Образование и охрана здоровья. Сборник научно-методических материалов

tion groups of 12 children with medium and severe hearing impairment. Therefore, overall 64 children attend pre-school education institutions, but 42 children attend mainstream kindergartens having specialized groups, the same number of children integrate into mainstream kindergartens. [14.] Children with severe hearing impairment acquire basic education at Riga Basic Boarding School for Deaf Children and Valmiera Secondary Boarding School for Hearing-Impaired Children — Development Centre having 227 children with severe and medium hearing impairment. Children of minorities can acquire education at Riga Secondary School of Humanities No. 51 having 26 children, but at Daugavpils Speech Therapy School — 13 children. Thus, 266 children acquire basic education at special schools. 42 children attend specialized schools, e. g., art, sports, but 42 integrate into mainstream schools.

Secondary education is acquired at Riga J. Rainis (Shift) Evening School No. 8—34 students, Valmiera Secondary Boarding School for Hearing-Impaired Children — Development Centre — 12 students, 16 students of minorities learn at Riga Secondary School of Humanities No. 51. Professional and general education is acquired at SIVA Jurmala Professional Secondary School — 13 students, Alsviki Professional School — 9 students, Barkava Vocational Secondary School — 24 students, Riga Professional Secondary School of Car Mechanics — 10 students, LU P. Stradins Medical College — 2 students. Thus, in 2010 overall 120 students acquired secondary and professional education. [9.]

In 2010, 22 deaf people acquired a bachelor degree, and 4 — a master degree. 23 deaf people are studying at higher education institutions.

CONCLUSION

The legislation of Latvia is based on international normative documents and national normative acts. As follows from legislation, rehabilitation of disabled children is closely related to education. Each parent chooses the most appropriate institution for the child as well as hearing rehabilitation.

In compliance with the legislation it is determined to have hearing screening of newborns, but it would be advisable to have additional screening at the age of 12—18 months because it is a risk age group. It would let discover hearing impairment facilitated by pathological factors in this period of development.

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It would be advisable to promote parents’ awareness of hearing and speech development and the features of their disturbances.

It would be necessary to inform parents actively, for example, by organizing seminars, educational camps together with children to acquire practical skills in communication with the child.

Early diagnostics has a significant role, thus closer cooperation is needed between Latvia Children Aural Centre and paediatricians, neurologists and otolaryngologists at children health institutions by informing about early and late diagnostics.

Hearing diagnostics can be done for children having speech and mental disturbances because according to the statistical data 20 % of weakened hearing is observed among children having autism, but it is up to 70 % for Down’s syndrome 80 % for uranoshcisis.

A differentiated syllabus will be needed at special education institutions for children having impaired hearing, combined disturbances and hearing and mental disturbances.

At general education institutions it would be necessary to inform teachers and develop their practical skills to work with children having various kinds of hearing impairment.

References

1.URL: www.european-agency.org/about-us/key-documents

2.URL: www.european-agency.org/publications/ereports/special-needs-education -country-data-2010/SNE-Cou

3.URL: www.ielasberni.lv/latviski/wfc.doc

4.URL: www.likumi.lv/doc.php?id=223423&from=off

5.URL: www.likumi.lv/doc.php?id=140695

6.URL: www.likumi.lv/doc.php?id=223858&from=off

7.URL: www.lizda.lv/content/files/izm_jaunumi%202011_2012.pdf

8.URL: www.lm.gov.lv/upload/berns_gimene/bernu_tiesibas/akti/bpl.pdf

9.URL: www.lns.lv/lat/jaunumi/avize__kopsoli_/www.mk.gov.lv/doc/2005/ LMNstP6_310107.doc

10.URL: www.mk.gov.lv/doc/2005/LMNot_231210.3613.doc

11.URL: www.social.lv/portal/izgltba/.../1924-grozijumi-visparejas-izglitibas

-likuma

12.URL: www.tiesibsargs.lv/lat/tiesibu_akti/ano_dokumenti/?doc=49

13.URL: www.vcbikernieki.lv/index.php

14.URL: www.vvbis-ac.valmiera.lv/index.php?option...

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School-children smoking behavior was measured by two items: ever smoking („Have you ever smoked a puff or two of cigarette?“) and current smoking („How many days during last month you smoked a cigarette? Current smoker — more than one day /nonsmoker — 0 days).

School-children intentions to smoke were measured by two items: intention to smoke during next year („Do you think you will smoke a cigarette at anytime during the next year?“) and intention to smoke after 5 years („Do you think you will be smoking cigarettes 5 years from now?“). Schoolchildren self-efficacy to refuse smoking was measured by one item („If one of your best friend offered you a cigarette, would you smoke it?“).

School-children attitudes towards smoking were evaluated by 4 measures: perceived image of a smoker was measured by two items („When you see a smoking man, what do you think about him?“, and „When you see a smoking women, what do you think about her?“); school-children answered negative to both questions (e. g. stupid, looser, not confident) were classified as having negative image of a smoker, those who answered positive to both or at least to one question (e. g. lucky, smart, masculine or modern) were classified as having positive image of a smoker.

