RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES



RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES

BENGALURU, KARNATAKA

PROFORMA FOR REGISTRATION OF SUBJECTS FOR

DISSERTATION

|1 |NAME OF THE CANDIDATE |JOY PRISCILLA |

|2 |NAME OF THE INSTITUTION AND ADDRESS |K.R COLLEGE OF NURSING, |

| | |PROPERTY NO.59, 25/4/74, KATHA NO. 1935, C & M COMPLEX, OMKAR |

| | |LAYOUT, UTTARAHALLI-KENGERI MAIN ROAD, BANGALORE-60 |

|3 |COURSE STUDY AND SUBJECT |I YEAR M.SC NURSING |

| | |CHILD HEALTH NURSING |

|4 |DATE OF ADMISSION TO THE COURSE |1-6-2011 |

|5 |TITLE OF THE TOPIC |“EFFECTIVENESS OF STRUCTURED TEACHING PROGRAMME ON DYSLEXIA AND ITS|

| | |IDENTIFICATION AMONG SCHOOL TEACHERS IN SELECTED PRIMARY SCHOOLS OF|

| | |BENGALURU” |

6. Brief resume of the intended work

INTRODUCTION

“When we care for the children, we care for the future”

-Joyce Kristen-

Children are our most valuable resource because every child we encounter is a divine appointment. They are the hands by which we take hold of heaven, and they are the best hope for the future. Whatever they grow up to be they are still children, and the one most important of all things we can give to them is unconditional love. Children are important to the society because they are recognized to be unique individuals with physical, intellectual, emotional and social, spiritual needs, having a wide range of abilities but with each child requiring distinctive gifts and talents to be recognized and fostered.1

Early care and education is what many professionals are calling child care. All children can succeed with the right support. Being a teacher of any child is not always easy. You can often feel overwhelmed and confused. If the child has special needs, you have many questions and you may not always know where to go for answers. Sometimes you might not even know what to ask in the areas where your child needs individualized supports and services to help develop and to rule out learning difficulties. Sometimes these special needs are called disabilities. So there is a need to understand the root of all learning difficulties or disabilities. The most common type of learning disability is Dyslexia, a learning disability in which someone has trouble understanding the written word.2

The word dyslexia comes from the Greek which means ‘difficulty with words’, and encompasses a wide variety of features. This disorder is one type of specific learning disability. It commonly affects the person to have difficulty in verbal skills, abstract reasoning, hand-eye coordination, concentration, perception, memory and social adjustment. These problems result in the individual having poor grades and become classified as an under achiever. This intrigued the educators and subsequently more similar cases were recorded and dyslexic disorders were officially recognized as a learning disorder.3

The common symptoms of dyslexia are, difficulty in comprehending, expressing written or oral, understanding letters phonetically or otherwise, reading, inability to memorize (sequential problem), spelling and reading. Dyslexia can be caused by inherited factors, and/or hearing problems at an early age. Children with dyslexia often find school life challenging. When the child begins to learn to read and write at primary school, their dyslexia will become more evident in their school work. Having dyslexia means that your child will take longer to do written work, or take notes, because they may have problems with processing rapid language. These difficulties can cause a dyslexic child to experience a lack of self-esteem. If assessed as dyslexic in an educational environment, students may be taught adaptive strategies to deal with these difficulties.4

The Disability Discrimination Act gives people the right to ask for ‘reasonable adjustments’ to take account of a disability. They can complete high school classes and have read all the class assignments. College programs can be mastered by these students so they can become statisticians, lawyers, biologists, teachers, journalists, etc. All this is possible because of the new technologies that allow people to "read" what they cannot read and to "write" when they cannot spell. All the print that we need to read can be read using alternative methods for reading. And the writing that we need to do can be done using alternative methods for writing.5

