RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES, KARNATAKA, BANGALORE ANNEXURE II PROFORMA FOR REGISTRATION OF SUBJECTS FOR DISSERTATION

1. Name of the candidate and MR. SUNIL KUMAR AWATE address (in block letters) IST YEAR M.Sc. NURSING NITTE USHA INSTITUTE OF NURSING SCIENCES, MANGALORE. 2. Name of the institution NITTE USHA INSTITUTE OF NURSING SCIENCES, COLLEGE OF NURSING PANEER, DERALAKATTE, MANGALORE – 574 160 KARNATAKA, INDIA. 3. Course of study and subject Ist YEAR M.SC. NURSING PSYCHIATRY NURSING 4. Date of admission 06-5-2007

5. Title of the topic “ A STUDY ON THE EFFECTIVENESS OF COGNITIVE SKILL TRAINING ON PERFORMANCE OF SELF HELP SKILLS AMONG MENTALLY RETARDED CHILDREN IN SELECTED INSTITUTION IN MANGALORE TALUK.”

6. BRIEF RESUME OF THE INTENDED WORK: 6.1 Need for the study: Mental retardation has been defined and renamed many times throughout history. The most recent change in the definition was “Mental retardation refers to substantial limitation in the present intellectual functioning, existing concurrently with related limitation in two or more of the following applicable adaptive skill areas like the communication skill, self care, home living, social skill, community use, self direction, health and safety, functional academics, leisure and work. Mental retardation manifests before the age of eight years.1 All parents wish for a healthy and a normal child but when a disabled child is born all hopes of the parents are shattered. The parents feel that this child will be a burden for them throughout their life. Because of the cognitive deficit the mentally retarded when left to his own device is unable to utilize the cues and stimuli from his surrounding as appropriate guide to behaviour. In abroad the parents of child send the mental retarded child to special schools were they train the child in various aspects. This training helps the child to be independent in activities of daily living to some extent. Efficient therapy programme through the use of goal directed activities plays an efficient role for acquisition of useful skills. This training helps the child to be independent to some extent.1 In India parents will send the child to the residential institute where there will not be any kind of facilities for the mentally retarded children. There is growing evidence that MR children are capable of learning through efficient therapy programme to a far greater extent. The investigator has not come across any repeated studies on effectiveness of cognitive skill training on performance of self help skills among MR in Indian studies. So the researcher felt the need to find the effectiveness of cognitive skill training on performance of self help skills 6.2 Review of literature: 1. A quasi experimental study was conducted in RaJahmundry in year 2001. The purpose of this study was on effectiveness of cognitive skill training on performance in dressing skills. The study included 15 mentally retarded children. The data were collected based on ordinal scale to assess effectiveness of cognitive skill training in performance in dressing skills. The therapy was given over a period of 5 months by using variety of teaching material like flash cards, picture book, human puzzle, color cubes, wooden blocks etc. The results showed that therapy was effective. Researcher recommended that along with acquisitions, maintenance and generalization of skills are equally important.1 2. An experimental study was conducted in san diego, USA to know the effect of teaching symbolic play skills to children with autism using pivotal response training seven children with autism were given pivotal response training to engage in symbolic play behaviours. Symbolic play, complexity of play behaviour and creativity of play were assessed. Interaction with the play partners and comparison with typical control were also examined. Results indicated that children with autism rarely exhibited symbolic play before training or after a control condition. After specific symbolic play training using pivotal response training, all of the children learned to perform complex and creative symbolic play.2 3. A study was conducted in Boton rouge on teaching self help skills to autistic mentally retarded children. The sample were three autistic ranging in age from 4-11 years and a six year old mentally retarded girl. A multiple baseline design was used to teach various adoptive skills like shoe typing, tooth brushing ,hair combing, putting on pants, shirt and socks and eating and drinking. Training included were modeling, verbal instructions, prompting and edible and social reinforcement. The results of this study was effective and their implications for future research are discussed.3 4. A study was conducted in university of California, san Diego USA to know the effect of teaching daily living skills to children with autism in unsupervised settings through pictorial self management. The sample were 3 low functioning children with autism. stimulus and response generalization, stimulus control of self management materials, and maintenance of behavior change were assessed. Results showed that children with autism could successfully use picture to manage their behavior in the absence of a treatment provider, generalize their behavior across setting and tasks and maintain behaviors at follow up.4 5 An experimental study was conducted in autism support center, salem. The purpose of study was to teach independent living skills to children and young men with visual impairment by using independent training. The sample were 7 visually impaired students among which 5 were diagnosed as mentally retarded. A multiple base line design was used to demonstrate the efficacy of the comprehensive training package in training various independent living skills like folding a shirt, making an emergency telephone call and spreading soft food with a knife and leather work tasks. The result revealed that follow up data collected 10 months after the completion of training indicate a good degree of maintenance.5 6.3 Problem statement “ A study on the effectiveness of cognitive skill training on performance of self help skills among mentally retarded children in selected institution in Mangalore Taluk.” 6.4 Objectives of the study: The study objectives are to:- 1. assess the cognitive level of mentally retarded children 2. assess the self help skills of mentally retarded children 3. determine the effectiveness of cognitive skill training on self help skills among mentally retarded children 4. find association between cognitive skill training and self help skills among mentally retarded children 6.5 Operational definitions 1. Effectiveness In this study effectiveness refers to the extent to which the cognitive skill training will help to achieve the self help skill, as measured by rating scale for assessing cognitive skill and self help skill. 2. Cognitive Skill In this study cognitive skill refers to the ability to identify body parts , colour concept, size and spatial orientation as measured by rating scale for assessing cognitive skill and self help skill. 3. Self help skill In this study self help skills refers to the dressing skills of the subjects. 4. Training In this study training refers to helping the child in learning cognitive skills through modeling, verbal instructions, use of picture book, human puzzle and colour cubes. 5. Mentally retarded children In this study mentally retarded children are those children whose IQ level is between 35-49 and are in the level of moderate MR and are trainable. 6.6 Delimitations The study is limited to 1. Moderate level of M.R. children. 2. Attending special school. 3. Who are not able to do self help skills. 4. Who can understand and follow model and verbal instructions. 5. Available during data collection period. 6.7 Assumption The study assumes that 1. Moderate M.R children are unable to perform self help activities. 2. Moderate M.R children are trainable. 3. Effective training in cognitive skills will help the child in doing self help skills. 6.8 Hypothesis

