Journal articles on the topic 'People with mental disabilities Nutrition Teaching'

Gentle Teaching (McGee et al, 1987) has been described as a technique for working with people who have learning disabilities and severe behavioural disorders. I attended a two-day workshop from 25–27 May 1994 run by the Royal College of Nursing, Bexley MENCAP and Values Incorporated.

Purpose To develop and implement an educational programme to improve medical students’ attitudes towards intellectual disabilities. The purpose of this paper is to improve the healthcare outcomes for individuals with intellectual disability. Design/methodology/approach The development of an educational programme involving actors with an intellectual disability as simulated patients. Scenarios were developed involving basic healthcare interactions. The programme was piloted in three sessions with 45 students. A qualitative analysis of student feedback was then used to develop a student attitude questionnaire for completion pre- and post-educational intervention. Findings The student attitude questionnaire was completed by 23 different medical students. Two domains were analysed: affect and understanding domain scores, mean difference (95% CI) 3.17(2.41-3.94) p<0.001, knowledge and skills domain scores, mean difference (95% CI) 4.22(3.3-5.14) p<0.001. Social implications Student feedback reveals significant positive changes in affect and understanding, and an improvement in knowledge and skill levels when interacting with people with an intellectual disability following the educational intervention. Some major institutions now offer comprehensive programmes involving people with intellectual disabilities as tutors, and in the role of simulated patients. However, more needs to be done to encourage the increased participation and good practice for all of tomorrow’s doctors to benefit. Originality/value Following the publication of recent enquiries into the deaths of people with intellectual disabilities. We know that many of these deaths are premature and potentially preventable. The main failing identified repeatedly is that healthcare staff lack of awareness of the needs of people with intellectual disabilities. This emanates from poor quality and limited curricula time dedicated to intellectual disabilities. There is a need to drastically change the approach to teaching about intellectual disabilities to medical students. All the evidence promotes the involvement of people with intellectual disabilities and their careers in designing and delivering this teaching.

Purpose This paper aims to determine whether an inclusive teaching session changes student attitudes towards people with intellectual disabilities (ID). To investigate the impact of an inclusive teaching session in terms of student perceptions. Design/methodology/approach 66 years 4 students at Cardiff University completed the attitudes towards disabled people form B questionnaire (ATDP-B) before and after a communication skills session on ID. Before and after scores were collated and compared using a paired t-test analysis. Common perceptions were identified using anonymised ATDP-B results to conduct five semi-structured interviews and one focus group with nine students. The common perceptions were discussed, alongside how the teaching session tackled them and suggestions for further improvements. Findings Mean ATDP-B score before the teaching session was 115 (SD = 14.5). Mean ATDP-B score after the teaching session was 122 (SD = 17.2). The teaching session improved scores in the ATDP-B by a mean of 6.92 (4.69, 9.16). A paired t-test found this to be a statistically significant difference, t(65) = 6.20, p < 0.001. Qualitative data was thematically analysed and three main themes were identified: Student identity, patient contact and curriculum content. Originality/value This is the first study to investigate the origin of the negative attitudes of medical students, and found they stem from a lack of confidence in their abilities and failure to develop a professional identity. The impact of the teaching session stems from its focus on meaningful patient contact and identifying and overcoming communication barriers.

Purpose – The purpose of this paper is to provide some thoughts following on from reading: “Experiential learning: changing student attitudes towards learning disability”. Design/methodology/approach – This commentary outlines some considerations for the continued development of using service users in tertiary education as educators. Findings – The literature is not clear on the involvement of people with more profound and multiple learning disabilities, or for those who do not use much spoken language in tertiary level teaching. Originality/value – A further cultural shift is needed to ensure that all people with learning disabilities regardless of their communication style have the opportunity to share their experiences within a teaching and learning context.

Purpose – It is widely recognised that people with intellectual disabilities receive a poorer quality of healthcare than their non-disabled counterparts. Training for healthcare professionals in intellectual disability is often scant or non-existent. The purpose of this paper is to explore the usefulness of employing actors with intellectual disabilities as simulated patients in the assessment of trainee psychiatrists. Design/methodology/approach – The development of a structured clinical exam “station” designed to assess the ability of trainee psychiatrists to communicate with a simulated patient played by an actor with an intellectual disability is described. The paper also assesses the potential benefits of this kind of assessment and the experience of actors and examiners taking part in this process. Findings – The station was found to perform well in discriminating between candidates of various abilities and was well received by actors, examiners and observers. The station is now routinely used in the formal assessment of trainee psychiatrists. Practical implications – The use of people with intellectual disabilities in training and assessment appears to be advantageous in terms of improving knowledge, attitudes and skills amongst healthcare professionals and gives increased opportunities for people with intellectual disabilities to undertake valued social roles. Originality/value – Few institutions currently employ actors with intellectual disabilities as simulated patients as part of their training programmes and as a result there is little in the way of literature on this subject. This paper describes an alternative approach to teaching and assessment which falls in line with recommendations from the Department of Health to involve service users in the training of healthcare professionals.

PurposeIt is widely recognised that people with intellectual disabilities receive a poorer quality of healthcare than their non-disabled counterparts. Training for healthcare professionals in intellectual disability is often scant or non-existent. The purpose of this work is to explore the usefulness of employing actors with intellectual disabilities as simulated patients in the assessment of trainee psychiatrists.Design/methodology/approachThe development of a structured clinical exam “station” designed to assess the ability of trainee psychiatrists to communicate with a simulated patient played by an actor with an intellectual disability is described. The paper also assesses the potential benefits of this kind of assessment and the experience of actors and examiners taking part in this process.FindingsThe station was found to perform well in discriminating between candidates of various abilities and was well received by actors, examiners and observers. The station is now routinely used in the formal assessment of trainee psychiatrists in the UK.Practical implicationsThe use of people with intellectual disabilities in training and assessment appears to be advantageous in terms of improving knowledge, attitudes and skills amongst healthcare professionals and gives increased opportunities for people with intellectual disabilities to undertake valued social roles.Originality/valueFew institutions currently employ actors with intellectual disabilities as simulated patients as part of their training programmes and as a result there is little in the way of literature on this subject. This paper describes an alternative approach to teaching and assessment which falls in line with recommendations from the UK Department of Health to involve service users in the training of healthcare professionals.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Purpose – The purpose of this paper is to amalgamate recommendations from contemporary national reports on healthcare provision and needs of people with intellectual disabilities. The paper combines these with recommendations for undergraduate curricula of medical students from the GMC and Royal College of Psychiatrists (RCPsych). Design/methodology/approach – National reports from Mencap, Department of Health, Disability rights commission, NHS Executive, the GMC and RCPsych were searched for relevant recommendations to undergraduate medical education in ID psychiatry. Recommendations were collated and grouped to form a single list for use when planning future curricula or auditing existing teaching. Findings – In total, 13 relevant recommendations were identified in nine groups. These included that people with intellectual disabilities and their carers should be involved in the teaching. That teaching should include the ethical, moral and legal obligations and should include the mental capacity act and equality act. Institutional and individual discrimination should be highlighted as a problem and diagnostic overshadowing should be covered. Originality/value – This paper has collated in a single document the combined recommendations of multiple reports. These are relevant to medical undergraduate teaching and may also be of use to other undergraduate healthcare courses. They are a useful template for others wishing to examine or benchmark the content of their medical undergraduate ID psychiatry teaching against an amalgamated list.

IntroductionIn the last years, there has been a paradigm shift in the educational system of young people with disabilities. Regular schools associated with specific support plans have become the destination of choice for these adolescents, instead of schools with special education. This integrated teaching seeks to reduce stigma and to promote tolerance but frequently these students become easy targets of psychological and physical violence or discrimination.ObjectiveTo evaluate the integration of adolescents with disabilities in mainstream education compared to special teaching.MethodsAnalysis of 32 patients with disabilities from the adolescence consultation of the psychiatry service of hospital de Santa Maria, between January 2015 and September 2016.ResultsAbout 30% of the adolescents with disabilities who attend regular schools with special support complains of poor adjustment associated with some kind of mistreatment by peers.ConclusionViolence among students in school is a current problem very difficult to fight. Young people with disabilities often find themselves in a significant minority presenting less efficient defense mechanisms. If unprotected, they may easily develop school phobia or refusal. These situations must be identified and avoided to prevent the associated suffering.Disclosure of interestThe authors have not supplied their declaration of competing interest.

“Autism” refers to a wide variety of disabilities, with numerous possible clinical signs and heterogeneous origins. Nevertheless, beyond those diverse clinical signs, a consensus exists concerning the necessity of interventions, particularly educational interventions, for people with autism . In a society such as ours, turned towards digital technologies and tactile devices, (e.g. ), it is important to question the use of these technologies with people with developmental disabilities. Especially as some authors pointed the utility of these devices for teaching skills . Various theoretical corpuses and elements of the scientific literature were taken into account and integrated to develop the LearnEnjoy applications, created initially for children with autism. These facts and knowledge, linked to the peculiarities of people with autism, to the functional approach of language, to the fundamental principles of learning, to an ABA approach, were integrated from the first stages of the development of the applications, to create tools having solid scientific foundations. This way, the LearnEnjoy apps give the users (i.e. the “teachers”) the possibilities of teaching in a progressive and coherent way, different skills such as language (receptive, expressive), imitation, play and motricity, cognitive, academic skills or even independence skills. They also allow the progress in each area to be shared with the parents and the whole team, a necessary feature for the implementation of global and coordinated interventions. Finally, and maybe more importantly, these applications were created so as to specifically foster the contact between the person with autism and the “teacher”. This way the apps, at the same time, reduce the risk of pervasiveness of the tactile tablet, while favouring, just as much for the person with autism than for the accompanying person, the development of a positive, structured and structuring social relationship.

