Journal of Special Education and Rehabilitation

19-30

Authors: Dragana M. KLJAJIKJ, Sanja M. TRGOVCHEVIKJ,Radmila M. NIKIKJ

Interpersonal communication, psychosocial and mental development of personality and its all other functions take place through the motor control. The most common neurological syndrome is a type of peripheral paresis/paralysis of plexus bracialis, which in most cases occurs at birth and significantly compromises the growth and development of the upper extremities and affects the psychomotor performance. The aim of this study was to evaluate the level of visual perception in children with lesion of plexus brachialis and the effect of the somatopedic treatment over the level of increase of the visual perception. The study sample was consisted of 60 preschool children accommodated at the Rehabilitation Centre “Dr. Miroslav Zotović” in Belgrade (experimental group) and examiners that followed regular checkups and had discontinuity in their therapy (control group). For the research purposes, we used The Test for Visual Perception Assessment. By analyzing the results, we concluded that in both, in the first and the second measuring there was a statistically significant correlation between the experimental and the control groups (I measuring: p<0.001, r = 0.408; II measuring: p <0.001, r = 0.593).

46-60

Authors: Roza N. KRSTESKA

Introduction: Late-life depression is one of the most frequent disorders among the seniors and often remains unrecognized. One of the reasons why late-life depression often passes unrecognized is the comorbidity. Hearing and visual impairments are very common condition among the elderly. Thus, depression among the elderly is commonly accompanied by hearing and visual impairment. The epidemiology together with the visual and hearing-related problems still remains poorly investigated. Objective: The aim of the study was to evaluate the relationship between hearing and visual function and the late-life depression. Methods: This was a cross-sectional study with a random sample of 120 participants, 60 patients with late-life depression and 60 community-dwelling older adults aged over 60 and without the symptoms of depression. All participants were examined using a questionnaire designed for the aim of the study to measure the severity of the symptoms (scale with scores from 1 to 3 - from mild to profound degree) of self-reported hearing and visual impairment. In addition, existing medical records and the Geriatric Depression Scale were used as well. Results: The patients with late-life depression in larger number suffered from hearing and visual impairment compared to the non - depressed elderly people: hearing impairments (χ2=6.97, df=1, p=0.0083) and visual impairments (χ2=4.37, df=2, p=0.012). Conclusion: These data suggest that the risk of late-life depression is higher among elderly patients with hearing and visual impairment. A comprehensive annual eye exam is the most important step that can be undertaken to help monitor and protect normal visual function in the elderly. It is necessary to conduct routine screening and early treatment of depression in elderly patients with hearing and visual impairment within the primary care practice. Ophthalmologists and otologists should be aware of the need for routine screening for geriatric syndromes in the eye and otology clinics.

77-94

Authors: Roy I. BROWN

INTRODUCTION: Quality of life as an approach to intellectual and developmental disabilities has developed considerable over the past 30 years and now is having major impacts on the research, the delivery of services and the setting of policy in the field of intellectual and developmental disabilities. AIM: This article introduces and describes the development of quality of life, its major concepts and principles and links them to research, practice and policy. DISCUSSION: Quality of life is seen as a sensitizing concept and one that can bring further cohesion to research and practice and provide a framework for policy. Quality of life is, as a developmental process or approach, bringing together previous ideas such as normalization and pulling together a number of principles, which are relevant to those working in this field. CONCLUSIONS: The ideas and the areas described are linked, and it is argued that a full understanding of the research concepts and their practical implications are necessary, if the policy is to become the driver of practice over the life span, while including intervention and support along with the education of personnel.

