Zbornik Rezimea Novi Sad 2012

II International Scientific Conference
Special Education and Rehabilitation – Cerebral Palsy
Book of Proceedings and

Summaries
Belgrade, 2012
SPECIAL EDUCATION AND REHABILITATION – CEREBRAL PALSY
Book of Proceedings and Summaries
Publisher:
Society of Special Educators and Rehabilitators of Serbia
For publisher:
Mikailo Kijanovic, President
Editors:
PhD Milan Kulic, Associate Professor
Srecko Potic
Reviewers:
PhD Goran Nedovic, Associate Professor
PhD Dragan Rapaic, Associate Professor
PhD Dragan Marinkovic, Assistant Professor
Processing and printing

Planeta print, Belgrade
Cover design
Veselin Medenica
Circulation
200 copies
ISBN 978-86-84765-40-8
Review of Book of Proceedings and Abstracts “Special Education and Rehabilitation – Cerebral
Palsy” was accepted by the decision (No. 72/12) of the Presidency of the Society of Special
Educators and Rehabilitators of Serbia in the meeting on June 6th 2012.
II International Scientific Conference
SPECIAL EDUCATION AND REHABILITATION – CEREBRAL PALSY
Organizers of Conference:
University of Belgrade – Faculty of Special Education and Rehabilitation,
Department of Special Education and Rehabilitation of Persons with Motor Disorders
University of Novi Sad – Faculty of Medicine,
Department of Special Rehabilitation and Education
Association of Special Educators and Rehabilitators of Vojvodina
School for Elementary and Secondary Education “Milan Petrovic”, Novi Sad
Scientific Committee of Conference: Organizing Committee of Conference:

PhD Jasmina Kovacevic, Serbia PhD Goran Nedovic, President
PhD Goran Nedovic, Serbia M.A. Snezana Ilic, Secretary General
PhD Nikola Grujic, Serbia PhD Kosta Savic
PhD Goran Ajdinski, Republic of Macedonia PhD Fadilj Eminovic
PhD Spela Golubovic, Serbia M.A. Vesela Milankov
PhD Milan Kulic, Bosnia and Herzegovina Marinela Scepanovic
PhD Danijela Bratkovic, Croatia M.A. Slavica Markovic
PhD Keith Storey, USA M.A. Adnan Ahmetasevic
PhD Hana Valkova, Czech Republic Stefania Reversi
PhD Berit Johnsen, Norway Srecko Potic
PhD Glenn Roswal, USA Veselin Medenica
PhD Yeshayahu Hutzler, Israel Milena Milicevic
PhD Bota Aura, Romania Sanela Pacic, Master
PhD Claire Boursier, France M.A. Sanela Slavkovic
PhD Carlo Lai, Italy Snezana Stantic
PhD Eudokia Samouilidou, Greece M.A. Sanja Trgovcevic
PhD Elena Kalenik, Russia Ivana Sretenovic, Master
PhD Briskin Yuri,Ukraine Dragana Pascan
PhD Aleksandra Mikov, Serbia Srdjan Lukic
PhD Dragan Rapaic, Serbia Svetlana Kekic
PhD Snezana Nikolic, Serbia Nevena Ivkovic
PhD Miodrag Stosljevic, Serbia Renata Skrbic
PhD Stevan Jovic, Serbia Mirjana Isakov
PhD Gordana Odovic, Serbia
PhD Danijela Ilic-Stosovic, Serbia
PhD Radmila Nikic, Serbia
PhD Vera Ilankovic, Serbia
PhD Fadilj Eminovic, Serbia
PhD Dragan Marinkovic, Serbia
Program
October 25th 2012
13.00-17.00 Registration
Working Presidency: Goran Nedovic, Spela Golubovic, Slavica Markovic and
Marinela Scepanovic
17.00-17.30 Opening of the Conference
17.30-17.50 Book Presentations
Miodrag Stosljevic, Dragan Marinkovic and Fadilj Eminovic (Eds.):
Thematic Collection of Papers “Cerebral Palsy – A Multidisciplinary and
Multidimensional Approach” (Dragan Marinkovic)
Milan Kulic and Srecko Potic (Eds.): Book of Proceedings and Abstracts
“Special Education and Rehabilitation – Cerebral Palsy” (Srecko Potic)
Dragan Rapaic and Goran Nedovic: Cerebral Palsy – Praxis and Cognitive
Function (Spela Golubovic)
Emira Svraka, Dijana Avdic and Enedeina Hasanbegovic-Anic:
Occupational Therapy (Edina Saric)
Other Books (Department of Special Education and Rehabilitation
of Persons with Motor Disorders, Faculty of Special Education and
Rehabilitation, University of Belgrade)
Presentation of the School for Elementary and Secondary Education
17.50-18.00
“Milan Petrovic”, Novi Sad
18.00-19.00 Cocktail
October 26th 2012

Plenary session
Working Presidency: Goran Nedovic, Spela Golubovic and Aleksandra Mikov
Dragan Rapaic, Goran Nedovic Methodological approach to the study
10.00-10.10
and Sanja Trgovcevic of persons with cerebral palsy
Goran Nedovic, Danijela Ilic- Educating children with cerebral palsy
10.10-10.20
Stosovic and Fadilj Eminovic in the Republic of Serbia
Work methodology of the Special
10.20-10.30 Mirjana Boskovic Hospital for Cerebral Palsy and
Developmental Neurology in Belgrade
History of the development of children’s

10.30-10.40 Kosta Savic
rehabilitation in Vojvodina
Aleksandra Mikov, Cila Demesi- Therapeutic possibilities in the

10.40-10.50 Drljan, Jelena Stanic and Lidija tretament of patients with cerebral
Dimitrijevic palsy
The efficiency of application of medical
technology “Phase Fibrotomy in
10.50-11.00 Aleksandar Nazarkin Orthopedics” by professor V. B. Ulzibat
in the rehabilitation of patients with
infantile cerebral palsy
How to implement natural supports
11.00-11.10 Keith Storey in the workplace to increase task
performance and social integration
7
11.10-11.20 Pause
Session 1: Cerebral Palsy, Etiology and Diagnostic
Working Presidency: Dragan Rapaic, Aleksandra Mikov and Spela Golubovic
Mirela Babajic, Emira Svraka,
Structure of prenatal etiologies factors
Senad Mehmedinovic, Edina
11.20-11.30 and types of cerebral palsy in Tuzla
Saric, Damir Babajic and Azem
Canton
Poljic
Vladimir Trajkovski and Biljana Associated conditions in persons with
11.30-11.40
Krstevska-Kokormanova cerebral palsy
Maternal cognitive and emotioanal
Tatjana Krstic and Biljana
11.40-11.50 denial of child’s diagnosis of cerebral
Obradovic
palsy: Nonresolution
Responding to the challanges while
Roksana Hoque and Mohammad
11.50-12.00 raising a child with cerebral palsy in
Monjurul Karim
the context of Bangladesh
Cila Demesi-Drljan, Aleksandra
Mikov, Mirela Vulovic, Vera Functional ability of children with
12.00-12.10
Bekic, Daliborka Borkovac and cerebral palsy
Rastislava Krasnik
The possibilities of assessment and
Spela Golubovic and Sanela classification of capabilities of upper
12.10-12.20
Slavkovic extremity of children with cerebral
palsy
Ofelija Bocka-Pepelcevic, Functional status of youth and adults
12.20-12.30 Andrijana Radulovic and Sanela with cerebral palsy in a residential
Slavkovic facility
Assesment of functional ability of
Sanja Trgovcevic, Blagoje
12.30-12.40 children with cerebral palsy at school
Gesoski and Maja Nedovic
age
Motor performance in primary school
12.40-12.50 Erna Zgur and Miran Cuk
children with cerebral palsy
12.50-13.10 Discussion
13.10-14.30 Pause
Session 2: Treatment of People with Cerebral Palsy
Working Presidency: Snezana Nikolic, Miodrag Stosljevic and Vesela Milankov
Ines Ayadi, Fatma Kamoun, Ines
Hasairi, Emna Ellouz, Houda
Is early treatment of infants at risk of
14.30-14.40 Ben Othmen, Nejmeddine
cerebral palsy warrented?
Hentati and Chahnez Charfi
Triki
Vera Ilankovic, Andrej Ilankovic,
Treatment of children with cerebral
14.40-14.50 Lana Marija Ilankovic-Kambeitz
palsy: Vilan method
and Nikola Ilankovic
„Open stimulation system of human
Miodrag Stosljevic and Milosav
14.50-15.00 development“ as the therapeutic model
Adamovic
of cerebral palsy children rehabilitation
Occupational therapy treatment for
15.00-15.10 Maria Arango
8
Lidija Dimitrijevic, Aleksandra Application of the Halliwich
15.10-15.20 Mikov, Hristina Colovic and hydrotherapy method in children with
Marko Aleksandrovic cerebral palsy
Miodrag Stosljevic and Milosav Treatment of enuresis nocturnae in
15.20-15.30
Adamovic children with cerebral palsy
The influence of therapeutical horse-
Vesna Pausic, Jelena Stanic and
15.30-15.40 riding on improvement of psychological
Aleksandra Mikov
functions in cerebral palsy patients
Marina Oros, Ivan Jerkovic and The use of robots in children therapy –
15.40-15.50
Agota Major Attitudes of parents
Family therapy and education by
occupational therapist for creating
Mohammad Monjurul Karim environment at home for the children
15.50-16.00
and Roksana Hoque with cerebral palsy: Evaluate child’s
learning from caregiver’s perception in
the context of Bangladesh
16.20-16.30 Pause
Session 4: Social Welfare of People with Cerebral Palsy
Working Presidency: Gordana Odovic, Sanja Trgovcevic and Renata Skrbic
Accessible housing for person with
16.30-16.40 Emira Svraka
cerebral palsy
Possibilities for social integration of
16.40-16.50 Ivana Mitrovic-Djordjevic
persons with the cerebral palsy
Vojislava Bugarski, Dragana
Health-related quality of life in
16.50-17.00 Miscevic, Renata Skrbic and
Spela Golubovic
Gordana Odovic, Dragan Rapaic,
Life habits accomplishment level of
17.00-17.10 Jelena Stanisavljevic and Ivana
persons with cerebral palsy
Sretenovic
Svetlana Kaljaca, Gordana Self-esteem of individuals with
17.10-17.20
Odovic and Bojan Ducic cerebral palsy
October 27th 2012
Session 3: Education of People with Cerebral Palsy
Working Presidency: Danijela Ilic-Stosovic, Radmila Nikic and Slavica Markovic
Speech and language abilities in
Ivana Terzic, Nadica Jovanovic,
10.00-10.10 children with cerebral palsy in
Mile Vukovic and Goran Nedovic
elementary school
Goran Nedovic, Sanja
Graphomotor skils of children with
10.10-10.20 Trgovcevic, Milan Kulic and
cerebral palsy
Dragan Marinkovic
Sanela Pacic, Fadilj Eminovic,
Graphomotor expresion of children
10.20-10.30 Radmila Nikic, Snezana
with cerebral palsy in school age
Mirkovic and Mirjana Gavrilovic
9
Fadilj Eminovic, Gordana
Colic, Milos Djordjevic, Marija Writing ability in children suffering
10.30-10.40 Knezevic, Sanela Pacic, from cerebral palsy after phased
Marienka Zolnjak and Dejan fiberotomy: Case report
Likic
Lucija Djordjevic and Srboljub Peculiarities of artistic expression of
10.40-10.50
Djordjevic students with cerebral palsy
Danijela Ilic-Stosovic, Anita
The analyzes of individual education
10.50-11.00 Kovacic, Snezana Nikolic and
plans for children with cerebral palsy
Jasmina Maksic
Methodology for individual support
Snezana Nisevic and Lidija
11.00-11.10 plan in education for students with
Banjac
cerebral palsy
Condition of students with cerebral
11.10-11.20 Marija Davcevska palsy when switching from lower
grades to upper classes
Conductive education in special
11.20-11.30 Renata Kos and Blazenka Maltar classes in educational centre “Tomislav
Spoljar” in Varazdin
“Inclusive”, “Integrated” or “Special”?
Reflections on the perceptions of,
Shyamani Hettiarachchi and discourse on and perceived training
11.30-11.40
Ajay Das needs in „Inclusive” education for
children with cerebral palsy in Sri
Lanka
Adapted physical activities as the part
11.40-11.50 Hana Valkova of education: Chance for children with
cerebral palsy
12.10-12.30 Pause
Session 5: Others
Working Presidency: Fadilj Eminovic, Sanela Slavkovic and Snezana Ilic
Isabel Catarina Martins,
Motor imagery in cerebral palsy: Is that
12.30-12.40 Armando Mónica de Oliveira
true?
and Bert Steenbergen
The role of the central nervous system
12.40-12.50 Sinisa Ristic and Zvezdana Kojic in the organization and control of
voluntary motor activity
Dusanka Tesanovic, Dragana Early detection of breast cancer by
12.50-13.00 Djilas-Ivanovic, Danijela Pisaric mammography in woman suffering
and Fadilj Eminovic from cerebral palsy
The role of gender and the type of
hospitalization in training self care
13.00-13.10 Nada Savkovic
activities of preschool children with
cerebral palsy
Dermatogliphic characteristics of
Miodrag Stosljevic and Milosav
13.10-13.20 digito-palmar complex of a child with
Adamovic
cerebral palsy – Case study
10
The physical education and sports
Evdokia Samouilidou and
13.20-13.30 activities, socialization instruments for
Constantine Mouratidis
students with phyical disabilities
Danijela Vukicevic, Stevan Jovic,
Wheelchair fencing – An adaptive sport
13.30-13.40 Dragan Vulovic, Aleksandra
for person with cerebral palsy
Sekulic and Jelena Stikovic
Sports and recreational activites –

13.40-13.50 Admira Konicanin
Boccia for people with cerebral palsy
Vojislav Todorovic and Slobodan Digital media working with children

13.50-14.00
Vuletic with multiple disabilities
Kurt Coble, Martin Kalamkovic, Possibility of using new types of
14.00-14.10 Slavica Markovic and Radmila musical electronic instruments for
Ristovski assistive tecnology
14.20-15.30 Pause
Poster Presentations
15.30-16.30
Moderators: Spela Golubovic, Slavica Markovic and Vesela Milankov
Is there risk of cerebral palsy
Milena Milicevic, Srecko Potic
in children born after assisted
and Vera Ilankovic
conception?
Gordana Panova, Nevenka
Velickova, Blagica Panova, Life expectancy in children with
Nenad Panov and Lence cerebral palsy
Nikolovska
The importance of application
Mirna Zelic, Neda Milosevic and
logopedic instruments in treatment
Dragan Causevac
Nada Iric, Suzana Mikovic, Milka Demonstration of rehabilitation of
Milovanovic-Minic and Fadilj persons with cerebral palsy and
Eminovic multiple disabilities
Srecko Potic, Milena Milicevic,
Snezana Ilic, Andrijana Pavlovic, Preschool education of children with
Bojana Mastilo and Ivana cerebral palsy in the Republic of Serbia
Zecevic
Marina Radic-Sestic, Milica Problems of employment and job
Gligorovic and Biljana acommodation of persons with cerebral
Milanovic-Dobrota palsy
Biljana Milanovic-Dobrota,
Professional training for persons with
Marina Radic-Sestic and Vesna
cerebral palsy - A case study
Radovanovic
Lidija Ivanovic, Dragan
Activities of daily living in persons
Rapaic, Veselin Medenica,
with cerebral palsy in institutionalized
Sanja Trgovcevic and Marinela
conditions
Scepanovic
Slobodan Bankovic, Nenad Behavioral problems in children with
Glumbic, Ksenija Stanimirov cerebral palsy and mild intellectual
and Mirjana Djordjevic disability
11
Veselin Medenica, Lidija Using the computer software for
Ivanovic, Katarina Uzunovic, observation and analysis of motor
Radica Dragojlovic-Ruzicic and behavior for apraxia assessment in
Marica Drcelic persons affected by cerebral palsy
Jasmina Karic, Vesna The inclusive potential of applied
Radovanovic and Sladjana theatre in activities with people with
Andjelkovic disabilities
Swallowing and chewing problems in
Vesela Milankov and Kosta Savic
Evaluation of literature data on the
Rosica Stoilova and Zivka prevalence of dental caries and oral
Bataska hygiene status in children with cerebral
palsy
Vesela Milankov, Mila
The influence of respiration on the
Veselinovic and Slavica
quality of phonation in dysarthria
Markovic
Gross motor function and classification
Snjezana Mergon
system
16.30-17.00 Presentation of the Conference Sponsors
October 28th 2012
10.00-11.30 Roundtable and Conclusions of the Conference
10.00-11.00 Closing of the Conference

11.00-12.00 Closing Meeting of the Conference Organizing Committee
12
Plenary Session
METHODOLOGICAL APPROACH TO THE STUDY OF PERSONS
WITH CEREBRAL PALSY
Dragan Rapaic1, Goran Nedovic1 and Sanja Trgovcevic2

1
University of Belgrade – Faculty of Special Education and Rehabilitation, Serbia
1
University of Belgrade – Faculty of Political Sciences, Serbia
During the fifties of the last century there was a real expansion in the
studies of problems that cerebral palsy entailed. Medical research in this
field dealt with the etiology, clinical picture, classification, treatment and
rehabilitation. At the same time, in the research focuse of psychological studies
were intelligence, perception, memory, learning abilities, etc. The practice of
special education was facing the resolving of learning problems in children with
cerebral palsy, and the theory was facing the studying of the nature of learning
problems and the discovering of intervention methods. Special attention was
given to motor disorders that generated problems in motor behavior, and also
to effectiveness of children with cerebral palsy.
When talking about motor behavior, by that we imply “a product of
biological characteristics and environmental influences that can be seen in
the domain of learning and execution of movement or motor skills. Motion
planning, control of execution and motor learning represent cognitive aspects
of motor behavior but also are problems that constantly confront the theory
and practice of special education and rehabilitation” (Rapaić, Nedović, 2007,
p. 616).
Before saying anything more about the methodological approach we have
chosen when studying cerebral palsy, we would first like to present different
research approaches used in other sciences in the studying of this condition.
In a wider scientific context, a field of motor behavior studying is truly
diverse. However, for understanding of research and attitudes presented in
this publication, two directions of motor behavior studying are highlighted as
very important: “The study of “mental representations” of motor activities is
relatively more recent and linked to the cognitive psychological framework.
Another research direction consists of studies recognized as the “brain and
behavior” and which belong to the domain of medically-oriented research”
(Nedovikj, Rapaikj, 2010, p. 31-42). In psychology, research of relation between
cognitive function and motor behavior was conducted on healthy subjects. On
the other hand, research in medicine, which was directed to consideration of the
relationship between motor behavior and biological structures, was carried out
in patients who suffered from an organic brain syndrome or head or brain injury.
So far, studies on a relationship of cognition and motor action in people with
disabilities have been partial. Specific motor skills in some forms of disability
or handicap were studied. “Studies of motor behavior in people with disabilities
15
indicate the existence of different planning mechanisms that are characteristic
for each type of disability (Rapaić, Nedović, 1995; Rapaić, Nedović, Nikolić,
1995; Jablan, Rapaić, Nedović, 1997; Nedović, Rapaić, Subotić, 2006; Rapaić,
Nedović, 2006, 2007). These studies profiled the assessment methodology of
the structure of motor behavior in people with disability, and also connected
this information with educational and rehabilitation programs of preventive
and corrective work. The problem of differential assessment and construction
of theoretical and practical models of education and rehabilitation represent
further research need in this area” (Rapaić, Nedović, 2007, p. 616).
One of possible methodological approaches in studying of people with
cerebral palsy is the analysis of two segments of their functioning – the motor
and the cognitive. In this approach, motor and cognitive functioning are
conditionally divided into two separate units in order to make discussion of
these issues more systematic and more clear.
In the scientific literature, methodological approach is described as a
construction, based on the belief of researchers, that serves for the elaboration
or the verification of an idea. Its clear presentation allows the reader to follow
the conceptual course with understanding, and also further considerations
that derive from it. The methodological approach is not a theory, but its testing
and verification can provide proving of an existing theory (highlighting of
some of its aspects), or serve the new theory construction. Broader framework
of our approach is the theory and practice of defectology (special education and
rehabilitation) and consideration of context which consists of children with
developmental disabilities and people with disabilities in a social environment.
The basic idea of our approach is the analysis of two segments of behavior
of children with cerebral palsy in a way that is presented in scheme 1.
Scheme 1.
← Cognitive functioning ⇒
Social environment ⇒ ← Social environment
← Motor functioning ⇒
Motor and cognitive functioning of children with cerebral palsy are