The health status and health behaviors among support staff providing daily support for people with intellectual and developmental disabilities (IDD-SS) in community-based organizations (CBOs) have not been systematically studied. This study examined the health impact of IDD-SS workers who participated in a HealthMatters Program: Train-the-Trainer Certified Instructor Workshop followed by implementing a 12-week HealthMatters Program for people with intellectual and developmental disabilities (IDD) that they care for as part of their employment. A total of 48 IDD-SS were enrolled into either an intervention ( n = 28) or control group ( n = 20). IDD-SS in the intervention group received an 8-hour HealthMatters Program: Train-the-Trainer Workshop immediately prior to teaching a 12-week HealthMatters Program for people with IDD. Assessments were conducted with IDD-SS before and after completing the 12-week HealthMatters Program to evaluate whether IDD-SS experienced any benefit of the training and teaching the program on their own health and health behaviors. Relative to the control group, the IDD-SS in the intervention group showed significant improvements in social/environmental supports for nutrition ( F = 4.92, p = .032), exercise outcome expectations ( F = 6.58, p = .014), nutrition outcome expectations ( F = 8.87, p = .005), fruit and vegetable intake ( F = 13.62, p = .001), knowledge of fruit and vegetable intake recommendations ( F = 11.25, p = .002), and stages of change for eating fruits and vegetables ( F = 6.86, p = .012). Results demonstrated that IDD-SS benefited from the health education programming. Findings support the need to develop programs and organizational policies for health promotion activities for direct care staff.

Although the high rate of food insecurity among people with disabilities and their households has emerged as an important concern in public health and nutrition policy, the available data on these issues are still too limited to fully understand this phenomenon. This study aimed to compare the prevalence of food insecurity between households with and without persons with disabilities and to explore which sociodemographic and disability characteristics are associated with household food insecurity among households with members with disabilities. The data of 2690 households with and without members with disabilities from the 2013 Korea National Health and Nutrition Examination Survey were analyzed. Household food insecurity was more prevalent among households including persons with disabilities than among those without such members. The likelihood of experiencing food insecurity was especially high in households having a female head with a disability (odds ratio (OR) = 1.98); working-age adults with disabilities (OR = 1.70); members with disabilities who were not economically active (OR = 1.53); and members with mental disabilities (OR = 2.81), disabilities involving internal organs (OR = 4.38), or severe (grades 1–3) disabilities (OR = 1.73). The findings indicate that the disability status and sociodemographic characteristics of disabled family members are closely associated with household food security status.

As we know, there are many fields of pedagogical science. One of the most important areas is special pedagogy. Special pedagogy studies the issues of education and upbringing of children with physical and mental disabilities. People with disabilities are those who are relatively disabled in terms of any part of the body or the brain. In our country, special attention is paid to the education of people with disabilities. Inclusive education creates conditions for the protection of social equality, education and other special needs of children with disabilities. According to the teaching methodology, inclusive education prevents discrimination against children, allows people with various diseases to get a perfect education and succeed. Its main task is to create an environment for vocational training of people with disabilities. In modern times, people with disabilities should not be seen as sick, but as people with disabilities. This shapes the social approach to disability. The social model allows these children to exercise their rights to develop their skills. The purpose of inclusive physical education is to teach students to move together, which promotes the improvement and development of human psychophysical abilities. Different exercises should be chosen for each lesson and combined in such a way as to have a comprehensive effect on the body and ensure that each student can perform. It is necessary to ensure the general requirements and their specificity when arranging lessons. Sports have a great impact on the development of the personality of children with disabilities as normal children. Sport is one of the most important conditions for everyone and is acceptable for any age group. All these procedures are more effective when performed in unison. Let's protect our child's life together for a healthy life and step into a healthy future Key words: Inclusion, inclusive education, inclusive physical education, a person with disabilities, special education

Communication is powerful instruments of interaction that provide equality to those who have a severe intellectual disability. We are presenting a comprehensive communication model to enhance their chances of interacting with others and improving professionals' understanding of intellectual disability. Most of the existing literature on different disabilities focuses on people who have some capacities to perform certain skills to a certain degree. Our model allows effective learning and proactive interaction for both the disabled and the professionals. Moreover, it offers resources and a wide range of knowledge about the syndromes and the right strategies to be used. The idea of this research paper arose out of an awareness that students with language learning disabilities are completely ignored in the educational system, and there are no special programs that cater to these students. They are placed in normal schools that are not prepared to deal with their unique difficulties. This paper, therefore, is an attempt to provide teachers with multiple-strategies models for teaching English language skills to these students at the intermediate level and beyond. Also, this research paper describes strategies for language learning and language use in regular language activities. Communication is powerful instruments of interaction that provide equality to those who have a severe intellectual disability. We are presenting a comprehensive communication model to enhance their chances of interacting with others and improving professionals' understanding of intellectual disability. Most of the existing literature on different disabilities focuses on people who have some capacities to perform certain skills to a certain degree. Our model allows effective learning and proactive interaction for both the disabled and the professionals. Moreover, it offers resources and a wide range of knowledge about the syndromes and the right strategies to be used. The idea of this research paper arose out of an awareness that students with language learning disabilities are completely ignored in the educational system, and there are no special programs that cater to these students. They are placed in normal schools that are not prepared to deal with their unique difficulties. This paper, therefore, is an attempt to provide teachers with multiple-strategies models for teaching English language skills to these students at the intermediate level and beyond. Also, this research paper describes strategies for language learning and language use in regular language activities.

The article describes measures to improve the situation of social groups and children with disabilities who are subjected to violence, discrimination, and degrading treatment by able-bodied, healthy, sane people in society. The study has been written in order to describe the role of the social educator and the types of psychological and pedagogical support for the adaptation of children with special educational needs to societyAccording to the results of a scientific study, in some cases, a discriminatory and abusive attitude towards people with disabilities, representatives of other nationalities, members of low-income society has been revealed. It is indicated that there is the necessity of teaching children with disabilities in inclusive schools in order to make them feel as a full members of society; it is revealed that there is the need for special psychological and pedagogical support for children with disabilities for learning in a regular school. The authors have considered the functions of psychological and pedagogical support (disclosure, development, stimulation, compensation, disclosure - correction), the levels of psychological and pedagogical support, regular monitoring of the child’s mental state; monitoring the learning process of a disabled child individually and in groups. Applicable methods of the study are description, analysis, control methods.

Purpose The purpose of this paper is to establish and evaluate a psychotropic medication education group for men with intellectual disability on a secure psychiatric ward. Design/methodology/approach A multi-disciplinary team was convened to oversee the project. A curriculum was developed that covered major classes of psychotropic drugs as well as broader themes related to taking medication and general wellbeing. Each group session incorporated a range of teaching methods supported by accessible materials. Evaluation was by qualitative and quantitative methods. Findings There was interest and enthusiasm for the group. Participant feedback was generally positive and most of those who completed the group reported achieving their personal learning goals. There was no significant difference in results of a medication knowledge test at baseline and at the end of the course. Feedback from group members and reflections of the course facilitators are discussed. Research limitations/implications The results of this small-scale study may not be applicable to other groups or settings. Evaluation measures seemed unable to capture some elements of the group processes and outcomes. Practical implications Establishing and running a psychoeducational group on a low-secure ward for men with intellectual disabilities is possible and potentially valuable. Learning from this project will be useful for others considering group-based interventions for people with intellectual disability. Originality/value This paper adds to the limited literature describing interventions to improve medication knowledge in people with intellectual disability.

Abstract Practices of exclusion towards deviance based on prejudices or ideologies have been present in every age and in every cultural context, often taking the stigmatization process. Recently UNESCO in 2015 released its latest report indicating that despite the efforts of governments, civil society and the international communities, the Education for All was not yet a reality in the world. The poor, people with mental or physical disabilities, children with learning disabilities “are not in a position” to grow and develop as the others. In particular as regards students with Special Educational Needs, to still a challenge to find a teaching that is “common denominator” for all students without leaving anyone out is still a “inclusive” rather than a “special” that favours the relationship within whole class and relationships outside it.

Background: Mental disorders have been associated worldwide with human rights’ violations. Controversially, many occur in mental health facilities. Aim: This work aimed to assess the rights of people with mental disorders in healthcare facilities in Tunisia. Methods: A cross-sectional study, using the World Health Organization (WHO) quality-rights toolkit, assessed the human rights levels of achievement in Elrazi Hospital, the only psychiatric hospital in Tunisia, in comparison with the National Institute of Nutrition (NIN). The framework was the Convention on the Rights of Persons with Disabilities (CRPD). The assessment was carried through observation, documentation review, and interviews with service users, staff, and family members. The sample was composed of 113 interviewees. Results: In Elrazi Hospital, three out of the five evaluated rights were assessed as only initiated: the right to an adequate standard of living, to exercise legal capacity and to be free from inhuman treatment. By comparison, these rights were partially achieved in the NIN. The right to enjoyment of the highest attainable standard of health was partially achieved and the right to live independently and to be included in the community was not even initiated. These last two rights were at the same level of achievement in the NIN. Conclusion: Significant improvements are needed to adapt the practice in Elrazi Hospital to comply with human rights, especially since the achievement level of these rights is lower than in a non-psychiatric hospital. Our study emphasizes the importance of spreading the CRPD as a standardized framework.

Abstract People with intellectual or developmental disabilities (IDD) face higher levels of poverty than others, which can lead to concerns regarding areas of well-being, such as food security. Young adults with IDD who are, in many cases, transitioning from the system of educational, health care, and income supports of their youth into the adult world may be particularly vulnerable. Using pooled data from the 2011–2014 National Health Interview Survey, we find that young adults with IDD have significantly higher levels of food insecurity than young adults without disabilities, even when controlling for poverty. Young adults with IDD who are living in low-income households are not significantly more likely to participate in the Supplemental Nutrition Assistance Program (SNAP) than young adults without disabilities who are also living in low-income households. Although our results suggest that SNAP is effectively reaching many young adults with IDD in need of nutrition assistance, further research is needed to determine the specific effects of food insecurity and SNAP participation on overall economic and health outcomes for this population.

Diet is a modifiable factor that ensures optimal growth, biochemical performance, improved mood and mental functioning. Lack of nutrients, notably vitamin B, has an impact on human health and wellbeing. The United Arab Emirates is facing a serious problem of micronutrient deficiencies because of the growing trend for bariatric surgery, including Roux-en-Y gastric bypass and sleeve gastrectomy. People undergoing bariatric surgery are at high risk of developing neurological, cognitive, and mental disabilities and cardiovascular disease due to deficiency in vitamin B. Vitamin B is involved in neurotransmitter synthesis, including γ-aminobutyric acid, serotonin, dopamine, and noradrenaline. Deficiency of vitamin B increases the risk of depression, anxiety, dementia and Alzheimer’s disease. In addition, vitamin B deficiency can disrupt the methylation of homocysteine, leading to hyperhomocysteinemia. Elevated homocysteine levels are detrimental to human health. Vitamin B deficiency also suppresses immune function, increases the production of pro-inflammatory cytokines and upregulates NF-κB. Considering the important functions of vitamin B and the severe consequences associated with its deficiency following bariatric surgery, proper dietary intervention and administration of adequate supplements should be considered to prevent negative clinical outcomes.