For those with dyslexia, the prognosis is mixed. The disability affects such a wide range of people, producing different symptoms and varying degrees of severity that predictions are hard to make. The prognosis is generally good, however, for individuals whose dyslexia is identified early, who have supportive family and friends and a strong self-image, and who are involved in a proper remediation program. The teacher is a dynamic force in the school. A teacher’s place in a child’s upbringing is of vital importance. Teachers strive with heart and soul to raise children upto highest perfections of mankind to such a degree so that everyone of them will be trained in the use of mind in acquiring knowledge.

|6.1.NEED FOR THE STUDY |

|Dyslexia is a major educational problem, but the studies on genetics of dyslexia are very limited in India, because the |

|inheritance pattern of dyslexia is not well established in our population. About 5% of the population will have enduring, severe|

|reading disabilities that are very difficult to treat. In India around 13-14 % of all school children suffer from learning |

|disorder, unfortunately most schools fail to lend a sympathetic ear to their problems. As a result these children are branded as|

|failures. Dyslexia is not a disease but its a lifelong problem and presents challenges that needs to be overcome every day.6 |

|Dyslexia is perhaps the most common neurobehavioral disorder affecting children, with prevalence rates ranging from 5-20% in the|

|US. Dyslexia is the most common cause of reading, writing and spelling difficulties. Of people with poor reading skills, 70-80% |

|are likely dyslexic. It is the most common type of language based learning disability. Nearly the same percentage of males |

|and females have dyslexia. And the same percentage of people from different ethnic and socioeconomic backgrounds have dyslexia.7|

|Percentages of children at risk for reading failure are much higher in high poverty, language-minority populations who attend |

|ineffective schools. The National Assessment of Educational Progress (NAEP) found that approximately 38% of fourth grade |

|students have "below basic" reading skills. These students are below the 40th percentile and are at greater than 50% chance of |

|failing the high-stakes, year-end school achievement tests. In the national disabled student population the incidence of |

|dyslexia is reported to be 41.3% as the most common disability.8 |

|In the general population estimates of prevalence vary, from 2% to 15%. This can be explained by different studies identifying |

|cases based on different cut-off points on the continuum between mild and severe dyslexia. The exact causes of dyslexia are not |

|known, however, it is known that dyslexics process their thoughts differently to non-dyslexic people. Acccording to WHO it is |

|said that 5 -15% of the world population i.e. approximately, one billion people, may be diagnosed to be suffering from various |

|degrees of Dyslexia. So there is a need to provide appropriate remedial assistance. And this assistance has been implemented by |

|the government by different organizations, to name a few they are Action Dyslexia Delhi Initiated in 1997, Maharashtra Dyslexia |

|Association started in march 1996. And they have also given provisions such as exemption from spelling mistakes, extra time for |

|all written tests, allowing scribes/writers and exemption of Xth std Maths and substitute with lower grade maths.9 |

|With sound information children with dyslexia can build better conceptions of their disability, their strengths and weaknesses. |

|Educators and parents must talk to children and help them understand what science is telling us about the dyslexic brain. The |

|investigator will assess the teachers knowledge and develop a structured teaching program to enhance the target population. |

|Based on the above mentioned literature, the Researcher felt the need to identify Dyslexia among the school children. But with |

|this information comes the challenge of making it practical and useful. One way to do this is to provide the latest, best, |

|scientific information we have, to the teachers who need it most, and the children with dyslexia. |

|6.2. REVIEW OF LITERATURE |

|Review of literature is defined as a broad, comprehensive, in depth, systematic and critical reviews of scholarly publication, |

|unpublished scholar print materials, AV aids and personal communication. Review of literature is a study of prevalent materials |

|related to research, this helps the researcher to get a clear idea about the particular field. It is important for the |

|researcher to carryout research successfully. A critical summary of research on a topic of interest, often prepared to put a |

|research problem in context. Review of literature for the study has been organized under the following headings. |

|1)Reviews related to general information on dyslexia |

|2) Reviews related to knowledge of teachers regarding Dyslexia |

|3) Reviews related to Structured teaching program on Dyslexia |

|Reviews related to general information on Dyslexia |

|A cross-sectional multi-staged stratified randomized sampling study was conducted in J N Medical College, Belgaum to measure the|