considered in the context of social environment as a two-way relation, the impact
of social environment on motor and cognitive functioning of children with
cerebral palsy, and its cognitive and motoric impact in a social environment.
We find a reason for this type of analysis in the theory of defectology (special
education and rehabilitation) that deals with studies of function disorders
16
in people with disabilities within the social environment. Under these
circumstances handicap situation occurs. When it comes to children with
cerebral palsy, then they are observed in the peer group context (preschool and
school-aged), and through expected behavior which is related to that context. If
it comes to people with cerebral palsy in a productive life period, then they are
observed in working-professional context, with all the expected abilities that
are necessary for such activity, and expected characteristics of peer groups.
Motor and cognitive functioning within a social context are induced by
the satisfaction of needs or result from some other motive. In any case, activated
are those potentials (within motor and cognitive) that will be sufficient for the
intended action, i.e. goal, to be achieved. Healthy individuals meet the needs
(for food, personal hygiene, education, artistic value, etc.), realize short-term
or long-term goals (writing homework, decorating an apartment, completing
of education or employment), mostly uninterrupted with appropriate energy
consumption. In the case of people with cerebral palsy, motor and cognitive
functioning in a social context is considerably more difficult, and sometimes
completely impossible.
“If the focus is directed on the socio-psychological conditions in which
children with cerebral palsy grow, then it is clear that these children are largely
deprived in terms of outside influences as one of the major factors of adequate
development. Motor disorder itself causes numerous limitations to a child and
makes the acquisition of spontaneous experiences difficult by depriving him/her
of many sensory and social stimulations. Therefore, not only perceptual, motor,
visuo-motor abilities are affected, but also are many other abilities and skills,
because a child does not practice them due to the primary, motor impairment.
Therefore these individuals subsequently or partially learn activities of daily
living (eating, dressing, personal hygiene), they get later included in the family
life and peer group activities, and also they later learn other abilities that are
highly important for inclusion in the school environment, and both life and
work in a social environment” (Nedović, Odović, Rapaić, 2010, p. 35-36).
“Mutual effect of motor and cognitive functioning is most evident in the
case of dominant dysfunction in one area. In summary, as an example, people
with cerebral palsy (in which a motor impairment is the primary one) and
people with intellectual disabilities whose mental dysfunction dominates the
clinical picture, could be mentioned. Motor dysfunction disables people with
cerebral palsy in acquiring of experiences and knowledge that can be reached
only through motor action, and on which higher cognitive functions and social
experiences are further built. The negative impact of intellectual disability
(which is primarily characterized by deficits in cognitive functioning) is
reflected in an inability of individual with intellectual disability to design a
goal, and then to cognitively support the planning, controlling and executing
of motor actions” (Rapaić Nedović, Nikolić, 1995, p. 68-76).
17
Testing of components of functional units in the area of motor and
cognitive functioning in people with cerebral palsy can be carried out at the
levels shown in the scheme 2 (Rapaić, Nedović, 1995, p. 34)
Scheme 2.
THE AREAS OF FUNCTIONING
MOTOR COGNITIVE
- elementary movements - attention
- nonrepresentative movements - experience of body wholeness
- nontransitive movements - orientation
- transitive movements - perception
- leg praxis - memory
- bilateral movements - thinking
- ideational movements - speaking
- constructive praxis
- graphomotoric
- praxis of dressing
- facial praxis
- movement imitation
“In the area of motor functioning, movements that are the building
components of functional units, can be identified (elementary movements,
nonrepresentative, nontransitive, transitive, bilateral, etc.), but also the
movements that consist of movement sequences and that are functional only
when are connected in certain order and time-limited (ideational movements,
constructive praxis, praxis of dressing, etc.). Impairment, disorder or complete
omission of one or more groups of movements directly cause dysfunction of
the individual (low, medium or high) within a social environment” (Rapaić
Nedović, 1995, p. 33). In the area of cognitive functioning, the following
functional units can be analyzed: attention, perception of body wholeness,
orientation, perception, memory, thinking and speaking.
Each of these, motor and cognitive areas, can be analyzed separately or in
interaction with other areas (Rapaić Nedović, Nikolić, 1995, p. 68-76; Nedovikj,
Jachova, Rapaikj, 2009). Finding a connection is possible within the same area,
e.g. bilateral and nonrepresentative movements or attention and memory.
Testing of cognitive aspects of motor behavior in people with disabilities is
particularly important for us (Rapaić Nedović, 2007). Therefore, it is a classic
framework within cognitive psychology, which is used in the study of motor
behavior in participants from the typical population, and which is used, for the
purposes of our approach, in the analysis of children with cerebral palsy.
18
In the understanding of cerebral palsy, we started from the basic fact
that cerebral palsy is a multidisciplinary and multidimensional problem, and
therefore different aspects of studying and analyzing of cerebral palsy are
possible. They often reflect researchers’ personal preferences, their professional
orientation and basic education. Our approach to studying of cerebral palsy is
the result of years of theoretical analysis and research in the area of defectology
(special education and rehabilitation), i.e. somatopedics. We believe that
the proposed methodological framework is flexible enough so that different
disability situations and different life periods studied in a defectology (special
education and rehabilitation) can be described. The efficiency of its use is found
in the description of people with visual impairment (Rapaić Nedović, Jablan,
1997), and people with intellectual disability (Rapaić Ivanuš, Nedović, 1996),
but also in gerontology (Rapaić Nedović, Potić, 2010). The aims of these studies
are the assessment of abilities, potentials and deficient areas in participants as
the basis for the proposal and creation of defectological treatment.
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19
psihofiziološke poremećaje i govornu patologiju ’’Prof. Dr Cvetko Brajović”
Beograd, Zbornik radova i sažetaka, 96-105.
9. Rapaić D., Nedović G. (1995). Metodološki pristup u dijagnostici i
rehabilitaciji osoba sa oštećenjem centralnog nervnog sistema. Defektološka
teorija i praksa, 1, 33-38.
10. Rapaić D., Nedović G., Nikolić S. (1995). Polazni parametri u rehabilitaciji
osoba sa poremećajima kognitivnih i praksičkih funkcija nastalih povredama
mozga. Defektološka teorija i praksa, 1, 68 -76.
11. Rapaić D., Ivanuš J., Nedović G. (1996). Izvođenje pokreta kod menalno
retardiranih, Beogradska defektološka škola, 1, 105-116.
*Corresponding author: Goran Nedovic, e-mail: [email protected]
20
EDUCATING CHILDREN WITH CEREBRAL PALSY IN THE
REPUBLIC OF SERBIA
Goran Nedovic, Danijela Ilic-Stosovic and Fadilj Eminovic

Educating children with cerebral palsy have not long tradition, nor in the world,
nor in our country. In the development of this educational forefront technologically and
economically developed countries, and the first school for the education of children
in Serbia opens only 1972nd year. Education in special conditiones in ourcountry is
dominated to 2009., when the came of the Law on Basic Sistem of Education.
The main objective of this paper is to present models and methodology of
education of children with cerebral palsy in the Republic of Serbia, as well as through
critical review indicate the best forms of education of these children.
Special education is of the view that knowledge of bio - psycho - social
characteristics of these children prerequisite for their education, and that every
child should receive appropriate the educational content and support in learning.
The complexity and interdependence of these factors is such that requires a specific
methodological approach when it comes to the identification of educational needs of
children with cerebral palsy.
Key words: education, cerebral palsy, methodological frameworks.
Introduction
Upbringing and education of children with physical disabilities, including
the children with cerebral palsy has no tradition,neither in our country nor in the
rest of the world. The exceptions are countries where this practice began in the
second half of the nineteenth century, but in most countries special pedagogical
practice did not begin until the twentieth century. The sources that would
provide theoretical support for practical work were very scarce and mostly limited
to practical care of these children, with little contribution to the development
of the profession. Later on, literature that was dealing with organizational and
methodological issues as well as issues of educational practice methodology for
children with physical disabilities emerged (Henneberg et al., 1968).
Children with physical disabilities are covered with medical treatment much
earlier than with special-pedagogical and rehabilitation process, which is not the
case with children with different conditions and impairments (children with
visual dysfunctioning, children with hearing disabilities, etc.). Among the fields
of medicine that pioneered the coverage of children with physical disabilities in
the rehabilitation process, were orthopedics and physical medicine. “Different
attitude towards education of physically disabled children and education of some
other categories of children disabled in psychosomatic development comes from
21
various points of view at different disorders that cause disability in one or in the
other case. Disorders that cause blindness or deafness are still seen as permanent
and unchangeable, “static” in functional terms, while the organic and functional
disorders, and disorders that cause physical disability are often viewed as a
variable or “dynamic” in the functional sense, of course, except for the cases of
the loss extremities “(Henneberg et al., 1968, p.59).
The idea of organized education for children with physical disabilities
in Serbia was introduced rather late, compared with the fact that first class
education for disabled children in Europe was opened in the nineteenth
century (it was founded by Jacques Matthias Delpek). In Serbia, Regulation
of establishment of the State department for Child Protection that foreseen
the opening of the Institute for the accommodation, teaching and training of
disabled children was brought in 1919. but not until 1923. Zemun disability
institute began to accept children with disabilities to learn crafts« (Macić,
Nikolić, 1991, p.11). Special schools were included in the state education system
in 1929. when the Ministry of Education took care of disabled children, but
in the 1928. only school in Serbia that dealt with education of these children
(placed in a Disability Institute in Zemun) stoped working. For children whose
illness character required longer hospitalization schools and hospitals were
opened in Kraljevici (1935) and Sremska Kamenica (1936).
Of all the schools for children with physical disabilities in Europe schools
for children with cerebral palsy were opened last. The first school for these
children was opened in England in 1947 and then began to set up service
centers for cerebral palsied individuals, preschool classes, special schools and
other institutions. The first primary school for children with cerebral palsy
in the Republic of Serbia was founded in 1972. by the Education Council of
the Republic. »At that time the school consisted of 142 students, divided into
17 classes. The teaching staff consisted of 13 special education teachers in the
classroom and three special education teachers in the living room, who worked
with the children to prepare their homework »(Macić, Nikolić, 1991, p.12).
Today, the school is housed in the premises of the Hospital for Cerebral Palsy
and Developmental Neurology in Belgrade and called PS »Miodrag Matic.« In
addition to the school education of children with cerebral palsy, and children
with other forms of disability is performed also by the school »Dragan Hercog«
in Belgrade, which works under this name since 1971 year, as the school »Milan
Petrovic« in Novi Sad, founded in 1960/61 year.
The main objective of this paper is to present the main organizational
forms of education and upbringing of children with cerebral palsy and, through
critical reflection, point the need of respect for basic methodological aspects of
creating education programs for children with cerebral palsy.
22
The organizational forms of education for
Until the adoption of the Law for Educational System of the Republic of
Serbia (2009), all children with special needs, including children with cerebral
palsy in Serbia were able to study under several organizational forms: 1) regular
primary schools (no special adjustment program, methods and teaching aids),
2) in regular schools, but individual departments and specialist curriculum,
and 3) schools for children in hospital and home care (according to the regular
curriculum, but the adaptation of content, teaching methods, and studied
conditions), and 4) schools for children with cerebral palsy (with special
curriculum with an adaptation conditions, devices, methods, and particularly
the educated professionals), 5) in special schools under a special curriculum.
Such a widespread network of educational opportunities for children with
cerebral palsy exists due to several reasons, including basic: the existence or
non-existence of special schools for the child in place of birth, a long and rich
tradition of special education for children with disabilities, and education staff
working with these children, specially developed methodological approaches
in guiding children towards a particular form of education etc.
Upon the adoption of the Law for Educational System of the Republic of Serbia
(2009), which promoted the education of children in inclusive terms, children
with cerebral palsy could be educated in regular schools, schools for children with
cerebral palsy, as well as schools for children in hospital and home care, but only in
the ordinary curriculum, as well as by Individual educational plans.
A critical review
Although inclusive education is clearly a humane idea and aspiration that
all children with special should be included in the educational system, however,
the question remains whether it is, as it was theoretically designed, proven in
practice as the best achievable solution for children with cerebral palsy. This
dilemma is supported by the fact that cerebral palsy is followed by a number
of associated damage. Falkman (2005) highlights a marked heterogeneity of
manifested symptoms. Specifically, problems in motor skills can range from
barely noticeable to those that the child is practically helpless without outside
help and care. As a result of this heterogeneity, for two children who were
diagnosed with cerebral palsy, we can see such a difference in motor and speech
and language behavior, that someone who does not deal with this problem, gets
the impression that these are two different states of disability.
Research suggests that in addition to motor dysfunction, around 60% of
children with cerebral palsy have two or more additional damage (Falkman,
2005). In addition to hearing and sight impairments, according to different
23
studies 20 - 40% of children with cerebral palsy suffer from epilepsy, especially
children with hemiplegia, and quadriplegia (Sanner, according Falkman, 2005;
Oddding, Roebroeck, Stam, 2006). The percentage of children with cerebral
palsy and intellectual disability varies, depending on the type of cerebral palsy,
and can range from 10% in children with dyskinetic syndrome to 100% in
children with spastic quadriplegia (Sanner, 1999, according to Falkman, 2005).
Anvor et al. (2006) cite figures that 67% of children have impaired speech,
and according to Odding, Roebroeck and Stam (2006) found that nearly 80%
of children with cerebral palsy have a speech impairment.
This is all reflected in the ability of these children to participate in
teaching. Ilic-Stosović and Nikolic (2008), while examining the ability to
participate in the teaching of children with cerebral palsy who are educated
in the ordinary and the special curriculum, indicated that students of both
groups had very low achievement on assessment of the material acquired in
the Serbian language, although among the first group of students were those
who adopted the material completely, while in the second tested group there
was no such students. Ability to efficiently direct the individual activity was
better for students who are being educated in regular conditions compared
to students who were educated under a special curriculum and program.
These authors have pointed out the remarkable diverse ability to participate
in teaching, especially when the students need to receive education in special
circumstances, the ability to comply with guidelines for working with these
children ranges from unsatisfactory to outstanding. The ability to participate
actively in the work of the group, for the children with cerebral palsy who
attend the regular curriculum and program, moves within the training needs
for improvement to complete absence of this ability. The average achievement
of students with cerebral palsy in special schools is in range of training needs
for improvement, but it is very variable (ranging from failure to outstanding).
All this supports the fact that the implementation of the class for students
with cerebral palsy is very complex, that it is preceded by a detailed, individualized
and continuing preparation of teachers. This also speaks in favor of the realization
of teaching content, for a number of children with cerebral palsy, in the classes
that have more than 20 students, it is not possible, and in this form of teaching
can not meet the needs of many students with cerebral palsy, that are not related
to the educational purposes only. It is therefore very important to develop and
adhere to the methodological aspects of identifying their needs and accordingly,
sorting children into appropriate forms of education.
24
The methodological framework of identifying the
needs of children with cerebral palsy in Education
Children with cerebral palsy in the modern theoretical concepts and
practical organizational forms of education are considered as students with
“special needs” or learning disabilities, according to which all further is defined.
It is believed that a student has special educational needs when learning requires
special educational measures. There is a particular need when the child has a
bigger problem with the learning than most of students of his age or have a
disability that prevents use of regular educational institutions. Children with
cerebral palsy have not developed adequate skills to independently participate
in education. They can not overcome in courses under the same conditions as
students in regular schools. They need organized and systematic help.
The methodological framework for identifying the needs of children with
cerebral palsy in education is based on an assessment of the ability of students
that is necesary for them to function in the school. It includes: assessment of
motor functioning, cognitive functioning, communication skills assessment
and evaluation of adaptive capacity (Nedovic, Rapaic, 2012). Assessment of
motor functioning is based on: identification of somatic status, assessment
of psychomotor organization, the ability to perform motion estimation and
evaluate the level of acquired motor skills. Cognitive functioning, is assessed
in the following areas: attention, orientation, perception, memory, speech and
thought. The communication area includes: speaking, writing and reading.
Whereas, the assessment of adaptive capacity includes: an assessment of the
student’s behavior in different situational contexts of school, home, public
services, etc.. Recorded deficits in these areas of functioning of the students,
are the basis for defining the needs of these students: A special design and
organization of the school, a special program and working methods, and the
development of learning support, special tools and technology etc.
The development of science has led to a significant correction of the
methodological approach to working with children with cerebral palsy, leading
to changes in the classical and traditional views on their rehabilitation and
education. Numerous studies have shown that the causes of disability rather
than ability level functions (motor and cognitive) are one of the important
criteria for classifying and determining ways of educating children with
cerebral palsy. Taking into count the criteria is in accordance with the modern
understanding of education of children with cerebral palsy, which puts the child
in focus. Organization and technology of the school is a reflection of the specific
needs of students, rather than the need of adjusting their existing (regular)
system. Upbringing and educational work is based on the specific organization
capabilities, it monitors and encourages their development. Quantity of learned
content is not important, but how the content affects a child’s development.
Curricula and programms are carried out under controlled conditions.
25
Individual extracurricular programs are introduced, whose task is to raise
the students’ nonbehavioral ability essential for monitoring and mastering
the curriculum. Special education is becoming part of the (re) habilitation of
children with cerebral palsy.
Numerous studies show the justification of such a methodological
approach, because there are differences between children with cerebral palsy
and therefore there are special requirements (needs) that are used in their
education and rehabilitation.
Conclusion
The conditions in which a society is developed are different, and models
relating to the education of children with cerebral palsy are different from
one country to another. Therefore, one can not speak of a single, ideal, global
model of education of these children. We prioritize a complex and continuing
education that includes special education as an integral part of rehabilitation,
we see education and rehabilitation as unique and indivisible system. At
the same time one must beare in mind that the idea of uniform programs is
abondoned. The view that all students should not be asked to fulfill the same
requests because their skills are not the same, prevailed with good reason.
Therefore, in practice, differentiated program are introduced (or individual
programs) that match the abilities of these students and are in accordance with
the demand – that everyone in the education system, progressing at their own
pace according to their abilities.
Special education is based on the view that knowledge of bio-psycho-social
characteristics of the condition of these children is the best source for their
education (Nedovic, Rapaic, Ilic, 2002), and that every child should receive
appropriate education – the educational content and support learning. The
complexity and interdependence of these factors is such that requires a specific
methodological approach when it comes to the identification of educational
needs of children with CP.
Researching studies, as well as its attainable content, is an issue in special
education. By that we mean the search for models that children will be able to
implement, and at the same time meet the standards and norms prescribed by
the Law for Education System.
26
Literature
1. Anwar S., Chowdhury J., Khatun M., Mollah A. H., Begum H. A., Rahman
Z., Nahar N. (2006). Clinical profile and predisposing factors of cerebral
palsy, Mymeshing Medical Journal, 15 (2), 142 – 5.
2. Arsić, S., Eminović, F., Stanković, I., (2011), ‘’The ability of conceptual
monitoring and the quality of working memory at children with calculation
difficulties’’, International journal ‘’Psychology Research’’, Vol. 1, No.1,
str.12-18, ISSN 2159-5542, David Publishing Company, Chicago, IL, USA
3. Falkman K. W. (2005). Communicating Your Way to a Theory of Mind,
The development of mentalizing skills in children with atypical language
developement, Department of Psychology, Goteborg University, Sweden,
Vasastandens Bokbinderi AB, Goeteborg.
4. Hennenberg Z, Karić J, Mandić V, Mašović S, Stančić V, Špoljar T. (1968).
Kompleksna rehabilitacija tjelesno invalidne djece i omladine, Savez
društava defektologa Jugoslavije, Sekcija za tjelesno invalidne, Zavod za
unapređivanje osnovnog obrazovanja SR Hrvatske, Zagreb
5. Ilić-Stošović D, Nikolić S. (2008): Sposobnost učestvovanja u nastavnim
aktivnostima učenika sa cerebralnom paralizom, Specijalna edukacija
i rehabilitacija, br. 1-2, str. 103-120, Fakultet za specijalnu edukaciju I
rehabilitaciju Univerziteta U Beogradu.
6. Macić, D., Nikolić, S. (1991). Metodika vaspitno-obrazovnog rada sa telesno
invalidnim licima predškolskog uzrasta. Naučna knjiga, Beograd.
7. Odding E., Roebroeck M. E., Stam H. J. (2006). The epidemiology of cerebral
palsy: incidence, impairments and risk factors, Disability Rehabilitation,
28(4), 183 – 91.
8. Zakon o osnovama sistema vaspitanja i obrazovanja. Službeni glasnik RS,
br. 72/09.
27
WORK METHODOLOGY OF THE SPECIAL HOSPITAL FOR CEREBRAL
PALSY AND DEVELOPMENTAL NEUROLOGY IN BELGRADE
Mirjana Boskovic
Special Hospital for Cerebral Palsy and Developmental Neurology, Belgrade, Serbia
Special Hospital for Cerebral Palsy and Developmental Neurology in Belgrade

is a highly specialized health institution of the secondary level that deals with early
detection, treatment and monitoring of children born with risk, with developmental
disabilities, as well as with cerebral palsy.
It was founded in 1958 as The Cerebral Palsy Center, with a mission to conduct
the treatment of children with cerebral palsy from the city area, and exceptionally
from up-country, to conduct out-patient consultations and clinical testing, to study
and examine the causes of disorder and to take measures of education and professional
promotion of medical personnel. More than three decades ago cooperation was
established with Belgrade gynecological clinics where physicians from our institution,
together with neonatologists, examine children born with risk, and if necessary, point
them to our hospital for further treatment and developmental follow-up.
Today the work is taking place in two hospitals facilities through out-patient
department and ambulatory-polyclinic services with all related therapy sessions, EEG
cabinets, ultrasound and EMNG, stationary departments for children from 1-7 years
of age which are admitted in accompany of their mothers, and also for patients from
7-18 years of age who attend elementary school by regular and special programs in
addition to the complete treatment.
A team of specialists consisting of: physiatrist, pediatrician, children’s
neurologist, children’s neuropsychiatrist, kinesiotherapist, occupational therapist,
psychologist, special educator and rehabilitator, social worker, nurse and kindergarten
teacher, is dealing with a patients with cerebral palsy or other neurodevelopmental
disorders. An essential team member is a parent, usually mother who is trained to
exercise with her child at home because the treatment of these patients implies whole
day practicing with the child.
The importance of early detection and early treatment has proven to be an
essential factor in the prevention of pathological movements, and in reduction of the
incidence of cerebral palsy.
Keywords: cerebral palsy, developmental neurology, early detection, treatment,
children with developmental disabilities
*Corresponding author: Mirjana Boskovic, e-mail: [email protected]
28
THERAPEUTIC POSSIBILITIES IN THE TRETAMENT OF PATIENTS
WITH CEREBRAL PALSY
Aleksandra Mikov¹, Cila Demesi-Drljan¹, Jelena Stanic² and Lidija Dimitrijevic³

