A CASE STUDY ON CLINICAL DOHSATHERAPY ON THE SELF-CONTROL OF CHILDREN WITH MENTAL RETARDATION Dr. Kim, Il-myung(Brain Korea21 Project Force of Special Education) Dr. Ok, Jung-dal(Brain Korea21 Project Force of Special Education) Prof. Byun, Can-suk(Department of Special Education Daegu University) Prof. Lee, Hae-gyun(Department of Special Education Daegu University) 1. Introduction Our society requests education to set up an image of personal character ensuring recognition, establishment and realization of the self. For those who are mentally retarded, in especially, the study needs education to instruct them with how to make self-control, self-assertion and self-expression properly. Even those who are unable to deal with their own body or mind should be respected regarding their demands or interests and at the same time warranted in terms of basic human rights. In especially, mentally retarded children should be instructed into self-assertive people who can make decisions and selections by themselves. Spiritual aspects such as self-consciousness, self-control and self-assertion may be established through cognitive education, but they can be otherwise built up by way of setting physical shape properly or improving one's ability to treat his body at his own will, that is, the ability to control body based on the self. This is supported by previous studies. The ability of the self-control of body can be obtained through Clinical Dohsatherapy(movement exercise through psychological rehabilitation program). In other words, we may increase the ability to control our own body for ourselves and thereon experience meaningful behavioral changes. The purpose of Clinical Dohsatherapy lies in making possible for those who receive the exercise to better control their own bodies in accordance with their own will (Naruse, 1995). Existing pervious studies(tanaka, 1995; Konno, 1985a; Konno, 1996) suggest that mentally retarded children could improve their own improper movements and make themselves adaptable to peripheral environments through controlling their own body by themselves. The adaptation to such
environments implies a better treatment of interpersonal relations, more collaboration with others and more rational self-assertions to others. At a discriminative education of the past, children with mental retardation had to be instructed under a strong influence of human pathology which stressed a therapy-oriented approach to the children's weak points or problematic behaviors. But now, the 21st century is the era of social integration-oriented education that should provide mentally retarded students with better qualities of life by instructing the students to obtain social skills for better interpersonal relations, have better postures for higher self-confidence and have the sense of self-respect covering self-determination, self-control and self-assertion, eventually becoming a member of social life as not different with other ordinary people, rather than to learn common skills only. Facing the 21st century, as described before, school education is aiming at the cultivation of voluntary people who make selections and decisions on their own will. Such people may be referred to as those who have creativity, rather than memorize something blindly or learn skills repeatedly. This statement may be true to everyone including mentally retarded persons. However much their mental and physical inability may be, children with mental retardation deserve being instructed to express their own demands properly and rationally. Now it is essential to develop ways of making mentally retarded students have confidence in life and realize their own intents. In relation, this study used an experimental research, or the program of Clinical Dohsatherapy to clearly determine a correlation between the ability of the selfcontrol of body and behavioral change, which was suggested by previous studies. Substantially speaking, the study tried to clarify whether children with mental retardation could really enjoy the promotions of body control by themselves, selfassertion and self-control of their own behavior when they are applied with Clinical Dohsatherapy. 2. Purpose The purpose of this study is to know what changes could be given by Clinical Dohsatherapy to the ability of body control and behaviors by students at a school for mentally retarded children. The purpose may be divided into the following three objectives.
First, the purpose of this paper is to clarify effects of Clinical Dohsatherapy on the ability of the self-control of body by mentally retarded children. Second, the purpose of this article will be to clarify effects of Clinical Dohsatherapy on self-assertions by mentally retarded children. Third, the aim here is to clarify effects of Clinical Dohsatherapy on the selfcontrol of behavior by mentally retarded children. 3. Definitions The following shows manipulated definitions about terms used in this study. 1) Clinical Dohsatherapy Clinical Dohsatherapy herein specified is a training program as the outcome of this researchers' appropriate, systematic reorganization of Motor-Action Training, which was developed by Naruse(1973) for the self-control of body. Now, Clinical Dohsatherapy is often termed as the technique of clinical movement. In this however, such original term is used literally in order to stress that the technique is training for strategic intervention in children with mental retardation. The training includes its sub-areas such as relaxation movement, seating, kneebent standing, normal standing and arm-raising movement control. That is, all of the sub-areas are incorporated into a training program that helps the students control their existing uncontrollable movements under collaborations with their teachers. Relaxation movement is an area of training that children control their bodies at their own will by decreasing and increasing the strength of the body purposedly. Seating is an area of training that children keep their physical balance by erecting the upper part of body vertically and then moving the center of the part. knee-bent standing is an area of training that children keep their physical balance by sustaining the upper part of body using both of the knees, erecting the part vertically and then bending the thigh and moving the center of the body. Normal standing is an area of training that children keep their physical balance by reducing strengths of the waist and shoulder, fixing both of the feet onto the floor firmly and then straightening up the upper part of body.