H1: There will be a significant difference in the pretest and posttest score in the dressing skill.

H2: Cognitive skill training will be effective in the performance of self help skills among MR child.

MATERIALS AND METHOD: 7. 7.1 Source of Data: MR children of selected institution for mentally retarded children. 7.1.1 Research design Quasi experimental design. 7.1.2 Setting Selected institution for mentally retarded children in Mangalore Taluk. 7.1.3 Population: children with mental retardation.

7.2 METHOD OF DATA COLLECTION 7.2.1 Sampling procedure Purposive sampling technique to select institution and Random sampling technique to select subjects. 7.2.2 Sampling size A Random sample of 35 moderate MR children will be selected for therapy. 7.2.3 Inclusion criteria for sampling 1. Who are in the age group between 5-12 years. 2. Who are able to follow the instruction. 3. Who are trainable. 4. Who can understand Kannada, Hindi, English. 5. Who are present at the time of data collection. 6. who have not attended dressing skill training. 7.2.4 Exclusion criteria for sampling 1. Who are not willing to participate in training. 2. Severe and mild MR children. 3. Who are undergoing special training. 4. Who are having physical illness. 5. Who are having psychiatric illness. 7.2.5 Instrument used 1. Demographical data. 2. Rating scale to assess cognitive skills and self help skill. 7.2.6 Data Collection method Investigator will obtain written permission from the head of the institution prior to data collection period. Purpose of the study will be explained to the subjects and informed consent will be taken. Pre test will be given to the subjects by using rating scale to assess cognitive skill and self help skill. After the assessment training will be given to the subjects for 4 weeks. After the therapy post test will be conducted for the subjects by using the same scale. 7.2.7 Data Analysis Plan The data will be analyzed in terms of objectives using both descriptive and inferential statistics which will be as follows 1. The cognitive level among mentally retarded children will be assessed by frequency and percentage. 2. The self help skills among mentally retarded children will be assessed by frequency and percentage. 3. The effectiveness of cognitive skill training on self help skills among mentally retarded children is assessed by paired ‘t’ test. 4. The association between cognitive skill training and self help skills among mentally retarded children is assessed by chi-square test. 7.3 Does the study require any investigation or intervention to be conducted on patients or other humans or animals? If so describe briefly. Study requires to assess the effect of cognitive skill training on self help skill among moderate MR children. 7.4 Has the ethical clearance been obtained from your institution in case 7.3. Ethical clearance has been obtained and certificate is enclosed. List of Reference : 1. Behera A. The effectiveness of cognitive skill training on performance in dressing in the mentally retarded. IJOT 2001 Jan ;33(2):15-19. 2. Stahmer AC. Teaching symbolic play skills to children with autism using pivotal response training. Journal of autism and developmental disorders 1995 Apr; 25(2):123-41. Available from:URL:http://www.eric.ed.gov 3. Matson JL, Taras ME, Sevin JA, Love SR, Fridley D. Teaching self help skills to autistic and mentally retarded children. Research in developmental disabilities 1990;11(4):361-78. Available from:URL:http://www.eric.ed.gov 4. Pierce KL, Schreibman L. Teaching daily living skills to children with autism in unsupervised setting through pictorial self-management. J Appl Behav Anal 1994;27(3):471-81. Available from:URL:http://www.pubmed.gov 5. Taras ME, Matson JL, Felps JN. Using independence training to teach independent living skills to children and young men with visual impairments. Behav modif 1993 Apr;17(2): 189-208.