¹Clinic of Child Habilitation and Rehabilitation, Institute of Child and Youth Health
Care of Vojvodina, Faculty of Medicine, Novi Sad, Serbia
²Institute of Pulmonary Diseases of Vojvodina, Novi Sad, Serbia
³Clinic of Physical Medicine and Rehabilitation, Clinical Center,
Faculty of Medicine, Nis, Serbia
Cerebral palsy (CP) describes a group of disorders of the development of

movement and posture, causing activity limitation, that are attributed to non-
progressive disturbances that occurred in the developing fetal or infant brain.
Botulinum toxin type A (BoNT-A) is relatively recent addition to the available
medical interventions for children with CP. Our research showed (41 patients) that
spasticity of adductors of the hips and plantar flexors were significantly decreased two
weeks, one and half months and three months after the treatment. Approximately 85%
of patients achieved the expecting therapeutic goals according to Goal Attainment
Scale. In combination with post-injection physiotherapy this treatment could provide
long-term benefits. Functional Electrical Therapy is the clinical application of a
small electric current to the intact nerves in order to trigger a muscle contraction.
This contraction is then incorporated into a functional activity, for example walking,
reaching etc. Our preliminary study (7 patients) showed improvement in performances
of the paretic hand, better control and quality of movements. This method can serve
as an additional treatment for habilitation of children with hemiparetic cerebral palsy.
Therapeutic horse riding (THR) is one of the possible ways of habilitation in children
with CP. As the horse walks, its center of gravity is displaced three-dimensionally
with a movement very similar to the action of the human pelvis during gait. The
warmth of the horse coupled with this rhythmical movement is thought to be useful
in reducing abnormally high muscle tone and promoting relaxation in the rider with
spastic CP. In our research (12 patients), passive range of motion (lower extremities)
and muscle strength (muscles of the trunk) were significantly higher after 10 weeks
of riding. Spasticity was significantly lower after the THR. The important principles
in the treatment of patients with cerebral palsy are good evaluation of patients and
tailored treatment for each patients.
Key words: cerebral palsy, children, therapy
*Corresponding author: Aleksandra Mikov, e-mail: [email protected]
29
THE EFFICIENCY OF APPLICATION OF MEDICAL TECHNOLOGY
“PHASE FIBROTOMY IN ORTHOPEDICS” BY PROFESSOR V. B.
ULZIBAT IN THE REHABILITATION OF PATIENTS WITH
INFANTILE CEREBRAL PALSY
Aleksandar Nazarkin
Institute of Clinical Rehabilitation, Tula, Russian Federation
In the complex clinical-instrumental and morphological studies, performed

by the experts of the Institute of Clinical Rehabilitation, Tula, Russian Federation,
with the participation of the independent medical experts, it was found that, in
the case of different nosological diseases of locomotor system, one of the causes
of muscular dysfunction, pain syndrome and motor disorder is the development
of dystrophic-sclerotic changes in the skeletal musculature. The outcomes
of expressed dystrophic process are an irreversible change in the structure of
muscle tissue, replacement of muscle fibers with connective tissue (fibrosis),
formation of the organic muscle contractures – fixed shortened and bolded
sections of muscles that are painful at palpation, and which do not disappear
with a relaxation of muscles. Thereby, skeletal muscle injury occurs during
the direct influence of pathological factors on the muscles, but also indirectly,
due to diseases of the nervous system, spine and joints. Long-term increase in
muscle tone in the case of infantile cerebral palsy and other diseases, leads to
circulatory disorders and disorders of the process of exchange in skeletal muscle
and contributes to the forming of organic muscle contracture in them. We have
found that organic muscle contractions can be formed in children even in the
intrauterine period in the cases of complicated pregnancy courses and existence
of acute or chronic maternal diseases.
Medical technology “Phase Fibrotomy in Orthopedics” which was developed
by Professor V.B. Ulzibat, is practiced in our institution in the surgical treatment
of patients with congenital and acquired pathology of the locomotor apparatus,
including infantile cerebral palsy. This technology is aimed at the removing of
organic muscle contractures and myofascial pain syndrome. It is based on the
phase subcutaneous excision of fibrously altered muscle fibers using a special
scalpel in order to improve muscle function.
• The qualitative characteristics of technology “Phase Fibrotomy in
Orthopedics” are following:
−− universality in terms of nosologically different types of locomotor
pathology related to the unity of the mechanisms of development of
identical processes in muscle tissue (dystrophy, necrosis, sclerosis),
whose outcome is the forming of organic muscle contractures,
irrespective of the type of primary etiological factor;
30
−− functionality which is provided by the simultaneous action on different
muscle groups taking into account their synergism and antagonism,
the possibility of a combination of operations on all superficial
skeletal muscles of the head, trunk and extremities in order to achieve
maximal effect;
−− minimally traumatic which is achieved through precise movements
of specially constructed scalpel; absence of skin excision, blood
loss, and complete muscle excision and transplantation, there is no
working on tendons and bones, and subsequent cast immobilizations
are unnecessary, which all further contribute to the shortening of the
recovery period and a patient’s early activation after surgery;
−− the possibility of working in the outpatient setting which contributes
to faster recovery under the conditions that are usual for the patient;
The therapy of surgical treatment with the use of Phase Fibrotomy includes
several phases. According to statistical data, one patient generally requires
3 phases of treatment, and an average of 15 micro-surgery on the muscles is
performed in each stage.
The following indications for treatment by technology of Professor V.B.
Ulzibat are determined:
−− presence of organic muscle contractures and chronic myofascial pain
syndrome;
−− absence of effect of the conservative therapy application.
Absolute contraindications for surgery are considered to be the following:
−− presence of developmental disorders and chronic diseases in the stage
of decompensation;
−− dysfunction of vital organs.
Relative contraindications for surgery are:
−− acute infectious and somatic diseases, including the reconvalescence
period;
−− acute and subacute period of neuroinfection, head injury and cerebral
vascular disorders;
−− chronic disease in the deterioration period;
−− intolerance of medical anesthesia products;
−− presence of severe allergic reactions in anamnesis;
−− presence of injuries, inflammatory skin and soft tissue diseases;
31
−− post spastic seizure status: after the “small” seizures – at least 3 months,
after the “big” (generalized) seizures – at least 6 months; after status
epilepticus – at least 12 months;
−− status after the Botox intervention (Dysport) – at least 6 months;
−− status after vaccination – at least 1 month
For the final differentiation of functional (muscle-dystonic) and organic
(dystrophic) stages of muscle contractures, and for the determination of
type and intensity of contractures and locomotor deformations, “Relaxation
probe” is practiced in our practice, by using inhalational anesthesia (surgical
stage, levels 2-3) or local anesthetics (Novocaine, Lidocaine): during muscle
palpation in a state of relaxation “functional” contractures disappear, and the
“organic” muscle contractures remain in the form of thickened lacertus.
The prescribed selective and operative action on fibrously-modified
fibers by using the technology “Phase Fibrotomy in Orthopedics”, provides
the improvement of blood circulation and function of the operated muscles,
liquidation of focuses of pathological impulsing and local pain. Moreover,
removing of organic muscle contracture contributes to restoration of normal
central nervous system function due to the strengthening and optimization of
the impulses flow that starts from the muscles that were previously inactive or
that functioned irregularly.
In accordance with the obtained data, we believe that early removal of
organic muscle contracture is a condition necessary for the successful treatment
of patients with orthopedic profiles and patients with infantile cerebral palsy, in
order to correct pathological status, arrest chronic myofascial pain syndrome,
and prevent development of persisting locomotor deformations and joints
changes that require more complex operational corrections.
During the last twenty and a half years, the experts of “The Institute of
Clinical Rehabilitation” AD have been providing specialized orthopedic care
for patients with congenital and acquired pathology of the locomotor apparatus,
including infantile cerebral palsy.
In the working period of our center, 36781 patients were admitted for the
treatment (data on 31.12.2011), and 29749 of them were children (80.9%). An
average of 4000 patients per year were operationally treated, and more than
2000 of them applied for the first time, including 81.7% percent of children
(1650 patients).
The age structure of all patients admitted for the treatment of locomotor
system pathology was the following: 1–3 years: 14.4%; 4–7 years: 36.3%; 8–10
years: 14.8%; 11–14 years: 15.4%; 15–17 years: 17.7%; and older than 18 years:
1.4%.
32
The largest group of patients includes people with the incoming diagnosis
of “infantile cerebral palsy”. The patients with cerebral palsy accounted for
84.3% of total patients number (31006). Among patients with infantile cerebral
palsy, 86.9% were children (26959). The following age distribution of patients
with infantile cerebral palsy was determined: 1–3 years: 16.3%; 4–7 years:
40.2%; 8–10 years: 16%; 11–14 years: 15.3%; 15–17 years: 11.9%; and older
than 18 years: 1.2%. The structure of patients according to the type of infantile
cerebral palsy was the following: the double hemiplegia: 42%; spastic diplegia:
36.7%; hemiparetic form: 13.3%; hyperkinetic form: 6.3%; atonic-astatic
form: 1.5%. Patients with severe and moderate level of motoric disorders were
prevailing.
The analysis of treatment results of 3849 patients over a long period of
time, compiled by the doctors from different cities of Russia and the experts of
the Institute in the period from the year 1993 till 2011, showed that on average
of 92.84% of cases has achieved a “good” clinical effect which is manifested
through the increasing range of motion, the emergence of new or substantial
improvement of previously existing motor habits, the forming of a qualitatively
new motoric stereotypes, and the disappearance or reduction of pain syndrome
and hyperkinesia. In the case of 4.34% of patients “satisfactory” result was found,
the improvement of individual motor habits was noted, and also the expansion
of the features within the initial level of motor development. In the case of 2.79%
of patients, their condition was “unchanged”. In the case of 0.03% of patients, the
occurrence of pain in the muscle areas that were not previously operated, was
considered to be the deterioration, however, these changes were eliminated in the
following phases of treatment. In 52% of cases, the motor function changes had
a qualitative character and were manifested through the development of new
habits (sitting, crawling, walking, self-service habits). The effectiveness of phase
fibrotomy in relation to local organic muscle contracture or the pain spot was
97.5% in average.
Apart from the indicators of motor development improvement, in the
case of muscle contractures removal, additional positive effects were found:
improvement of speech (62%), mastication (49%), swallowing (50%), facial
expressions (22%), emotional and behavioral indicators (64%), sleep (49%),
appetite (58%) reduction of strabismus (55%), salivation (56%), nystagmus
(22%), the frequency and severity of seizures (25%) increase in visual acuity
(17%) and hearing acuity (15%). The frequency of qualitative changes
(occurrence of speech, mastication, termination of strabismus and salivation)
was 35%.
Katamnestic monitoring of patients during the period of 20.5 years
confirms that the surgical procedure is optimal at the early stages of organic
muscle contractures, before the occurrence of persisting contractures and
deformities of locomotor apparatus. In relation to this, in order to achieve the
33
maximum results, in the cases of adequate indications, it is the most appropriate
that surgical treatment starts at age of 2–3 years of life when pathology is
congenital, and at age of 3–5 years of life when it comes to acquired pathology
of the locomotor apparatus and infant cerebral palsy.
Comparative analysis of the effectiveness of treatment of children with
disorders of locomotor apparatus and infantile cerebral palsy from different age
subgroups showed that the percentage of positive results in pre-school children
is higher than in older children. Reason for this lies in more pronounced
changes in the muscles of school-aged children and older boys and girls, and
also in the forming of fixed deformation of locomotor apparatus over time.
A higher efficacy of the treatment of patients with spastic types of infantile
cerebral palsy, and in the cases of moderate motoric disorders, unless there are
changes in the joints, or they are minimal, was found.
According to our monitoring results, a timely mannered surgical
intervention performed by medical technology “Phase Fibrotomy in
Orthopedics” by professor V. B. Ulzibat, contributes to the orthopedic
correction of existing deformities and reduction of myofascial pain syndrome,
which, in combination with conservative recover therapy, greatly increase the
rehabilitation potential of patients with the pathology of locomotor apparatus
and infantile cerebral palsy, especially in children.
*Corresponding author: Dejan Likic, e-mail: [email protected]
34
HOW TO IMPLEMENT NATURAL SUPPORTS IN THE WORKPLACE
TO INCREASE TASK PERFORMANCE AND
SOCIAL INTEGRATION
Keith Storey
Touro University – College of Education, USA
Natural supports for workers with Cerebral Palsy involves using co-workers,
supervisors, and other supports intrinsic to the job setting to facilitate job skill
acquisition, maintenance, and integration. The use of natural supports is based upon
the understanding that utilizing people who are typically found on the job and typical
environments enhances integration more effectively than relying on specialized
services, personnel and settings. In the workplace, natural supports involves work-
site personnel and others providing support to employees with Cerebral Palsy with a
special emphasis on enhancing social integration. Supports may involve: (a) continued
skill training, (b) social skills instruction, (c) advocacy, (d) community skill training,
(e) crisis intervention, (f) validating instructional strategies, (g) collecting subjective
evaluations, (h) collecting social comparison information, and (i) job modifications
and adaptations.
The audience will gain an understanding of natural support strategies for
increasing supports and integration at work sites which have been empirically validated
as well as a better understanding of current research issues concerning natural supports.
I will offer guidelines for implementation of natural support strategies for individuals
with Cerebral Palsy.
Key words: Natural Supports, Supported Employment, Independent
Performance
*Corresponding author: Keith Storey, e-mail: [email protected]
35
Theme 1
Cerebral Palsy, Etiology and

Diagnostics
IS THERE RISK OF CEREBRAL PALSY IN CHILDREN BORN AFTER
ASSISTED CONCEPTION
Milena Milicevic1, Srecko Potic2 and Vera Ilankovic3

Institute of Criminological and Sociological Research, Belgrade, Serbia
1
2
Medical College of Professional Studies “Milutin Milankovic”, Belgrade, Serbia
3
Interest of professional and scientific public has been focused on adverse

maternal, prenatal and perinatal outcomes of pregnancies conceived through assisted
conception, such as in vitro fertilization (IVF) and intracytoplasmic sperm injection
(ICSI), but also on different aspects of long-term health and early cognitive and motor
development of these children for more than three decades. The research review on
risk factors in children born after assisted conception is presented in this paper with
special emphasis on the risk of cerebral palsy. Extensive literature search for new data
was conducted in order to evaluate and systematize findings in this field. The results
of numerous studies indicate higher frequency of multiple pregnancies and preterm
delivery, and lower mean birthweight as the risk factors. Although most children
born after assisted conception are healthy and typically developing, there is still
an increased risk of various developmental problems and delays, also neurological,
such as cerebral palsy, when compared to their naturally conceived peers. Regular
developmental follow-up of children born after assisted conception is generally and
the most recommended through program of early detection and prevention.
Key words: assisted conception, in vitro fertilization, risk factors, cerebral palsy
Corresponding author: Milena Milicevic, e-mail: [email protected]
39
STRUCTURE OF PRENATAL ETIOLOGIES FACTORS AND TYPES OF
CEREBRAL PALSY IN TUZLA CANTON
Mirela Babajic1, Emira Svraka2 , Senad Mehmedinovic3, Edina Saric4,

Damir Babajic5 and Azem Poljic6
1
JZU Spa „Ilidza“, Gradacac, Bosnia and Herzegovina
2
University of Sarajevo – Faculty of Health Studies, Bosnia and Herzegovina
3
Center for Education and Profesional Rehabilitation,
Tuzla, Bosnia and Herzegovina
4
University of Tuzla – Faculty of Education and Rehabilitation,
Bosnia and Herzegovina
5
Medzlis of Islamic Community Srebrenik, Srebrenik, Bosnia and Herzegovina
6
Ministry of Labor, Social Policy and Return of Canton of Tuzla,
Bosnia and Herzegovina
The aim of this study was to determine the structure of prenatal etiologic factors
and types of cerebral palsy in Tuzla Canton. The survey included the total sample of
48 patients with cerebral palsy, both gender, at the age 2-19 years. Realization of the
research is performed in home visits to each family of children with cerebral palsy
who had a spa treatment at „Ilidza“ Center for Physical Medicine and Spa Treatment,
Gradacac.
In order to study structural questionnaire was used for parents of children and
adoloscents with cerebral palsy. Data analysis was performed using nonparametric
statistics. Calculate the basic statistical parameters, frequencies and percentages,
and the tabulation results performed. Results showed that 68.8% of mother had the
disease inpregnancy, of which the highest percentage of births (86.1%) children with
spasmodic type of cerebral palsy. Also, the results imply that professional counseling
and education of future mother in leading a healthy pregnancy, whic would have the
primary objective, the prevention of cerebral palsy.
Key words: structure, prenatal etiological factors, cerebral palsy
*Corresponding author: Mirela Babajic, e-mail: [email protected]
40
ASSOCIATED CONDITIONS IN PERSONS WITH
CEREBRAL PALSY
Vladimir Trajkovski1 and Biljana Krstevska-Kokormanova2

University “St. Cyrill and Methodius” – Faculty of Philosophy, Institute of Special
1
Education and Rehabilitation, Skopje, Republic of Macedonia

2
Institute for Rehabilitaion of Speech, Hearing and Voice, Skopje, Republic of
Macedonia
Cerebral palsy is a disorder of motor control due to a static lesion of the developing
brain. It was described almost 150 years ago and is quite familiar to both the lay and
medical communities. Continuing advances in our understanding of the causes and
treatment of this heterogeneous disorder, when broadly understood and applied, will
allow more children and adults with cerebral palsy to reach their full potential.
The aim of this study is to compare associated conditions in two groups of
persons with cerebral palsy and intellectual disability (ID) and persons with cerebral
palsy without intellectual disability.
In this research 62 examinees were included. They were divided in two groups:
persons with cerebral palsy with ID (N=31) aged 4–18 years and persons with cerebral
palsy without ID aged 4–18 years. All participants were members of Association of
Physically Disabled Persons from city of Skopje. The study was conducted in the
period May-June 2004.
The most frequent type of cerebral palsy was spastic (65%). There was no
statistically difference in epileptic convulsions between two groups (p=0.52).
Receptive and expressive speech were poorly developed in the first group with ID
compared with the group without ID (p=0.002 respectively p<0.001). Orthopedic
deformities of shoulder, hip and spine were not correlated with intellectual disability.
Audiologic diagnostics was insufficient in 89% of participants. A large percent of
persons with cerebral palsy and ID had visual impairments (71%). Parents of these
persons with cerebral palsy had low educational level and low socioeconomic status.
Mothers of persons with cerebral palsy had pathological pregnancy in 19% and
pathological delivery in 44%.
Associated conditions in persons with cerebral palsy were more frequent in the
group with ID in comparison without ID.
Key words: cerebral palsy, intellectual disability, associated conditions, Skopje
*Corresponding author: Vladimir Trajkovski, e-mail: [email protected]
41
LIFE EXPECTANCY IN CHILDREN WITH CEREBRAL PALSY
Gordana Panova, Nevenka Velickova, Blagica Panova, Nenad Panov and

Lence Nikolovska
University “Goce Delcev”, Stip – Faculty of Medical Sciences, Republic of
MacedoniaIntroduction: Cerebral palsy is the most common cause of severe physical
disability in children and its prevalence is increasing because of improved survival of
low birth weight babies. Limited information is available on life expectancy, which
is needed to plan adequate provision of services for handicapped persons. Survival
rates (up to 20 years) of children with special needs are lower than those from general
population. These results have important role in providing social, educational and
health services.
Objective: To determine the life expectancy of children with cerebral palsy.
Materials and methods: A group of children for analysis were sampled using a registry
compiled from multiple sources.
Subject Test: 258 subjects with idiopathic cerebral palsy, of which 251 are
monitored and included in analysis in time frame 2003-2011.
Main outcome measures: Effect of functional ability (manual ability, mental
ability, birth weight and gestational age for survival).
Results: 20 year survival for the entire group was 89.3% for female and 86.9%
for male. For children without severe functional disabilities 20 year survival was 99%
(95% confidence interval 98% to 100%), while children in all three functional groups
were 20 year survival of 50% (42% to 58%). Children with birth weight <= 2500 g
have an annual survival of 92% (89% to 95%), while those with a birth weight <2500g
tonnage survival of 87% (84% to 89%). Children with gestational age <37 weeks have
20 years survival of 93% (91% to 96%), while those with a gestational age >= 37 weeks
survive from 85% (83% to 88%). Birth weight and gestational age are less predictive of
survival than functional disability. As the best statistical model used gestational age
and number of severe functional impairment.
Conclusion: The life expectancy of this group of children with cerebral palsy,
was greater than that occurring in some previous research. This has important
consequences for social, educational and health services. Although cerebral palsy is
the most common cause of severe physical disability in children, the ongoing routine
health information systems do not allow tracking of prevalence. More reports of
people with cerebral palsy noted increased prevalence among infants with low birth
weight.
Key words: cerebral palsy, disability, gestational age
*Corresponding author: Gordana Panova, e-mail: [email protected]
42
MATERNAL COGNITIVE AND EMOTIOANAL DENIAL OF CHILD’S
DIAGNOSIS OF CEREBRAL PALSY: NONRESOLUTION
Tatjana Krstic and Biljana Obradovic

University of Novi Sad – Faculty of Medicine, Department of Special
Rehabilitation and Education, Serbia
Parental denial of the child’s diagnosis of cerebral palsy increases the risk of
insensitive parenthood and of development of insecure attachment in the child, and
such a parental reaction is called unresolved. Unresolved parents are unable to direct
themselves to the reality of their child’s diagnosis, but rather express unrealistic beliefs
about the child’s condition, actively searching for its cause and turning their attention
to the past. Emotionally, they may be overwhelmed with grief, depressed or angry,
and may deny the emotional impact of the diagnosis, or even idealize it. Considering
that nonresolution of diagnosis may have numerous negative implications for the
child, parent, and parent-child interactions, timely recognition of such reactions is a
very important task for clinical psychologists.
The aim of the research was to identify mothers’ resolution regarding their child’s
diagnosis of cerebral palsy, in particular nonresolution. Maternal resolution of diagnosis
was assessed using the Reaction to Diagnosis Interview and the Reaction to Diagnosis
Classification System. In addition to the main classification of Resolved/Unresolved,
six further subtypes of Unresolved were differentiated: Emotionally Overwhelmed,
Angrily Preoccupied, Neutralizing, Depressed, Distorting, and Confused.
The research included 100 mothers of children diagnosed with cerebral palsy,
2-7 years of age. Of these, 41 were classified by blinded coders as Unresolved. Most
mothers (36.6%) were emotionally overwhelmed, and other subtypes of Unresolved
were equally distributed. The emotionally overwhelmed reaction indicates that the
mother still has extremely painful reactions to the trauma of receiving the child’s
diagnosis. Overwhelmed by her own feelings such a mother remains emotionally
detached and insensitive for her child’s signals and needs.
Our findings have important clinical implications in the fields of prevention,
psychological support and management of unresolved mothers. Helping them
cognitively and emotionally accept the child’s condition is an important target of
psychological intervention.
Key words: nonresolution, cerebral palsy, child, mother
*Corresponding author: Tatjana Krstic, e-mail: [email protected]
43
RESPONDING TO THE CHALLANGES WHILE RAISING A CHILD
WITH CEREBRAL PALSY IN THE CONTEXT OF BANGLADESH
Roksana Hoque1 and Mohammad Monjurul Karim2