Arm-raising movement control is an area of training that children, lain to the ceiling, raise their arms and fall them onto the floor at specific strength and speed under assistance by their teachers. II. Methods 1. Subject This study was applied to 2 students(2 male) at A School, an educational institution in Busan for mentally retarded children provided that they wanted to participated in the study. 2. Design This study employed Clinical Dohsatherapy as the experimental factor, while the ability of self-control of body and behaviors of self-assertion and self-control as dependent factors. Multiple Baseline Across Subjects was used as the main method of measurement of the study, in which the analysis of mentally retarded children's behaviors was carried out by using data collected from observation at each of the measurement and exercise sessions, consultations between teachers and parents of the students, VTR records and portfolios 3. Means 1) Training Program In this study, the system of Clinical Dohsatherapy was used as the main part of training program which contains techniques such as relaxation movement, perpendicular movement training and the training of arm-raising movement control. Initially started from Motor-Action Training developed by Naruse(1973), Clinical Dohsatherapy has been recently into a new method, perpendicular movement training. To obtain a significant experimental result of the study, this researcher partially reorganized such main sub-areas of Clinical Dohsatherapy as perpendicular
movement training(naruse, 1988b), Systematic Relaxation Movement Training for self-control(naruse, 1988a) and Arm-Raising Movement Control. 2) Measurement Device In this study, abilities of the self-control of body, self-assertion and behavioral control in part of children with mental retardation were all measured using Measure of the Self-Control of Body Ability Evaluation, a measurement device from the reorganization by this researcher of Motor-Action Training Evaluation, developed by Naruse(1973), and Measure of Social Skills Evaluation which had been first devised by Gresham and Elliot and then modified and adapted Kim Hyang-ji(1996) as suitable for local circumstances. 4. Procedure This study was carried out by this researcher only in principle. To ensure a higher reliability of the study, however, the researcher performed at each session of measurement under assistance from teachers concerned who were instructed by the researcher in advance about techniques of Clinical Dohsatherapy. This researcher measured mentally retarded children's ability to control their own body by themselves at each of the measurement sessions together with three teachers concerned by using Measure of Posture Evaluation. The self-assertion and behavioral control of those children were observed and examined by the researcher and teachers by way of randomly proving the arrangement of social skills behavior test to the subject over 1 hour. More details are described below. 1) Training Condition Movement exercise through psychological rehabilitation program, Clinical Dohsatherapy, was actually applied at a special room of A school as mentioned above. The room, 2 times as large as an ordinary classroom, was initially made for teachers' rest with armchairs inside. The room had all of its wall surfaces painted in white without any publications on them, which may be stimuli making the children inattentive.
To perform the training better, the space was screened from outside by using a bright color curtain. And a prior notice was given to prevent other faculties as not concerned from entering the room with no permission. A movie camera was installed at a corner of the room to take close shots of responses and behaviors by the students throughout the training. For the training, the bottom of the room was covered with mats for therapy education available in the school. The movement exercise was implemented two sessions a week, 2nd(10:20 a.m) to 4th class times(12:40 p.m) every Tuesdays and Fridays during the period from May 11, 2004 to Aug. 31, 2004. Results of the exercise were clarified for consecutive three times from a week after the exercise was terminated. 2) Training Procedure Prior to the use of Clinical Dohsatherapy, this researcher surveyed actual circumstances of students who are to receive the training under the help of their teachers. The survey was performed from May 11(Tuesday) to 13(Thursday), 2004 in regard to those students' physical development level, MA, IQ and home environment, and their movement and posture conditions by using Measure of the Self-Control of Body. Then, student named Y firstly received the training during a predetermined fourday standard period beginning from May 14, 2004(Friday). Each of the students was applied with Clinical Dohsatherapy for 30 minutes at each of the training sessions, and effects of the training were evaluated for 10 minutes by teachers concerned and this researcher after every session. Any conditional changes shown by the students during the time not belonging to the training session were vocally advised by their teachers to the researcher. The training was applied to students Y, K in sequence. After any intervention effect of the training was actually appeared to Y, the training was made to K. Similary, when K actually experienced such intervention effect. Any effects of the training on the subject were recorded using relevant measures at each session of the exercise. In case that such effects were kept secure over some three consecutive training sessions, the training was not applied any longer. Sometimes, however, responses by some of the subject to the training were carefully observed