|prevalence of specific learning disabilities (SpLDs) such as dyslexia, dysgraphia and dyscalculia among primary school children.|

|It was a conducted among children aged 8-11 years from third and fourth standard. The prevalence of specific learning |

|disabilities was 15.17% in sampled children, whereas 12.5%, 11.2% and 10.5% had dysgraphia, dyslexia and dyscalculia |

|respectively. This study concludes that the prevalence of SpLDs is at the higher side of previous estimations in India. The |

|study is unique due to its large geographically representative design and identification of the problem using simplified |

|screening approach and tools.10 |

|A comparative study was conducted to investigate the incidence of dyslexia among young offenders in Kuwait. A total of 91 |

|children 8 juvenile delinquent welfare centers across Kuwait were interviewed and tested. A measure of non-verbal reasoning |

|ability was used to exclude those with low general ability. The remaining 53 participants were tested on their ability to |

|identify alliteration and rhyme, retain and manipulate sequences of digit and letter names, decode novel letter strings and |

|identify words within letter chains. The results indicated that the percentage of individuals presenting evidence of dyslexia |

|was much larger (greater than 20%) in this population of young offenders than would be expected based on the national average |

|(around 6%) of dyslexics in Kuwait derived from a nationwide study. This study concluded that there is a previous evidence for |

|an increased frequency of dyslexia among young offenders.11 |

|A descriptive study was conducted to know the dearth of proper statistical data and to show the incidence of dyslexia in Indian |

|population. Aiming to establish the inheritance pattern of dyslexia in 23 selected families, they have ascertained 23 dyslexic |

|probands and their families from the state of Karnataka. Individuals with above 8 years of age, normal performance intelligence |

|quotient (>85) and remarkable deviation in reading and writing skills compared to chronological age were considered for the |

|study. Based on the affectedness, the dyslexia phenotypes were classified into four types: severe reading spelling deficit, mild|

|reading spelling deficit, severe spelling deficit and mild spelling deficit. Severe dyslexia phenotypes were more frequent than |

|mild phenotypes. The study concluded that the Family history of dyslexia is a consistent risk factor, therefore this knowledge |

|can be applied to the prevention and remediation of dyslexia.12 |

|A study was conducted to examine the incidence of development of literacy skills in children in a district that used a Response |

|to Intervention (RTI) model. The district included children whose first language was English and children who were learning |

|English as a second language (ESL). After systematic instruction and annual monitoring of skills, their reading abilities |

|improved to the extent that only a very small percentage had reading difficulties. The results demonstrated that early |

|identification and intervention and frequent monitoring of basic skills can significantly reduce the incidence of reading |

|problems in both the ESL and language majority children.13 |

| |

| |

|Reviews related to knowledge of teachers regarding dyslexia |

|A retrospective study was conducted to explore the experiences of teachers on dyslexia at Children’s University Manchester. |

|Qualitative methodology was used and semi-structured interviews were carried out with a convenience sample of seven teachers |

|with formally diagnosed dyslexia. Data were analyzed using a thematic network approach. Fear of ridicule and discrimination |

|exist for students with dyslexia, and delays in identification, referral and testing may adversely affect learning. Requirements|

|for support relate to personal attributes, knowledge and perception. A perceived lack of caring in teachers for dyslexics is of |

|concern. The study concluded that the early diagnosis of dyslexia enables the provision of appropriate support Professional and |

|legislative guidance provides information for those working with students who have a disability.14 |

|A study was conducted to examine elementary school teachers' knowledge of basic language concepts and their knowledge and |

|perceptions about dyslexia. Consequently, elementary school teachers are teaching students who struggle with inaccurate or slow |

|reading, poor spelling, poor writing, and other language processing difficulties. Findings from studies have indicated that |

|teachers lack essential knowledge needed to teach struggling readers, particularly children with dyslexia. However, few studies |