1
Special & Inclusive Education Unit, Centre for the Rehabilitation of the
Paralyzed CRP, Savar, Dhaka, Bangladesh
2
Department of Occupational Therapy, Centre for the Rehabilitation of the
Paralyzed, Dhaka, Bangladesh
Background: Cerebral Palsy is the most cost common physical and intellectual
disability in childhood. In Bangladesh, the total number of children with cerebral
palsy is 282.680 among 141.340.476 (US Census Bureau 2004 cited in Statistics by
country for Cerebral Palsy 2007). So, the number of cerebral palsy is huge. So, it is
very important to find out their challenges and its responses from parents experience.
It helps professionals to teach parents appropriate approach to raise a child.
Aim of the study: To explore challenges of parenting and to explore the feasibility
of new parenting approach while raising a child with Cerebral Palsy in Bangladesh.
Design: The study was conducted using phenomenological method.
Participants and setting: A total of 20 parents of children with Cerebral Palsy
took part in this study in school setting and hospital setting.
Methodology/Method: The study was conducted using phenomenological
method. Twenty Caregivers of children with Cerebral Palsy were selected as the study
participants by purposive sampling. Data were generated by using data triangulation
through 5 individual interviews, 3 focus-group discussions and observation. Data
were analyzed using content analysis under category, code and preparing theme for
result.
Results: Parents mentioned that they face problem with their Childs’ uncertain
behavior, developmental milestone, parenting under time pressure, with additional
parenting tasks and parenting under public security and grief. In the context of
Bangladesh, they have another challenge of societal attitude and superstitions
towards their child. In response to these challenges, they become depressed as they
have no support from family to embark upon challenges. Sometimes challenges are
so overwhelming for them and they flew away from the society they live. This is why
Parents suggest running awareness program in rural areas with all people and special
parent’s education program for the parents of children with Cerebral Palsy. This will
help them to embark upon their challenges.
Conclusion/Significance: In Bangladesh, Parents of Cerebral Palsy faced a range
of challenges while raising their child. These challenges may be effectively reduced by
awareness program and special parent’s education program.
Key words: cerebral palsy, parents, society, attitudes
Corresponding author: Roksana Hoque, e-mail: [email protected]
44
FUNCTIONAL ABILITY OF CHILDREN WITH CEREBRAL PA
Cila Demesi-Drljan, Aleksandra Mikov, Mirela Vulovic, Vera Bekic,

Daliborka Borkovac and Rastislava Krasnik
Institute for Children and Youth Helath Care of Vojvodina, Novi Sad, Serbia
Background: The most important clinical feature of cerebral palsy (CP) is the
impairment of motor skills, which refers to the degree of restriction of motor function
in all body regions including the function of speech. The ability to walk is often used
as a rough measure for the severity of motor impairment.
The objective of this study was to determine the functional ability of children
with cerebral palsy.
Material and methods: The study included 206 children with cerebral palsy.
They were classified according to the Gross motor function classification system
(GMFCS) in V levels. Level I refer to best functional ability and level V the most
limited motor function. There are four age groups described within each of the five
levels of GMFCS (under 2 years, 2 to 4 years, 4 to 6 years and 6 to 12 years). Four
to eighteen years old children with CP were also classified according to the Manual
ability classification system (MACS) in V levels. Level I relates to the best ability to
handle objects in daily life, while in level V there is no ability to handle objects.
Results: Two-thirds of children with CP were able to walk independently or
with an aid (level I-III), while third of children had no ability to walk (level IV and
V). Limitations of medium level (level III) were present in every sixth child. Half the
children were classified according to the MACS classification as level I or II, a fifth
of children as level III and less than a third of children were classified as level IV or V.
Conclusion: The GMFCS and MACS classification systems enable to settle
rehabilitation goals for each level of motor function according to different age groups.
Key words: cerebral palsy, child, functional ability
*Corresponding author: Cila Demesi-Drljan, e-mail: [email protected]
45
THE POSSIBILITIES OF ASSESSMENT AND CLASSIFICATION OF
CAPABILITIES OF UPPER EXTREMITY OF CHILDREN
WITH CEREBRAL PALSY
Spela Golubovic and Sanela Slavkovic

University of Novi Sad – Faculty of Medicine,
Department of Special Rehabilitation and Education, Serbia
Numerous classification of cerebral palsy have been proposed in literature but

none of these classifications suffice to present full information about severity or
deficit level of gross and fine motor upper limbs abilities. The abilities of the upper
extremities are of great importance in activities of daily life and determine the degree
of independence in the same. The aim of the study was to determine manual dexterity
(capacity) and ability (performance) in these children. The study sample consisted of
30 children aged 7-15 (AS 12,1 ; SD 2,6) both genders. In order to study the manual
dexterity Nine hole peg test and Box and Block test were used, and manual skills were
assessed using the Manual Ability Classification System, as well as by Abilhand-Kids
questionnaire which was filled in by parents. In order to assess motor functioning
Gross Motor Function Scale was applied. The received results show statistically
significant correlation at the level p<0.001 between the demonstrated level of gross
motor skills and development of manual skills. A statistically significant correlation
was obtained also between the gross motor skills and manual skills in relation to
the type of cerebral palsy (p<0.001). In tests of manual dexterity children who are
at the level 1 have better results than children at higher levels. Performance on the
tests of manual dexterity is caused by the functional capabilities which undertakes
the selection of tests and classification which is used to assess the ability of children
Key words: cerebral palsy, capacity, classification
*Corresponding author: Spela Golubovic, e-mail: [email protected]
46
FUNCTIONAL STATUS OF YOUTH AND ADULTS WITH CEREBRAL
PALSY IN A RESIDENTIAL FACILITY
Ofelija Bocka-Pepelcevic, Andrijana Radulovic and Sanela Slavkovic

Center for Handicaped Children Veternik, Novi Sad, Serbia
Cerebral palsy causes permanent disorders of posture, movement and motor

function and consequently affects the person’s functional status. The aim of the work
is to determine the functional status, i.e. functional limitations that a person has in
activities of daily life by observing the inability to carry out certain activities and as
social problem which consequently affects the quality of life of the target group. The
study includes users with cerebral palsy aged over 15 years on permanent placement
in a residential institution. Methods applied in the study were: Test of the activities
of daily living, Somatic status, Questionnaire for the assessment of quality of life,
Classification of fine motor functions, graphomotor skills assessment with sex, age,
degree of intellectual disability, years of education, available services in the social
welfare system and available assistive technology as predictor variables. The obtained
data are important for establishment of determinants of functional status of people
with cerebral palsy on permanent housing, as well as in defining of services in the
social welfare system that would contribute to improving the functional status and
quality of life of youth and adults with cerebral palsy.
Key words: functional status, cerebral palsy, residential institution
*Corresponding author: Sanela Slavkovic, e-mail: [email protected]
47
ASSESMENT OF FUNCTIONAL ABILITY OF CHILDREN WITH
CEREBRAL PALSY AT SCHOOL AGE
Sanja Trgovcevic1, Blagoje Gesoski2 and Maja Nedovic3

1
2
Commission on Verification of the Facts, Republic of Macedonia
3
Primary School “Anton Skala”, Belgrade, Serbia
The object was to assess the ability of motor and cognitive functioning of
children with cerebral palsy at school age.
The study included a total of 40 subjects with cerebral palsy, both sexes. Criteria
for the formation of the group were: age (6-11 years), established clinical diagnosis
of cerebral palsy (verified by the pediatrician) and available medical and school
history (from birth on wards). The first group, 20 subjects with cerebral palsy was
included in regular schools. The second group, which numbered 20 subjects that
was diagnosed with cerebral palsy with associated disorders and related problems,
attended primary school for children with special needs. Clinical data of subjects were
classified according to the ICD-10 and the Berg balance scale for assessing children
with cerebral palsy. Functional status of the subjects was obtained using standard
defectology estimates of motor and cognitive functioning in children with cerebral
palsy.
The structure of the results showed that the children of school age with cerebral
palsy have not developed adequate skills to independently participate in the education.
After comparing general motor skills, cognitive-perceptual integration skills and
skills of visual information communication, there were no statistically significant
differences found in tested variables between tested groups.
Key words: cerebral palsy, education, motor and cognitive functioning
*Corresponding author: Sanja Trgovcevic, e-mail: [email protected]
48
MOTOR PERFORMANCE IN PRIMARY SCHOOL CHILDRENWITH
CEREBRAL PALSY
Erna Zgur1,2 and Miran Cuk2

1
Centre for Education, Rehabilitation and Training, Vipava, Slovenia
2
University of Ljubljana – Faculty of Education, Ljubljana, Slovenia
Purpose. The study defines the overall motor performance in children with
cerebral palsy, which defines their latent motor space.
Methods. The study was conducted on a sample of 80 children aged 6 to 16
years. Only children with cerebral palsy attending primary schools with equivalent
educational standards were included in the research.
Results. A discriminant analysis confirmed that children with cerebral palsy
differ in the latent structure of their motor space depending on the diagnosis of
cerebral palsy (the type of cerebral palsy). At common motor space, children with
different type of cerebral palsy have a distinction. The comparisation of three groups
/ types of cerebral palsy have shown two discriminative functions, first we called
function of common motorics, second function of maturity.
Conclusions. The study confirmed the impact of individual motor components
on the formation of motor space. The latter also comprises other dimensions of the
broader neuro-therapeutic spectrum. The type of cerebral palsy, causing individual
neurological deficits, determines the differences in motor space.
Key words: motor performance, motor skills and abilities, cerebral palsy
*Corresponding author: Erna Zgur, e-mail: [email protected]
49
Theme 2
Treatment of People with

Cerebral Palsy
IS EARLY TREATMENT OF INFANTS AT RISK OF CEREBRAL PALSY
WARRENTED?
Ines Ayadi, Fatma Kamoun, Ines Hsairi, Emna Ellouz, Houda Ben Othmen,
Nejmeddine Hentati and Chahnez Charfi Triki
Child Neurology Department, Sfax, Tunisia
Objective – To test the possible link between first investigation and development
of cerebral palsy.
Method – A long-term prospective study was carried out in the child neurology
department and the ASHMS.
Results – The study undertaken from January 1, 2005, to December 31,
2007, involved 100 children suspected of developing cerebral palsy and requiring
a specialized course of treatment during the evolution of disease. In 47, evolution
of disease was favourable, and in 53. An unfavourable evolution was significantly
associated with late intervention.
Conclusion – Early detection and intervention seem to be determining factors
in cerebral palsy.
Key words: cerebral palsy, early detection, early intervention.
*Corresponding author: Ines Ayadi, e-mail: [email protected]
53
TREATMENT OF CHILDREN WITH CEREBRAL PALSY:
VILAN METHOD
Vera Ilankovic1, Andrej Ilankovic2 , Lana Marija Ilankovic-Kambeitz 3 and

Nikola Ilankovic4
1

2
3
IOP Kings College, London, United Kingdom and LMU Munich, Germany
4
University of Belgrade – Faculty of Medicine, Serbia
Thes methods and our new, original approach the Vilan method (Ilankovic
& Ilankovic, 1996) with stimulative and reconstructive exercises – exteroceptive,
proprioceptive and vestibular stimulation, stimulation of postural reactions,
regulation of tonus and balance, reeducation of complicated psycho-motor and
behavioral patterns.
Indicationes of the Vilan technics: cerebral palsy, medication – induced and
other movement disorders, hyperkinetic and tic disorders, mental (psychomotor
and psychosensoric) retardation, pervasive and specific developmental disorders
(childhood autism, Rett’s syndrome, atypical autism...), motor (psychomotor)
deficiency in other neurological and psychiatric disorders, organic mental disorders
and schizophrenia – residual and other type.
Effects of the Vilan technics: 1) regulation of muscel tone; 2) restoration of
muscel power; 3) regulation of balance; 4) reconstruction of postural reaction;
5) recontruction of body image; 6) recovery of spatial perception; 7) recovery of
communicationes; 8) reconstruction of static and dynamic posture; 9) regulation of
coordination in movement; 10) reeducation of complex motor pattern and behaviour;
11) recovery of self-concsiousness, and 12) development of creativity.
On the basis of results stemming from our research it can be said that the
applied rehabilitation model, with Vilan method, although conceptually a novelty, and
representing pioneer work being applied on this type of psychiatric population, has
provided very satisfactory therapeutic results.
Key words: Vilan, cerebral palsy, rehabilitation, children
*Corresponding author: Vera Ilankovic, e-mail: [email protected]
54
“OPEN STIMULATION SYSTEM OF HUMAN DEVELOPMENT” AS THE
THERAPEUTIC MODEL OF CEREBRAL PALSY
CHILDREN REHABILITATION
Miodrag Stosljevic and Milosav Adamovic

Rehabilitation of children with cerebral palsy is complex and often involves

physiotherapy, different orthopedic procedures, work therapy, speech therapy and
somathopedic treatment. In this work we have elaborated theoretical settings of
somathopedic treatment showed through therapeutic model called ‘Open stimulation
system of human development’ (Stošljević L., Stošljević M.) which is, in our region,
in use since 1969. This model consists of seven areas of treatment of CP children
and they include: 1) Motor development stimulation; 2) Sensory development
stimulation; 3) Verbal stimulation; 4) Gnostic function stimulation; 5) Social
development stimulation; 6) Relaxation and 7) Motivation. The system is called
“open” because it allows incorporation of all known (until now) systems of incentives
of human development which are used in ever day somathopedic practice, as well as
in work with CP children.
Key words: cerebral palsy, rehabilitation, somatopathology
*Corresponding author: Milosav Adamovic, e-mail: [email protected]
55
OCCUPATIONAL THERAPY TREATMENT FOR CHILDREN
WITH CEREBRAL PALSY
Maria Arango
United States of America Armed Forces (NAVY- ARMY)
Educational and Developmental Intervention Services (EDIS Japan and Belgium)
Objective: Occupational Therapy for children with Cerebral Palsy focuses on the
development of skills necessary for the performance of Activities of Daily Living and
work (school and play specifically for children) to improve and achieve independence.
The aim of this systematic review is to explain how different Occupational Therapy
interventions would improve the outcome for children with Cerebral Palsy.
Content: General overview of the Occupational Therapy frames of reference
and specific models of practice to link them into the treatment for children with
Cerebral Palsy. The Occupational Therapist works in different settings such as
acute, rehabilitation, outpatient, home care and schools. The treatment can meet
children’s needs by working on fine motor skills to develop object manipulation,
handwriting skills and motor control. Occupational therapists also address hand-eye
coordination to improve play skills, such as hitting a target, batting a ball, or copying
from a blackboard. Occupational Therapy treatments are focused to help children
with mild or severe developmental learning delays in basic daily tasks, providing
different adaptive devices to increase their independence. The treatment also is
focused on teaching strategies to work on cognitive and visual perceptual activities
that are difficult for them in order to meet the school curriculum and participate
in different activities with their peers. Cerebral Palsy patients are evaluated for
specialized equipment/adaptive technology, such as wheelchairs, voice command
activators, touch screens and computers. Occupational Therapists can also help kids
with behavioral disorders to use different strategies to cope and manage themselves
properly to meet societal and environmental demands.
As an Occupational Therapist with 18 years of experience working in all different
settings with children with Cerebral Palsy and using an eclectic approach I want to
present some specific personal professional experiences using different treatments
techniques that have helped me to achieve a better outcome. Neurodevelopmental
Treatment and Sensory Integration approaches (with the use of equipment such as
bolsters and therapeutic balls) are used to manage the tone and increase the quality of
movement. The use of therapeutic tape and therapeutic orthotic garments with straps
(Theratogs) during and after the session as a way to carryover the muscle facilitation
or inhibition of specific body posture and/or movement. Therapeutic taping and
garments are recent interventions used in rehabilitation programs. They produce a
cutaneous stimulation of the sensoriomotor and proprioceptive systems. A sample of
research studies in these techniques will be reviewed to show how they support the
outcomes.
Occupational Therapists are also involved with children that receive botox
injections, tendon transfers, baclofen pump insertions, or a rizothomy as techniques
56
to reduce tone following the different protocols established by the physicians in order
to increase functional motor performance.
The last point to address is the importance of working closely with all different
team members in order to have better outcomes and provide children with Cerebral
Palsy the maximum independent level in all areas to increase their self-esteem and
sense of accomplishment.
Conclusion: Intensive therapy using different approaches have shown how
children with Cerebral Palsy can improve in all different areas. From research
studies and personal experience it can be suggested that Therapeutic Tape and
Orthotic Garments as an adjunct to treatment (NDT, SI) may assist with the goal
of independence and quality of movement in Occupational Therapy treatment.
Further studies are recommended to test the effectiveness of these methods and to
determine the lasting effects on motor skills and functional performance once the
tape or garments are removed.
Key words: cerebral palsy, rehabilitation, occupational therapy
*Corresponding author: Maria Arango, e-mail: [email protected]
57
THE IMPORTANCE OF APPLICATION LOGOPEDIC INSTRUMENTS IN
TREATMENT CHILDREN WITH CEREBRAL PALSY
Mirna Zelic, Neda Milosevic and Dragan Causevac

Institute for psycho-physiological and speech disorders
“Professor dr Cvetko Brajovic”, Belgrade, Serbia
Much has been written about oral dysfunctions of children with cerebral
palsy but there is no much about application of logopedic’s intruments. Children
with cerebral palsy have three categories of oral disorders: 1) moderate to severe
oral function problem as reduced lip closure and reduced tongue coordination; 2)
moderate to severe problems and delay in triggering the swallow; 3) neuromuscular
abnormalities including reduced tongue base movement and reduced laryngeal
elevation. Huge problem those children have is salivation and swallowing disorders.
We found the importance of application logopedic’s instruments in passive massage
and termo-tactile stimulation of oral cavity and also increasing of sensory awareness.
Application of logopedic’s instruments is valuable in: 1) gradually increasing of
pressure on tongue (usage no.6 from logopedic’s set of intruments); 2) introduction
of strong senses of taste (sweet, salty, sour, bitter); 3) termo-tactile stimulation (usage
no. 1 from logopedic’s set) with cold and warm massage. Termo-tactile massage is
performing by rubbing in circular motions inside of the cheek, lateral sulcus and
faucial arch. Importance in classic passive massage of oral cavity has application of
logopedic’s vibrafon whit direct vibrations in oral cavity. There is a need to emphasize
application of logopedic’s instruments in therapy with children with cerebral palsy to
improve oral function, salivation and movements wich helps in speech and swalowing.
Key words: logopedic instruments, treatment, cerebral palsy
*Corresponding author: Neda Milosevic, e-mail: [email protected]
58
APPLICATION OF THE HALLIWICH HYDROTHERAPY METHOD IN
CHILDREN WITH CEREBRAL PALSY
Lidija Dimitrijevic1, Aleksandra Mikov2 , Hristina Colovic3 and

Marko Aleksandrovic4
1
University of Nis – Faculty of Medicine, Serbia
2
Institute of Health Protection of Children and Youth of Vojvodina, Novi Sad, Serbia
3
Clinic for Physical Medicine and Rehabilitation, Nis, Serbia
4
University of Nis – Faculty of Sport, Serbia
Introduction: Impaired motor function in children with cerebral palsy (CP)

leads to reduced physical activity, and thus to reduced cardiorespiratory endurance,
physical fitness and general health condition. One of the most popular therapeutic
methods in children with cerebral palsy is hydrotherapy. In therapeutic purposes,
water is used due to its physical characteristics which are key elements in designing a
hydrotherapeutic program. The Halliwick Method is the method of teaching people
with disabilities to swim. It consists of 10 items grouped into 4 unities. The method
is individual, which means that one therapist works with one patient. The aim is to
teach a person with disabilities to swim using the simplified technique of backstroke.
Aim: To examine the effects of the hydrotherapeutic Halliwick method on
motor functional status and cardiorespiratory endurance in children with cerebral
palsy.
Methods: The research included 24 children of both sexes, aged 6-12, with CP.
The children participated in the Halliwick hydrotherapeutic program twice a week,
during 16 weeks. The following measurements were conducted before and after the
16-week treatment: GMFM (Gross Motor Function Measurement- with a test), heart
rate (HR), maximal oxygen consumption (VO2 max). The results before and after the
treatment were compared.
Results: Average GMFM value before the treatment was 78.8 % and it was
statistically significantly lower than the same value after the therapy, which was
88.2% (p=0.002). Furthermore, the treatment led to the statistically improved
cardiorespiratory endurance, decrease in the mean value of HR, as well as increased
aerobic capacity (VO2 max) (p<0.001).
Conclusion: the Hallwick Hydrotherapeutic Method has positive effects on
motor functional status and cardiorespiratory endurance in children with cerebral
palsy.
Key words: hydrotherapy, the Halliwick Method, cerebral palsy, motor
functions, cardiorespiratory endurance
*Corresponding author: Lidija Dimitrijevic, e-mail: [email protected]
59
TREATMENT OF ENURESIS NOCTURNAE IN CHILDREN
WITH CEREBRAL PALSY

This paper theoretically elaborates on enuresis nocturnae treatment in children

with cerebral palsy. We have described definitions and types of enuresis in the
introduction\and then we have presented enuresis prevalence in common population
and CP children to argue that CP children have much higher prevalence of enuresis in
comparison to ordinary children. Following to this, we have shown ethyopatogenesis
of enuresis with special attention to the development of this condition in children.
The last chapter deals with the treatment itself based on medical therapy, and a
selected medicine desmopressin. Conclusion suggests that in our opinion the most
efficient treatment in children with CP is precisely medical, unlike integral treatment
of this condition in ordinary children.
Key words: enuresis nocturnae, cerebral palsy, desmopressin
*Corresponding author: Milosav Adamovic; e-mail: [email protected]
60
THE INFLUENCE OF THERAPEUTICAL HORSE-RIDING ON
IMPROVEMENT OF PSYCHOLOGICAL FUNCTIONS IN
CEREBRAL PALSY PATIENTS
Vesna Pausic, Jelena Stanic and Aleksandra Mikov