Perceived social consequences of smoking were measured by scale of 5 items („Do you think boys who smoke have more or less friends?“, „Do you think girls who smoke have more or less friends?“, „Do you think smoking makes boys more or less attractive?“, „Do you think smoking makes girls more or less attractive?“, „Does smoking helps to feel more comfortable during parties?“). The scale was made in the way that it’s upper values indicate more negative social consequences (standardized Cronbach alpha — 0,678). Perceived smoking harm to health was measured by one item („Do you think, that smoking cigarettes damage your health?“). Perceived smoking insecurity was measured by one item („Do you think that it is secure to smoke for 1—2 years, if you will stop later?“).

The effectiveness of smoking prevention program was measured by positive and negative changes in smoking behavior and smoking cognitions (intentions to smoke, self-efficacy to refuse smoking and attitudes towards smoking) during one year.

Study design and sample

Survey of the smoking prevention program was implemented as a collaboration project among Kaunas district municipality and VMU De-

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partment of Theoretical psychology and Psychology Clinics. Survey was conducted in 2003—2005. 24 schools in Kaunas district participated in the survey. Random selection was used to assign in schools the control and the intervention groups. 12 schools in intervention group were randomly chosen in basic and advanced prevention program groups (6 schools in each group). 12 schools were selected as the control group. In the intervention groups smoking prevention program, based on social influence approach, was implemented during one school year in grade 6th. In the control group such smoking prevention program was not implemented. Students in 6th grade in all 24 schools were surveyed using GYTS (Global Youth Tobacco survey) questionnaire before the program implementation and one year after.

A total number of 1765 school-children in 6th grade participated in the survey before smoking prevention. 1317 school-children who participated in the first survey took part in the follow-up survey.

Program implementation

The smoking prevention program was implemented by 60 nonsmoking female psychology bachelor students motivated to participate in the program and by one of the authors of this presentation with two levels of intensiveness (basic and advanced). Three criteria were used for intensiveness assessment: number of sessions, time between the sessions and content of the sessions. In the basic prevention program 2 cycles were used during one school year (one cycle per semester). One cycle included 2 sessions, limited number of prevention activities, without repeating them in the next cycle. In the advanced prevention program 3 cycles of sessions were used during one school year (one cycle per trimester). One cycle included 2—3 sessions, used more prevention activities, repeated activities during the next cycles. In total, 9 sessions were used in the advanced program, 4 sessions were used in the basic program.

Results

Analysis of the group differences at the initial survey in smoking behavior, smoking cognitions and demographic, as well as psychosocial factors related to smoking revealed that there were no differences between the intervention and the control groups in gender, grade, intention to smoke after 5 years and some measures of attitudes towards smoking, but there were found differences between these groups in ever and current smoking, intention to smoke in the next year, self-efficacy to refuse smoking

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and some attitudes towards smoking. It was found that there are differrences between groups in parent and friends smoking, but no differences were found in smoking at home and antismoking education at home.

In order to control these initial differences between groups, effectiveness of the prevention program was measured in 3 steps: firstly changes in by differences in positive and negative changes of smoking behavior and smoking cognitions between intervention and control groups, and then between high and low intensive intervention groups. The final decision on the effect was made using regression analysis controlling the initial differences between the groups.

Changes in smoking prevalence

Number of ever smokers increased in all groups during one year. Approximately 40 % of never smoking boys and 20 % of never smoking girls in 6th grade tried to smoke after one year in the advanced and basic intervention, and the control groups (see pic. 1).

Picture 1. Percentage of started to smoke boys and girls in one year in the advanced and basic intervention groups and the control group

No statistically significant differences were found in increasing number of ever smokers between both intervention and control groups, neither between the advanced and the basic intervention groups.

Meanwhile, number of current smokers changed differently in the intervention and the control groups during one year (see pic. 2).

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Picture 3. Changes in % of definitely not intending to smoke in the next year in the advanced and the basic intervention groups and the control group

Similar results have been found in changes of intentions to smoke after 5 years. While the number of definitely not intending to smoke after 5 years school children in 6th grade decreased by 10% in both intervention groups and remained stable in the control group, but these differences were not significant after controlling initial differences between groups.

Changes in self-efficacy to refuse smoking

Approximately 80 % of 6th grade girls in all groups remained refusing an offered cigarette (see pic. 4).

Picture 4. Changes in % of definitely not intending to smoke in the next year in the advanced and the basic intervention groups and the control group

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But more boys in 6th grade of the basic intervention group declared no intention to refuse an offered cigarette compared to the control and the advanced intervention group in the follow up survey.

Changes in and attitudes towards smoking

Changes in attitudes towards smoking were different in both intervention and control groups. Some attitudes (e. g., image of a smoker and attitude towards smoking insecurity (see 2.Table and 3.Table)) remained negative and did not differ in the advanced intervention and the control or the basic intervention and the control groups during one year for both genders in 6th grade (see 1.Table and 2.Table). But attitude towards social consequences of smoking became more positive for all school children in all groups (see 4.Table); still these changes were statistically significant only for girls in 6th grade in the basic intervention group compared to the control group (taking into account initial differences between these groups). Attitude towards smoking harm remained negative during one year for both grades in all groups, except 6th grade boys in the basic intervention group: number of 6th grade boys with negative attitude towards smoking harm reduced compared to the control group.

Table 1

Changes % of those with negative attitude towards smoking harm

All differences among groups — non significant

T1 — first time screening; T2 — second time screening.

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