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Aim and Objectives: Although inclusive education of children with intellectual disability is currently an accepted practice, it is often challenged by negative attitude of schoolteachers. We undertook two surveillance studies aimed at Study A - identifying knowledge and teachers' attitudes towards children with intellectual disability and practices of inclusive education in a semi-urban school of South India. Study B -Determining the effect of educational intervention towards attitudes on inclusive education. Method: Knowledge, Attitude and Practice surveillance questionnaires (KAP and ATPD) were given to ninety-six consenting schoolteachers in Study A and twenty schoolteachers in Study B and analyzed. Results: In Study A, the overall attitude mean indicated a favorable attitude towards the children with intellectual disability. The mean overall attitude score was 77.1 (SD: 9.58), with a normal distribution. Forty to fifty percent were aware of intellectual disability and attributed them to biological causes. Ninety-two percent agreed on the need for education and stepwise training for a child with an intellectual disability. In real-life practice, results of classroom management were inaccurate. In Study B, knowledge, attitudes and practices towards inclusive education improved with educational intervention with a positive change of 7.19% on the ATDP scale. Conclusion: These findings suggest a generally positive attitude towards intellectual disability and inclusive education. Comprehensive training programs improve knowledge and attitudes towards inclusive education.

Objectives: Family dysfunction is observed in families with children with intellectual disability (ID). We study the prevalence, pattern of dysfunction, and severity of impairment in these special families using Systems approach. Methods: Sixty-two special families (a child with ID) and 62 typical families (all children with typical development) were included in the present study. The presence of ID was confirmed and quantified with the Binet--Kamat Scale of intelligence or Gesell's Developmental Schedule and Vineland Social Maturity Scales among the special families. In the typical families, brief ID scale was used to rule out ID. Prevalence, pattern, and severity of family dysfunction were assessed using Family Apgar Scale, Chicago Youth Development Study Family Assessment Scale and Global Assessment of Relational Functioning Scale, respectively. Appropriate bivariate analyses were used. Results: About 53% of special families and 19% of typical families had family dysfunction. About 21% of special families and 71% of typical families had the satisfactory relational unit. Areas of adaptability, partnership, growth, affection, resolve, beliefs about family, beliefs about development, beliefs about purpose, cohesion, deviant beliefs, support, organization, and communication were significantly different between special and typical families. The functional impairment was significantly more in the special families. Conclusion: Family dysfunction is more prevalent among special families in India using systems approach. These families should be screened for dysfunction, and family therapy be prescribed when required. [ABSTRACT FROM AUTHOR]

Objective: Brief Intellectual Disability Scale (BIDS) is a measure validated for identification of children with intellectual disabilities (IDs) in countries with low disability resources. Following the publication of the exploratory factor analysis of BIDS, the authors have documented the confirmatory factor analysis (CFA) of BIDS in this study. Materials and Methods: A prospective cross-sectional study was conducted to document the CFA of the BIDS. Primary caregivers (N = 124) of children with ID were recruited and rated the BIDS. We used alternative fit indices for the evaluation of comparative fit index (CFI) and root mean square error of approximation (RMSEA) to evaluate the model fit. The 2-index fit strategy was used to select the best factor model. Results: The model fit index for the original 3-factor model and alternative 2-factor and 1-factor models with 9 items of the BIDS was under identified along with another 3-factor, 7-item model. Another 1-factor, 7-item model was identified but did not satisfy the 2-index fit strategy. A short version of the scale with a 2-factor and 7-item model of BIDS presented the best fit indices of CFI = 0.952 and RMSEA = 0.069. Conclusion: Although the original factor structure of BIDS was not confirmed in this study, another alternative a priori model for the construct validity of BIDS was confirmed. Therefore, the BIDS factor structure has been revised, refined, and trimmed to the final 2-factor, 7-item shorter version. Further documentation of the diagnostic accuracy, validity, and reliability of this shorter version of BDI is recommended. [ABSTRACT FROM AUTHOR]

Objective: To develop and validate a concise, parent-completed Brief Intellectual Disability Scale (BIDS) for children in low--disability resource and high--disability care burden countries. Study Design and Setting: In this prospective cross-sectional study of 124 children recruited from a facility for intellectual disability (ID), the newly developed BIDS as the measure for validation as well as for the gold standard and convergent and divergent validities was administered by independent raters. Tests for diagnostic accuracy, reproducibility, and validity were conducted at the item and scale levels. Results: The BIDS scores of ≥5 (sensitivity [Sn]71.43%, specificity [Sp]580.95%) and ≥11 (Sn=4.29%, Sp=100%), with area under the curve of 0.79, are suggested, respectively, for screening and diagnostic use in Indian populations. The inter-rater reliability (intraclass correlation coefficient [ICC]=0.96) and test--retest reliability at 4 weeks (ICC=0.95) for BIDS are strong. Besides the adequate face and content validities, BIDS demonstrates good internal consistency (Cronbach a50.80) and item-total correlation. There is moderate convergent validity with BineteKamat Test of Intelligence or Gesell's Developmental Schedule (r50.66, P50.001) as well as with adaptive behavior measure of Vineland Social Maturity Scale (r5 0.52, P50.001) and low divergent validity with the subscales of Attention Deficit Disorder with Hyperactivity: Comprehensive Teacher Rating Scale (r50.11, P50.7; r50.18, P50.5; r50.13, P50.6; r50.08, P50.7). An exploratory factor analysis demonstrated a three-factor structure, explaining 60% of variance. Conclusion: The BIDS shows promise as a psychometrically adequate, yet brief measure for identifying ID in countries with low disability care resources and high disability-related burden. [ABSTRACT FROM AUTHOR]

Aim: Most children with autism do not receive early intervention, unless parents are trained, in countries with low child mental health resources. To maximize the existing resource, we evaluated the feasibility and effectiveness of an intensive, parent mediated, multi-component, early intervention for autism in India. Methods: Data of 77 children with an ICD-10 diagnosis of autism who completed a 12- week, five days a week, intervention program and regular practice at home was collected from the database of a teaching hospital. Intervention components included the standard intervention protocol, the Psycho-Educational Profile intervention (PEP-R) and the Carolina Curriculum for Infants and Toddlers with Special Needs. Pre and postintervention PEP-R rating of parents were used to evaluate the intervention outcome. Appropriate bivariate, multivariate and resampling techniques were used to evaluate the intervention effectiveness. Results: The effect size (ES) for the intervention was moderate to large for the PEP-R developmental age as well as perception, fine motor, gross motor, eye-hand coordination,cognitive performance and cognitive verbal domain among children with mild to moderate (ES ranged from 0.70 to 0.88) and severe autism (ES ranged from 0.73 to 0.87). There was no difference in the intervention effect between the groups (ES ranged from 0.004 to 0.30). The effectiveness of the intervention continued after controlling the confounding effect of baseline developmental quotient, developmental age and adaptive skills. Conclusion: It is feasible to provide an effective parent mediated early intervention for mild to severe autism in countries where parents are the cornerstone in childhood disability care. [ABSTRACT FROM AUTHOR]