Introduction: The Cerebral Palsy is an illness that apears as a consequence of a

brain damage suffered during the early phases of development – before birth, during
the birth or after the birth up to the second year of age of an infant. The characteristic
clinical sign of Cerebral Palsy is motorical insuficiency that manifests as abnormal
paterns of position and movement of the body and limbs, combined with abnormal
muscular tonus and its distribution. Therapeutical horse-riding and hipotherapy
are recognized as rehabilitation methods which could improve some of the physical,
psychological and social functions and to make learning easier for the disabled people.
The Aim: The goal of the research was evaluation of some psychological
functions in a group of attendants of therapeutical horse-riding conducted to improve
their physical functions.
Materials and Methods: An anonimous questionaire, designed for this research,
was used to obtain the data. The evaluation of presence of particular features was
achieved by 1-5 scaling, in which smaller numeric value represented lower level of
presence of particular psychological feature and vice versa.
Results: The results of the research showed that disorders of psychological
functions can be identified as concomitand disorders in the group of people who suffer
from Cerebral Palsy. Statistically significant differences were found for every feature
in the first and second measurement, as well as statistically significant differences of
total scores in first and second measurement.
Conclusion: As a conclusion, therapeutical horse-riding has positive effects on
studied psychological functions of people who suffer from Cerebral Palsy, and for this
reason can be recommended as a complementary therapy in habilitation treatment of
these patients.
Key words: psychological functions in cerebral palsy, cerebral palsy,
therapeutical horse-riding
*Corresponding author: Vesna Pausic, e-mail: [email protected]
61
DEMONSTRATION OF REHABILITATION OF PERSONS WITH
CEREBRAL PALSY AND MULTIPLE DISABILITIES
Nada Iric1, Suzana Miković1, Milka Milovanovic-Minic1 and Fadilj Eminovic2

1
Center for Handicaped Children “Sremcica”, Belgrade, Serbia
2
University of Belgrad – Faculty of Special Education and Rehabilitation, Serbia
Persons with cerebral palsy and those with multiple disabilities are limited in
acquiring social experience through motor activity. The aim of this study was to
determine the correlation between the motor and social functioning of examinee.
The sample consists of people with cerebral palsy (N=4) and those with multiple
disabilities (N=10), both sexes.
Assessment of motor and social /emotional skills was conducted by questionnaire
adapted Lin Anderson, Margaret Blizard, Ajmi Vjuver, 1998. In the study, we applied
the techniques of drama. Method of play activities include integration and enrichment
experiences in the game.
The results of treatment suggest that there has been progress in controlling
motor activity and social skills, people with cerebral palsy and those with multiple
disabilities.
Key words: cerebral palsy, multiple disability, play activities
*Corresponding author: Nada Iric, e-mail: [email protected]
62
THE USE OF ROBOTS IN CHILDREN THERAPY – ATTITUDES
OF PARENTS
Marina Oros, Ivan Jerkovic and Agota Major

University of Novi Sad – Faculty of Psilosophy, Department of Psychology, Serbia
An exploratory research examining parents’ attitudes towards the use of robots

in therapy has been conducted as a part of the project “Design of Robot as Assistive
Technology in Treatment of Children with Developmental Difficulties”. The sample
consisted of 130 parents of healthy first grade children – 28.5% fathers and 71.5%
mothers, aged 23 to 59. Two questionnaires were used – one measuring general
attitudes towards the use of robots, and another examining attitudes towards the use
of robots in the treatment of children. The results show that the attitudes of parents
towards the use of robots are more positive than negative (most frequently chosen
level of agreement on the questionnaires is a neutral option and partial agreement).
Comparing the average responses on both questionnaires, results showed that parents’
attitude towards the use of robots in the treatment of children are more positive than
general attitude towards the use of robots. Most parents think that it is a good idea
to use robots in therapy of children, that their children would like to interact with a
robot, that a robot could further motivate the child to learn, play, exercise, etc. Gender
differences in the responses were obtained on an assessment of potential negative
aspects of the interaction of the robot and the child – mothers are more fearful that
the child could damage the robot, that the child may be frightened by robots and less
trusting then the fathers of the robot independently working with the child (although
the sample is unbalanced considering gender). Also, parents with higher education
have a more positive attitude towards the idea of using robots in the treatment of
children and are more certain that their child would like to be in contact with the
robot.
Key words: robot, therapy, children, attitudes, parents
*Corresponding author: Marina Oros, e-mail: [email protected]
63
FAMILY THERAPY AND EDUCATION BU OCCUPATIONAL
THERAPIST FOR CREATING ENVIRONMENT AT HOME
FORTHE CHILDREN WITH CEREBRAL PALSY:
Evaluate child’s learning from caregiver’s perception
in the context of Bangladesh
Mohammad Monjurul Karim1 and Roksana Hoque2

Department of Occupational Therapy, Centre for the Rehabilitation of the
1
Paralyzed, CRP, Chapain, Savar, Dhaka, Bangladesh

2
Centre for the Rehabilitation of the Pralyzed, CRP, Chapain, Savar, Dhaka, Bangladesh
Background: Various aspects of the home literacy environment are considered

to stimulate the emergent development of learning process in children with disabilities.
It is important to gain insight of learning environment of children with Cerebral Palsy
through parents’ education. Parents’ education and its implementation are very important
for creating learning environment at home for the children with Cerebral Palsy.
Aim of the study: To evaluate child’s (children with cerebral palsy) learning at
home from caregiver’s perception after receiving family therapy and education from
Occupational Therapist.
Design: The study was conducted using phenomenological method.
Participants and setting: A total of 13 parents of children with Cerebral Palsy
took part in this study in school setting.
Materials/Methods: Data were generated through focus group discussion
by using semi-structured questionnaire. In focus group, discussion was guided by
researcher and two other assistants. Participants of the research were selected by
using purposive sampling. Generated data were analyzed through content analysis.
Result: After receiving family therapy and education, parents are able to gain a
good knowledge about their child’s condition. They also learned how to make their
child able in doing functional activities such as self care, study and play activities in
a step by step manner. They mentioned that this education and therapy make other
family members helpful at home for better learning of child. This training reduces
their superstitions and misbelieves about their child. Through doing these activities
with family members, their children are able to learn about timing, sequence and
steps of self care, study and play activities. Children learned to use the assistive
devices (splints, modified spoon, pen etc) with daily visual schedule, intake sensory
stimulation through play, and perform activities in different position etc.
Conclusion / Significance: Parents find it helpful to create a friendly environment
for their children at home by family therapy and education. By this, parents are able to
teach their children different tasks.
Key words: cerebral palsy, education, family, therapist
*Corresponding author: Mohammad Monjurul Karim, e-mail: [email protected]
64
Theme 3
Education of People with

Cerebral Palsy
PRESCHOOL EDUCATION OF CHILDREN WITH CEREBRAL PALSY IN
THE REPUBLIC OF SERBIA
Srecko Potic1, Milena Milicevic2 , Snezana Ilic3, Andrijana Pavlovic4, Bojana

Mastilo4 and Ivana Zecevic4
1
2
Institute of Criminological and Sociological Research, Belgrade, Serbia
3
4
University of East Sarajevo – Faculty of Medicine, Foca, Bosnia and Herzegovina
Theoretical discussion of the problems in education of preschool children with

cerebral palsy in the Republic of Serbia is presented in this paper. The problems are
viewed from the aspect of legal framework and the aspect of inclusion of these children
in educational system. Also, consideration of the problems is based on the analysis
of legal regulations, as on the review of available data on the inclusion of children
with cerebral palsy in preschool educational system and on the comparison with the
available data on the overall number of children diagnosed with cerebral palsy.
The results showed that the framework of education for children with
developmental disabilities, including children with cerebral palsy, was defined by
the law and could be considered adequate, given the variability of opportunities for
inclusion of this population. However, from the perspective of special education and
rehabilitation, when the professional personnel are discussed, some gaps are identified.
Thus, in accordance with the legislation, the educational work in the developmental
groups is realized by special educator and rehabilitator. On the other hand, in
the regular, or inclusive, educational groups, as well as in the educational groups
for children in hospital care, the education is realized by preschool teacher. These
teachers are trained to work with children with developmental disabilities by special
curriculum, which is, at least, controversial. Furthermore, analysis of available data
on the inclusion of children with developmental disabilities in the system of preschool
education has highlighted the dramatically lower involvement. The problem becomes
more evident when it comes to children with cerebral palsy, due to their even lower
involvement in the educational system at preschool age, particularly when related to
the overall number of children diagnosed with cerebral palsy.
In addition, the theoretical consideration of the causes of the detected problems
is performed and the proposed measures for improvement of the system of preschool
education of children with cerebral palsy are given.
Key words: education, cerebral palsy, preschool age
*Corresponding author: Srecko Potic, e-mail: [email protected]
67
SPEECH AND LANGUAGE ABILITIES IN CHILDREN WITH CEREBRAL
PALSY IN ELEMENTARY SCHOOL
Ivana Terzic, Nadica Jovanovic, Mile Vukovic and Goran Nedovic

Cerebral palsy is a heterogeneous set of pathological symptoms that manifests

clinically as a motor impairment and motion inability, followed by intellectual,
sensory, speech and language, emotional, behavioral and other disorders.
Impairments associated with cerebral palsy differ from child to child in their severity
and consequent effect on communication development. Children may have mild or
severe speech, language, and/or communication disorders.
Objective of this study was to determine the speech and language abilities of
children in elementary school who had a cerebral palsy as a primary impairment.
The presence of associated disorders was explored as well as their possible relation to
additional speech and language deficits, difficulties in reading and writing, as well as
to success in managing the school curriculum.
The sample consisted of 12 elementary school students with cerebral palsy as a
primary disorder, while most, but not all children, have associated problems such as
intellectual disability, attention and memory deficits, visual impairment, seizures and
others. The sample consists of two students from I, III, IV, V, and VIII grade and one
student from VI and VII grade, including 7 male and 5 female students.
Results were presented as case studies, with a qualitative description of the
abilities of each student, taking into account the impact of primary damage and
associated disorders, particularly intellectual disability, on speech and language
abilities of individuals. Results are shown separately, for students who predominantly
use nonverbal communication and for students who use verbal communication.
Key words: cerebral palsy, speech and language abilities, associated disorders
*Corresponding author: Ivana Terzic, e-mail: [email protected]
68
GRAPHOMOTOR SKILS OF CHILDREN WITH CEREBRAL PALSY
Goran Nedovic1, Sanja Tgovcevic2 , Milan Kulic3 and Dragan Marinkovic1

1
2
3
University of East Sarajevo, Faculty of Medicine Foca, Bosnia and Herzegovina
This paper shows the results of research of graphomotor skills of students

with cerebral palsy. The basic paradigm is that the combined motor and perceptual
disturbances associated with cerebral palsy present the difficulty in developing
graphomotor skills of drawing and writing.
A total of 17 patients with cerebral palsy (10 male and 7 female subjects) were
tested. The average calender age of respondents was 10, 16 years. The criteria for the
the sample formation was: determined clinical diagnosis of cerebral palsy (verified
by a pediatrician), respondent’s age of 7-16 years and IQ>70. All subjects attended
regular elementary school during the testing.
For student testing, we have used: Ozoretski motor tests, Acadia Test (Subtest II
and subtest IV), Drawing reproduction test, Test of the drawing on demand, copying
of the given sentence and dictation. Analysis of the results was based on the method
of comparison of the achievements of the respondents and maximum possible score.
Further analysis were performed in relation to the respondent`s gender.
The results indicate that more than 60% of patients with cerebral palsy had low
perceptive graphomotor skills which are attributable primarily to the damaged motor
skills and visual perception disorders.
Key words: cerebral palsy, graphomotor skills, motor and preceptive skills
69
GRAPHOMOTOR EXPRESION OF CHILDREN WITH CEREBRAL
PALSY IN SCHOOL AGE
Sanela Pacic¹, Fadilj Eminović¹, Radmila Nikic¹, Snezana Mirkovic² and

Mirjana Gavrilovic³
¹University of Belgrade – Faculty of Special Education and Rehabilitation, Serbia
²Emergency Services, Health Center Krusevac, Serbia
³Institute for Oncology and Radiology of Serbia, Belgrade, Serbia
Writing represents that form of linguistic expression as skill develops gradually

and is a means of communication and expression. This process runs under dual
control: kinesthetic and visual, so the handwriting characteristics are studied in
relation to the types of normal and pathological psychological states, and differ from
the character of the writing of a child who just mastered this skill. The maturity of
the manuscript is one of the factors that speaks of quality and perceptive skills you
develop through three phases. In order to master the skills necessary to write a
harmonious functioning afferent-efferent structures composed of perceptual, motor
and cognitive-linguistic system.
The main objective of this study was to establish the level of graphomotor
abilities in children with cerebral palsy. The survey was conducted on a sample of 37
subjects of both sexes, with cerebral palsy, primary school students, aged 8 to 19 years.
Ability motor expression is evaluated by assessing the following skills: the ability to
copy the design, the quality of the lineation and the ability to perform fine motor
series. We have also evaluated the ability in relation to variables such as patient sex,
class, age, type of school, type of palsy and uses lateralization.
The results indicate that students with cerebral palsy in our sample have
graphomotor difficulties in expressing himself, that their achievements are much lower
in comparison to the prescribed standards. From evaluated variables as important to
distinguish the differences with respect to: patient sex, type of school, age, grade and
type of paralysis, while such differences were observed with respect to the utilization
of our respondents handedness.
Our findings and the findings of other authors lead us to think that the
process of writing children with cerebral palsy is a very complex area. Such results
suggest that the need for special training, especially in the initial teaching of writing
to these students as easily and to master this skill.
Key words: cerebral palsy, graphomotor skills, writing
*Corresponding author: Sanela Pacic, e-mail: [email protected]
70
WRITING ABILITY IN CHILDREN SUFFERING FROM CEREBRAL
PALSY AFTER PHASED FIBEROTOMY: CASE REPORT
Fadilj Eminovic1, Gordana Colic1, Milos Djordjevic2 , Marija Knezevic1,

Sanela Pacic1, Marienka Zolnjak1 and Dejan Likic3
1
2
University of Novi Sad – Faculty of Medicine, Serbia
3
Special Surgical Hospital Cuprija, Serbia
Writing is a complex ability which includes a series of different abilities and

activities which have to interact during writing. Successful writing is achieved only
if all of these abilities and processes function and if, during the learning phase, their
full interactivity is achieved. Cerebral palsy doesn’t have a single typical clinical
manifestation. It is specific to each individual in relation to: the etiology of brain
damage, localization and size of defects, and the period in which the damage occurred.
Given these facts, the assessment of a child with cerebral palsy should be based on
the potential estimate model and through profiles of achievements in certain areas,
and the qualitative and quantitative interpretation. The aim of this study is to assess
the writing skills of a boy who had undergone surgery of phased fiberotomy. For the
assessment of writing, through qualitative analysis, we used the “Scale for assessment
of handwriting dysgraphia” (Aziriagera, Ozias), according to Cordic and Bojanin
(1997).
Key words: cerebral palsy, graphomotor ability, writing, phased fiberotomy
*Corresponding author: Milos Djordjevic, e-mail: [email protected]
71
THE ANALYZES OF INDIVIDUAL EDUCATION PLANS FOR CHILDREN
WITH CEREBRAL PALSY
Danijela Ilic-Stosovic, Anita Kovacic, Snezana Nikolic and Jasmina Maksic

According to official document of Serbian Ministry for education Individual

Education Plan is written document with the main aim to provide individual support
for children with special need in school activities as much as to provide optimal
conditions for socialization.
In this paper 8 Individual Education Plans for children with cerebral palsy were
analyzed with main aim to establish the most frequently structure of support, as much
as, to establish which school subjects were most challenging for these children. New
classification based on education profile of children with cerebral palsy is offered too,
with main aim to point out the mistakes made by the legislature in the official Serbian
documents for creating Individual education plans and to better explain problems
that teachers and professionals are cope with every day in their work.
The results show that children with cerebral palsy mostly need support in
learning and learning strategies as much as in independence and self-care. The
most challenging and in the same time, the most difficult curriculum demands were
demands of following two school subjects: Serbian language and Math. The structure
of professionals which realized support in Individual Education Plan do not correlate
with severity of disability.
Key words: cerebral palsy, Individual Education Plan
*Corresponding author: Danijela Ilic-Stosovic, e-mail: [email protected]
72
METHODOLOGY FOR INDIVIDUAL SUPPORT PLAN IN EDUCATION
FOR STUDENTS WITH CEREBRAL PALSY
Snežana Nisevic1 and Lidija Banjac2

1
Primary School „Bosko Buha“, Belgrade, Serbia
2
Special Hospital for Cerebral Palsy and Developmental Neurology, Belgrade, Serbia
In this paper we present case study the boy with cerebral palsy at the age 9
years, attending first grade of primary school in Belgrade. The boy was involved in a
rehabilitation program in the Special Hospital for Cerebral Palsy and Developmental
Neurology from the age of 11 months old until to starting education. He was 8.5 years
old when he started education in first grade at school for children with disabilities.
But, he transferred to a regular school at the beginning of the same school year. A
student has had a number of difficulties in participating in teaching during the first
year of education, although all measures of adjustment implemented at school. To
provide additional support for special educator at the school was necessary for further
progress. The school has requested assistance from the Mobile Team of Primary
School „B. Buha”. A thorough assessment of students’ ability and adaptation in the
school environment was performed by special educator. Profile of student needs in
education created, based on analysis of Interdepartmental Commission’s opinions,
health, developmental and educational status and family situation. We analyzed
school resources, too. Based on collected data, we created individual support plan for
student in education.
In this study the initial premise was the view that students with cerebral palsy
require additional support to include and participate optimally in the process of
education. The study has a double importance:
1. highlights necessity to organize rehabilitation programs within the school,
contributing to the development and progress of student with cerebral palsy
in education
2. contributes to the development of methodology for creating individual
support plan to these students in inclusive education.
Key words: individual support plan, cerebral palsy, school
*Corresponding author: Snezana Nisevic, e-mail: [email protected]
73
CONDITION OF STUDENTS WITH CEREBRAL PALSY WHEN
SWITCHING FROM LOWER GRADES TO UPPER CLASSES
Marija Davcevska
SES “Maca Ovcharova”, Veles, Republic of Macedonia
A subject of case study: a case study of the pupil F. I. (14 years). The student
started its education in our school “Maca Ovcarova” Veles.
Research Methodology: The following methods are implemented in the
researching process:
−− An interview with family members
−− An interview with the student F. I.
−− An interview with the class supervisor/tutor
−− Defectology diagnostics and treatment (Individual Education Plans)
−− A survey conducted (students and teachers)
−− Results: A contrastive analysis of the following two periods:
−− One year observation period of student’s behavior at deportment including
defectology thretments
−− An observation period without any treatment
Conclusion:
−− Easy adaptation period process with the new teachers with some given
expectations
−− Students with cerebral palsy are accepted by classmates and teachers
Key words: a case study, individual education plan, cerebral palsy
*Corresponding author: Marija Davcevska, e-mail: [email protected]
74
CONDUCTIVE EDUCATION IN SPECIAL CLASSES IN EDUCATIONAL
CENTRE “TOMISLAV SPOLJAR” IN VARAZDIN
Renata Kos and Blazenka Maltar

Centre for Upbringing and Education “Tomislav Spoljar”, Varazdin, Croatia
Children with rather low intellectual functions and some additional troubles
have been educated in special classes in COO “Tomislav Spoljar” in the assistance of
special teachers.
In 2011/2012 school year there are 15 students of certainly low intellectual
functions and cerebral palsy (CP) in special classes, 8 -17 years of age (8 students need
a special help to move – a wheelchair). They also suffer from clearly impaired motor
functions and have troubles in everyday activities. These students have been educated
according to a special curriculum which includes the following fields of education:
communication, getting acquainted with school and its surroundings, education
for work, taking care of themselves, socialization, art and music creativity, physical
training and religion. These subjects stimulate the development of speech, verbal
and nonverbal communication, getting acquainted with school and its surroundings,
self-orientation and orientation concerning time and space, visual perception and
sensitivity, ocular-motor and graphic---motor co ordinations, the development of
concentration, attention and self-confidence, socialization skills, the skill of self-care
and self-service appropriate to child’s motor and mental status and chronological
age. In order to form their self-confidence, the students are regularly included in
performances in and outside COO.
These students’ curriculum and the programme of logopedics and kinesitherapy
have been coordinated. There are different didactic tools used in teaching. These
are: building and modelling materials, natural unshaped materials, different texture
materials, pull – out puzzles, insets, stringing up elements, auditory tools (rattles,
small bells), balls of different shapes and different technical tools. In teaching the care
is taken of adjusting work place (light, e.g., the length, frequency and size of visual
tools, adjusting the texts and the use of tools to perform fine motor activities.
During physical training the students go swimming and recreation horse-riding.
In spite of an effort to eliminate architectural barriers in COO, some of them still
exist (there is no lift). There is also lack of adequate equipment (desks, chairs). Besides
education, special education aims to support, help and stimulate motor skills which
will contribute child’s self-reliance.
Key words: Educational Centre “Tomislav Spoljar” (COO); education; cerebral
palsy (CP)
*Corresponding author: Renata Kos, e-mail: [email protected]
75
“INCLUSIVE”, “INTEGRATED” OR “SPECIAL”? REFLECTIONS ON THE
PECEPTIONS OF, DISCOURSE ON AND PERCEIVED TRAINING
NEEDS IN “INCLUSIVE” EDUCATION FOR CHILDREN WITH
CEREBRAL PALSY IN SRI LANKA
Shyamani Hettiarachchi1 and Ajay Das 2