|have sought to assess teachers' knowledge and perceptions about dyslexia in conjunction with knowledge of basic language |

|concepts related to reading instruction. The study concluded that teachers, on average, were able to display implicit skills |

|related to certain basic Language concepts (i.e. syllable counting), but failed to demonstrate explicit knowledge of others |

|(i.e. phonics principles).15 |

|A study was conducted to explore the academic learning experiences on Dyslexia among teachers in a skill based programme. It was|

|examined using a self-report questionnaire which was distributed to 29 teachers. Twenty seven responses were received and were |

|assessed in terms of peer support, shared knowledge, life experiences and levels of understanding, motivation, and learning. |

|They valued the support of peers, and shared existing knowledge and skills to help each other to learn. The study concluded that|

|the teachers developed a strong learner identity and had different needs to their non-secondary peers. More work is required to |

|explore the specific learning needs of teachers.16 |

|Reviews related to structured teaching program on dyslexia |

|An experimental study was conducted to determine the effectiveness of Structured teaching on identification of Dyslexic students|

|among CBSE school teachers. The study revealed that mean post test knowledge score of the experimental group was found to be |

|significantly higher than the mean pre test knowledge score of the control group t=9.24. P< 05. This suggests that structured |

|teaching process for an experimental group was effective which indicates it as an effective teaching strategy in bringing about |

|change in the knowledge among teachers.17 |

| |

| |

|A study determined the effectiveness of Structured teaching program on the knowledge of Dyslexia and its management. The study |

|showed statistical difference between pretest score and post test on knowledge at .001 level. It suggested Structured teaching |

|program was an effective teaching and learning material in bringing a change in the knowledge. And it was also accepted by |

|majority of the subjects as a useful material for learning.18 |

|A study was conducted to develop, teach, and supervise a structured teaching program for identifying Dyslexia and to evaluate |

|its effect on teachers knowledge, skills, and attitudes toward dyslexic children. To evaluate the entire structured teaching |

|program teachers were surveyed. The authors obtained 95% response of 144 surveys. They had administered to 72 consecutive |

|teachers rotating through the schools. Freshers had little confidence in their ability to identify Dyslexia, but after exposure |

|to the program, their perceptions of these abilities increased (all P < .05). Eighty-five percent of the teachers felt that |

|attending supervision of the structured teaching process was useful or extremely useful, but only 51% viewed the |

|lecture/small-group session about the program as useful. The study concluded that the structured teaching program improved the |

|participating teachers perceptions of their knowledge and their ability to identify Dyslexic children effectively.19 |

|PROBLEM STATEMENT |

|“A Study to assess the effectiveness of structured teaching program on Dyslexia and its identification among school teachers in |

|selected primary schools of Bengaluru.” |

| |

| |

|6.3. OBJECTIVES: |

|To assess the existing knowledge of school teachers regarding Dyslexia and its identification by Pre test knowledge scores. |

|To administer the Structured Teaching Program on Dyslexia and its identification. |

|To assess the knowledge of school teachers regarding Dyslexia and its identification by Post test knowledge scores. |

|To find out the association between pretest knowledge scores with their selected demographic variables. |

|6.4. OPERATIONAL DEFINITIONS |

|ASSESS: Refers to explore the knowledge of teachers on Dyslexia and its identification. |

|EFFECTIVENESS: It refers to the significant gain in knowledge of school teachers regarding Dyslexia and its identification as |

|determined by significant difference between pretest and posttest knowledge score measured by structured questionnaire. |

|STRUCTURED TEACHING PROGRAM: It refers to systematically organized, teaching strategy designed for teachers to provide |

|information regarding Dyslexia and its identification. |

|KNOWLEDGE: It refers to the correct response of school teachers to the items on cognitive aspects regarding Dyslexia and its |

|identification, and is expressed in terms of knowledge scores measured by structured questionnaire. |

| |

|DYSLEXIA: Dyslexia is a disorder in children who despite conventional classroom experience, fail to attain the language skills |