The Covid-19 pandemic and the lockdowns enforced by many countries resulted in indispensable adjustments to the way people live and communicate. The introduction of online education in secondary and tertiary education was one such adjustment and gave rise to a new dynamic whose educational angle and potential were unknown to many teachers. Special Education teachers in particular encountered difficulties with online teaching, stemming from a number of issues common in their field: lack of uniformity special education cases present; the confusion and stress of special needs learners when faced with the teacher’s physical absence; a dearth in studies on teaching Music Technology to people with mental disabilities; and the fact that Music Technology necessitates that learners already be in possession of certain digital skills. The present study aims at presenting not only its researchers’ systematic recording of their teaching approach but also of the researchers’ actions (March 2020 lockdown-present) regarding the teaching of Music Technology online to a learner with Down syndrome, through differentiated teaching, motivation, steady interaction, and communication. Assessment was accomplished through systematic observation of the learning process, successful completion by the special needs learner of specially designed actions, and semi-structured interviews at the end of every session.

The aim of the article is to analyze the theoretical approaches to the study of the problem of professional self-definition of the disabled people in young age and the empirical definition of individually typological characteristics in motivating the choice of a future profession. Among the factors influencing professional self-determination, there are the auto-psychological competence of the individual, self-awareness, activity, internal contradictions, individual psychological specifics etc. The effectiveness of the professional activity in young age depends on the individual typological characteristics of a young person with disabilities. At the same time, the developing characteristics of the subject of professional activity (orientation, knowledge, abilities and skills, professional competence, etc.) are significant, they turn out to be in the integral characteristics of the personality (interests, orientation, emotional and behavioral restraint and the ability to adjustment) forms of professional development of personality (individual, personal, individual-personal), stages of psychological restructuring of the personality (self-determination, self-expression, self-realization) in connection with adaptive behavior or development of personality in professional activity, individual typological features. It is very essential for the professional development of a young person, and moreover for a person with disabilities, to take into consideration her individual and typological characteristics while teaching. Correctly selected psychological tools for definition of the weak and strong points of a personality and necessary psychological support, the corrective work of a psychologist, in our opinion, make it possible to adapt adjustment of a person with disabilities to the conditions of professional activity. The empirical part of the article deals with the results of a study of the characteristics of professional self-definition and individual-typological characteristics (temperament) of young people with disabilities, the leading role of motivation in choosing a profession and defining patterns in the formation of the motivational sphere. It was found that among the optants of a specialized college, internal individually significant motives (compliance with individual abilities, the possibility of mental and physical development, attractiveness, the opportunity for creativity) are predominant, most of them have decided on their professional preferences. Thus, after analyzing and comparing the results of the survey among students of schools and specialized colleges, we found some differences in the motivation of the youth with disabilities to choose a future profession. Young people, who have almost decided upon a profession, are going to take into account their own physical capabilities in their future professional activities and rely on real material support.

Purpose – The purpose of this paper is to reflexively examine the challenges of implementing a community dialectical behaviour therapy (DBT) service for adults with intellectual disabilities (ID) and describes the practical lessons learned about how to maximise the effectiveness of DBT with this client group. Design/methodology/approach – A brief overview of DBT is provided and reference is made to literature which highlights the potential benefits of providing a DBT service to clients with an ID. This is followed by a discussion of the clinical presentation of the clients receiving DBT in the service that is the focus of this case study. Using a reflexive approach, a detailed discussion follows of the challenges faced in implementing a community DBT service for the clients served. Findings – Solutions to a variety of challenges faced in four years of service delivery are described, key lessons learned are highlighted, together with issues meriting further research. Research limitations/implications – This case study and its implications are limited to community DBT services. Another limitation is that, although outcome data have been collected over the past two years, the dataset is not yet large enough to draw statistical conclusions. Practical implications – The paper describes adaptations to treatment structure and strategy which the authors believe are necessary to improve treatment outcomes in community DBT services for adults with ID. In particular, the practical experience suggests that a didactic approach to teaching DBT skills is not effective and should be replaced by the “community of learners” approach that involves the trainer contingently responding to client input. Pre-set lesson plans inhibit the trainers’ ability to respond contingently. Originality/value – The existing literature on providing a DBT service for people with an ID has principally focused on providing a rationale for providing this type of intervention, and on assessing outcomes. Given that this is still a relatively new type of provision for this client group, a detailed examination of process issues is called for.

In this paper, the author addresses the problem of socialisation of children with a history of disabilities and mental retardation by means of visual arts. It is important to look at the very sphere of life of these categories of children. As a rule, these children, for the most part, live in dysfunctional families, which makes it almost impossible to provide them with a form of socialization. This article focuses on the extent to which and how a programme of socialisation of these children can be achieved through the medium of visual arts. At the moment there are works of modern pedagogues who have devoted their scientific researches to this problem, but there are few teachers-artists who deal with this problem. In this article the author devotes his creative attention to this issue and reflects on what means of fine arts and visual literacy can develop and guide in the right direction the socialization of children and young people with disabilities by means of fine arts. A number of scientific works devoted to this problem are seriously reviewed. The author is actively trying to draw the attention of the teaching community to the problem of prevailing social conditions, to reach an educational and cognitive level and, as a consequence, to a better product of the set task of socialization of children with special needs and disabilities in the learning process by means of subject disciplines: drawing, painting, composition, printmaking, etc.

The article is devoted to the discussion of the results of a survey of parents of children with disabilities conducted by the “All-Russian Organization of Parents of Disabled Children and Disabled People over 18 Years of Age with Mental and Other Disabilities Who Need Representation of Their Interests” (VORDI). The authors discuss the problems that parents say — home education, lack of psychological and pedagogical assistance and special conditions at school, disagreement with the opinion of the psychological, medical and pedagogical commission. The key problem of the education system, in the opinion of the respondents and the authors of the article, is the absence or lack of training of teaching staff who could work in an inclusive education with students with special educational needs. The position is expressed about the need for systematic development of inclusive education resources, and above all human resources. The creation of regional resource centers for the development of inclusive education in the constituent entities of the Russian Federation, providing for retraining and advanced training of teachers, their methodological support, is seen as a priority direction of the state policy in the field of education.

This paper aims at providing an overview of Brazilian schools focusing on the development of Vygotsky’s concept of Higher Mental Functions (HMF), especially in the case of students with disabilities. We often see that a lack of appropriate teacher education leads to further excluding students and others involved in the teaching-learning processes — such as the educators themselves, who feel increasingly overwhelmed by their classes of 45 to 60 students, shortage of money and governmental investment. We can even say that Brazilian official schools are immersed in a conflicted-conflicting, alienated-alienating and oppressed-oppressive contradictory reality that is increased by this exclusion-inclusion dichotomy that hinders teachers’ and students’ participation in dialogically organized activities. This diminishes students’ possibilities for developing HMF, which require an argumentative, critical language organization not often accessible to students whilst they continue to be educated on the receiving end of a system that is based on principles of assistance, as are the teachers. With this in mind, the text aims at answering the following question: To what extent are HMF pursued in classrooms allowing young people with(out) specific educational needs to develop (as close as possible) to their fullest potential?

Abstract: Mentally retarded children have obstacles in the activity of the name of the child who still needs proper education in the learning process. SLB Shanti Yoga is one of the best schools that provides educational facilities for children with special needs for people with mental disabilities. The number of criteria determining the level of mentally retarded students makes SLB Shanti Yoga have difficulty in dividing the class according to the results of observations made. So from that research was made to classify data on students with mental retardation to determine the class occupied so that the school can prepare it. The K-Medoids algorithm of clustering techniques can help in grouping students who will occupy classes including light, medium, and heavy classes. The class that has the highest number of students is the heavy mental retardation class while the class that has the lowest number of students is the moderate mental retardation class, with known data grouping results, SLB Shanti Yoga can prepare the class to be used for teaching and learning activities. Keywords: Mentally retarded, data mining, clustering, K-Medoids

School closures during pandemics raise important concerns for children and adolescents. Our aim is synthesizing available data on the impact of school closure during the coronavirus disease 2019 (COVID-19) pandemic on child and adolescent health globally. We conducted a rapid systematic review by searching PubMed, Embase, and Google Scholar for any study published between January and September 2020. We included a total of ten primary studies. COVID-19-related school closure was associated with a significant decline in the number of hospital admissions and pediatric emergency department visits. However, a number of children and adolescents lost access to school-based healthcare services, special services for children with disabilities, and nutrition programs. A greater risk of widening educational disparities due to lack of support and resources for remote learning were also reported among poorer families and children with disabilities. School closure also contributed to increased anxiety and loneliness in young people and child stress, sadness, frustration, indiscipline, and hyperactivity. The longer the duration of school closure and reduction of daily physical activity, the higher was the predicted increase of Body Mass Index and childhood obesity prevalence. There is a need to identify children and adolescents at higher risk of learning and mental health impairments and support them during school closures.

IntroductionCognitive behavior therapy (CBT), which is used by mental health professionals including occupational therapists (OT) is a time-sensitive, structured, present-oriented therapy directed toward solving current problems and teaching clients skills to modify dysfunctional thinking and behavior.ObjectivesSupporting the development of CBT theory and efficient use by mental health professionals are vital.AimTo present the results of CBT training for OTs, which was funded by “European Union technical assistance for increasing the employability of people with disabilities” project (Europe Aid/136449/IH/SER/TR).MethodsUsing a basic CBT theoretical framework the participants attended 96 hour face to face training modules with written materials including fundamental features, preconditions and methods used in CBT. A Turkish CBT book was published for course. Participants trained their skills under supervision and send the results to educators. Pre-post of training CBT knowledge and quality of training (plan-contents, educators, and environment) were evaluated by 5-Likert scale.ResultsThirty OTs (f = 23, m = 7) mostly 43.3% PhD; 20–25 (30%) and 45–50 (26.7%) years age period were included. Total mean score for quality of education was 109.4 ± 29.4 with 23.63 ± 4.34, 47.36 ± 6.41, 38.40 ± 21.61 for plan-contents, educators, and environment subscores, respectively. CBT knowledge was increased from 15.70 ± 6.08 to 45.06 ± 4.59 (P < 0.001).ConclusionTraining increased CBT awareness and practice skills of OTs. Teaching OTs CBT may increase their understanding of person-environment-occupation approach, psychological problem solving, occupational engagement and participation of individuals. Our result supports that mental health professionals should collaborate to share ideas, develop guidelines and promote good practice examples in client-centered and holistic rehabilitation care.Disclosure of interestThe authors have not supplied their declaration of competing interest.

