Multiple Disabilities

Rad je osmišljen s ciljem da se izdvoje i prikažu novija istraživanja fenomenologije cerebralne paralize i da se skrene pažnja stručne i naučne javnosti na neophodnost i značaj formiranja nacionalnog registra. Poseban naglasak je na izmenama definicije cerebralne paralize tokom prethodnih decenija, na različitosti postojećih klasifikacija i na varijabilnosti podataka o preva-lenci cerebralne paralize i pridruženih stanja i poremećaja. Prikazano je i upoređeno šest najčešće korišćenih definicija i predstavljene tri klasifikacije (konvencionalna, fiziološka i Evropska klasifikacija cerebralne paralize). Uporedo su prikazani podaci o učestalosti s osvrtom na nalaze dostupnih nacionalnih istraživanja. Prikazom najčešćih pridruženih poremećaja je istaknuta heterogenost pojavnih stanja cerebralne paralize i ukazano na vi-soku zastupljenost višestruke ometenosti u ovoj populaciji. Umesto zaključ-ka, upućen je svojevrsni apel za iniciranje formiranja nacionalnog registra i sagledavanje mogućnosti sistematskog organizovanja usluga i podrška na nivou populacije osoba s cerebralnom paralizom i njihovih porodica. Ključne reči: motorički poremećaj, nacionalni registar, planiranje usluga, višestruka ometenost
The paper was designed with the aim to select and present the recent research on phenomenology of cerebral palsy and to draw the attention of the professional and scientific public to the necessity and importance of establishing a national registry. Special emphasis was on changes to the cerebral palsy definition over the past decades, on the diversity of existing classifications and on the variability in the data on the prevalence of cerebral palsy and associated conditions and disorders. The six most commonly used definitions were introduced and compared, as well as three classifications (conventional, physiological and European classification of cerebral palsy). Data on the frequency were presented along with an overview of the findings of national surveys available. By presenting the most common associated disorders, the heterogeneity of manifestations of the conditions in cerebral palsy was emphasized. The high prevalence of multiple disabilities in this population was acknowledged. Instead of a conclusion, a kind of an appeal for initiating the formation of the national registry and considering possibilities of systematic organization of service and support at the level of the population of persons with cerebral palsy and their families was addressed.
Keywords: motor disorder, national registry, service planning, multiple disabilities

The prevalence rate of psychiatric disorders are 4 to 5 times higher for people with intellectual disability than the general population (Rush et al., 2004). Most of the persons affected by intellectual disabilities with mental illness go unnoticed with regard to their etiological condition. This study would expect to create an impact in providing awareness amongst the common public and professionals working in the field of rehabilitation to identify and to make possible efforts in preventing the potential factors attributing to such condition, which in turn will prevent a person with single disability becoming a person with multiple disabilites. By using the purposive sampling method parents of persons with intellectual disabilities were only incorporated for this study. The participants responses were collected by using Kuppuswamy SocioEconomic Status Scale (2014) and Reiss Screen for Maladaptive Behavior (2009) and the data were analysed with SPSS. The results of the study confirm the fact that psychosocial factors are influencing the psychotic features in persons with intellectual disabilities.

Few studies have been conducted in Greece, which focus on the education of children
with multiple disabilities (motor and intellectual disabilities, ID). Four children between
the ages 9 and 15 with multiple disabilities (motor and ID) were selected to be taught
social skills. The aim of this qualitative study was to provide training with regard to
cognitive and communication skills and more specifically conversational skills to the
four children in order to allow them to engage in conversational exchanges with their
peers. Participants were evaluated for their mental capacity and assigned to two groups according to their ability. The intervention combined a table game (puzzle pairs), smallgroup teaching of structured questions with their answers, modeling, error correction, social praise and tangible reinforcement. A within-subject withdrawal design was used to show the acquisition of knowledge and of the ability to converse through conditions of baseline, teaching, probes and generalization measures. All participants learned to engage in structured conversations. This knowledge generalized and maintained to different settings after 3 and 7 months. A social validity measure affirmed these improvements in their ability to converse.

ההרצאה ניתנה על ידי נילי ברויאר, הרכזת האקדמית של המרכז ללימודי מוגבלות, עבור עובדי סל שיקום ירושלים במסגרת סדנא שקיימו בנושא ריבוי מוגבלויות. ההרצאה מציגה עקרון מרכזי של החשיבה הביקורתית אודות מוגבלות והוא ההכרה בהקשר. בנוסף ההרצאה פורשת כמה סוגיות מרכזיות שתנועות הנכים בעולם פועלות לקדם. בסיום מועלות כמה נקודות למחשבה בהקשר של ריבוי מוגבלויות מתוך הבנה כי מדובר בתופעה רחבה לה מספר גורמים והשלכות.