109-112

Authors: Hristina MITREVA

On the 29.08.2011, at the Faculty of Philosophy was held a successful seminar with the topic "Early intervention: prevention and challenges in the early childhood", a subject that nowadays attracts great interest. The seminar had a goal to achieve better life quality for families. It was followed with great pleasure and attention by a large number of participants, who were directly or indirectly involved in the early intervention. Leading and experienced professionals from Austria, Germany and Macedonia held presentations which created atmosphere for open discussion and dialog. This resulted with many shared experiences and opinions for improvement of this issue in our country. The introduction was brought by Prof. Dr. Lena Damovska, a full time professor at the Institute of Pedagogy. Afterwards, Prof. Dr. Manfred Pretis showed gratitude to the guests for their attendance and emphasized his great pleasure for the realization of this scientific gathering and the diligence of the participants to this subject. At the end of introductory part the main organizer of the seminar, Prof. Dr. Vladimir Trajkovski, welcomed the audience and thanked the guest speakers for their impeccable motivation and desire in their unselfish expansion of knowledge among the attendees. The first lecture was presented by Prof. Dr. Manfred Pretis, a professor for trans-disciplinary early childhood intervention at the Faculty of Medicine in Hamburg, Germany. In his presentation, “Family before everything else: common collaboration with parents”, he emphasized the crucial need for parents involvement in their child’s development. This engagement leads to creation of environment that will represent “window of opportunity”, filed were practical stimulation will dominate as most important element in the early intervention. Accent was placed on the need of creating confidential interaction and communication between the parents and the professional team, in order to form a collaborative partnership that results with positive outcomes. By his own experience he explained that in the developed countries there are many different programs for early intervention from which parents can choose the most appropriate one. While in Macedonia unfortunately this is still an unfulfilled need. The following presentation was given by Prof. Dr. Zons Armin, a professor for special education at the University for Applied Sciences in Harthausen. His lecture was titled as “Legal basis for early child intervention: What kind of collaboration is necessary for us”. He gave a description of the legislations in Germany and some outcomes from Kiggs’s research. He also presented the laws for performance of rehabilitation and the centers that are responsible for the implementation of early intervention. He noted that there are centers for early help that are family centered aiming for better insight and work with the child, involved interdisciplinary team and manly pedagogical focus. At the end of the first part in this seminar, a presentation was given by Prof. Dr. Annette Hartung, a professor for early childhood intervention. She discussed the “Family focus in practice”, presenting a real practical examples from the everyday life, which she experienced during the application of early intervention. She emphasized that the family as one unit always needs to be seen as a whole, where higher stimulations need to be present for the use of different services, using the ones that are most relevant for their better function. The first presentation in the second part of the scientific gathering was given by Prof. Dr. Lena Damovska on the topic “To what extend are being inclusive the EIC services in Macedonia”. This subject once more expressed the need of these services in Macedonia, very important domain in the early prevention and intervention during the education. The early intervention in our country is still at the beginning or on unsatisfactory level. First of all, the parents as primary care givers deny they have problem causing difficulties when the intervention is applied in the letter developmental period. Her experience agreed with the views of the attendees, meaning that the implementation of the inclusive services in our county is still on a level of “baby steps”. This means that Macedonia has the need of professionals-special educators in the field of education. The deficiency of staff, as well as the insufficient knowledge of the parents indicates that our country has a lot to do in order to reach realistic and sufficient results. Further statement was given by Dr. Aleksandra Dimova, expert in early intervention for vulnerable children in the context of mental disorders among their parents, who at the moment works as a psychiatrist in Austria. Her presentation had the topic “New target groups in the EIC: children of mentally vulnerable parents”. She emphasized that children who live with parent/s that have some psychiatric disorder are at a risk and are target groups for initiation of early interventional process. She presented this alarming condition which needs immediate resolution in order to create place and time for early prevention. The need for a team to work seriously with this riskier by the day group of young individuals and the need of creation and the maintenance of healthy and normal developmental environment was emphasized. Real barriers that professionals are facing with this group of parents were shown, taking into consideration that the necessary help is achieved with great difficulty. In order to reduce these obstacles, an earlier preventive action is important to be started. Prof. Dr.Vladimir Trajkovski, M.D., Ph.D., associate professor at the Institute of Special Education and Rehabilitation in Skopje gave the final presentation. He discussed the topic “Early childhood intervention of children with Autism”, giving various reviews of early intervention of children with pervasive developmental disorder Autism, a disorder that has unfortunately increase in Macedonia. He presented the services of early intervention that are important for the children with autistic spectrum disorders which are responsible for additional financial pressure within the family, as well as the achievement of some better quality. Trough his presentation, he emphasized the comprehensive programs such as the TEACCH program that aims to obtain communication, perception, imitation, social and motor skills. The Denver model was mentioned as a developmental approach based on the comprehensive ABA program which contains procedures for identification of the reasons that influence the behavioral swings. The early intervention is provided by a team obtaining continuous parental collaboration and strategies for solving problems in the behavior and intensive work with the child. At the very end of this seminar, discussion was initiated, where the attendees were asked to share opinions and examples for early intervention and the principles in other countries, or their suggestions for improvement in any professional field that handles this issue. Indeed, this scientific gathering attracted the attention of many visitors that took active parts aiming to achieve some results that will not stay only verbal, but create basis for practical use in their work. One more time was proven that there is an interest for knowledge improvement and even the public holidays were not an obstacle for professional upgrading.