PurposeThe purpose of this paper is to explore to what extent neuro-typical theories of sexual offending apply to clients with Levels 2 and 3 autism with a co-morbid intellectual disability (ID). The paper develops a model of harmful sexual behaviour (HSB) for this client group and makes suggestions for how these behaviours can be understood and reduced.Design/methodology/approachThe revised Integrated Theory of Sexual Offending (ITSO) (Ward and Beech, 2016) is used as a starting framework to understand HSB in this client group. This attends to specific neuropsychological systems, brain development, motivation and emotional processing.FindingsThe revised ITSO has some utility in understanding HSB in this client group. This is improved when neuro-atypical specific state factors are identified. Practical ways of establishing these state factors are made which attend to the function of the behaviour in line with “Good Lives” model of rehabilitation.Research limitations/implicationsRecommendations for ways in which the function of HSB in this client group can be identified are made as well as recommendations for how treatment can be tailored dependent on the function of behaviour in this client group.Practical implicationsThe paper makes practical recommendations for how interventions for people with ID and autism in line with Ward, Clack and Haig’s (2016) Abductive Theory of Method which noted that interventions should be adopted to consider wider explanations for offending thus acknowledging that treatment could extend beyond cognitive behavioural therapy for clinical phenomena. Future treatments for clients with autism and LD are suggested which attend to sensory needs, teaching alternative communication strategies for seeking out “deep pressure” or attention in ways that do not involve sexual offending, using picture communication, information technology or Makaton to communicate needs or using social stories to explain the consequences of behaviour. In addition, neuro-atypical interventions which attend to the neuropsychological functioning of clients could also be included in treatment for neuro-typical clients, thus ensuring that interventions attend to every aspect of the ITSO and not purely clinical phenomena.Social implicationsEnhancing treatment interventions for clients with ID and autism could both reduce risk and enhance quality of life for this client group.Originality/valueMuch of the work to date exploring HSB in clients with autism has attended to clients with Level 1 autism or those without an additional ID. This paper provides practitioners with a theory upon which to understand HSB in clients with a dual diagnosis of Levels 2/3 autism and an ID as well as practical recommendations for reducing HSB in this client group.

The article analyzes the historical stages of inclusive education in the United States: the first – 1960 – the stage of segregation and marginalization of people with special educational needs, the second (from 1968 to 1975) – the stage of normalization, the idea of involving disabled students in the educational environment, the third stage – educational mainstreaming (1975–1983), the fourth stage – (1983–2004) – inclusive education characterized by joint training of people with special needs with peers using typical development, the fifth –mixed educational system – a comprehensive inclusive education system starting in 2004 and until now in the United States.It was determined that the definition of “special educational needs” (learning disability), means developmental delay, disorder of one or more processes related to speaking, reading, pronunciation, writing or arithmetic abilities as a result of possible cerebral dysfunction, but not in the result of mental disorders, loss of sensitivity, cultural, educational or upbringing factors. It has been found that disorder or disability is not one specific concept, but often a mixture of disorders grouped under one broad term, and inclusive education is seen as “the process of addressing and responding to the diverse needs of students by ensuring their participation in learning, cultural activities and community life and reducing exclusion in education and the learning process”. Now intellectual level is determined by using standard intelligence tests, mostly Stanford-Binet, that allows to use individualized curricula as a basis for teaching children with disabilities in inclusive settings. But it is still clear that even in such circumstances, the problems of inclusive education remain to be complex and ambiguous. Keywords: special educational needs, children with disabilities, inclusive environment, inclusion, child with special educational needs, inclusive education, state acts, US general education system.

The application of inclusive education in Indonesia is a way for the government to continue to provide educational services to the community openly and non-discriminatively, both for typical children and children with special needs, one of which is mentally disabled children. This study aims to understand about 1) Characteristics of Tunagrahita Students in the Junrejo 01 SDN inclusion class and 2) Tunagrahita Student Management Strategies in the Junrejo 01 SDN inclusion class in Batu. This research method is a qualitative approach, the type of case study located at SDN Junrejo 01 Kota Batu for ABK students with mental disabilities class II inclusion in the 2019 school year. This study indicates that the mentally disabled students have IQ characteristics below between 70 -80, have the same physical condition as an average child, have high imagination despite weak language skills, and have low self-confidence. From the motor aspect, the mentally retired student can perform psychomotor activities like other students. The mental retardation student management strategies are 1) Applying cooperative learning models, 2) Learning with the Peer Teaching method, 3) Giving the same task in study groups, 4) Assigning homework specifically for mentally disabled people, 5) Using educational games in learning, 6) Giving Rewards for Group and Personal Achievement 7) Environmental Therapy to Train the Solidarity of Retarded Students, 8) Teachers Establish Cooperative Relations with Parents of Tunagrahita students.

In a number of occupations, there is a shortage of labor force that can be filled with economically active part of the population, including people with disabilities (handicapped, HC). Unfortunately, observance of hygienic requirements in the context of HP adolescents vocational training has not been studied sufficiently: most scholars have researched only the conditions of teaching healthy adolescents. This study aimed to examine the HC adolescents vocational training conditions and develop measures to improve their working conditions with pathologies factored in. We examined adaptation potential, anxiety level, mental efficiency, sick rate and personal well-being assessment in HC adolescents (n = 120) aged 16–18, not impaired intellectually, studying sewing equipment operation, shoe repairs in the boarding scool. In the context of the study, we applied Smirnov hygiene criteria, Giessen Symptom Questionnaire, Spielberger's Test Anxiety Questionnaire, Sivkov scale, correction tables, Baevsky adaptation index. For the purposes of statistical analysis, we used parametric (Student t-test) and non- parametric (Mann–Whitney) criteria. The Spearman's correlation coefficient helped determine interrelationship of the studied parameters. We identified the following key adverse hygienic factors that have a significant impact on the students' health: intense character of labor performed, insufficient artificial lighting, noise level above the norm, high content of organic solvents and dust in the workshop's air. The timetable of the boarding school was also found to be inefficient. The results of this study allowed developing and introducing a software program to automatically compile the school's timetable with the aim to improve psychosomatic health of the students and halve the number of health-related complaints.

The purpose of this study illustrate the Children who are born with disabilities or mental retardation. Has characteristics that are easily recognizable as mental retardation (mental obstacles), visual impairment (visual barriers), hearing impairment (hearing barriers), physical impairment (disability). Seen as a useless person. Not many people know that they can also be self-sufficient and achievement. Communication with parents to see children with Down Syndrome. With descriptive qualitative methods, this study using the Theory of Applied Behaviour Analysis (ABA) on Ivar O.Lavass to change deviant behavior to control the behavior of children with Down syndrome. organize a matter of habit and teaching capabilities required to accept the way of communication and behavior in the family. The author has observed a child with Down syndrome by interviewing parents plus a look at the achievements that can be achieved Down syndrome children. It turned out that the success of Down syndrome children participate in daily life activities, introduced like a normal person, respond to and appreciated. Communication with mercy and patience and practice areas of interest, can make a Down syndrome child independently, achieving even be the name of the nation. Tujuan penelitian ini menggambarkan Anak yang dilahirkan dengan berkebutuhan khusus atau down syndrome. Memilik karakteristik yang mudah dikenali dengan sebutan tunagrahita (hambatan mental), tunanetra (hambatan penglihatan), tunarungu (hambatan pendengaran), tunadaksa (cacat tubuh). Dipandang sebagai orang yang tidak berguna. Belum banyak yang mengetahui bahwa mereka ini juga dapat mandiri dan berprestasi. Dengan melihat Komunikasi orangtua terhadap anak penderita down Syndrom. Dengan metode deskriptif kualitatif, penelitian ini menggunakan Teori Applied BehaviourAnalysis (ABA) dari Ivar O.Lavass yangdapat mengubah perilaku menyimpang untuk mengontrol perilaku anak down syndrome. mengatur masalah kebiasaan dan mengajarkan kemampuan yang diperlukan dengan menerima cara komunikasi dan perilaku dalam keluarganya. Penulis mengamati seorang anak down syndrome dengan mewawancarai orangtuanya ditambah dengan melihat prestasi-prestasi yang dapat diraih anak-anak down syndrom. Ternyata keberhasilan anak down syndrome kesehariannya diikutsertakan dalam aktivitas kehidupan, dikenalkan layaknya orang normal, direspon dan dihargai. Dengan komunikasi kasihsayang dan kesabaran serta latihan bidang yang diminati, dapat menjadikan anak down syndrome mandiri, berprestasi bahkan dapat mengharumkan nama bangsa

Coaches play an extremely valuable role in a profession that offers the opportunity to help develop young people. The purpose of this study, which assessed the state of coaching education, was two-fold: 1) to determine coaching education knowledge and skills in meeting the National Coaching Standards, and 2) to determine the application of effective coaching principles in meeting the National Coaching Standards. An email containing a website link for an online survey was sent to all athletic directors in Kansas middle and high schools asking them to forward the website link to all coaches they worked with. A total of 1,414 surveys were returned. The current state of coaching education assessment listed the national coaching standards developed by NASPE and used a Likert scale to ask how prepared and successful the coaches are in meeting the standard. Results of the survey indicated that coaches feel highly prepared and successful in the following coaching standard topics: teaching positive behavior (Standard 2), demonstrating ethical conduct (Standard 4), environmental conditions (Standard 7), positive learning environments (Standard 19), and skills of the sport (standard 27). Coaches indicated that they felt least prepared and least successful in the following standards: coordinated health care program (Standard 10), psychological implications (Standard 11), conditioning based on exercise physiology (Standard 12), teaching proper nutrition (Standard 13), conditioning to return to play after injury (Standard 15), mental skill training (Standard 24), managing human resources (Standard 32), managing fiscal resources (Standard 33) and emergency action plans (Standard 34). Findings from the study can be used to direct coaching education in the areas coaches feel they are less prepared and less successful.