Τα άτομα με πολλαπλές αναπηρίες αποτελούν έναν ιδιαίτερα ετερογενή πληθυσμό ατόμων με μεγάλο εύρος δυσκολιών μάθησης και άλλων προβλημάτων, ο οποίος στην Ελλάδα δεν έχει καταμετρηθεί. Κυρίαρχο χαρακτηριστικό των ατόμων με πολλαπλές αναπηρίες είναι η διάγνωση πολλών, ιδιαίτερης βαρύτητας, διαταραχών ή συνδρόμων σε κάθε άτομο ... Η ετερογένεια του πληθυσμού των μαθητών με πολλαπλές αναπηρίες σχετίζεται με την αιτιολογία, τη διαφορετικότητα των βιωμένων εμπειριών, τα μαθησιακά χαρακτηριστικά, τη συμπεριφορά και τις επιδόσεις, ενώ τα παρατηρούμενα επίπεδα λειτουργικότητάς τους παρουσιάζουν ιδιαίτερη ποικιλομορφία, οδηγώντας στην αδυναμία περαιτέρω κατηγοριοποίησης. Στον μαθητικό αυτό πληθυσμό διαπιστώνεται ανάγκη για ατομικές προσδοκίες επίδοσης, οι οποίες θα ισορροπούν ανάμεσα στους μαθησιακούς στόχους του σχολείου και σε αυτούς που θέτει η οικογένεια, με ιδιαίτερη έμφαση σε θέματα λειτουργικότητας σε καταστάσεις καθημερινής ζωής. Για τον σχεδιασμό Ατομικών Προγραμμάτων Εκπαίδευσης (Α.Π.Ε.) προϋπόθεση αποτελεί η όσο γίνεται σαφέστερη περιγραφή της λειτουργικότητας και των αναγκών των ατόμων με πολλαπλές αναπηρίες...
[Απόσπασμα από την Εισαγωγή]

Parenting factors are one of the most striking gaps in the current scientific literature on the development of young children with significant cognitive and motor disabilities. We aim to explore the characteristics of, and the association between, parental behavior and children's interactive engagement within this target group. Twenty-five parent-child dyads (with children aged 6-59 months) were video-taped during a 15-min unstructured play situation. Parents were also asked to complete the Parental Behavior Scale for toddlers. The video-taped observations were scored using the Child and Maternal Behavior Rating Scales. Low levels of parental discipline and child initiation were found. Parental responsivity was positively related to child attention and initiation. Compared to children with no or other levels of disabilities, this target group exhibits large differences in frequency levels and, to a lesser extent, the concrete operationalization of parenting domains. Further, thi...

Μετά την ψήφιση του Νόμου 2817/2000, την πρόσφατη συμπλήρωση και αναθεώρησή του και την υπογραφή των σχετικών υπουργικών αποφάσεων και εγκυκλίων, η εκπαίδευση των παιδιών και νέων με πολλαπλές αναπηρίες αλλάζει προσανατολισμό. Στη βάση της αλλαγής φιλοσοφίας αυτής, βασικός σκοπός σημαντικών δράσεων της Πολιτείας είναι η βελτίωση των συνθηκών ένταξης στο εκπαιδευτικό σύστημα των προσώπων με πολλαπλές αναπηρίες. Τα ιδιαίτερα χαρακτηριστικά του μαθητικού αυτού πληθυσμού, το ατομικό προφίλ κάθε νηπίου, παιδιού ή νέου με πολλαπλές αναπηρίες και η πορεία του στο εκπαιδευτικό του σύστημα αποτελούν ζητήματα σημαντικά, τα οποία απαιτούν συστηματική ανάλυση. Στην εργασία αυτή γίνεται προσπάθεια να καταγραφούν σημαντικά στοιχεία, τα οποία αφορούν την εκπαίδευση των παιδιών και νέων με πολλαπλές αναπηρίες και την πορεία τους στο πλαίσιο του εκπαιδευτικού συστήματος. Ακόμα, καταγράφονται δεδομένα που αφορούν την εκπαίδευση του μαθητικού αυτού πληθυσμού στο υπαρκτό ελληνικό εκπαιδευτικό σύστημα, με αναφορές στα υπάρχοντα σχολικά πλαίσια: Νηπιαγωγείο (γενικό, ειδικό, Τμήμα Ένταξης), Δημοτικό (γενικό, ειδικό, Τμήμα Ένταξης), Εργαστήριο Ειδικής Επαγγελματικής Εκπαίδευσης και Κατάρτισης (Ε.Ε.Ε.Ε.Κ.) και Τεχνικά Επαγγελματικά Εκπαιδευτήρια (Τ.Ε.Ε.) Ειδικής Αγωγής.

This article discusses different dimensions of the educational process for students with multiple disabilities enrolled in specialized educational services – SES- offered in two multi-functional features at a school located in Baixada Fluminense, in the state of Rio de Janeiro, in 2013. Four non-verbal students with multiple disabilities and two SES teachers participated in the investigation.  The methodology employed was an action-research approach, as well as data collection procedures including participant observation (journaling and field video recording) and semi-structured interviews (audio recording). The theoretical basis followed the historical cultural pattern inspired by Vygotsky’s work. The results showed, among other things, the importance of action-research in teachers’ continuing education. Likewise, these results also indicate the possibilities for development of higher psychological processes in students with these disabilities based on pedagogic interventions with systematic use of alternative communication and assistive technology resources.

Inclusive education was introduced in Serbia by The Law on the Fundamentals of the Education System from 2009. The formal meaning of such education is in the realization of every child's right to education, and in the realization of parents' right to choose the school for their child. There are multi-sectoral projects that develop the capacities of local services for the providing of effective services based on the user's needs, including the education of pupils with disabilities. Schools for the education of pupils with disabilities are also in the position of inclusive schools when it comes to pupils with multiple disabilities. These schools are now being transformed to be able to work with pupils with various types and levels of disabilities in the future (which has not been the case so far), but this transformation does not apply to the developing of these schools' capacities in working with pupils with multiple disabilities. Studies have shown that pupils with multiple disabilities have different capacities and are disadvantaged in terms of education when compared to pupils with a single disability, with whom they usually attend school for the education of pupils with developmental disabilities (formerly "special school"). Special Education and Rehabilitation has the task ahead to set an adequate basis for the planning of models of education and rehabilitation for people with multiple disabilities.
Keywords: multiple disabilities, inclusive education, schools for the education of pupils with developmental disabilities.