115-119

Authors: Hristina MITREVA

The professionals working with persons with developmental disabilities started to publically discuss the problems that these persons have related to fulfilling their sexual needs as well as the essential need of adapted sexual education for them. Since there is no longer a breach for ignoring the everyday existence of this reality, on 02.11.2011 at the Faculty of Philosophy in Skopje was held very interesting and practical conference with the subject: "Experiences and challenges while working with persons with disability". This event was organized by the association for health, education and research – H.E.R.A., an organization that impeccably fights for popularization and expansion of the policy supporting the sexual needs of the persons with disability. The initiative itself showed that Macedonia is no longer afraid or reluctant to talk in public on the subject that is generally being avoid, which is unfortunately even more vulnerable and sensitive when persons with disabilities are concerned. At the beginning of this gathering, introduction was given by Mila Caroska who is the program coordinator of the program for approach-H.E.R.A. She greeted the participants and thanked for the expressed interest on the issue. Afterwards Doc. Dr. Zoran Kitkanj thanked the organizers for enabling a concept with theme that has great interest, emphasizing that sexuality of children in the period of development and the sexual abuse are serious problem for everyone and for the same thing should openly be discussed. Right after his presentation, Eleonora Nikolovska gave an introduction as a representative of the city of Skopje, at the department for child and social protection of children. Trough her presentation she talked about current and future priority plans in the field of social and health protection. She also highlighted the productive collaboration of the department together with the organization „Poraka“ (Message). This organization sets and achieves goals while creating an en­vi­ron­ment for direct collaboration in certain areas or for certain issues and has a goal to achieve their actualization, implementation and creation of a better future. At the end of the interdictory part, a presentation was given by the executive director Bojan Jovanovski who expressed great appreciation to the Faculty of Philosophy and the Institute for Special Education in regards to their unselfish and consistent support of the project H.E.R.A. He confirmed that, because of the inaccessibility of the sexual education and its mandatory implementation within the schools, the organization takes great swing and advocacy for sexual education of the children. This issue in our country is unfortunately still being avoided, creating big barriers and challenges, especially for the persons with disabilities. He highlighted that even though sexuality is inconvenient topic for a discussion; their motto remains to be popularization and expansion of the sexual education, the rights and protection, as well as the right for pleasure and enjoyment of sexuality that is a part of every person’s life. Further, along the program followed several presentations by the organizers and the people who were directly involved in the issue, as well as a time for open discussion was considered at the end of every presentation. The first presentation was given by Mila Caroska a program coordinator of the program for approach H.E.R.A., in which she presented what this organization has done so far and the adequate goals that the organization has set in the domain of team effort. Trough her comprehensible presentation she emphasized the sexual rights of the persons with disabilities, including and underlining that when it comes down to the question of sexual activity, these individuals should not be discriminated. On the contrary, they should have the same sexual rights as the residual population. She also presented relevant recommendations for the persons with disabilities and their sexuality, with clear goals which, despite the development of appropriate politics and sexual education, their essential part is to support the right of every person to enjoy, regardless of their handicap. Further, M-r Olivera Rašič started her presentation with practical information for her research with the topic "Sexual behavior, sexual education and prevention from sexual abuse of persons with disability". She defined particular terms and showed in details the types of unaccepted sexual behavior and actions towards the children with disabilities. Trough the presentation could be noticed the urgent necessity of adequate and adapted sexual education for these individuals. The presence of sexual activity of the disabled should not be neglected or considerate aimless, despite of their handicap. The results unfortunately showed that the sexual abuse of the persons with disabilities is evident, leading to recommendation for serious approach towards the education, prevention and protection of these persons. The practical results gave an idea that shouldn’t be ignored, but must be considered as an inevitable action where a need for constant and professional involvement exists. Further, Doc. Dr. Zoran Kitkanj held a presentation with the topic "Sexual abuse, problems in practice". He