CHAPTER IV

DESIGN
&
METHODOLOGY
 DESIGN AND METHODOLOGY
The present investigation was intended to study the impact of level of

mental retardation on the quality of life of the parents of mentally challenged

children. The following design and methodology was used to test the

hypotheses formulated in Chapter III.

Sample

Sample Criterion

The mentally challenged children between chronological age range of

10 to 18 years from the centers of special education in the field of mental

retardation were selected from different districts (Faridabad, Karnal, Rewari,

Rohtak) of Haryana, Chandigarh, Pathankot and Nagpur. These children

were identified as mild, moderate and severe on the basis of their Intelligent

Quotient (IQ) and Social Quotient (SQ) levels. Further they were classified

as residential and non-residential on the basis of residential status (care

setup). In this way six groups of mentally challenged (15 in each group)

were formed in relation to the level of mental retardation and nature of the

care setup.

Sample characteristics:

On the basis of purposive sampling procedure, a sample of the

parents of 90 mentally challenged were selected. Only the parents with the

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 minimum academic qualification of matriculation between 35-40 years of

age were included in the sample. They were interviewed and administered

the measures of Family Support, Disability Impact and Quality of Life.

Design
3x2 factorial design was used in which two independent variables

were taken. First independent variable i.e. level of mental retardation

(Factor A) was taken at their levels - mild (a,), moderate (a2) and severe

(a3). Second independent variable i.e. residential status of mentally retarded

(Factor B) was taken at two levels - residential (b,) and non - residential

(b2). The dependent variables on which the six groups (n=15) were tested

were the disability impact, family support and the quality of life. The fathers

(n=90) and mothers (n=90) were tested separately on these variable.

Mental retardation (Factor A)

Mild(a,) Moderate^) Severe(a3)

Residential Status
(Factor B) I I I

Residential(15) Non-residential(15) Residential(15) Non-residential(15) Residential(15) Non-res idential(15)

<bi) (b2) (bi> 0*at> (b1) (b2)

n=30(15+15) n=30(15+15) N=30(15+15) n=30(15+15) n=30(15+15) n=30(15+15)

n=90 (Fathers)
n=90 (Mothers)
N=180

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Material Used:

The following tools were used in the study:

1. Seguin Form Board Test: Indian Adaptation S.K. Goel (1984)*.

2. Vineland Social Maturity Scale: Indian Adaptation Dr. A.J. Malin

(I960)*.

3. NIMH Disability Impact Scale (NIMH-DIS) Peshawaria, Menon, Bailey

and Skinner (2000).

4. NIMH Family Support Scale (NIMH-FSS) Peshawaria, Menon, Bailey

and Skinner (2000).

5. WHOQOL-BREF Shakher Sacxena (1996).

*The material at Sr. No. 1 and 2 were used for identifying the level of

mental retardation of mentally challenged.

Seguin Form Board Test

‘Seguin Form Board Test’ was developed by S.K. Goel (1984) used to

test the Intelligent Quotient of normal children. It is also used to test the IQ

of mentally challenged children. The boards position is so placed that the

star is toward the examiner. With the subject watching, the ten pieces are

stacked in three piles, starting with the rectangle, in order shown by the

numbers below.

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 Examiner’s Examiner’s middle Examiner’s right

Left

Top: Hexagon (3) Triangle (7) Diamond (10)

Oval (2) Cross (6) Circle (9)

Square (5)

Bottom: Rectangle (1) Half circle (4) Star (8)

For the child with proper hearing the investigator say, “put these back

as fast as you can, ready, go” The investigator start the stop watch after

giving the command. If any block is left partly outside, residing on the edge

instead of fitting into the recess, the investigator do not record the time but

treat trial as incomplete. The investigator then call the subject’s attention to

the fact that the blocker blocks were not complete in place. The blocks

should be stacked by the investigator rapidly, but without any suggestion of

nervous haste; memorize the bottom to top order; to avoid any hesitation

say nothing during the progress of a trail. The investigator has to make:-

Sure that the subject does not start before the signal is given. The

test consists of three trials including any trial marked incomplete. The

investigator score the shortest time in seconds out of the three trials. By

referring the norms, the scores are being converted into mental age (MA).