<p><strong>Abstract.</strong> This paper presents part of the results obtained by a master’s research entitled “Teaching of Geography to visually impaired students: new methodologies to discuss the concept of landscape”. The data collected was the result of 8 years’ experience in teaching Geography to visually impaired students at the Benjamin Constant Institute (IBC), a school in Rio de Janeiro specialized in teaching blind and visual impaired students for over 150 years. This study was motivated by the difficulty such students face during the learning process of geographic concepts.</p><p>The hypothesis raised during the research was that the use of didactic materials, which include the senses other than sight, mitigate such difficulties by enabling alternative sensorial paths. We chose the topic <i>landscapes</i> and the representation forms of such an important category in Geography.</p><p>Three visually impaired students (blind) were asked to represent the landscapes they find during their daily trip to school, highlighting their own perceptions, and how the other senses collaborate to the apprehension of the landscape. Each student drew and described his route. According to Kozel (2007, p.120), “the concept of lived world, brought by phenomenology, works as meaningful input to understand mental maps”. Therefore, these maps represent the world, in which the students are inserted.</p><p>Student 1 – Lives in Japeri, state of Rio de Janeiro, 84km far from the Institute. In his drawing, he chose to depict streets close to his house, the Institute, the train service line Central do Brasil and the beaches. He did not place the items in correct order: the drawings were placed side-by-side.</p><p>Student 2 – Lives in Honório Gurgel, a neighborhood in the north region of the city of Rio de Janeiro, 33km far from the Institute. He walks to the train station in Honório Gurgel. He states that he can apprehend and identify the surroundings of his house and the changes that occur throughout the day. In his drawing, he chose to depict the entire path from his house to school, including all details he was able to apprehend. His notion of laterality, space and distance is very keen. This means he understands well the spatial organization of his neighborhood and his path to the Institute.</p><p>Student 3 – Lives in Duque de Caxias, 33km far from the Institute. He wakes up daily at 4h30. He also apprehends the silence and the small number of people and cars on the streets. When he leaves home, he has his mental map ready, indicating how he must proceed, in order to get to the Institute. “When I leave home, I already have my mental map analyzed and planned”. He chose to draw the main points of his path, starting with the train station Central do Brasil, where he arrives by bus, followed by the beaches Aterro do Flamengo, and finally the Institute. He arranged all places according to his commuting.</p><p>The development of the research showed the importance of mental maps for the spatial organization of people with disabilities. It also showed how they use other senses to apprehend their surroundings. After the activity, it was possible to build a model with texture and sound, so that the students could compare their own perceptions with the representation of the path from their houses to the Institute. It is important to use multisensorial didactic materials elaborated according to tactile cartographic techniques, so that visually impaired students have quality throughout their learning process.</p></p>

The article analyzes the issues of inclusion and special education in the creative heritage of Sofia Rusova – teacher, citizen, politician, state maker, who considered them in the context of world scientific achievements of the interwar period of the XX century. Inclusion, as a process of increasing the participation of all citizens in society, including those with physical or mental disabilities, involves the development and implementation of specific solutions that will allow each person to participate equally in academic and public life. The evolution of the idea of inclusion and the birth of special education S. Rusova closely linked with the understanding and interpretation of the leading principles of pedagogy, general and social psychology, sociology, philosophy of education, historical and pedagogical searches of the late XIX - early XX century. Perhaps the most important source of new pedagogical ideas of S. Rusova, embodied in the writings of the interwar period (“New School of Social Education”, “Education and Sociology of Durkheim”, “Social Education: Its Importance in Public Life”, “Public Issues of Education” became acquainted with the latest trends in Western European pedagogy, which allowed her to keep up with the times, psychologize pedagogy. Extensive education, fluency in the leading European languages (first and foremost, French) made it possible for S. Rusova to access the original literature - works by J. Dewey, E. Claapared, G. Kerschensteiner, V. Lai, E. Meiman, and G. Spencer with the most prominent pedagogical figures of the 1920s and 1930s, including O. Decroly and M. Montessori, and studying the experience of their practical work. Guided by the statement that “ development of the child is influenced by three main factors: education, heritage, and environment”, based on the experiments of foreign (German, Belgian, Czech) researches, the scientist revealed the specifics of social and educational impact of the environment, preparing the groundwork inclusion as a set of conditions, methods and means of their implementation for joint learning, education and development of the educational recipients, taking into account their needsand opportunities. At the same time, I emphasize the shaft that no child “is passively influenced by the environment: it takes from it what its individuality seeks.” The issue of special education, in particular, the psychological and pedagogical principles of working with children with intellectual disabilities, is most fully revealed in S. Rusova's work, “Something about defective children in school”. It clearly traces the idea that children of all walks of life are necessarily subject to process education and training. According to S. Rusova, children with deviant behavior (in particular, “child offenders”), for whom the conditions for education as a factor of their re-education should be created, and for the needs of such schools, should not be left out of the educational influence in order to organize teacher training “with a deep psychological understanding of their sick students, with a heart warmed with love for them, and with a certain understanding of their social and pedagogical task: to return these children to citizenship ...”. Summarizing the above, it can be argued that the issues of inclusion, studying, education of children and young people with special educational needs, as represented by the property of Sofia Rusova are a significant contribution to Ukrainian and world pedagogical thought, an important factor in the revival of national educational systems in the teaching experiences of the past.

Lifestyle is the interest, behavior, opinion, style of living or world outlook of an individual, group, or culture; a combination of tangible factors like demographics and intangible factors like personal values and preferences.1 Recently researchers have more interest in the relationship between life style and health. Millions of people, following unhealthy lifestyle (or risk-factors), are plagued with morbidity, disability and mortality due to non-communicable, communicable diseases & nutritional disorders. Persons having unhealthy behaviors may be called as ‘at risk groups’.2 Although a healthy lifestyle has consistently been shown to decrease mortality, the population prevalence of healthy living remains low.3 The mental health of an individual can be assessed by his behavior and attitude. Common lifestyle variables influencing health include diet, exercise, sleep, smoking, alcohol consumption, substance abuse, stress management, sexual behavior, internet, recreation, etc.4 Besides, weight management, exposure to the sun, social contact, work life balance, leisure activities, screening for cancer etc. make a healthy life style. Healthy ways of living are developed through processes of socialization with parents, friends, relatives and community. However, not all life style factors are harmful. There are many life styles that promote health. For example, adequate nutrition, exercise, meditation, enough sleep etc.5 Modern or slow epidemics of non-communicable diseases (NCDs) e.g. hypertension (HTN), coronary heart disease (CHD), diabetes mellitus (DM), obesity, cancer etc. have been increasing in incidence compared to the previous century. With the increase in life expectancy, the prevalence of NCDs is on the rise. About 2 billion people are overweight in developed as well as low to middle income countries.6 Comorbidities of obesity include HTN, CHD, DM, stroke, cancers, gallbladder disease, dyslipidaemia, osteoarthritis, gout and sleep apnoea.7 Obesity is not only preventable but treatable with lifestyle modifications to forestall DM.8 Furthermore, several pathways linking obesity and CHD have been described; in particular coronary atherosclerosis, heart failure, and atrial fibrillation.9 In a study by CDC conducted in late 1970s in US, approximately 48% of all premature deaths prior to age 75 years could be traced to one’s lifestyle or health behavior choices, hence focusing on a personal responsibility model whereas another study accounts for about 63% of all deaths.10 Human behavior is a major obstacle to disease control. Changes in human behavior may prevent most of the world's major health problems & premature deaths at low cost. Public health is defined as ‘the health status of a defined group of people and the governmental actions and conditions at the local, state, and national levels to promote healthy behaviors, prevent spread of disease and injuries, protect against environmental hazards & disasters and assure the curative and rehabilitative health services. Many public health recommendations and clinical guidelines emphasize that healthy lifestyles have substantial health benefits.11 Changes in the life-style of the population by health education encompass three approaches of primary prevention as recommended by the WHO for prevention of chronic diseases. In first approach or primordial prevention, children are discouraged from adopting harmful lifestyles through individual/ mass education in countries in which many adult health problems (e.g., obesity, hypertension) have not yet appeared. Lifestyles are formed during childhood and aim is to prevent the emergence of risk factors. Second approach or population (mass) strategy is directed at the whole population, irrespective of individual risk level. A small reduction in the average blood pressure/ serum cholesterol in the community, helps in reducing the CHD prevalence. Third approach or high-risk strategy, on the other hand, aims to detect individuals at high risk by the optimum use of clinical methods and provide preventive care to them. To have an impact on the population, all the above three approaches should be implemented as they are usually complementary but the results are perceived after several decades and not immediately. Besides health education the population must have access to preventive measures.5 Lifestyle medicine program serves as a systematized approach to manage NCDS by addressing multiple risk factors through self-management skills.12 Physical activity leading to cardiorespiratory fitness is needed in all age groups, both sexes, race & ethnicities to prevent NCDs including CVDs.13 Better control of behavioral risk factors alone could prevent one-third of all acute and two-thirds of chronic disabilities. Physical activity, consumption of fresh rather than processed foods, limited use of cooking/ table salt to

