952 .605 54 3.8400 0.823 3.6667 0.758 .390 55 3.9200 0.812 4.1000 0.607 .365 56 3.6250 1.209 3.6667 0.758 .884 57 3.2000 1.414 3.1333 0.776 .834 58 3.4400 0.961 3.2000 0.847 .335 59 2.9200 1.152 2.9333 1.081 .965 60 3.4000 1.000 3.4333 0.884 .796 61 3.4000 1.155 3.5172 0.785 .670 62 3.6800 0.988 3.6552 0.769 .919 63 4.0000 0.645 4.2000 0.551 .228 64 4.1200 0.440 4.0333 0.850 .630 65 3.6800 0.988 3.5667 0.817 .649 66 3.4800 0.872 3.2333 0.817 .288 67 2.9600 1.020 3.7333 0.785 .003* 68 3.5200 0.872 3.6000 0.770 .723 69 3.4000 1.080 3.4333 1.040 .908 70 3.7200 0.980 3.7931 0.559 .744 71 3.9600 0.611 3.8000 0.925 446 72 3.8333 0.868 3.7000 0.750 .554 73 3.5600 1.044 3.3000 0.837 .320 74 4.0000 0.764 3.6000 1.003 .099 75 2.7391 1.287 3.8621 0.693 001* 76 3.2400 1.165 3.8000 0.761 .045* 77 3.4400 1.044 3.8621 0.743 .099 78 3.8400 0.746 3.7333 0.868 .627 *Significant at the .05 1eve1. 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