Family and community intervention services through self help groups (CBR) for enhancement of development of mental retardates 

Tehal Kohli, India

 Any type of disability/handicap is stigmatization.  This stigmatization can be removed if the attitudes of the Society towards disabilities/handicaps become favourable.  Society can only then take initiate of organising community based programmes for training, education and welfare of the disabled, especially mentally handicapped children.  The National Policy on Education (NPE, 1986) and its modification (1992) has laid a lot of emphasis on the education of the mentally handicapped.  It is emphasized that mentally retarded individuals should be provided with equal educational opportunities as others, with the aim of developing in them the self-confidence, courage and integrating them into the mainstream of community as equal partners. 

 There are various helping strategies to promote education among mentally retarded children wuch as special education, integrated education, and community based rehabilitation programmes which include home-based early intervention programme such as portage rural-based District Rehabilitation Centre Scheme, Vocational training and self-help groups. 
 Intervention through self-help groups programme cares and provides training and education to all levels of mentally retarded individuals according to their individual rehabilitation plans.  Services are delivered to urban and rural population.  Parents are involved directly in the training and education of their mentally retarded children.  National Policy on Mental Handicap (1987) reported that the self0help group movement is an expression of the potentials for helping each other among families with a mentally handicapped individual.  This movement allows for services to develop within homes and in small communities without excessive amounts of professional inputs.  Studies by Balgopal et al. (1986, Banerjee (1986), Pamer (1987), Halperin (1987).  Rao (1987, 1988, and 1990) reported that self-help group has become an increasingly important vehicle for providing educational and mental health services for this population and is highly cost effective.  

 India, a developing country with meager resource, massive population and geographic immunity, is faced with an estimated population of 3 percent mentally retarded (Table 1), which require services in various areas.  There is a need for cost effective delivery system to reach this population.  Besides financial problem, the lack of trained personnel and professionals compound the problem.  Self-help group intervention requires little infrastructure to conduct a suitable programme and appears to be within the reach of the community.  Also, the professional help is sought to the minimum.  Self-help groups programme can easily find a suitable place within the locality, convenient to all.  Self-help intervention holds the hope of reaching out to the millions of urban and rural, silently suffering mentally retarded and their parents in India.  

SELF-HELP GROUP PROGRAMME 

 Self-help groups are small groups of parents (ranging from 3 to 25) of mentally retarded children, who meet periodically.  These groups meet either daily or weekly.  In the daily self-help group the parents assist the teacher (in rotation), which takes the form of a school.  During the weekly self-help groups, parents meet for 3 to 5 hours once a week, where they are encouraged to discuss their problems with the professionals, regarding their mentally retarded child.  

 Parents select a target behaviour (such as self-help skills, cognitive, language, socialization, motor etc. and work during the rest of the week.  They receive professional guidance in structuring the individual educational programme for their children.  This ultimately generates a group feeling among parents.  Parents can provide help to their children by themselves, with minimum professional help.  

 The parent focus of research centred around the development of support services and habitation of mentally retarded individuals with community self-help groups.  Intervention through self-help group programmes, cares and provides training to all levels of mentally handicapped persons, according to their individual habitation, rehabilitation plans with very little infrastructure and minimum demand on professional help.  

OBJECTIVES 
 

1. To study the effectiveness of self-help groups for improvement inmental and social maturity of mental retardates. 

 
2. To find out the impact of self-help group services on attitudes of parents towards mental retardation. 

 The study aimed to assess the effectiveness of self-help group programme on a sample of mild and moderately retarded individuals who participated in self-help group programmes and attended all its group meetings.  

 Since it was not possible to use stricly experimental design, a time-series, quasi-experimental design was used with one pre-test and three bi-monthly periodic post-tests on variables under study.  

SAMPLE 

 A sample of 15 mild and moderately retarded individuals with an age-range of 6 to 18 years were selected out of 150 non-institutionalized children living in and around Bangalore.  Parents of these children participated in all self-help group meetings.  Parents were assessed for their change in attitude towards mental retardation. 