|of reading, writing and spelling commensurate with their intellectual abilities. |

|PRIMARY SCHOOL: It refers to the school meant for children between the age group of 6-10 years. |

|TEACHERS: It refers to the school teachers who teach in selected primary schools. |

|6.5.ASSUMPTIONS |

|Teachers may have inadequate knowledge regarding Dyslexia and its identification. |

|A structured teaching program will help to enhance the knowledge regarding Dyslexia and its identification among school |

|teachers. |

|Teachers will be having more interest to learn about Dyslexia. |

|6.6 DELIMITATIONS: |

|The study is delimited to school teachers who teach in selected primary schools in Bengaluru. |

|6.7. RESEARCH HYPOTHESIS |

|H1: There will be significant difference between pretest and post test knowledge scores of school teachers regarding Dyslexia |

|and its identification. |

|H2: There will be significant association between the pretest knowledge scores with the selected demographic variables. |

|6.8.VARIABLES OF THE STUDY |

|Independent variable |

|In this study the independent variable is Structured teaching program on Dyslexia and its identification. |

|Dependent variable |

|In this study the dependant variable is knowledge of school teachers. |

|Selected demographic variables: age, sex, experience, income, marital status, professional qualification, and source of |

|information. |

|7. MATERIALS AND METHODS |

|7.1 Source of data: teachers working in selected primary schools of Banashankari, Bangalore |

|7.2 METHOD OF DATA COLLECTION: |

|7.2.1 Research approach: |

|In this study, Evaluative approach is used. |

|7.2.2 Research design: |

|In this study, Quasi experimental one group Pre test and Post test design is used. |

| |

|7.2.3 Research setting: |

|In this study, selected primary schools of Bangalore city are taken. |

|7.2.4 Population: |

|In this study, school teachers of selected primary schools of Banashankari, Bangalore are taken. |

|7.2.5 Sample: |

|In this study, School teachers working in selected primary schools of Banashankari, Bangalore are taken. |

|7.2.6 Sampling technique: |

|In this study, Non Probability Purposive sampling technique is used. |

|7.2.7 Sample size: |

|In this study, 40 School teachers working in selected schools of Banashankari, Bangalore are taken. |

|7.2.8 SAMPLING CRITERIA |

|Inclusion criteria |

|Teachers of Primary school who are willing to participate in the study. |

|Teachers of Primary school who are available during the time of data collection. |

| |

|Exclusion criteria |

|School teachers who are not willing to give consent. |

|School teachers who are not available during the time of study. |

|7.2.9 TOOLS OF DATA COLLECTION |

|PART A: A structured questionnaire is used for collecting demographic data of the school teachers such as age, sex, experience, |

|income, marital status, professional qualification and source of information. |

|PART B: A structured questionnaire is used to assess the knowledge of school teachers regarding Dyslexia and its identification.|

|PART C: This part includes a structured teaching program on Dyslexia and its identification for primary school teachers. |

|7.2.10 DATA COLLECTION PROCEDURE |

|Formal permission will be obtained from the school authorities to conduct the study. The researcher introduces herself to the |

|participants in the study. Structured questionnaire will be given to the participants. The time duration for each participant |

|will be 15-20 minutes. |

| |

| |

| |

| |

| |

|7.2.11 METHOD OF DATA ANALYSIS |

|The investigator will analyze the data by using descriptive and inferential statistics. |

|Descriptive Statistics : |

|The obtained data will be calculated by mean, mode, median and standard deviation. |

| |

|Inferential Statistics : |

|Paired t-test will be used to compare pretest and postest knowledge of school teachers regarding Dyslexia and its |

|identification. |

|Chi-Square test will be used to determine the association between the post test knowledge scores of teachers in primary schools |

|regarding Dyslexia and its identification with the selected demographic variables. |

| |

|7.3. Does the study require any investigation or intervention to be conducted on students or human or animals? If so please |

|describe briefly. |

|Yes, it involves primary school teachers to see the effectiveness of Structured teaching program. |