emphasized the sexual abuse of children as a very important part that is currently unfortunately increasing. He stated that the term sexual abuse includes not only violent force over the child to sexual intercourse, but also other sexual activities such as showing porn materials, rude cuddling with the intimate parts of their body and other although not much impressive but crucial signs of existing sexual abuse and harassment over the children. As a professional in the legal part, he underlined the punishment for these shameful acts, such as initiation of actions and procedures for sanctioning the abusers. Luckily, he had numerous experiences that he unselfishly shared with the visitors in the auditorium, in many ways educating them of the possible signs, symptoms and acts over children that could be a sign of the presence of sexual abuse. In the second part of this conference, Prof. Dr. Vladimir Trajkovski, the president of the Macedonian scientific association for Autism gave a presentation with the topic "Sexually transmitted diseases at persons with disability". Because of the insufficient records of the persons infected with sexual diseases in Macedonia, he decided to share information from the USA. First he presented what sexually transmitted diseases actually are and what kinds of diseases exist. Very important point was made saying that persons with disabilities should continuously attend gynecological examination, due to asymptomatic signs showing that they can develop much more serious consequences. It was emphasized that the presence of some kind of handicap does not have to mean that the persons with disabilities are not sexually active. On the contrary, they are sexual active and in the Western countries there are adequate persons that are paid to sexually satisfy these individuals. Among the other, individuals with disabilities also are more exposed to and victims of sexual harassment. Trough the presentation he showed realistic barriers witch the persons with disabilities encounter. As a result of the poor medical conditions and the in adapted means, the assessment very often can give incomplete or incorrect results. Impolite behavior of the professional staff can also prevent the persons with handicap to ask for help, while barriers in the communication can create serious obstruction in performing appropriate assessment. However, it was emphasized that need for sexual education, good media coverage and a project that will include this serious problem exist. Afterwards, Vlado Krstovski, the director of the RCPLIP, talked about "The role of NGO’s in the improvement of the conditions of the persons with disabilities in the Republic of Macedonia". He presented his involvement trough setting up a civil sector that deals with elaboration, evaluation and implementation of the politics for sexual rights and the persons with disability. He underlined clearly that continuous effort should be placed on the sexual education such as respecting the human rights regardless of physical or psychical disabilities. He recommended the audience to take a look in the given brochure that explains the existing politics and to think in which way they can take a part in order to contribute in more practical and efficient use. At the end of the conference there were remarkable presentations inspired from the practical experiences working in the special institutions in Skopje, Štip and Gostivar. The professional staff very explicitly and realistically presented their own results, methods, assets, ways and approaches of work, that they have applied with a goal to accomplish the program of sexual satisfaction of the persons with disability. Real situations, problems and solutions were shared with the audience having a chance to get useful information for their own practical work. Interesting discussions and questions were open of the evident problems that the persons with disabilities have, to which were given unselfish and professional answers. At the end it was concluded that this project should continue aiming for welfare of these persons, such as arising the awareness of the parents who need to understand that the sexual need is part of every person, including their children with disability. At last was created an event where a chance to speak openly about the everyday life was given, which aimed for elimination of the sensitivity and increase of the understanding that the lack of public discussion will not bring solutions that will improve life quality.

123-124

Authors: Goran PETRUSHEV

After successful organization of the last year's International Symposium for early intervention and developmental disorders, the Association of Special Educators and Rehabilitators of the Republic of Macedonia continues its activities for promoting the theory and practice of special education through organizing professional events. At the meeting held on 26.12.2011, the presidency of the Association decided to organize a symposium with the subject "Inclusive education - current status, future challenges". Aside the Association, among the organizers will be the Macedonian Ministry of Education and Sciences and the Faculty of Philosophy - Institute of Special Education and Rehabilitation. The symposium will be held from 17th until 19th of May 2012, in Strumica.