HYPOTHESIS 

1. Self-help group programmes would have positive impact on mental maturity, social maturity and adaptive behaviour of mental retardates. 
2. Self-help group programmes would have positive impact on the orientation, knowledge and attitude of parents towards mental retardation and its management. 

1. Binet Kamath’s intelligence tests of Indian Children by Kamath (1934) for IQ1. 
2. Developmental screening test by Bharath Raj (1977) for IQ2. 
3. Vineland Social Matuarity Scale, Nagpur Adaptation by Malin (1965) for SQ. 
4. Parental attitude Scale (PAS) by Bhatti (1975). 
5. Madras Developmental Programming System (MDPS, 1986) 
6. Raven’s Coloured Progressive Matries (RCPM, 1960). 

 The results in table 2 and 105 figures, i.e. >figures for each of the 15 subjects show that there is significant improvement in IQ2, SQ and IQcomb.  No significant improvement in IQ1 has been found.  The total of measure of social maturity (SQ) has shown that post test 1,2 &3 were all significant at .05 level, IQcomb which is the average of IQ1, IQ2 and SQ has shown significant improvement and the pretest scores compared with post test scores give the t-values, all of which are significant at 0.01 level.  The other measures of mental maturity have also shown significant improvement.  Pre-test scores of MDPS also shown significant improvement.  Pre-test scores of MDPS compared with the post tests 1, and 2 have given t-values which are significant at .01 level as compared with post-test 3, t-value significant at .05 level.  In case of RCPM, pre-test compared with post test 1 score shows no significant improvement but when compared with post-test 2 & 3 give the t-values which are significant at .05 and .01 level respectively.  The measures of parental attitude (PAS) show that all the 15 parents have shown improvement is scores but this improvement was not significant at any level of significance.  Thus, it can be concluded that the self-help groups programme has a positive impact on the mental maturity, social maturity and adaptive behaviour of mental retardates and also lead to more favourable parental attitudes.  

CONCLUSIONS: 

 Gain scores of the measures of mental and social maturity as well as adaptive behaviour indicate that the self-help groups programme had a positive and statistically significant impact on the mental retardates.  Parents participating in the self-help programmes showed more favourable parental attitudes towards mental retardation and their management, though due to short training and lack of education, the gain scores in measure of parental attitude were not statistically significant. 

RECOMMENDATIONS 

1. Government and voluntary social agencies should be involved for expanding and enriching self-help groups programmes. 
2. Self-help groups programmes should be used for providing early intervention to all the children who are at risk of developmental delays, learning disabilities, mental handicaps etc. 
3. Indian National Portage Association with its major aim of service delivery can do a lot for expanding portage services through formation and training of self-help groups with the help of its networking centres throughout the country. 

Balgopal et al. (1986).  Self-help groups and professional helpers.  Small Group Behaviour, 17(2),  
123-137. 

Banerjee, R. (1986).  Reaching the unreached.  Paper submitted at the Regional Conference of  
Rehabilitation International during September 15 – 20th at Bombay, India. 

Halperin, D. (1987).  The self-help group; The mental health professional’s role.  Groups, 11 (1), 47-53. 

National Policy on Education (1986).  National Policy on mental Handicapped: Present status. A report on  
Policy on Mental Handicap, sponsored by Thakur Hari Prasad Institute of Rehabilitation for the Mentally Handicapped Children, Hyderabad, India. 

Palmer, K. L. (1987).  Guidelines for a Resources Person Assisting a Self-help group.  Research paper for  
the Master of Science Degree, Northern Illinois University. 

Rao, I. (1987).  Down’s Syndrome Children in rural Areas.  Paper presented AT THE National Down’s  
Syndrome Congress held from October 8-10 at Hyderabad, India. 

Rao, I (1988).  Seva-in-action-A community Based Rehabilitation Programme in Karnataka, South India.  
Paper presented at the 16th World congress of Rehabilitation International, Sept. 5-10, at Tokyo, Japan. 

Rao, I (1990).  Reaching the unreached through community based Rehabilitation Programmes.  Paper  
submitted at the Third Annual Seminar held during January 19-20, at the national Institute for the Orthopaedically handicapped, at Calcutta, India.