Challenges bring an opportunity for success and each success is followed by a new challenge. Challenges and successes witnessed in the discipline of medicine are numerous. When world was preparing to enter the new millennium twenty years ago many great challenges were faced by medical professionals in-order to implement plans of quality health provision to every human globally. Health for all strategy, Millennium Development Goals (MDGs) and many other similar plans are the examples of such great vision to provide health care with equitable distribution, appropriate technology, community participation and acceptance among masses. Telemedicine is the use of telecommunication and information technologies in order to provide clinical health care at far flung areas with connections through networking. In absence of telemedicine, the equitable access to deliver better health care is difficult especially in remote communities as some health standards could not be implemented on providers and recipients in different places at the same time. Recent advances in telemedicine have created opportunities for health care providers and recipients to overcome the barriers of lack of awareness and deficiency of standard approach towards prevention and management. The experts could extend their teaching and evidence based medical practices in order to increase standards of health care globally. Information technology helps to eliminate distance and communication barriers and can improve access to medical services that are deficient or in distant rural communities. The communities in far-flung areas and isolated populations can receive health care from specialist residing at a distance without patient to the need of travel to visit them. Telemedicine can also be used to train health workers in field, providing evidence based medical practices, facilitation in standard operating procedures, delivery of medical education, sharing best practices and experiences. Recent advances in mobile techno-logy and the potential for global health elevated telemedicine as a popular force in health care. The special-ties that can be focused during implementation of telemedicine practices include preventive medicine, radiology, pathology, cardiology, mental health services, primary care, emergency care, physical rehabilitation, pediatrics, obstetrics, immunization, nutrition, mother and child health, disaster management, epidemic control, health system monitoring and management and many others. Telemedicine in developing countries like Pakis-tan is a tool of global health. Pakistan is an over populated country where people are, by the large, deprived of proper medical facilities especially those living in far flung areas. The implementation of telemedicine can facilitate the patients and educate the health care providers for the purpose of improving patient care. In Pakistan, biometric verficationby Pakistan Telecommunication Authority (PTA) has declared mobile phone users in the country; according to which the figure for mobile phone users is estimated to be near 114.7 million. Thus big resource is available that can be channelized to improve health and prevent disease through telemedicine across the country and beyond geographical boundaries.According to World Health Organization (WHO), the use of telemedicine in provision of health care is not simply about technology, but a means to reach an out-come, such as better decisions for provision of prevention and management, vulnerable populations received high quality and safer care, more awareness about health making people to have better choices for their health, better surveillance of communicable and non-communicable disease, government become more responsible and aware of health needs of populations. More-over equitable, appropriate, acceptable, effective and efficient monitoring of resources at Healthcare Centers. The satisfaction of patients and health care provi-ders were found positive over time. According to Care Hill more than 80% of consumers find their health care to be satisfactory. Telemedicine is occasionally blamed of being driven by commercial rather than public health interests. However in spite of this criticism, telemedicine is linking the rich communities with poors globally. Nevertheless, telemedicine is an effective tool for surveillance, monitoring, standardization, research, and implementation. There is no alternative to telemedicine. There are several telemedicine networks linking the industrialized and developing world, this is an area that is likely to grow in the future. Global health strategies have to focus on underutilized tool for better access to health care.

Nine people with mental health diagnoses wrote a dialogue to discuss how we navigate our conditions and ask for accommodations within an academic setting. We cogitate on the challenges of obtaining a diagnosis, how and when we disclose, the affordances and challenges of our symptoms, seeking accommodations, and advocating for ourselves. We consider how current scholarship and other perspectives are changing the conversation about mental health in the academy. We conclude that while the 2008 revisions to the Americans with Disabilities Act have addressed necessary accommodations, that those with mental health conditions are still seeking access.

Youth with disabilities generally struggle to earn a good livelihood as they journey through life. Disability acceptance is acceptance of impairment or loss of worth or acceptance of failure in the sense of disability. It involves changes in one’s values, placing less importance on one’s physical disability and more on one’s remaining assets or abilities. To develop the Self-Acceptance Scale for youth with physical disabilities (SAS-PD), this study adopted the sequential exploratory design. The scale was administered on 247 persons with physical disabilities. Following the compilation and analysis of qualitative data, a quantitative study was conducted. The Exploratory Factor Analysis (EFA) identified six factors, viz. social stigma, enlargement, and asset value, containment of disability effect, family support, and body acceptance that were represented by fifty items in a questionnaire that covered the attributes examined in the scale. The assessment of the level of self-acceptance by youth with disabilities using the SAS-PD may be a valuable intervention for transition programs. Going forward, the scale could also be used to build the profile of people with physical disabilities before they begin participating in any face to face or virtual training program. The assessment of youth with disability self-acceptance level enables their parents and teachers to be aware of their mental state and lead to more strategic planning for the teaching-learning approach.

Students with disabilities have been going through different forms of discrimination and exclusion. These include inaccessible learning materials and learning platforms, negative attitudes from lecturers, fellow students and more. This paper comes from a qualitative study that sought to explore how Covid-19 deepened these educational inequalities at an Open Distance Learning institution in South Africa. The results of the study reveal that institutions of higher learning had to quickly adjust their teaching and assessment to online mode. This led to heightened exclusion of students with disabilities as their examinations had to be postponed to second semester due to lack of preparations for special examinations. Students also reported experiencing extra pressure as they had to write double the examinations at the end of the year. Some students reported lack of access to assistive technologies which they normally borrow from the library, this was because the Post Office was not operating during the National Lockdown Level 5. The novel nature of Covid-19 is such that the real barriers it caused on people and students with disabilities in particular and it will keep revealing itself gradually. This paper ends by making recommendations on how an ODL institution could accommodate the needs of students with disabilities to enhance their learning experiences during pandemics or natural disasters.

Abstract Background and Objectives There is a lack of information on intervention strategies employed for health promotion and disease prevention for older adults with intellectual and developmental disabilities (IDD), who usually experience poorer health compared to their peers without IDD. We carried out the first systematic review to scrutinize the impact of intrinsic factors (e.g., cognitive, mental, and physical health, etc.), on health status of older adults with IDD. Research Design and Methods To assess the efficacy of such interventions, we examined 23 articles including prospective ‘healthy aging’ interventions designed for adults with IDD. Searches were carried out in the databases Web of Science; Scielo; PsycINFO in April 2020. Articles were organized in thematic areas: (1) Physical activity and health nutrition (n=10); (2) Health education and health screening (n=6); (3) Social inclusion and community participation (n=3); and (4) Multi-components (n=4). Except for five RCT studies, the designs were mainly non-randomized, involving small sample sizes (Nrange = 8 to 379 participants), and lacking follow up. Results The studies included 2,398 men and women with IDD (ranging in age from 18 to 86 years [mean age: 44.3 yrs.]). Overall, intervention outcomes were mostly positive, however some negative outcomes were reported. Discussion and Implications In brief, healthy aging interventions for people with IDD remain scarce, incipient, and sporadic. We recommend that more attention needs to be given to active health promotion with people with IDD as a program practice among organizations and as a focal public policy among governments.

already experiencing significant revenue and job losses. The ability to ‘Work from Home’ (WFH) can helpdamp down the impact of the situation, undoubtedly. Overall, the effects of WFH arrangements rely a loton the job status of parents and presence of dependents (children & elderly), and this current situation islikely to intensify these differences. It does not necessarily mean, however, that the effect of the crisisshould inevitably be gender neutral. Working women have been particularly affected. It seems to be veryfascinating to work from home, while sitting on a comfortable couch, casually dressed, even sometimesin sleep suits, without stepping out in scorching heat and wasting time in traveling, but this may not be apreferred situation for everybody, especially women. The most significant impact on working womenduring the crisis will be trying to balance household demands, childcare needs and work demands.The group most likely to be hardest hit then would be lower income families with young children, and singlemothers in particular. Generally women are in charge of planning, organizing and recalling of everythingthat needs to be remembered. The mental stress and load that comes with such work has risenexponentially in present circumstances. Even though many countries are relied on lockdown to controlwidespread of COVID-19 pandemic, the mental problems such as depression, anxiety, insomnia, suicidalthoughts and other psychological trauma are most common in case of normal individual and extensive incase of people who are psychologically ill. Females are more prone to psychological distress. The mainconcern is to manage and provide opportunities for regulation of stress caused due to anxiety and lack ofpeer contact. Another main threat is an increased risk of parents to develop mental illness, women mayalso suffer from domestic violence and consequently it results child maltreatment. The current scenariomay be particularly challenging especially for children and adolescents with special needs ordisadvantages, such as disabilities, also if someone has prior trauma experiences, undiagnosed mentalhealth problems, background of migration and low socioeconomic status.Dr. Sana HassanUniversity College of Medicine and Dentistry,The University of Lahore, Teaching Hospital,Lahore, Pakistan

Abstract The novel coronavirus (COVID-19) pandemic has disrupted the educational system not only in regard to teaching and learning, but also in relation to the other services and supports (mental health services, meal and nutrition programs, and so on) provided to students and families. School district Web sites are critical access points for families during this crisis to learn information about key resources being provided during school closure. This study used content analysis to examine whether school district Web sites in one southeastern state provided information about COVID-19 and 11 other resources. Findings indicate that about half of the Web sites provided both COVID-19 information and additional resources. Few districts provided information on resources for students with disabilities, a subgroup of students at heightened vulnerability during this time of virtual learning. Approximately a third of school district Web sites provided no information on COVID-19 or any of the other resources. The article concludes with a discussion of the implications for school social workers related to crisis response and leadership around contributing to efforts that aim to address educational disparities and inequities and maximize student success during this time of crisis.