up to five times in accordance with their own conditions and behaviors until the responses were not changed, when the training was terminated. To determine whether children as the subject of this study showed certain changes at home, this researcher asked statements by their children through phone conversations or using contacts after every two sessions of the training. Under Clinical Dohsatherapy, relaxation movement training was applied first, followed by perpendicular movement and arm-raising movement control training in sequence. Sub-areas of each of the three training were sometimes adjusted by this researcher considering physical or emotional conditions of those individual students at the date of the exercise. The reliability of observation here in the study refers to the degree of agreement among four observers and calculated through dividing agreed frequency by total frequency and then multiplying by 100. The degree of agreement as mentioned above was found 98% in the ability of the self-control of body and 95% in selfassertion and control behavior. 5. Data Processing The ability of the self-control of body was measured using relevant items of the training program herein as the evaluation measure. This measure consisted of five sub-measures each of which included seven criteria of measurement, Further, a qualitative measurement was made during the application of Clinical Dohsatherapy to check and record many different responses by the students and support their enhancement in the ability as mentioned above. At each of the training sessions, video tape recorders were used to put in memory behavioral and psychological changes shown by the students during the movement exercise. Records made using the machines were carefully observed jointly by this researcher and the students' teachers. If necessary, photographs were taken to be used as evidences supplementally supporting the training effects. 1) Rating (1) Measure of the Self-Control of Body Ability Evaluation The ability of the self-control of body was rated by way of putting a value belonging to the range of scale, from 1 to 7, to each sub-part of the ability. Among the sub-areas, then, relaxation movement and arm-raising movement
control were given a value, between 8 and 56, for each of their respective subitems. And seating, knee-bent standing and normal standing all of which belong to sub-areas as above were rated with a value, selected between 4 and 21 on the relevant scale, for each of their respective four sub-items. (2) Measure of Social Skills How many social skills each of the herein surveyed children came to obtain through Clinical Dohsatherapy was evaluated by way of rating the frequency of the skills under the provision that the rated value of 0(zero) means 'never in the skills', 1(one), 'sometimes' and 2(two), 'often'. 2) Collection of Behavioral Evidences To evaluate dependent factors of this study such as body control, self-assertion and control behavior, the researcher collected evidential materials of the surveyed students' behavioral characteristics which may be revealed in the training observations, meetings between teachers and parents of the students and video tape records. III. Conclusion 1. Conclusion and Implications This article has attempted to clarify effects of the Clinical Dohsatherapy by mentally retarded children that have established self-consciousness and promoted spiritual and communicative activities for themselves by inducing the children to experience purported relaxation, tension and movement of their own body in an orderly manner. Dependent factors of this study include the ability of the self-control of body, self-assertion and the Self-Control of Behavior, all of which were experimented and reviewed here, finally giving the following conclusion. First, Clinical Dohsatherapy has effects of easing excessive tension and correcting wrong postures of mentally retarded children by enhancing their own
ability to deal with seating, knee-bent standing, normal standing and arm-raising movement control. In other words, the clinical movement training can greatly decrease cases of improper postures of such mentally problematic students and improve the students' consciousness about their own postures. This leads even to the students' behavioral changes such as the better arrangement of appearance and dressing, by forming the children's own physical shape properly. Seating, one of the sub-areas of Clinical Dohsatherapy, allows having a seemingly stable seating posture by forming a vertically straight line from the hip to the head. It also prevents the waist from being gone rear or withdrawn by allowing the reduced strength of the waist and the proper attachment of the hip to the seat. This makes possible keeping physical balance through the central movement of the body. As another sub-part of the movement exercise, knee-bent standing allows the maintenance of physical balance with the body sustained by both of the knees. This makes a more stability of the whole body than before, including a more smooth posture of walking. This may be seen a collective result from the training of seating, knee-bent standing and normal standing in this study. Second, Clinical Dohsatherapy can make effective a sub-area of social skills, or self-assertion by children with mental retardation. Also the movement exercise makes the children positive in self-expression and behavior by promoting their own ability to control body for themselves. For the children, the promotion as mentioned above helps them enhance selfexpression because it ensures a better physical manipulation and makes them cope positively with outside environments. And the promotion results in the improvement of self-confidence, activeness and positiveness and extremely the strengthening of self-assertion. Third, Clinical Dohsatherapy has an effect of improving a sub-area of social skills, or the self-control of behavior in part of mentally retarded children. Through the movement exercise, the children can help themselves enhance the treatment of interpersonal relations, social contacts and sociability. Children with mental retardation can have the ability to control their behaviors by experiencing the possible control of their own body by themselves. That is, such mentally troubled children become more sensitive to their own body and become mature spiritually, establishing a psychological foundation for behavioral control in accordance with situations.
2. Further Research Based on the above described conclusion, the researcher would like to make the following suggestions. First, studies should be continued about how to use Clinical Dohsatherapy properly in the existing classroom, that is, consisting of one teacher and numerous students. Teachers need to try using students' parents as their assistant in actual classes. This may lead to keeping the application of the movement exercise to students even at home by the assistants and having educational effects of the application. Second, further studies should be performed to demonstrate that the movement exercise could improve the self-concept and self-esteem of mentally retarded students if standard measures of the two senses are developed. This may become a basis on which educational researches for the students' social and emotional maturation could be made in various ways. Third, it is necessary to develop Clinical Dohsatherapy programs that can be more easily treated by students' parents at home. Further studies should be made for the development, eventually promoting better educational effects in part of students.