|7.4. Has ethical clearance been obtained from your institution? |

|Permission will be taken from Research committee of K.R.college of Nursing. |

|Written permission will be obtained from concerned authority of selected primary schools in Banashankari, Bangalore. |

|Informed consent will be obtained from School Teachers. |

8. REFERENCES:

1. Behrman, Kleigman, Jenson. Textbook of Pediatrics.17th ed. Elsevier; p. 110-111.

2. Cecily lynn betz, Mabel, Stephanie. Family centered nursing care of children. 2nd ed. Saunders; p. 992-993.

3. Helen Bee, Denise Boyd. The developing child. 10th ed. Pearson education; p. 437-440.

4. Understanding and Recognizing Dyslexia. December 2009. Available from URL:

Introduction to Dyslexia. Available from URL:

5. Alan M. Hultquist. An Introduction to Dyslexia for Parents and Professionals. 2006. Available from URL: libreriauniversitaria.it/books author_alan+m+hultquist-alan+m+hultquist.htm

6. Warnke, Andreas. "Reading and spelling disorders: Clinical features and causes". Journal European Child & Adolescent Psychiatry 8 (3). Available from URL:

7. Disability Discrimination Act (DDA) 2005. Available from URL:

8. Simon Garfield. Prognosis of Dyslexia. 2007 Jan. Available from URL:

9. Stanovich K. E, Siegel L. S, Phenotypic Performance Profile of Children with Reading Disabilities.  Journal of Educational Psychology. 1994; Vol 86: 24-53

10. John Bradford. What causes dyslexia? April 2010. Available from URL: .

Dyslexia and School Problems. Nov 2009. Available from URL: library/schoolproblems.htm

11. Jo Sanderson-Mann. Understanding dyslexia and nurse education

in the clinical setting. Elsevier ; October 2005. p. 127–133.Available from URL: journals/nepr

12. Ann W. Alexander,Anne-Marie Slinger. Current Status of Treatments for Dyslexia. 2005. Available from:

Jarome Matthew. How low the importance of children is in our society. Jan 2008. Available from URL:

13. The incidence of dyslexia. 2005. Available from URL:

14. O.P. Ghai, et al. Essential pediatrics. 6th ed. CBS publishers; p. 63-65.

15. Dyslexia Resources. 2011. Available from URL:

16. Hollis S. Scarborough.Child-directed talk in families with incidence of dyslexia. January 1999. Available from URL:

17. Aglaia Stampoltzis. Dyslexia in Greek higher education: a study of incidence, policy and provision. March 2008. Available from URL:

18. Behavioral and brain functions BBF . Journal of Experimental Child Psychology

2005. Vol 11(3); p. 135-139  

19. Elbeheri G, Everatt J, Al Malki M. Incidence of dyslexia among young offenders in Kuwait. 2009 May; vol 15(2):86-104. Available from URL: PMID:18433005

20. Lipka O, Siegel LS. The improvement of reading skills of L1 and ESL children using a Response to Intervention (RtI) Model. 2010 Nov; vol 22(4):963-9. Available from URL: PMID:2104453

21. .Mogasale VV, Patil VD, Patil NM, Mogasale V. Prevalence of Specific Learning Disabilities Among Primary School Children in a South Indian City. Indian J Pediatr. 2011 Sep. Available from URL: PMID:21887581

22. Saviour P, Ramachandra NB. Modes of genetic transmission of dyslexia in south Indian families. Indian Journal of Human Genetics. 2005 December; Vol 11: p. 135-139. Available from URL: .br/request/ hg05026

23. Washburn EK, Joshi RM, Binks-Cantrell ES. Teacher knowledge of basic language concepts and dyslexia .2011 May (2):165-83. Available from: .

24. Adele Pilliteri. Child health nursing care of child and family; Lippincott publishers; p. 1048-1051.

25. Verity Donnelly, teacher education for inclusion. 2009. Available from:

26. Brooks, G. The Effectiveness of Intervention Schemes. 2003. Available from:

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