What began as a simple request for a book by one of my former students, at times, has not been so simple. The student, whom I refer to as Carla (name changed), hoped to read about characters similar to herself and her friends. As a teacher, I have often tried to hook my students on reading by presenting books with characters to which they can relate. These books can help increase their overall knowledge of the world, open their minds to multiple realities and variations of the human experience and provide scenarios in which they can live vicariously. Carla’s request was a bit more complicated than I had imagined. As a “Deaf” student who attended a state school for the Deaf and who viewed herself as a member of a linguistic cultural minority, she expected to read a book with characters who used American Sign Language and who participated as members within the Deaf Community. She did not want to read didactic books about deafness but wanted books with unpredictable plots and believable characters. Having graduated from a teacher-preparation program in Deaf Education, I had read numerous books about deafness. While memoirs and biographical selections had been relatively easy to acquire and were on my bookshelf, I had not once read any fictional books for adolescents that included a deaf character. (I refer to ‘Deaf’ as representing individuals who identify in a linguistic, cultural minority group. The term ‘deaf’ is used as a more generic term given to individuals with some degree of hearing loss. In other articles, ‘deaf’ has been used pejoratively or in connection to a view by those who believe one without the sense of hearing is inferior or lacking. I do not believe or wish to imply that. ) As a High School teacher with so many additional work responsibilities outside of classroom teaching, finding fictional books with deaf characters was somewhat of a challenge. Nevertheless, after some research I was able to recommend a book that I thought would be a good summer read. Nancy Butts’ Cheshire Moon (1992) is charming book about thirteen-year-old Miranda who is saddened by her cousin’s death and furious at her parents' insistence that she speak rather than sign. The plot turns slightly mystical when the teens begin having similar dreams under the “Cheshire moon”. Yet, the story is about Miranda, a deaf girl, who struggles with communication. Without her cousin, the only member of her family who was fluent in sign language, communication is difficult and embarrassing. Miranda feels isolated, alienated, and unsure of herself. Because of the main character’s age, the book was not the best recommendation for a high school student; however, when Carla finished Cheshire Moon, she asked for another book with Deaf characters. Problem & Purpose Historically, authors have used deafness as a literary device to relay various messages about the struggles of humankind and elicit sympathy from readers (Batson & Bergman; Bergman; Burns; Krentz; Panara; Taylor, "Deaf Characters" I, II, III; Schwartz; Wilding-Diaz). In recent decades, however, the general public’s awareness of and perhaps interest in deaf people has risen along with that of our increasingly multicultural world. Educational legislation has increased awareness of the deaf as has news coverage of Gallaudet University protests. In addition, Deaf people have benefited from advances in communicative technology, such as Video Relay (VRS) and instant messaging pagers, more coordinated interpreting services and an increase in awareness of American Sign Language. Authors are incorporating more deaf characters than they did in the past. However, this increase does not necessarily translate to an increase in understanding of the deaf, nor does it translate to the most accurate, respectably, well-rounded characterization of the deaf (Pajka-West, "Perceptions"). Acquiring fictional books that include deaf characters can be time-consuming and challenging for teachers and librarians. The research examining deaf characters in fiction is extremely limited (Burns; Guella; Krentz; Wilding-Diaz). The most recent articles predominately focus on children’s literature — specifically picture books (Bailes; Brittain). Despite decades of research affirming culturally authentic children’s literature and the merits of multicultural literature, a coexisting body of research reveals the lack of culturally authentic texts (Applebee; Campbell & Wirtenberg; Ernest; Larrick; Sherriff; Taxel). Moreover, children’s books with deaf characters are used as informational depictions of deaf individuals (Bockmiller, 1980). Readers of such resource books, typically parents, teachers and their students, gain information about deafness and individuals with “disabilities” (Bockmiller, 1980; Civiletto & Schirmer, 2000). If an important purpose for deaf characters in fiction is educational and informational, then there is a need for the characters to be presented as realistic models of deaf people. If not, the readers of such fiction gain inaccurate information about deafness including reinforced negative stereotypes, as can occur in any other literature portraying cultural minorities (Pajka-West, "Perceptions"). Similar to authors’ informational depictions, writers also reveal societal understanding of groups of people through their fiction (Banfield & Wilson; Panara; Rudman). Literature has often stigmatized minority culture individuals based upon race, ethnicity, disability, gender and/or sexual orientation. While readers might recognize the negative depictions and dismiss them as harmless stereotypes, these portrayals could become a part of the unconscious of members of our society. If books continually reinforce stereotypical depictions of deaf people, individuals belonging to the group might be typecast and discouraged into a limited way of being. As an educator, I want all of my students to have unlimited opportunities for the future, not disadvantaged by stereotypes. The Study For my doctoral dissertation, I examined six contemporary adolescent literature books with deaf characters. The research methodology for this study required book selection, reader sample selection, instrument creation, book analysis, questionnaire creation, and data analysis. My research questions included: 1) Are deaf characters being presented as culturally Deaf characters or as pathologically deaf and disabled; 2) Do these readers favor deaf authors over hearing ones? If so, why; and, 3) How do deaf and hearing adult readers perceive deaf characters in adolescent literature? The Sample The book sample included 102 possible books for the study ranging from adolescent to adult selections. I selected books that were recognized as suitable for middle school or high school readers based upon the reading and interest levels established by publishers. The books also had to include main characters who are deaf and deaf characters who are human. The books selected were all realistic fiction, available to the public, and published or reissued for publication within the last fifteen years. The six books that were selected included: Nick’s Secret by C. Blatchford; A Maiden’s Grave by J. Deaver; Of Sound Mind by J. Ferris; Deaf Child Crossing by M. Matlin; Apple Is My Sign by M. Riskind; and Finding Abby by V. Scott. For the first part of my study, I analyzed these texts using the Adolescent Literature Content Analysis Check-off Form (ALCAC) which includes both pathological and cultural perspective statements derived from Deaf Studies, Disability Studies and Queer Theory. The participant sample included adult readers who fit within three categories: those who identified as deaf, those who were familiar with or had been acquaintances with deaf individuals, and those who were unfamiliar having never associated with deaf individuals. Each participant completed a Reader-Response Survey which included ten main questions derived from Deaf Studies and Schwartz’ ‘Criteria for Analyzing Books about Deafness’. The survey included both dichotomous and open-ended questions. Research Questions & Methodology Are deaf characters being presented as culturally Deaf or as pathologically deaf and disabled? In previous articles, scholars have stated that most books with deaf characters include a pathological perspective; yet, few studies actually exist to conclude this assertion. In my study, I analyzed six books to determine whether they supported the cultural or the pathological perspective of deafness. The goal was not to exclusively label a text either/or but to highlight the distinct perspectives to illuminate a discussion regarding a deaf character. As before mentioned, the ALCAC instrument incorporates relevant theories and prior research findings in reference to the portrayals of deaf characters and was developed to specifically analyze adolescent literature with deaf characters. Despite the historical research regarding deaf characters and due to the increased awareness of deaf people and American Sign Language, my initial assumption was that the authors of the six adolescent books would present their deaf characters as more culturally ‘Deaf’. This was confirmed for the majority of the books. I believed that an outsider, such as a hearing writer, could carry out an adequate portrayal of a culture other than his own. In the past, scholars did not believe this was the case; however, the results from my study demonstrated that the majority of the hearing authors presented the cultural perspective model. Initially shocking, the majority of deaf authors incorporated the pathological perspective model. I offer three possible reasons why these deaf authors included more pathological perspective statements while the hearing authors include more cultural perspective statements: First, the deaf authors have grown up deaf and perhaps experienced more scenarios similar to those presented from the pathological perspective model. Even if the deaf authors live more culturally Deaf lifestyles today, authors include their experiences growing up in their writing. Second, there are less deaf characters in the books written by deaf authors and more characters and more character variety in the books written by the hearing authors. When there are fewer deaf characters interacting with other deaf characters, these characters tend to interact with more hearing characters who are less likely to be aware of the cultural perspective. And third, with decreased populations of culturally Deaf born to culturally Deaf individuals, it seems consistent that it may be more difficult to obtain a book from a Deaf of Deaf author. Similarly, if we consider the Deaf person’s first language is American Sign Language, Deaf authors may be spending more time composing stories and poetry in American Sign Language and less time focusing upon English. This possible lack of interest may make the number of ‘Deaf of Deaf’ authors, or culturally Deaf individuals raised by culturally Deaf parents, who pursue and are successful publishing a book in adolescent literature low. At least in adolescent literature, deaf characters, as many other minority group characters, are being included in texts to show young people our increasingly multicultural world. Adolescent literature readers can now become aware of a range of deaf characters, including characters who use American Sign Language, who attend residential schools for the Deaf, and even who have Deaf families. Do the readers favor deaf authors over hearing ones? A significant part of my research was based upon the perceptions of adult readers of adolescent literature with deaf characters. I selected participants from a criterion sampling and divided them into three groups: 1. Adults who had attended either a special program for the deaf or a residential school for the deaf, used American Sign Language, and identified themselves as deaf were considered for the deaf category of the study; 2. Adults who were friends, family members, co-workers or professionals in fields connected with individuals who identify themselves as deaf were considered for the familiar category of the study; and, 3. hearing adults who were not aware of the everyday experiences of deaf people and who had not taken a sign language class, worked with or lived with a deaf person were considered for the unfamiliar category of the study. Nine participants were selected for each group totaling 27 participants (one participant from each of the groups withdrew before completion, leaving eight participants from each of the groups to complete the study). To elicit the perspectives of the participants, I developed a Reader Response survey which was modeled after Schwartz’s ‘Criteria for Analyzing Books about Deafness’. I assumed that the participants from Deaf and Familiar groups would prefer the books written by the deaf authors while the unfamiliar participants would act more as a control group. This was not confirmed through the data. In fact, the Deaf participants along with the participants as a whole preferred the books written by the hearing authors as better describing their perceptions of realistic deaf people, for presenting deaf characters adequately and realistically, and for the hearing authors’ portrayals of deaf characters matching with their perceptions of deaf people. In general, the Deaf participants were more critical of the deaf authors while the familiar participants, although as a group preferred the books by the hearing authors, were more critical of the hearing authors. Participants throughout all three groups mentioned their preference for a spectrum of deaf characters. The books used in this study that were written by hearing authors included a variety of characters. For example, Riskind’s Apple Is My Sign includes numerous deaf students at a school for the deaf and the main character living within a deaf family; Deaver’s A Maiden’s Grave includes deaf characters from a variety of backgrounds attending a