1
University of Kelaniya – Faculty of Medicine, Department of
Disability Studies, Sri Lanka
2
Murray State University, Department of Adolescent, Career and
Special Education, USA
Background: The paradigm shift from special education, through integrated

classrooms to inclusive education within a mainstream setting has been part of the
discourse of educationists and healthcare professionals worldwide. Nevertheless,
“inclusive education” remains a relatively new concept in Sri Lanka, largely inherited
from the global north. Although the right to education for every child within the
“mainstream” classroom has been enshrined within legislation (Parliament of
Sri Lanka, 1997), the reality of implementing such a policy has been questioned,
particularly in the light of few training opportunities for teachers and the anecdotal
evidence of closures of special educational units connected to mainstream schools.
Supporting children with cerebral palsy requires particular knowledge and
training with regard to positioning and handling, as well as in the use of Augmentative
and Alternative Communication systems (Workinger, 2005). Differences of ideology
and interpretation have influenced policy while the ground realities of limited
resources have not been conducive to the implementation of inclusive educational
placements or special educational units for children with cerebral palsy.
Objectives: To uncover perceptions and terminology regarding ‘inclusive
education’ and perceived training needs of teachers.
Research Design & Methods: 30 teachers working with children with cerebral
palsy will complete a validated survey questionnaire. In addition, key informants will
engage in an open-ended interview. A thematic analysis (Ritchie & Spencer, 1994)
and statistical analyses were undertaken.
Findings & Conclusions: The data provides valuable information on teachers’
understanding of ‘inclusive’ education, showing misconceptions and a lack of an
agreed definition. It also highlights the self-assessed need for specialist training and
on-going support for teachers working with children with cerebral palsy.
The results will be discussed with reference to a similar study conducted by the
co-investigator in Delhi. The results will also be discussed in terms of issues of access
to education for children with cerebral palsy within the Sri Lankan context and the
localized constructs of concepts involving education.
Key words: cerebral palsy, inclusion, teacher needs, training, pedagogy,
perceptions, terminology
*Corresponding author: Shyamani Hettiarachchi, e-mail: [email protected]
76
ADAPTED PHYSICAL ACTIVITIES AS THE PART OF EDUCATION:
CHANCE FOR CHILDREN WITH CEREBRAL PALSY
Hana Valkova
Palacky University in Olomouc – Faculty of Physical Culture, Czech Republic
School legislation in CR related to children with special needs (including

children with cerebral palsy – CP) is described. Two approaches of education linked
with the type of CP and preferred with parents are explained: inclusive – children
without cognitive problems, special – children with intellectual disability.
Beside school PE recreation as so as competitive sport opportunities are
presented both in Inas-FID and Special Olympics. The good examples as so as
problems are documented with results of research findings.
The documents support the idea adapted physical education is important part of
education, fitness and skills improvement and socialization.
Key words: physical education, inclusive education, special education,
Paraolympics, Inas-FID, Special Olympics
*Corresponding author: Hana Valkova, e-mail: [email protected]
77
PECULIARITIES OF ARTISTIC EXPRESSION OF STUDENTS
WITH CEREBRAL PALSY
Lucija Djordjevic1 and Srboljub Djordjevic2

1
2
University of Nis, Teachers Training Faculty in Vranje, Serbia
A child’s artistic expression can be studied from many different angles. Most
of the early researchers of children’s artistic expression dealt with defining the
characteristics of children’s drawings, the reasons why they occurred and with their
changes over the age. All researches of children’s artistic expression show that the
children’s artistic expression is conditioned by the achieved level of motor abilities,
consciousness and emotions. However, in addition to these internal factors there
are external factors that also influence the appearance and development of artistic
expression, including the child’s living conditions and stimulants from its social
environment. Early researchers of this topic, established a certain periodicity and
characteristics of a child’s ability to express itself through art, but also deviations from
the standards of development which could be caused by subjective and environmental
factors, in addition to mental retardation or physical handicap. Proceeding from the
above, the goal of the research we conducted was to investigate the level of artistic
expression of children with cerebral palsy, starting from “optical-thematic plan” and
compare it with the development standards of artistic expression of students with
typical development. The survey was conducted on a sample of 17 children with
cerebral palsy from first to eighth grade, aged 8 to 20 years. Drawing the human figure
were evaluated in relation to the level of reality display starting from the three phases
in the development of children’s artistic expression G. Kerschensteiner: 1) scribbling
and scribbling stage (from two to four years of age), 2) phase scheme or symbols
(ideoplastic drawing) (from four to seven years of age) and 3) the stage of shapes
and forms (physioplastic drawing) (from the seventh to the ten years of age). The
result of the empirical study indicates that the level of artistic expression of children
with cerebral palsy significantly deviates from the standards of the development of
art expression of children with typical development. This discrepancy in the artistic
expression of children with cerebral palsy are reflected in a significantly slower
passage through the stages of artistic expression, poverty detail in the drawing and
retaining the level of phase scheme or symbols (ideoplastic drawing). A small number
of young children with cerebral palsy are in the development of artistic expression at
the level of scribbling phase or transition to phase scheme. The result of Delay in the
development of artistic expression of children with cerebral palsy is, of course, the
primary damage, but the lack of training in drawing, too. The results can serve as a
basis for providing adequate didactic and methodological guidelines for working with
this population of students in the field of fine arts, which clearly draws attention to the
practical application of research performed.
Key words: cerebral palsy, artistic expression, drawing, optical-thematic plan
*Corresponding author: Srboljub Djordjevic, e-mail: [email protected]
78
PROFESSIONAL TRAINING FOR PERSONS WITH CEREBRAL PALSY –
A CASE STUDY
Biljana Milanovic-Dobrota, Marina Radic-Sestic and Vesna Radovanovic

In recent decades, knowledge of many aspects of professional rehabilitation

of persons with cerebral palsy has increased significantly thanks to case studies.
This paper presents the case of boy S.S (19) with infantile cerebral palsy and
mild intellectual disability considered through constraints and opportunities for
professional training for work in the conditions of our environment. After completing
elementary school “Miodrag Matic’’ in Belgrade in 2008/09 the boy was enrolled, at
the request of parents, in secondary school for professional training of students with
mild intellectual disability, and that was a big challenge. The dominant problems
were related to architectural barriers, inadequate and anachronistic job offers, and
as well reduced efficiency of institutions responsible for the introduction of new
occupations. Detailed assessments of a multidisciplinary team found that within the
current range of occupations, most compatible functional capacity of S.S is profession
of bookbinder’s assistant. Student’s monitoring was started because of the pioneering
school ventures. Individual interviews were conducted with a student, mother, which
is in a function of a personal assistant, instructor and professional working team of the
school. The dynamics of monitoring S.S was implemented as follows: every last Friday
of the month during the first (observational) year, and during professional training
for work at the end of each term. This paper presents the ways in which systemic
weaknesses were overcome primarily due to the understanding and enthusiasm of
employees. Detailed guidebook of support objectives development for all teachers
involved in the educational process of students is designed by individual educational
plan. Teachers of theoretical teaching, especially working instructor responded, with
the use of appropriate methods, forms and use of assistive technology, the needs and
principles of contemporary concepts of professional rehabilitation.
S.S has successfully completed the professional training and he will be employed
in a private firm as assistant operator of digital printing. His experience, school
experience and recommendations of the family, opened the door to other students
with the same difficulties to be involved in this system of professional training
and to achieve their basic rights-the right on education, professional training and
employment.
Key words: cerebral palsy and intellectual disability, professional training
*Corresponding author: Biljana Milanovic-Dobrota,

e-mail: [email protected]
79
PROBLEMS OF EMPLOYMENT AND JOB ACOMMODATION OF
PERSONS WITH CEREBRAL PALSY
Marina Radic-Sestic, Milica Gligorovic and Biljana Milanovic-Dobrota

Employment significantly contributes to the quality of life, social interactions,

economic security and independence of people with cerebral palsy (CP). The main
objective of this paper is to determine the barriers that people with CP are faced with
during a job search, as well how the workplace accommodation may provide them
with employment retention and promotion at work.
Six obstacles they are faced with were identified while analyzing the studies
of the employment of people with CP. Two aspects have been identified within the
education system. First aspect is the low expectations of society, primarily by teachers,
during the education of people with CP, which leads to limited or inappropriate
educational experience. Teachers do not expect that people with CP will ever be
able to work, and therefore they are not engaged enough in their education. In the
course of seeking and maintaining employment, that people with CP are faced with,
great challenges are reflected in the financing, personal care, access to services
and transport. Subsequently, in a series of barriers, there are negative attitudes of
employers and employees. Finally, when they eventually get an employment there may
be a problem with the job accommodation and with applying appropriate assistive
technology. Workplace accommodation is an important strategy for reducing and /
or easier job performance of employed persons with CP. The adaptive strategies that
involve flexible planning and working hours, modification of work tasks, frequent
breaks, assistive technology, supervisors support and additional training, which will
be reviewed separately in this paper were used on this occasion.
Key words: employment, barriers, workplace accommodation
*Corresponding author: Marina Radic-Sestic, e-mail: [email protected]
80
Theme 4
Social Welfare of People with

Cerebral Palsy
ACCESSIBLE HOUSING FOR PERSON WITH CEREBRAL PALSY
Emira Svraka
University of Sarajevo – Faculty of Health Studies, Bosnia and Herzegovina
Accessible design generally refers to houses or other dwellings that meet

specific requirements for accessibility. The laws dictate standards dimensions and
characteristics for such features as door widths, clear space for wheelchair mobility,
audible and visual signals, grab bars switch and outlet height, and more.
The aim: to determine accessible housing for persons with cerebral palsy.
Method: Sample was consisted of 30 respondents, members of the Association
of persons with cerebral palsy of the Canton of Sarajevo, age from 4 up to 53; 14 male
(46,67 %) and 16 (53,33 %) female. The age of eighteen clients (60 %) was under 18
years. The principal measure used was the International Environmental Assessment
– Home assessment form.
Results: 20 (66.7 %) clients are wheelchair users, 7 (23.3 %) have independent
mobility and 3 (10 %) require the use of particular device. Three clients can enter the
bathroom with wheelchairs. From whole sample of 30 clients, 3 (10 %) clients have
toilet seats equipped with grab bars, and 27 (90 %) clients do not have. From 20 clients
with wheel chairs, for 10 (50 %) of them height of kitchen tables allows wheelchairs
access.
Discussion: In Great Brittan one Study shows that over 4 million people are
persons with mobility disabilities, but there are only 80 000 accessible homes.
Conclusion: Private homes should be adapted according to individual needs of
person with disabilities. Multidisciplinary team should lead that planning, and find
such design solutions that overcome the problem of architectural barriers for people
with disabilities to improve their quality of life.
Key words: accessible housing, cerebral palsy
*Corresponding author: Emira Svraka, e-mail: [email protected]
83
POSSIBILITIES FOR SOCIAL INTEGRATION OF PERSONS WITH THE
CEREBRAL PALSY
Ivana Mitrovic-Djordjevic
Elementary School “Dusan Dugalic”, Belgrade, Serbia
In this work, we have covered the following topic: Possibilities for social
integration of persons with physical disability. Our research included assessment of
actual and nominal psycho-social support to persons with physical disability on one
hand, and assessment of possibilities for social integration of persons with physical
disability, on the other. The results were analyzed against possibility for integration
into school-, work- or wider social environment through opportunities for education,
employment and use of public services.
This research was conducted on persons with physical disability but with
preserved mental abilities, and the main issues were potential and achieved integration.
The research has identified all relevant factors which create obstacles or prejudices
and put this part of population in the state of occasional or constant incompetence.
We have achieved the defined goal through following: (1) assessment of psycho-
social support to persons with physical disability (actual and nominal support), (2)
assessment of motor and mental functions of persons with physical disability in social
environment and (3) comparison of abilities of persons with physical disability and
psycho-social support.
This research was conducted in Belgrade, during 2003/04. It involved 187
participants, persons with physical disability, of both genders. Criteria for the research
group were: belonging to the category of physical disability, age between 7 and 20,
preserved mental functions and residence in Belgrade.
According to defined research goals, conclusion is that the existing legal,
institutional and professional potentials are not sufficiently and adequately utilized
in the field of integration of persons with physical disability in social environment.
Key words: persons with physical disability, social integration, psycho-social
support
*Corresponding author: Ivana Mitrovic-Djordjevic, e-mail: [email protected]
84
HEALTH-RELATED QUALITY OF LIFE IN CHILDREN WITH
CEREBRAL PALSY
Vojislava Bugarski, Dragana Miscevic, Renata Skrbic and Spela Golubovic

Assessment of health-related quality of life in chronically ill children has, in

recent years, become a subject of increasing interest of research, primarily because
a chronic illness, with its physical and psychosocial aspects, inevitably and often
negatively affects quality of life of children suffering from it. Assessment of health-
related quality of life is difficult because of the complexity of the very phenomenon
and in order to define it, it is necessary first to define health. Health-related quality
of life is therefore a complex phenomenon that comprises physical, psychological and
social aspects of health. As a chronic illness, cerebral palsy inevitably affects some of
the determinants of quality of life. The aim of the study was to compare quality of
life in children with cerebral palsy and healthy children. Quality of life was assessed
using the Parent/Proxy version of the Kidscreen 27 questionnaire. The instrument
measures five main dimensions of health-related quality of life in children: Physical
Well-Being, Psychological Well-Being, Peer and Social Support, Autonomy and
Parents, and School Environment. The study included 56 parents divided into two
groups – 28 parents of children with cerebral palsy and 28 parents of healthy children.
The two groups of children whose quality of life was assessed by their parents did
not differ significantly with regard to age and sex. The obtained results showed
statistically significant differences between the groups in all studied variables, i.e. in
all five studied dimensions of quality of life. Children with cerebral palsy had lower
mean scores, i.e. lower quality of life, in all the dimensions. We may conclude that
cerebral palsy negatively affects different dimensions of quality of life in children
suffering from this chronic illness.
Key words: cerebral palsy, health-related quality of life, parent report, Kidscreen
questionnaire
*Corresponding author: Spela Golubovic, e-mail: [email protected]
85
LIFE HABITS ACCOMPLISHMENT LEVEL OF PERSONS
WITH CEREBRAL PALSY
Gordana Odović1, Dragan Rapaić1, Jelena Stanisavljević2 and Ivana Sretenović3

1
2
Association for Cerebral and Child Paralysis of Belgrade, Serbia
3
Association for Cerebral and Child Paralysis of Serbia, Serbia
Participation in daily activities is vital for all humans. World Health Organization,
stated that participation has a positive influence on health. The presence of disability
lead to less diverse participation, person is located more time in the home and involves
fewer social relationships, includes less active recreation as well. The WHO defines
participation as involvement in a life situation. In the ICF, participation is categorized
into domains: learning and applying knowledge; general task and demands;
communication; mobility; self-care; domestic life; interpersonal interactions and
relationships; major life areas such as work or school; and community, social, and
civic life (WHO, 2001).
The aim of this paper is to examine the life habits accomplishment level in
the domain of everyday activities of persons with cerebral palsy (CP). The sample
included 51 patients with CP of both sexes. The survey was conducted during May
2012 in the Association for Cerebral and Child Paralysis of Belgrade and Association
for Cerebral and Child Paralysis of Serbia. Part related to daily activities of Life
Habits Assessment 3.1 (Fougeyrollas, Noreau & St-Michel, 2001) was used for this
research. Descriptive statistics methods, absolute and relative indicators were applied
for datas processing and relation between independent and dependent variables was
investigated by chi-square test.
The results show that age and gender of respondents didn`t represent statistically
significant factors of life habits accomplishment level. Education proved to be a
significant variable in the field of nutrition (X2=12.244; p=0,032), and independent
living in the field of mobility (X2=14.596; p=0,012).
Key words: life habits, cerebral palsy, daily activities
Introduction
Seen from the perspective of social sciences, particularly from the
standpoint of special education and rehabilitation, the biggest problem with
explicative models which explaining the consequences of disease, trauma
or other disorders, such as model ICIDH or Nagi model, is related to their
institutional background or context of health (disease) from which they trace
their roots. Such models do not rely on generic, or the anthropological model
of development that are applicable to all human beings. In contrast, the model
of human development allows us to illustrate the dynamics of an interactive
process between the personal (internal) and environmental (external) factors
86
that determine the results of achievement in realizing the life style appropriate
to the age, sex and socio-cultural identity of a person.
It is difficult, to distinguish between “personal capacity” and “achievements
in social situations in real life” (referring to a set capacity profile, and the
environmental determinants), and argue that, for example, preparing meals
is inner characteristics of the person. Since this claim is supported by many
authors, it should be noted that personal activities (such as dressing, hygiene,
maintenance of security in the home) can not be categorized in category of
personal hallmark, but rather may represent the degree of realization of a social
activity in the real environment. That is the meeting between the people and
their environment in accordance with the expected and socially determined
result (Verbrugge & Jette, 1994; Bolduc, 1995; Sjogren, 1995; Robine et al.,
1997). Dimensions of environmental factors is therefore, from this perspective,
the key variable that allows the differentiation capacity of personal achievements
in the field of exercise life habits.
The life habits

A life habits are daily activities or social roles that an individual or his socio-
cultural context value depending on the characteristics of the person (age, sex,
socio-cultural identity, etc.). Life habits ensure the survival and well-being of
people in society throughout life. Quality exercise of life habit is measured on
a scale that runs from the full exercise of life habits to a situation of complete
disability. The major categories of life habits include: nutrition, fitness,
personal care, communication, housing, travel, responsibility, interpersonal
relationships, community life, education, work, leisure, other habits (habits
that are not included in the above group of habits).
The formation of handicap situation, in addition to individual and
environmental factors, implies the third dimension (Nedovic et al., 2012). The
third dimension relates to the subjective assessment of the situation of disability.
Each person is an individual unit, and this estimate is specific to each individual.
It is based on the observed differences between expectations and achievements.
The formation of handicap situation is not a model that is independent, separate
from the generic model of human development, but it is only one variation of
capacity related to biological, functional, and social norms.
Clarifying the concept of lifestyle as a result of the interaction of the
classification dimensions of what belongs to the person and what belongs to the
environment, requires that the level of social consequences include everything in
rehabilitation called “household activities” and “daily activities” and to the same
conceptual domain in which findings and social roles. The exercise of life habits, is
by definition, variable, and may be changed, in both terms of personal factors, and
environmental factors in the field (Fougeyrollas, 1995; Fougeyrollas et al, 1998).
87
Cerebral Palsy
Cerebral palsy occurs with brain injury, most often in the uterus or birth, so
that the further development of these people are quite specific. It is manifested
with impairment of motor function, but is often associated with other disorders,
such as vision problems, hearing loss, mental retardation, speech disorders or
behavioral disorders. Cerebral palsy is defined as a disorder of movement and
postural balance due to a variety of immature brain damage. Therefore, cerebral
palsy is not only a medical problem but also it is a social and economic, and as
such it, affects the overall quality of life for these people and their environment
(Križ & Prpic, 2005). This is a condition that in the social context gets attributes
of disability (retardation, disability, handicap) (Rapaic & Nedovic, 2011).
Many individuals with cerebral palsy have a low level of participation in daily
activities. The World Health Organization states that participation has a positive
impact on health, and it is of vital importance for all people. Donkervoort et al.
(2007) state, that participation and exercise of life habits in most cases depend on
the level of motor functioning. Respectively, a higher level of motor functioning
gives some lower limits in their daily activities. The level of motor functioning,
age and intellectual status are predictors of the level and quality of exercise of
life habits for people with cerebral palsy, particularly in the areas of personal
care and social engagement (Nedovic et al., 2012). On the other hand, there are
studies that indicate an increase in the number of people with cerebral palsy who
successfully participate and that, regardless of the severity of their condition,
show independence in daily activities and in the implementation of employment.
The reason of this change, can be found in the progress of rehabilitation and an
improving service achievements, but also in the environmental factors that are
becoming easier for people with cerebral palsy (Murphy et al., 2000).
Aim
The aim of this paper is to examine the life habits accomplishment level in
the domain of daily activities of persons with cerebral palsy (CP).
Methods
Participants
The sample included 51 persons with cerebral palsy both of sex.
Participants are aged between 35 and 55 years. Types of cerebral palsy based
on topographical distribution: diplegia, hemiplegia, paraplegia, quadriplegia.
Participants were recruited from the Association for Cerebral and Child
88
Paralysis of Belgrade and Association for Cerebral and Child Paralysis of
Serbia. The research was conducted during May 2012.
Instrument
The Assessment of Life Habits (LIFE-H) was developed to assess the
quality of social participation of people with disabilities by estimating how a
client accomplishes activities of daily living and social roles (Fougeyrollas et
al., 1998). The LIFE-H considers the degree of difficulty in carrying out life
habits and the type of assistance required (Desrosiers et al., 2004).
The short version of the LIFE-H 3.1 (Fougeyrollas, Noreau & St-Michel,
2001) was used in this research. It is composed of 77 life habits divided into
12 categories. We used the Activities of Daily Living sub-scale contains the
following categories: nutrition, fitness, personal care, communication, housing
and mobility. For each item in the accomplishment sub-scale the client is asked
about perceived difficulty in performing a life habit When a life habit is not
realized because it is not part of the person’s daily life, it is considered as a non-
applicable item (Desrosiers et al., 2005; Desrosiers, Bourbonnais, Noreau,
Rochette, Bravo, & Bourget, 2005; Fougeyrollas et al., 1998).
Statistical analysis
Analyses were performed using SPSS 12.0.1 for Windows. Descriptive
statistics methods, absolute and relative indicators were applied for datas
processing and relation between independent and dependent variables was
investigated by chi-square test.
Results
Characteristics of the study sample