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 The Intelligence Quotient is computed by the formula IQ = (MA/CA) x

100 where CA is chronological age and MA denotes mental age. The

S.F.B.T. can be used for the age group 3.6 years to 15 years old children.

Vineland Social Maturity Scale (VSMS)

Vineland Social Maturity Scale (VSMS) developed by Dr. A.J. Malin

(1960). The VSMS measures the differential social capacities of an

individual. It provides an estimate of Social Age (SA) and Social Quotient

(SQ), and shows high correlation (0.80) with intelligence. It is designed to

measure social maturation in eight social areas: self help general (SHG),

self help eating (SHE), self help dressing (SHD), self direction (SD),

occupation (OCC), communication (COM), locomotion (LOM) and

socialization (SOC). The scale consists of 89 test items grouped into year

levels. VSMS can be used for the age group of 0-15 years. The investigator

has to collect information on VSMS test items regarding child’s abilities

through direct observation and supplementing it by interviewing the mother

and father. The record sheet are used for noting the child’s responses.

Investigator mark the item pass [/) if the child is able to perform correct and

fail (X) if otherwise. Half credits may be given if it can be presumed that the

child could have passed the item if opportunity was present. These half

credits receive full credit if they lie between two passed items.

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 The passed scores both full and half are being added up. The raw

score are converted into the social age with help of VSMS manual. The

Social Quotient (SQ) is computed by dividing SA by CA and multiplying by

100. Higher scores in the scale represent the more social maturation in the

child.

NIMH Disability Impact Scale (NIMH-DIS)

NIMH-DIS has been developed by Peshawaria, Menon, Bailey and

Skinner (2000). This scale was administered to assess the nature and

degree of impact on the parents (both positive and negative) because of

having children with mentally challenge. The NIMH-DIS has been divided in

to eleven areas:

1) Physical care

2) Health

3) Career

4) Support

5) Financial

6) Social

7) Embarrassment/ Ridicule

8) Relationships

9) Sibling effect

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10) Specific thoughts

11) Positive effect

An open ended question leading to introducing each area in the tool

was included. A quantitative scoring of 2, 1 and 0 was adopted for each of

the impact areas to assess the degree of impact. The interview was

conducted in such a way that the investigator does not influence the

decision of the concerned subject. The investigator interviewed the subject

on each area of impact by stating the leading open question for the given

area followed by stating one by one each of the sub items listed in the given

area. The investigator scored each sub item in the given area by obtaining

the choice option from the concerned subject and check the score 2, 1 and

0 with the key given at the end of each area and also enter the score in the

appropriate box given in the scale. After this process the investigator then

enter the total score for each of the area as also the grand total score

obtained by the respondent on NIMH-DIS at the appropriate places provided

in the profile sheet. The scores were counted separately for areas 1 to 10

and area 11. Higher grand total scores in this scale in areas 1 to 10

represent the greater the negative impact. The higher the scores in area 11

represent the greater the positive impact.

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NIMH Family Support Scale (NIMH-FSS)

NIMH-FSS developed by Peshawaria, Menon, Bailey and Skinner

(2000) was used to collect the information regarding quantity, quality and

quality of support available to the parents of mentally challenged and normal

intelligence. This scale has been divided into six areas: i) personal ii)

financial iii) technical iv) recreation v) emotional and vi) material. Each area

is divided into 20 sources of support. The first ten are in relation to the index

individual with mental retardation.

1. Spouse

2. Mother

3. Father

4. Siblings

5. Paternal grandfather

6. Paternal grandmother

7. Maternal grandfather

8. Maternal grandmother

9. Paternal aunt/uncle

10. Paternal aunt/uncle

11. Friends

12. Neighbours

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13. Organisations/agencies

14. Boss/co-workers

15. Doctor

16. Other professionals

17. Religious / support group

18. Any other

19.

20.

The investigator ensured the subject to respond choice option of each

item under “Sources of Support” on all the three dimensions - “Utilization”,

“Level of satisfaction”, and “need for more support”. The

information/responses of the subject on all three dimensions for all the items

in the given area of support is obtained. Further, the information on the

“rank order utilization” of the services of support reportedly being used by

the subject starting from the most helpful to the least helpful is also

gathered. The interview is being conducted in such a way by the

investigator that the interviewer does not influence the decision of the

concerned subject.