residential school for the deaf and only a few hearing characters; and Ferris’ Of Sound Mind includes two deaf families with two CODA or hearing teens. The books written by the deaf authors in this study include only a few deaf characters. For example, Matlin’s Deaf Child Crossing includes two deaf girls surrounded by hearing characters; Scott’s Finding Abby includes more minor deaf characters but readers learn about these characters from the hearing character’s perspective. For instance, the character Jared uses sign language and attends a residential school for the deaf but readers learn this information from his hearing mother talking about him, not from the deaf character’s words. Readers know that he communicates through sign language because we are told that he does; however, the only communication readers are shown is a wave from the child; and, Blatchford’s Nick’s Secret includes only one deaf character. With the fewer deaf characters it is nearly impossible for the various ways of being deaf to be included in the book. Thus, the preference for the books by the hearing authors is more likely connected to the preference for a variety of deaf people represented. How do readers perceive deaf characters? Participants commented on fourteen main and secondary characters. Their perceptions of these characters fall into six categories: the “normal” curious kid such as the characters Harry (Apple Is My Sign), Jeremy (Of Sound Mind) and Jared (Finding Abby); the egocentric spoiled brat such as Palma (Of Sound Mind) and Megan (Deaf Child Crossing); the advocate such as Harry’s mother (Apple Is My Sign) and Susan (A Maiden’s Grave); those dependent upon the majority culture such as Palma (Of Sound Mind) and Lizzie (Deaf Child Crossing); those isolated such as Melissa (Finding Abby), Ben (Of Sound Mind), Nick (Nick’s Secret) and Thomas (Of Sound Mind); and, those searching for their identities such as Melanie (A Maiden’s Grave) and Abby (Finding Abby). Overall, participants commented more frequently about the deaf characters in the books by the hearing authors (A Maiden’s Grave; Of Sound Mind; Apple Is My Sign) and made more positive comments about the culturally Deaf male characters, particularly Ben Roper, Jeremy and Thomas of Of Sound Mind, and Harry of Apple Is My Sign. Themes such as the characters being dependent and isolated from others did arise. For example, Palma in Of Sound Mind insists that her hearing son act as her personal interpreter so that she can avoid other hearing people. Examples to demonstrate the isolation some of the deaf characters experience include Nick of Nick’s Secret being the only deaf character in his story and Ben Roper of Of Sound Mind being the only deaf employee in his workplace. While these can certainly be read as negative situations the characters experience, isolation is a reality that resonates in some deaf people’s experiences. With communicative technology and more individuals fluent in American Sign Language, some deaf individuals may decide to associate more with individuals in the larger culture. One must interpret purposeful isolation such as Ben Roper’s (Of Sound Mind) case, working in a location that provides him with the best employment opportunities, differently than Melissa Black’s (Finding Abby) isolating feelings of being left out of family dinner discussions. Similarly, variations in characterization including the egocentric, spoiled brat and those searching for their identities are common themes in adolescent literature with or without deaf characters being included. Positive examples of deaf characters including the roles of the advocate such as Susan (A Maiden’s Grave) and Harry’s mother (Apple Is My Sign), along with descriptions of regular everyday deaf kids increases the varieties of deaf characters. As previously stated, my study included an analysis based on literary theory and prior research. At that time, unless the author explicitly told readers in a foreword or a letter to readers, I had no way of truly knowing why the deaf character was included and why the author made such decisions. This uncertainty of the author’s decisions changed for me in 2007 with the establishment of my educational blog. Beginning to Blog When I started my educational blog Deaf Characters in Adolescent Literature in February 2007, I did not plan to become a blogger nor did I have any plans for my blog. I simply opened a Blogger account and added a list of 106 books with deaf characters that was connected to my research. Once I started blogging on a regular basis, I discovered an active audience who not only read what I wrote but who truly cared about my research. Blogging had become a way for me to keep my research current; since my blog was about deaf characters in adolescent literature, it became an advocacy tool that called attention to authors and books that were not widely publicized; and, it enabled me to become part of a cyber community made up of other bloggers and readers. After a few months of blogging on a weekly basis, I began to feel a sense of obligation to research and post my findings. While continuing to post to my blog, I have acquired more information about my research topic and even received advance reader copies prior to the books’ publication dates. This enables me to discuss the most current books. It also enables my readers to learn about such books. My blog acts as free advertisement for the publishing companies and authors. I currently have 195 contemporary books with deaf characters and over 36 author and professional interviews. While the most rewarding aspect of blogging is connecting with readers, there have been some major highlights in the process. As I stated, I had no way of knowing why the deaf character was included in the books until I began interviewing the authors. I had hoped that the hearing authors of books with deaf characters would portray their characters realistically but I had not realized the authors’ personal connections to actual deaf people. For instance, Delia Ray, Singing Hands, wrote about a Deaf preacher and his family. Her book was based on her grandfather who was a Deaf preacher and leading pioneer in the Deaf Community. Ray is not the only hearing author who has a personal connection to deaf people. Other examples include: Jean Ferris, Of Sound Mind, who earned a degree in Speech Pathology and Audiology. Ferris’ book includes only two hearing characters, the majority are Deaf. All of her characters are also fluent in American Sign Language; Jodi Cutler Del Dottore, Rally Caps, who includes a deaf character named Luca who uses a cochlear implant. Luca is based on Cutler Del Dottore’s son, Jordan, who also has a cochlear implant; finally, Jacqueline Woodson, Feathers, grew up in a community that included deaf people who did not use sign language. As an adult, she met members of the Deaf Community and began learning American Sign Language herself. Woodson introduces readers to Sean who is attractive, funny, and intelligent. In my study, I noted that all of the deaf characters where not diverse based upon race, ethnicity, and socio-economic status (Pajka-West, "Perceptions"). Sean is the first Deaf American-African character in adolescent literature who uses sign language to communicate. Another main highlight is finding Deaf authors who do not receive the mainstream press that other authors might receive. For example, Ann Clare LeZotte, T4, introduces readers to main character Paula Becker, a thirteen year old deaf girl who uses sign language and lipreading to communicate. Through verse, we learn of Paula’s life in Germany during Hitler’s time as she goes into hiding since individuals with physical and mental disabilities were being executed under the orders of Hitler’s Tiergartenstrasse 4 (T4). One additional highlight is that I learn about insider tips and am then able to share this information with my blog readers. In one instance I began corresponding with Marvel Comic’s David Mack, the creator of Echo, a multilingual, biracial, Deaf comic book character who debuted in Daredevil and later The New Avengers. In comics, it is Marvel who owns the character; while Echo was created for Daredevil by Mack, she later appears in The New Avengers. In March 2008, discussion boards were buzzing since issue #39 would include original creator, Mack, among other artists. To make it less complicated for those who do not follow comics, the issue was about whether or not Echo had become a skrull, an alien who takes over the body of the character. This was frightening news since potentially Echo could become a hearing skrull. I just did not believe that Mack would let that happen. My students and I held numerous discussions about the implications of Marvel’s decisions and finally I sent Mack an email. While he could not reveal the details of the issue, he did assure me that my students and I would be pleased. I’m sure there was a collective sigh from readers once his email was published on the blog. Final Thoughts While there have been pejorative depictions of the deaf in literature, the portrayals of deaf characters in adolescent literature have become much more realistic in the last decade. Authors have personal connections with actual deaf individuals which lend to the descriptions of their deaf characters; they are conducting more detailed research to develop their deaf characters; and, they appear to be much more aware of the Deaf Community than they were in the past. A unique benefit of the genre is that authors of adolescent literature often give the impression of being more available to the readers of their books. Authors often participate in open dialogues with their fans through social networking sites or discussion boards on their own websites. After posting interviews with the authors on my blog, I refer readers to the author’s on site whether it through personal blogs, websites, Facebook or Twitter pages. While hearing authors’ portrayals now include a spectrum of deaf characters, we must encourage Deaf and Hard of Hearing writers to include more deaf characters in their works. Consider again my student Carla and her longing to find books with deaf characters. Deaf characters in fiction act as role models for young adults. A positive portrayal of deaf characters benefits deaf adolescents whether or not they see themselves as biologically deaf or culturally deaf. Only through on-going publishing, more realistic and positive representations of the deaf will occur. References Bailes, C.N. "Mandy: A Critical Look at the Portrayal of a Deaf Character in Children’s Literature." Multicultural Perspectives 4.4 (2002): 3-9. Batson, T. "The Deaf Person in Fiction: From Sainthood to Rorschach Blot." Interracial Books for Children Bulletin 11.1-2 (1980): 16-18. Batson, T., and E. Bergman. Angels and Outcasts: An Anthology of Deaf Characters in Literature. Washington, D.C.: Gallaudet University Press (1985). Bergman, E. "Literature, Fictional characters in." In J.V. Van Cleve (ed.), Gallaudet Encyclopedia of Deaf People & Deafness. Vol. 2. Washington, D.C.: McGraw Hill, 1987. 172-176. Brittain, I. "An Examination into the Portrayal of Deaf Characters and Deaf Issues in Picture Books for Children." Disability Studies Quarterly 24.1 (Winter 2004). 24 Apr. 2005 < http://www.dsq-sds.org >. Burns, D.J. An Annotated Checklist of Fictional Works Which Contain Deaf Characters. Unpublished master’s thesis. Washington, D.C.: Gallaudet University,1950. Campbell, P., and J. Wirtenberg. How Books Influence Children: What the Research Shows. Interracial Books for Children Bulletin 11.6 (1980): 3-6. Civiletto, C.L., and B.R. Schirmer. "Literature with Characters Who Are Deaf." The Dragon Lode 19.1 (Fall 2000): 46-49. Guella, B. "Short Stories with Deaf Fictional Characters." American Annals of the Deaf 128.1 (1983): 25-33. Krentz, C. "Exploring the 'Hearing Line': Deafness, Laughter, and Mark Twain." In S. L. Snyder, B. J. Brueggemann, and R. Garland-Thomson, eds., Disability Studies: Enabling the Humanities. New York: Modern Language Association of America, 2002. 234-247. Larrick, N. "The All-White World of Children's Books. Saturday Review 11 (1965): 63-85. Pajka-West, S. “The Perceptions of Deaf Characters in Adolescent Literature”. The ALAN Review 34.3 (Summer 2007): 39-45. ———. "The Portrayals and Perceptions of Deaf Characters in Adolescent Literature." Ph.D. dissertation. University of Virginia, 2007. ———. "Interview with Deaf Author Ann Clare LeZotte about T4, Her Forthcoming Book Told in Verse." Deaf Characters in Adolescent Literature, 5 Aug. 2008. < http://pajka.blogspot.com/ 2008/08/interview-with-deaf-author-ann-clare.html >.———. "Interview with Delia Ray, Author of Singing Hands." Deaf Characters in Adolescent Literature, 23 Aug. 2007. < http://pajka.blogspot.com/ 2007/08/interview-with-delia-ray-author-of.html >.———. "Interview with Jacqueline Woodson, author of Feathers." Deaf Characters in Adolescent Literature, 29 Sep. 2007. < http://pajka.blogspot.com/ 2007/09/interview-with-jacqueline-woodson.html >. ———. 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The Deaf American 29.2 (1976): 27-28. Wilding-Diaz, M.M. Deaf Characters in Children’s Books: How Are They Portrayed? Unpublished master’s thesis. Provo, Utah: Brigham Young University, 1993.———. "Deaf Characters in Children’s Books: How Are They Perceived?" In Gallaudet University College for Continuing Education and B.D. Snider (eds.), Journal: Post Milan ASL & English Literacy: Issues, Trends & Research Conference Proceedings, 20-22 Oct. 1993.Adolescent Fiction Books Blatchford, C. Nick’s Secret. Minneapolis, MN: Lerner, 2000. Deaver, J. A Maiden’s Grave. New York: Signet, 1996. Ferris, J. Of Sound Mind. New York: Sunburst, 2004. Matlin, M. Deaf Child Crossing. New York: Aladdin Paperbacks, 2004. Riskind, M. Apple Is My Sign. Boston, MA: Houghton Mifflin, 1981. Scott, V. Finding Abby. Hillsboro, OR: Butte, 2000.