Table 1 presents the personal characteristics of the 51 adults with CP who
participated in this study. The mean age was 45.5 years and 51% were female.
All participants had a medium or low level of education.
Characteristics of the study sample (n = 51)
89
Table 1
Characteristics
Age n(%)
35 – 45 24 (47.1)
46 – 55 27 (52.9)
Gender, n (%)
Male 25 (49.0)
Female 26 (51.0)
Level of education, n (%)
High –
Medium 23 (45.1)
Low 28 (54.9)
Daily activities
The research resultats of daily activities are shown in Table 2.
Respondents accomplished without difficulty most of life habits in the
fields of nutrition, fitness and communication. They accomplished habits at
different levels in the fields of personal care, mobility and housing ranging
from accomplished with difficulties, accomplished by a proxy and to not
accomplished.
Level of functioning in daily dactivities
Table 2
Performing
Daily activities Performed with Performed with Performed by Not Not
no difficulty difficulty a substitute performed applicable
Nutrition f % f % f % f % f %
Selecting appropriate 38 74.5 11 21.6 / / 2 3.9 / /
food
Preparing your meals 10 19.6 3 5.9 / / 38 74.5 / /
Eating meals 44 86.3 7 13.7 / / / / / /
Eating in restaurants 37 72.5 7 13.7 / / / / 7 13.7
Fitness f % f % f % f % f %
Getting in and out of 33 64.7 14 27.5 4 7.8 / / / /
bed
Sleep 51 100 / / / / / / / /
Particip. in phys. 2 3.9 16 31.4 / / 6 11.6 27 52.9
activities
Particip. in relaxation or / / / / / / / / 51 100
mental focus activities
90
Personal care f % f % f % f % f %
Attending to personal 16 31.4 34 66.7 1 2 / / / /
hyg.
Using the bathr./toilet 21 41.2 29 56.9 1 2 / / / /
in home
Using the bathr./ toilet 15 29.4 23 45.1 / / 13 25.5 / /
other than those in
home
Dressing/undressing 39 76.5 11 21.6 1 2 / / / /
the upper half of your
body
Dressing and 31 60.8 19 37.3 1 2 / / / /
undressing the lower
half of your body
Putting on, removing, 6 11.8 19 37.3 / / / / 26 51
and maintaining your
AD
Taking care of your 15 29.4 36 70.6 / / / / / /
health
Using services provided 10 19.6 41 80.4 / / / / / /
by a hospital or rehab.
center
Communication f % f % f % f % f %
Communicating 35 68.6 13 25.5 / / 1 2 2 3.9
with person in the
community
Communicating with 39 76.5 10 19.6 / / / / 2 3.9
a group of people at
home
Written communication 35 68.6 2 3.9 / / / / 14 27.5
Reading and 34 66.7 2 3.9 / / / / 15 29.4
understanding written
information
Using a phone at home 33 64.7 7 13.7 1 2 1 2 9 17.6
or at work
Using a public or cell 6 11.8 4 7.8 / / 5 9.8 36 70.6
phone
Using a computer 22 43.1 2 3.9 4 7.8 2 3.9 21 41.2
Using radio,TV or 34 66.7 16 31.4 1 2 / / / /
sound s.
Housing f % f % f % f % f %
Maintaining your home 3 5.9 43 84.3 1 2 4 7.8 / /
Maintaining the 2 3.9 7 13.7 / / 4 7.8 38 74.5
grounds of your home
Doing major household / / 28 54.9 / / 22 43.1 1 2
tasks
91
Moving around within 28 54.9 12 23.5 11 21.6 / / / /
your home
Using the furniture 24 47.1 14 27.5 12 23.5 1 2 / /
and home-furnishing
equipment in your
home
Moving around out 14 27.5 29 56.9 8 15.7 / / / /
home
Mobility f % f % f % f % f %
Getting around on 13 25.5 32 62.7 6 11.8 / / / //
streets
Getting around on 1 2 47 92.2 / / 3 5.9 / /
slippery or uneven
surfaces
Riding a bicycle / / / / / / / / 51 100
Being a passenger in a 12 23.5 39 76.5 / / / / / /
vehicle
The results also showed that age and gender of respondents didn`t represent
statistically significant factors of life habits accomplishment level.
Education proved to be a significant variable in the field of nutrition
(X =12.244; p=0,032), and independent living in the field of mobility (X 2=14.596;
2
p=0,012).
Discussion
Much of the emphasis in cerebral palsy is on the pediatric aspects. Great
attention is paid to therapies to maximize the child’s potential for speech,
ambulation and other functions. Researchers have studied the developmental
trajectory of children with CP, considering questions such as the child’s chance
of learning to walk (Blair, et al., 2001). There is a large literature on medical
conditions of children with cerebral palsy and also a considerable literature
from around the world on survival of children and young adults with CP (Evans
et al., 1990; Crichton, et al., 1995; Hutton et al;., 2000; Hutton & Pharoah,
2002). By comparison, there has been less attention paid to adults and elderly
persons with CP.
The aim of this research was examining the life habits accomplishment
level in the domain of everyday activities of adults with CP.
According to the International Classification of Functioning, Disability
and Health (ICF), participation is defined as the involvement of a person in life-
situations and is determined by impairment or limitations of activity, as well as
by environmental or contextual factors (WHO, 2001; Jonsson et al., 2008). For
adults with CP, restrictions in participation have been demonstrated in several
92
areas of day-to-day living, including employment, independent living, and
social and leisure activities (Andersson et al., 2001, Andren & Grimby, 2004).
The results of our research showed a difficulties in accomplishment of
daily living habits in fields of personal care, mobility and housing. Donkervoort
et al. (2007) stated that a significant number of adolescents and younger adults
with CP without severe learning disabilities are restricted in daily activities and
social participation. These problems are mainly attributable to restricted gross
motor functioning, a low level of education and younger age. About 20–30% of
the participants encountered restrictions in daily activities (mobility, self-care,
nutrition). Level of education and age proved to be important determinants
of functioning in daily activities and social participation, explaining 70% and
66% of the variance in outcome respectively.
French historian and philosopher Michel Foucault asserted that power
and knowledge have been used to develop a society and health care system
that marginalizes people who are different from the “norm” (Foucault, 1975).
Research also has shown that institutional environmental factors (economic,
political, attitudinal) significantly affect the participation of persons with
disabilities (Law et al., 1999). Issues of poverty, cost of programs, affordable
housing, lack of information and physical assistance, lack of inclusion of persons
with disabilities in planning, and staff training and attitudes limit participation
(Imrie & Kumar, 1998; LaPlante et al., 1996).
The results also showed that age and gender dont represent statistically
significant factors of life habits accomplishment level. Education proved to
be a significant variable in the field of nutrition and independent living in
the field of mobility. Donkervoort et al. (2007) also found that the level of
education is important determinant, especially in the area of lifestyle related to
communication and nutrition.
Conclusion
The presence of disability has been found to lead to participation that is
less diverse, is located more in the home, involves fewer social relationships,
and includes less active recreation.
As the reason for that, on a broad level, we must consider societal production
of space or the whole organization of our cities and towns, including places of
employment, households, shopping districts, and transportation networks.
The research results show that there is greater need of community support
in terms of setting up a support services for people with CP who living alone and
those living with their parents. Except an accessible barrier free environment,
support for persons with CP should include assistance in housing, personal
hygiene and mobility in the home and environment.
93
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*Corresponding author: Gordana Odovic, e-mail: [email protected]
96
BEHAVIORAL PROBLEMS IN CHILDREN WITH CEREBRAL PALSY
AND MILD INTELLECTUAL DISABILITY
Slobodan Bankovic, Nenad Glumbic, Ksenija Stanimirov and Mirjana Djordjevic

Studying of childhood behavioral problems is of great importance, since the

problems of this type affect a child’s both functioning and overall development, and
as such, these problems can be considered as a predictor of behavioral disorders.
The aim of this research was to identify the frequency of externalizing and
internalizing behavioral disorders in children with multiple disabilities (mild
intellectual disabilities and cerebral palsy), and also in children with mild intellectual
disability as a control group. An additional objective was to examine the relation of
manifestations of these problematic behavioral patterns and gender and chronological
age of respondents.
The sample included 50 children chronologically aged from 8 years 2 months
to 17 years 6 months, a total of 26 boys and 24 girls. The entire sample was divided
into two subgroups: children with cerebral palsy and mild intellectual disability (20
respondents), and children with mild intellectual disability, without cerebral palsy
(30 respondents). Behavioral data were gathered from the teachers by using the
instrument ASEBA – TRF.
Significant differences were found within the Externalizing problems, that is
on the Rule-Breaking Behavior subscale (U=174, p=0.12), whereas respondents with
mild intellectual disability without associated cerebral palsy had a higher average
score rank (29.7), in contrast to respondents with cerebral palsy (19.2). In both groups
of respondents a positive and statistically significant correlation between certain
behavioral problems and chronological age was observed. In the subgroup of children
with cerebral palsy and mild intellectual disability, significant differences in relation
to gender (U=19.5, p= .025) on the Withdrawn/Depressed subscales was noted,
whereas girls had higher average rank (14.06) comparing to boys (8.13).
Future research should examine the relation between a wider range of socio-
demographic characteristics and the frequency of behavioral problems occurrence.
Key words: ASEBA, childhood, problematic behavioral patterns
*Corresponding author: Mirjana Djordjevic, e-mail: [email protected]
97
SELF– ESTEEM OF INDIVIDUALS WITH CEREBRAL PALSY
Svetlana Kaljaca, Gordana Odovic and Bojan Ducic

Self-concept is a subjective assessment, based on personal and social experience,

which serves as a cornerstone of personal identity formation. Self-development
process begins already in the childhood, continues throughout life and has an
important influence on a person‘s behavior.
Social messages and reactions, reflecting the impressions others have of us are
being adopted, processed and structured in accordance with the already existing
constructs. Factors such as positive support obtained by children from their parents
and other persons to whom children are emotionally closely related, are considered to
influence the development of the positive self.
Self-esteem is one of the key components of the self-concept, so that these two
terms are considered as synonymous by many authors. Persons with cerebral palsy
are often faced with social isolation and peer rejection. There is a number of barriers
related to social environment that hamper participation of persons with cerebral
palsy, which has particularly negative impact on possibilities in the fields of education,
employment, as well as on active participation in the community. This state has
negative influence on the level of self-esteem and development of impoverished
identity and integrity of these persons.
The study included 83 participants of both sexes. A number of participants (33)
were individuals with diagnosis of cerebral palsy without associated disorders. The
other subsample (50 participants) included individuals showing typical development.
During the data collection process, two subscales were applied, extracted from
the Self Concept Assessment Scale - Global Self-Esteem Scale and Social Evaluation
Scale.
Based on statistical analysis of obtained data, substantial differences between
participants with cerebral palsy and participants representing typical population were
established only for some items of the subscale of self-esteem assessment and for the
subscale of the social evaluation as a whole.
Key words: self-esteem, cerebral palsy, self-concept
*Corresponding author: Svetlana Kaljaca, e-mail: [email protected]
98
ACTIVITIES OF DAILY LIVING IN PERSONS WITH CEREBRAL PALSY
IN INSTITUTIONALIZED CONDITIONS
Lidija Ivanovic1, Dragan Rapaic1, Veselin Medenica2 , Sanja Trgovcevic3 and

Marinela Scepanovic4
1
University of Belgrade - Faculty of Special Education and Rehabilitation, Serbia
2
Medical College of Professional Studies „Milutin Milankovic“, Belgrade, Serbia
3
University of Belgrade - Faculty of Political Sciences, Serbia
4
Association of Special Educators and Rehabilitators of Vojvodina, Novi Sad, Serbia
Reviewing the literature we have revealed that there were gaps in research of
everyday activities of persons with impairments in institutions of social care. It is
often assumed that if a person is accommodated an institution of social care has all
the necessary support and that there are no major obstacles in everyday activities with
a given support. Therefore, we believe that this subject was not even studied. The
research that was conducted for the purpose of this paper gave us the overall picture
of everyday activities of persons with physical disabilities in social care institutions.
The main objective of this study was to determine the possibility of performing
everyday activities, including participation in special activities organized by the
institution, and thus find the indication for somatopedic treatment for persons with
cerebral palsy, quadriplegia and paraplegia, multiple sclerosis and muscular dystrophy
that are in institutionalized.
Method – For purposes of this study, we have used the descriptive method.
Methods of collecting data were: documentation, analysis and individual assessment
– testing. Assessment instruments – Test everyday activities (Rusk, 1971) and a
Questionnaire for assessing the intensity of needed psychosocial support (Nedovic,
Odovic, Rapaic, 2010).
The results show that users included in this research are heterogeneous group
regarding the success at the test of everyday activities and level of needed psychosocial
support and that they take very little part in programs provided by the institutions
and that there is a need for somatopedic treatment.
Key words: everyday activities, persons with cerebral palsy, institutionalized
conditions.
*Corresponding author: Lidija Ivanovic, e-mail: [email protected]
99
Theme 5
Others
motor imagery in cerebral palsy: is that true?
Isabel Catarina Martins1,2,3, Armando Mónica de Oliveira1, Bert Steenbergen3

1
Laboratory of Experimental Psychology, Institute of Cognitive Psychology, Faculty of
Psychology and Sciences of Education of University of Coimbra, Portugal
2
Portuguese Association of Cerebral Palsy
3
Behavioral Science Institute, Nijmegen, Netherlands
Mental Rotation (MR) paradigm is described, revealing functional equivalence

and monotically increase of time with the rotation angle. Some studies reveal that the
time to mentally simulate one’s action is often proportional to the time to perform
the motion. Others demonstrate that biomechanical constraints affect the mental
simulation of movements.
Data from studies in CP are inconsistent concerning whether they use motor
imagery (MR affected by their own body constraints) or visual imagery (merely
rotating pictures, not affected by body constraints) when solving MR tasks. Our
main aim in this presentation is to get a clearer picture of this by (1) comparing letter
rotation task with hand rotation, (2) comparing medial and lateral rotation reaction
times in the hand conditions.
45 participants with CP and 45 motor able participants were given a MR task of
photographs of hands and letters, according to different rotation degrees. Under the
assumption that people with CP are unable to use Motor Imagery, we expected to
find no differences between rotation of letters and hands, and no difference between
lateral and medial rotation in hands task.
CP participants revealed
−− Ability to use motor imagery. Motor constraints are expressed in MR
pattern: more constrained hand postures (lateral) showed an increase of
time in both groups;
−− Motor imagery deficits, although, (longer reaction times in MR by CP
participants), stressing the guidelines adopted by the new definition of CP.
Overall, outcomes argue for the involvement of motor representations (and not
just visual ones) in both tasks. Action and motor experiences appear to be important
for MR generally, (not only for rotations concerning body parts).
Moreover, the employment of motor imagery strategies by CP group pleads
for the potential usefulness of motor imagery training as a means to improve actual
motor performance in CP participants.
Key words: cerebral palsy, motor imagery, mental rotation, mental simulation,
action perception
This research was supported in part by a grant from the Portuguese Ministry of Science and
Technology, FCT-MCTES (awarded to Isabel Catarina Martins - SFRH/ BD/ 64960/ 2009).
*Corresponding author: Isabel Catarina Martins, e-mail: [email protected]
103
THE ROLE OF THE CENTRAL NERVOUS SYSTEM IN THE
ORGANIZATION AND CONTROL OF VOLUNTARY MOTOR ACTIVITY
Sinisa Ristic and Zvezdana Kojic

University of Eastern Sarajevo – Faculty of Medicine Foca, Bosnia and Herzegovina
University of Belgrade – Faculty of Medicine, Serbia
For understanding deficits in motor behavior in people with cerebral palsy, it is

necessary to know the basic components of the anatomy and physiology of the central
nervous system, especially the part that is related to voluntary motor activity (cortex and
brain stem). This paper summarizes current neurophysiological research in this area.
Broad areas of the cerebral cortex participate in the planning and execution
of voluntary motor action. These areas include the area of motor cortex – primary,
supplementary motor and premotor cortex and also somatosensory cortical areas
and heteromodal associative cortex. The brain stem connects the spinal cord to other
parts of the brain. It contains a number of nucleuses located in a very small area, and
many ascendant (sensory) and descending (motor) pathways also pass through them.
A number of neurons located in the brainstem are involved in the performance of
voluntary motor control, and functions such as the maintenance of upright posture
(posturality) and maintaining muscle tone as well as conduct of so-called stereotyped
body movements.
In recent years, mainly because of neurophysiological research, understanding
of the functioning and interconnectedness of the parts of the central nervous system
in the organization of voluntary motor activity have undergone considerable changes.
New findings preclude any sense of localization of the search engine physiologic
mechanisms act in a limited area of the brain. This knowledge can play an important
role in the development of a new concept of education and rehabilitation of persons
Key words: voluntary motor skills, cerebral cortex, brain stem, posturality,
muscle tone
*Corresponding author: Sinisa Ristic, e-mail: [email protected]
104
EARLY DETECTION OF BREAST CANCER BY MAMMOGRAPHY IN
WOMAN SUFFERING FROM CEREBRAL PALSY
Dusanka Tesanovic1, Dragana Djilas-Ivanovic1, Danijela Pisaric2 and

Fadilj Eminovic3
1
Institute of Oncology Vojvodina, Sremska Kamenica, Serbia
2
Aboot Laboratories S.A., Serbia
3
Breast cancer is the most common malignancy in women, and if detected early
patients have a relatively good chance to cope with the disease. Ar the Institute of
Oncology in Sremska Kamenica be conducted systematic reviews, screening program
for early detection of breast cancer base, control mammography and ultrasound. The
analysis of data from the records of the Institute revealed that the participation of
people with very little, and we believe that woman with breast cancer is not the time
uncovered and treated.
In this paper, we emphasize the need to identify the barriers to aprticipation
in mammography screening of women with cerebral palsy in Serbia. It was found
that timely mammograms significantly reduce the mortality rate, but women with
disabilities, such as cerebral palsy do not use this preventive method, potentially
leading to a delay in diagnosis of breast cancer and a worse prognosis of the disease.
Difficulties in communication, physical and psychological limitations, and attitudes
of health care professionals are an obstacle to the successful outcome of a prevention
program.
Necessary adaptation of mammographic techniques that correspond to the
physical limitations of a woman with cerebral palsy and education of health care
professionals to increase the effectiveness of prevention programs.
Key words: breast cancer, mammography, cerebral palsy
*Corresponding author: Dusanka Tesanovic, e-mail: [email protected]
105
USING THE COMPUTER SOFTWARE FOR OBSERVATION AND
ANALYSIS OF MOTOR BEHAVIOR FOR APRAXIA ASSESSMENT IN
PERSONS AFFECTED BY CEREBRAL PALSY
Veselin Medenica1, Lidija Ivanovic2 , Katarina Uzunovic2 ,

Radica Dragojlovic-Ruzicic1 and Marica Drcelic2
1
Medical College of Professional Studies „Milutin Milankovic“, Belgrade, Serbia
2
Software for observation and analysis of motor behavior can performe

acquisition, analysis and partial processing. Part of the software for data acquisition
includes the ability to playback stimuli, recording the movement and many other
features. In most studies assessment of apraxia involves the recording procedure
(stimulus examiners and execution of movement). The advantage of using a software
we developed is that the stimuli can be recorded in audio or video format, and then
reproduced.
The aim of this study was to determine whether use of the software provides a
greater degree of control conditions in assessing the presence of apraxia compared to
the standard procedure that involves the recording performance of the movement.
Assessment of apraxia was made in a person who suffers from cerebral palsy,
aged 38 years. For the assessment of apraxia was used 5 randomly selected tasks
from Waterloo apraxia battery. In the first part of the research, software was used for
observation and analysis of motor behavior, for setting the stimuli and recording of
movement performance. The subject was tested, and 7 days later a retest was done. In
the second part, instead of a specially developed software, we used a software that serves
only to record the whole procedure. The obtained video footage was subsequently
processed, so it would be impossible to detect its origin. Also video documents were
coded, mixed and given for the assessment. Trained evaluator assessed the quality
of the movements. Video files were reviewed, and quality of movement performance
were recorded in the protocol.
Test-retest reliability was α = 0.92 when the software was used. Test-retest
reliability was α = 0.86 when the software was not used.
Test-retest reliability indicates that the apraxia assessment procedures for people
with cerebral palsy is much better when using the Software for observation and analysis
of motor behavior. This result was attributed to a greater degree of control the conditions
of research when software was used. Further development and evaluation of software
and its characteristics is needed.
Key words: cerebral palsy, apraxia, computer software, assessment
*Corresponding author: Veselin Medenica, e-mail: [email protected]
106
GROSS MOTOR FUNCTION AND CLASSIFICATION SYSTEM
Snjezana Mergon
Center for Education and Rehabilitation, Krizevci, Croatia
A group of Canadian doctors for long time has explored the tests that would
assess motor function of children. The result of their work is the “Handbook for the
assessment of gross motor function,” according to Russell and others. The estimate is
accepted because it was extensive and reliable.
Testing with 66 tasks in practice is used as the basis for the classification of gross
motor function in cerebral palsy. Testing with 88 tasks is used in research, clinical
trials and as a complement to Test – 66. Testing is performed in 5 dimensions. Rules
and GMFM sheet for recording results are used in testing procedure.
The aim of the assessment is to measure the magnitude of change in gross motor
skills after a period of time. Initial measurement is essential to reveal the child’s
strengths, as they should be used as motivation for work. The measurement should be
used for further prognosis, in cerebral palsy, as well as with other motor impairment.
Classification system of gross motor functioning, GMFCS, is the assessment of
severity of the disorders of motor function. It is based on voluntary caused motions
classified in 5 levels. The main criterion is the function in everyday life, and it differs in
functional limitations, the need for aids and quality of movement. The classification
focuses on current capabilities and limitations of coarse motor function of children
and adolescents.
Key words: Gross Motor Function Measurement – GMFM, Gross Motor
Function Classification System – GMFCS, testing, prognosis, cerebral palsy
*Corresponding author: Snjezana Mergon, e-mail: snjezana.mergon@ skole.hr
107
THE ROLE OF GENDER AND THE TYPE OF HOSPITALIZATION IN
TRAINING SELF CARE ACTIVITIES OF PRESCHOOL CHILDREN
WITH CEREBRAL PALSY
Nada Savkovic
Health College Belgrade, Serbia
This research is a part of master’s thesis with the main assumption that special
education program may affect the ability of manipulative skills and self care of children
with cerebral palsy (Savkovic, 2011). The aim of the research is to determine the effects
of individually composed programs to ability of the child for taking food, personal
hygiene and dressing/undressing activities, and identification of the correlative
relationship between gender and the type of hospitalization, and achievement after
the implementation of special education program. The sample was formed of 30
children aged 4 to 7 years for treatment at the Special Hospital for Cerebral Palsy and
Developmental Neurology at Belgrade and separate protocol, designed specifically
for this study was used for evaluation before and after the applied program, which
was applied continuously for 12 weeks. On the basis of correlation analysis and by
T-test it is confirmed that the program led to improved hand function and its role in
prehension and manipulation of objects from everyday life and helped children with
cerebral palsy in achieving independence in basic self-care activities.
Key words: children, cerebral palsy, self care, special education program
Theoretical basis
Speaking of a hand as a blade of a mind Connolly (1998) wrote that our
hand is a central part of our psyche, as its executive, research and expressive
roles constantly rotate. Development of hand in the service of capturing and
manipulating objects exceeds a long way and is one of the ways in which children
experience a sense of loss and gain competence. Bruner (1973) has emphasized
that this competence in children include not only social interaction, but also
elements of domination over the facilities. Classification system that is based
on clinical physiology of motor dysfunction, the number of limb involvement,
and functional status of the child usually describes the patient’s inability, but
does not provide insight into the etiology and pathology (Ball, Morven, 2002).
The results of research on the relationship between the damage to his hands and
manual skills of children with cerebral palsy (ABILHAND-Kids questionnaire
applied to a sample of 101 children), verified that in 58% of children led to the
damage of the hands of manipulative abilities and limitations to the general
mobility of the dominant hand and power nondominant hand grip good
predictors of manual skills. Attempts by several comparative studies conducted
in order to prove the efficiency and validity of commonly used therapeutic
programs have been extremely unsuccessful (Metcalf et all., 2007).
108
Aim of the research
The aim of the research is to determine the effects of individually
composed defectological treatment to improve handling skills and self care of
children with cerebral palsy. From this base we produced partial goals, such
as determining the correlative relationship between the calendar age, gender,
type of hospitalization, the distribution of motor impairment and the degree of
intellectual deficits and achievements after the implementation of programs for
the development of manipulative skills.
Research tasks
At the beginning of the experiment we evaluate manipulative skills and the
ability for self care of each child with the battery of tests composed specifically
for this study. We developed individual program for each child and applied it
continuously during 12 weeks. After completion of the program, we used the
same battery of tests, to assess manipulative skills and self-care activities, and
compared the correlation with the initial assessment to determine the effects
of the applied program.
Hypothesis
We expected that the implemented program will improve handling
capabilities of a child with cerebral palsy. We expected that the program for the
development of manipulative skills will have an impact on the childs ability for
self-care activities. We assumed that the distribution of motor impairment and
intellectual level will significantly affect the development of manipulative skills.
We expected that the calendar age will have an impact on the development of
manipulative skills. We also assumed that gender will significantly influence
the development of manipulative skills of children with cerebral palsy. We
also assumed that the type of hospitalization will affect the development of
manipulative skills of children with cerebral palsy.
Research methodology
The study was conducted at the Special Hospital for Cerebral Palsy and
Developmental Neurology, in Belgrade during 2010 year. The study sample
was consisted of children with cerebral palsy who were on full or partial
hospitalization, alone or with a parent. Of the total number of children we
selected the number of thirty, and we folloved certain criterias to form a pattern.
Those criterias are that a child is aged between 4 and 7 years, regularly involved
in the rehabilitation program of the institution, and have a diagnosis of cerebral
109
palsy (children with other neurological and behavioral disorders were excluded
from the sample).
Data resources
Data on the type of of hospitalization, age, diagnosis, shape and form of
cerebral palsy and intellectual status were obtained from medical records of
the institution.
Variables
The independent variables were gender, calendar age, type of hospitalization,
distribution of motor impairment and the degree of intellectual deficit. The
dependent variables in this study were defined as the manipulative ability, and
they are expressed through: maturity/repertoire of grips, bimanual activities,
eye-hand coordination and the child’s ability to perform age relevant self-care
activities.
The structure of the sample by gender