The investigator then enter the total score for each area as also the

grand total score obtained by respondent on NIMH-FSS for both “utilisation”

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and “level of satisfaction” at the appropriate places provided in the profile

sheet. Information obtained from “need for more support and “rank order

utilisation” also compiled separately for understanding and helping the

families. The higher the scores in this scale on “utilisation” greater the

quantity/amount of support available to the parent. The higher the scores on

“level of satisfaction” the greater the quality of support available to the

parent. The grand total scores on “utilisation of support” and “level

satisfaction” of support are added to calculate the total “family support

score”. The higher the score the greater is the family support. The

investigator complete the NIMH-FSS profile sheets separately for both the

parents after the assessment.

World Health Organization Quality of Life (WHO QOL- BREF)

This consists of information regarding the subject name, age, sex,

education, marital status, health. To measure the QOL of the subject’s Hindi

version of WHO-QOL-BREF developed by S. Secxena (1996) was

administered. The main aim of using WHO QOL-BREF is to measure basic

quality of life of subject: the total quality of life and QOL in health, personal,

psychological and financial perspectives. The present scale in Hindi was

designed for studying the quality of life of the psychiatric patient but it is

equally applicable to the normals for studying their quality of life. WHO

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QOL-BREF questionnaire has twenty six statements, each statement was

rated on a five point scale i.e. ‘extremely dissatisfied’, ‘more dissatisfied’,

‘not satisfied’ and ‘not dissatisfied’, ‘more satisfied and extremely satisfied’

were given scores from 1 to 5. The extremely satisfied response being given

a score of 5 and extremely dissatisfied response given a score of 1. Higher

scores in this questionnaire represent the more better quality of life

experienced by the parents having mentally challenged children.

Procedure

First of all, the Coordinator / Principals of centre for Special Education

in the field of mental retardation were contacted personally by the

investigator. They were apprised of the purpose of the visit. Permission was

sought for including the students and their parents of the centre as subjects

in the ongoing research.

In the initial state the study the mentally retarded were identified,

categorized and ensured as mild, moderate and severe on the basis of

Intelligent Quotient (IQ) and Social Quotient (SQ) Scores by administering

Seguin Form Board Test and Vineland Social Maturity Scale (VSMS)

respectively. For each level of mental retardation, equal number of children

were taken from residential (24 hours care setup) and non-residential (day

scholars) status.

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 The parents of these children were contacted telephonieally for their

participation by the investigator. All the volunteered subjects were included

in study were approached personally and individually. Rapport was

established by apprising them about the objectives of the study. Cordial

relations based on the mutual trust were also build with the parents of

mentally challenged. They were taken into confidence by ensuring about the

anonymity of the responses as well as their identity. The subjects were also

informed about approximate 11/2 to 2 hours to be required for the interview

session so convenient day and time to them was fixed well in advance.

The specific instructions related to the each scales and questionnaire

were given one by one. The investigator comprised of literate subjects and

the structured interview technique was adopted for administering the scales

and questionnaire. The subjects who had difficulty in understanding the

items were explained each item in easy language and their responses were

noted down.

Queries put by the subjects were properly clarified by the investigator.

All the scales and questionnaire were administered individually to each

respondent. The administration of scales and questionnaire were kept very

flexible as no time limit was set, the respondent was allowed to have a rest

of 5-10 minutes whenever he/she feel like. As approaching the subjects at

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distant places was an expensive affair both in terms of time and money,

efforts were made to gather all information regarding subjects and to

complete the administration of all the scale and questionnaire of a subject in

a single day. The structured interviewing administration procedure was kept

strictly uniform for all the subjects.

Statistical Analyses

The obtained data were subjected to statistical analyses by using t-

test, two-way ANOVA, Pearson’s correlation method and multiple

regression analysis (step wise).

We may now pass on the next chapter dealing with the results and

discussion.

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‘Parents mayfind comfort, Isay, in
their children are not useless, But that their lives,
limited as they are, are ofgreat potential value to
human race. ‘We learn as muchfrom illness as
from health, from handicapsfrom advantage and
indeedperhaps more

tPearls. Puck