Outline of the respondents in relation to gender shows that the survey
covered a total of 30 patients, of which 16 are females (53.33 %) and 14 (46.66
%) are males. The sample included slightly more female respondents.
The structure of the sample by calendar age

From the outline of the respondents in relation to calendar age, we see
that the study included 3 patients (10 %) calendar age 4 years, 3 respondents
(10 %) calendar age 5 years, 12 respondents (40 %) calendar age 6 years and 12
respondents (40 %) calendar age 7 years.
The structure of the sample by type of of hospitalization

From the outline of the respondents compared to type of hospitalization
we can see that 13 respondents (43.33 %) at the time of the research were
partially hospitalized in the clinic. In the department was stationed in 17
patients (56.66 %) of which 8 patients (26.66 %) were accompanied by a parent
(mother) and 9 respondents (30 %) were inpatients without a parent.
110
The structure of the sample in relation to the form of
cerebral palsy
Cumulative review of subjects in relation to the form of cerebral palsy.
Classification and codes were taken from the ICD 10 (10th revision of
International Classification of Diseases 1990). The largest number of children,
25 (83.33 %) are with spastic cerebral palsy, 8 respondents (26.66 %) are with
quadriparesis, 12 respondents (40 %) are with diplegia and 5 respondents
(16.66 %) are with hemiparesis. Only 2 respondents (6.66 %) are with Ataxic
form of cerebral palsy, and 2 (6.66 %) are with non-specific form of cerebral
palsy and 1 respondent (3.33 %) is with dyskinetic form of cerebral palsy.
The structure of the sample in relation to the distribution of

motor impairment/number of limbs which are affected
From the outline of the sample in relation to the distribution of motor
impairment/number of limbs that are affected, we see that most kids – 13
(43.33 %) are with impairment of all four extremities, followed by children
with impaired two limbs – 12 (40 %). At least there were represented children
with hemiplegia – 5 (16.66 %).
Sample structure depending on intellectual level

From the outline of the subjects in relation to the intellectual level, it is
seen that most respondents are with average intellectual abilities that fit into the
broader framework of normal – 11 of them (36.66 %). The limited intellectual
ability, disturbed psychomotoric development and unbalanced and easy
lagging behind chronological age is shown in 7 cases (23.33 %). Children with
mild mental retardation were 8 (26.66 %). With moderate mental retardation
were 3 patients (10 %). One child (3.33 %) was with above average intelligence.
From 30 patients 7 (23.33 %) have some form of epilepsy.
Results
The assumption that the gender will be significantly correlated with
achievement was partially confirmed, as in only 6 out of 38 items evaluated,
the girls proved successful. In the first test which evaluates the grasps maturity
in only one of 11 items, or in one of the six tested grabs (palm-grip) is shown
a statistically significant effect of gender on the development of a mature
catch. In second test, which assesses bimanual activities, on the retest girls
showed significantly higher achievement in one of five items – dismantling and
assembling small objects. In the third test that evaluates eye - hand coordination,
111
in one of four items girls were more successful in placing the stick to the circle
with both hands. In carrying out activities in the second part of the protocol,
girls were at the retest significantly better in washing hands and face and in using
glasses and cups for drinking- in only three of 22 items.Our assumption that
the type of hospitalization will lead to higher improvement of the manipulative
ability and self care in children, who were hospitalized without parental care,
has not been confirmed. There was no statistically significant relationship
between the type of hospitalization and achievements in all 16 items which
evaluate manual abilities. Statistically significant correlation between type of
hospitalisation and achievment after the aplied program is shown in only one
activity (hair combing) of 22 tested items relating to self-care activities, when
children who were stationed with mother or alone were significantly better in
the re-assessment compared to children who were coming to ambulance and
day hospital.The difference in achievement at the re-evaluation in relation to
calendar age is shown only in using fingers for picking and eating food, where
the children of older calendar age (6 and 7 years) had better achievement,
but not enough to establish a statistically significant correlation (r=0.087).
Examining whether there is a statistically significant association between the
distribution of motor impairments and program for developing manipulative
skills, we have confirmed that there is correlation which was confirmed by
retest and showed throught statistically significant values, thus confirming our
hypothesis that the distribution of motor impairment significantly influenced
the manipulative abilities of a child with cerebral palsy.Statistically significant
correlation is shown in 30 of 38 items between the degree of intellectual deficit
and achievement at retest after applying the program, thus confirming our
hypothesis that the level of intellectual development significantly affects hand
function. Most children who have progressed are from the group of average and
limited intelectual abilities.
Conclusion
In relation to the investigated dependent variables – the maturity of the
basic grips, bimanual activity, eye-hand coordination and ability to perform
basic self-care activities, the results indicate the fact that most children in
this survey failed in many everyday activities because they have not been
taught to use their hands. The final conclusion based on this research, could
be that targeted activities at the preschool age can affect the development of
manipulative skills and abilities for self care of a child with cerebral palsy. XXI
century trends focuse on what children can (“focus on abbility”), but despite
the demolition of architectural barriers, the use of universally designed assistive
resources, new communication technologies, personal assistance services, and
inclusion / integration in educational processes, nothing can fully compensate
the role of the hand as an organ for capturing.
112
References
1. Ball, Morven, F. (2002). Developmental Coordination Disorder: Hints
and Tips for the Activities of Daily Living. Jessica Kingsley Publishers,
Philadelphia.
2. Bruner, J. (1973). Going Beyond the Information Given. Norton, New
York.
3. Metcalf, C., Adams, J., Burridge, J., Yule, V., Chappell, P. (2007). A
review of clinical upper limb assessments within the framework of
the who icf musculoskeletal care. Musculoskeletal Care 5(3): 160–173.
Published online in Wiley InterScience (www.interscience.wiley.
com)
4. Connolly, K.J. (1998). The psychobiology of the hand. Cambridge
University Press, Cambridge.
5. Savkovic, N. (2011). Influence of Special education Program for
developing manipulative abilities of children with cerebral palsy. Master
thesis. Faculty of Special Education and Rehabilitation, University of
Belgrade.
*Corresponding author: Nada Savkovic, e-mail: [email protected]
113
DERMATOGLIPHIC CHARACTERISTICS OF DIGITO-PALMAR
COMPLEX OF A CHILD WITH CEREBRAL PALSY – CASE STUDY

Dermatoglyphics is a science that examines dermal patterns (dermatoglyphs)

on volar side of both palms and soles. By using clinical dermatoglyphics more than
150 various diseases can be diagnosed with the probability of even 99,9%. Research’s
objective was to determine Dermatoglyphic Characteristics of Digito-Palmar Complex
(DPC) of a child with cerebral palsy (CP) that was being diagnosed in ‘Stosljevic’
Cabinet. Within the DPC digital area we examined tree types of dermatoglyphic
patterns on fingertips (arch, loop and whorl) as well as dermal ridge count on each
finger separately (FRC – finger ridge count) and also the total dermal ridge count on
all ten fingers (TRC – total ridge count). ). Within the DPC palmar area we measured
angles between triradius (atd, dat, adt, atb, btc, ctd) as well as dermal ridge count (RC-
ridge count) between triradius a-b, b-c and c-d. Child with CP had the arch count
number of 9,17%, on fingertips of both hands, which is significantly higher number
when compared with the data from the literature regarding normal population where
that percentage is within 4-5%. Higher arch count number was particularly pronounced
on third and fourth finger of both hands. Besides this characteristic, cerebral palsy
child had lower TRC and ab – RC. Study’s conclusion points out the fact that there
is a possibility that children with CP differ from normally developed population in
dermatoglyphic characteristics, therefore conducting a more comprehensive research
would be useful in the process of diagnosing this pathological state.
Key words: cerebral palsy, dermatoglyphs, somatopedics, diagnostics
*Corresponding author: Milosav Adamovic, e-mail: [email protected]
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SWALLOWING AND CHEWING PROBLEMS IN CHILDREN WITH
CEREBRAL PALSY
Vesela Milankov and Kosta Savic

Clinic for Pediatric Habilitation and Rehabilitation, Institute for Health
Protection of Children and Youth in Vojvodina, Novi Sad, Serbia
Difficulties in swallowing (dysphagia), may well be the result of anatomical

abnormalities or neuromuscular defects. Several decades ago, speech pathologists
(speech therapists) took part in the research, diagnosis and treatment of oral and
pharyngeal aspects of swallowing.
The act of chewing and swallowing food in children with cerebral palsy is
regulated with pathological reflex mechanisms that are a result of damage to the
motor cortex and abnormal development of motor functions.
Normal development of the swallowing and chewing reflex starts in a fetus at
3.5 months by swallowing the amniotic fluid. Until two years of age, chewing and
tongue movements are becoming increasingly automated, a lateralization of the
tongue occurs and the larynx is lowered to the level of the sixth cervical vertebra,
while the truly safe swallowing is associated with the age older than 4 years.
Training children with cerebral palsy begins at an early age, by implementing an
integral interventionist approach that involves: the assigning of equal importance to
the speech pathologist-child interaction, the development of sensory experience, the
movements of organs involved in swallowing and chewing, and learning and social
skills.
Rehabilitation procedures begin by modifying the diet and by individual
adjustment of food consistency in accordance with the type and degree of swallowing
disorders. Next, the head position is determined, which controls the passage of a bolus
of food and the elimination of aspiration. By the application of various swallowing
maneuvers a volitional control of the individual components of the oropharyngeal
phase of swallowing ensues.
As early diagnosis and treatment of children with cerebral damage serves as a
basic principle to this approach of the problem, likewise the feeding training should
begin as early as possible. This prevents the development of abnormal chewing
and swallowing schemes, and encourages the normal reflex activity while reducing
spasticity, by which later in the course the volitional movement is performed simpler
and easier.
Key words: children with cerebral palsy, swallowing, chewing, integral
interventionist approach
*Corresponding author: Vesela Milankov, e-mail: [email protected]
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EVALUATION OF LITERATURE DATA ON THE PREVALENCE OF
DENTAL CARIES AND ORAL HYGIENE STATUS IN CHILDREN WITH
CEREBRAL PALSY
Rosica Stoilova1 and Zivka Bataska2

1
Medical University Plovdiv – Faculty of Dental Medicine,
Department of Pediatric Dentistry, Bulgaria
2
Medical University – Medical College, Plovdiv, Bulgaria
The aim of this study was to summarize and systematize the available literature
data on the prevalence of the most common disease in the oral cavity – dental caries
and oral hygiene status in children with cerebral palsy, when compared to children
without psychomotor disturbances. Systemic manifestations and much potential
damage in individuals with cerebral palsy adversely affect their oral health, creating
problems with speech, chewing and swallowing food – factors modifying oral
functions. The comparison is difficult because of inconsistencies in the diagnoses,
age groups, approaches, using different indices, etc., but some trends are clear The
view that children with cerebral palsy have a higher incidence of caries registered by
dft / DMFT indices (d, D = decayed; M = missing; f, F = filled, t, T = teeth), as the
number of untreated and missing teeth is much greater than that of their peers without
CP. There is inadequate and poor oral hygiene, which is directly related to physical
constraints imposed by the underlying disease. Reported are interactions between
oral and systemic manifestations of CP. Dentist should be aware of the responsibilities
assigned to it in the treatment of patients with cerebral palsy The main factors for the
success of treatment are mutual trust, good preparation, early first visit to dentist and
prevention of subsequent indications.
Key words: Cerebral palsy (CP), dental caries (dft/DMFT indexеs), oral
hygiene, literature review
*Corresponding author: Zivka Bataska, e-mail: [email protected]
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THE INFLUENCE OF RESPIRATION ON THE QUALITY OF
PHONATION IN DYSARTHRIA
Vesela Milankov, Mila Veselinovic and Slavica Markovic

Introduction: Dysarthria in a broader sense, includes many problems of the

voice, speech, and speech fluency as a result of various neurological disorders. Voice
problems of children with cerebral palsy may include the inability of controlled
respiration. Oral, laryngeal and pharyngeal muscles can be damaged due to brain
dysfunction, and hence the problem in respiratory regulation, and thus the dysfunction
in the phonatory mechanism.
Objective: To determine the impact of respiration on the quality and duration of
phonation and the ability for a short conversation.
Materials and methods: The survey was conducted in SOŠO Milan Petrović
in Novi Sad. The sample included 16 elementary school children diagnosed with
cerebral palsy. All children were examined to Dysarthria Profile (Robertson, 1982)
test for dysarthria.
Results: Of the total number of tested, 62.5% had regular, while 37.5% had
impeded respiration (p> 0.05). Maximum phonation duration to 5 seconds had 31%
of children with cerebral palsy, phonation for 5-10 seconds had 37.5%, while the
other children having a quiet inhalation could phonate longer than 10 seconds (p>
0.05). Five children with phonation duration of less than five seconds were not able
to participate in spontaneous speech, while five children with phonation duration of
5-10s had partial success. In children with phonation longer than ten seconds, three
were successfully able to participate in a brief conversation (p> 0.05).
Conclusion: Respiration is significantly responsible for the quality and duration
of phonation; and a hampered respiration quantitatively and qualitatively contributes
further to the difficulties of communication in children with dysarthria.
Key words: dysarthria, respiration, phonation
*Corresponding author: Vesela Milankov, e-mail: [email protected]
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THE PHYSICAL EDUCATION AND SPORTS ACTIVITIES,
SOCIALIZATION INSTRUMENTS FOR STUDENTS
WITH PHYICAL DISABILITIES
Evdokia Samouilidou and Constantine Mouratidis

School Consultant of Physical Education for Northern Aegean region, Greece
Introduction
In Greece there are a significant number of students with disabilities
among them and physical disability. These disabilities associated with cases
of children who have difficulty in movement. These students often have and
other disorders (learning disabilities, sensory disorders, epilepsy), and this
affects their education. The term “motor disorder” includes disorders caused
by disease, spinal injuries, heredity, birth defects, etc.
Cerebral Palsy
Cerebral palsy is a neurological disorder affecting the motor control
centers of the brain. Consequence of all these is the difficulty of executing
simple movements and lack of motor control (Koutsouki, 1999).
Spina bifida
Spina bifida is a congenital birth defect in which the neural tube fails to
close completely during the first four weeks of fetal development.
Other motor disorders are traumatic injuries, poliomyelitis, muscular
dystrophy, amputations, child rheumatoid arthritis etc. (Winnick, 2000).
Targets
Physical Education teachers from a list of proposed activities have the
opportunity to teach and train students with physical disabilities to enhance
their socialization and integration in society, to gain confidence, respect and
self-esteem, to be educated on nutrition, exercise and health matters. To gain
positive perspective on sport and to incorporate into their daily lives (lifelong
exercise).
To express Social issues that concerns them, to learn about European and
world championships and the Olympic and Paralympic Games. To address
access issues.
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Methodology
Basic principles and methods governing the implementation of activities
for pupils with physical disabilities can be allocated as follows: Adaptation,
Personalization, Analysis and Simplification of the activities.
Adaptation: This is the process by which the space fits the needs of
each student (Physical environment, equipment, mobility, teaching methods
(individual and group instruction)).
Personalization: Students with physical disabilities show variability in
symptoms that vary in the same disability. There is heterogeneity of student
to student. The aim is to implement specific teaching based on disability and
learning pace of each student.
Given the level of functionality of each student formed the teaching in the
learning process.
Analysis and Simplification of activities: Several students with physical
disabilities have learning difficulties, ADHD and Intellectual disability. For
this reason, we simplify the activities of teaching in levels in order to achieve
better learning (from easy to difficult). The directions of teaching should be
simple, specific and understandable.
Method of repetition: Give sometimes stimuli repeatedly without getting
tired by the student.
Multi stimulation: Stimuli based on hearing, vision and touch is better
option than education – teaching with unilateral stimulation. In case of multi
stimulation can be used games, video, CD, Internet, painting, construction, to
enable the student to participate.
Teamwork: When physical education activities performed by small groups
of students enhances teamwork, solidarity and cooperation. This requires the
teacher to possess teamwork collaboration and learning (Matsagouras, 2008).
Creativity: The students on the basis that “everyone can” create original
activities with simple instruments, balls, skipping ropes, hoops.
Recommended sports according of invalidies

Recommended sports for athletes with amputations: archery, athletics
(roads, throwing, jumping), basketball, cycling, horse riding, weightlifting,
sailing, shooting, swimming, table tennis, volleyball sitting.
Recommended sports for athletes with cerebral palsy: archery, athletics,
basketball, boccia, cycling, fencing, football, weightlifting, sailing, shooting,
swimming, tennis, table tennis, volleyball, rugby wheelchair.
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Recommended sports for diseases/injuries spinal cord injury: archery,
athletics, horse riding, weightlifting, sailing, shooting, swimming, table tennis,
volleyball sitting.
The choice of sport is always based on the student’s level of functioning
in relation to Categorize/Classification, as apply at Paralympic Games
(Patatoukas, 2004).
Selected activities for students

“Boccia”
Materials: Adhesive tape, tennis balls (red and blue and a white which is
the target)
Children are divided into groups, and each group consists of three
students. In the center of the space we already have for the game put the white
ball as a target. Each student gets three tennis balls and throw tries to bring
closer to the target. The ball will move closer to the target scored 5 points. The
ball that will take the second closest position with 4 points and the third ball
scored 3 points. If the ball go outside of the designated area, is withdrawn from
the process of the game. The teams play by two and each part with a player.
Also the players sit in a chair or wheelchair. When finish the game summed
scores and wins the team with the highest score (The tennis balls should have
a different color, preferably red and blue) (Educational Olympic Education –
Special Olympics Athens 2004).
This game resembles the game “Boccia” Paralympic Games but which is
governed by regulations.
“On target”
Materials: Adhesive tape, chairs, colorful bags with beans
Students are placed with chairs / wheelchairs circle around the venue of the
game. In the center of the space defined by the target consists of a circle around
this bounded 4 concentric circles.
The first cycle target scored 100 points, the closest with 80 points, third
with 60 points and the last round with 40 points.
Students have at their hands a bag and try to achieve the goal and scored
accordingly.
Social dimension
These activities can be implemented in Education Programs for students
with and without disabilities.
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At the Olympic Games in Athens in 2004 through a giant Olympic
Education Programme, students General Education had the opportunity to train
and participate in athletic activities focused mainly for students and athletes with
physical and other disabilities. The whole process was aimed Social Dimension,
the elimination of social discrimination for people with disabilities.
The invalidity or Kinetic or otherwise, is a multidimensional phenomenon.
Vary based on the culture of each nation and is influenced by ethnicity, beliefs,
expectations of the individual (Sherill, 1997). Participation of students in sports
is possible socialization factor. It offers shared experiences and interaction
opportunities for participation in group projects (Gallahue, Ozmun, 1997).
The sensitization of society takes the implementation of legislative provisions
on social policy issues. Culmination of these efforts is the ability of students
with disabilities to attend mainstream education.
Inclusion of students with disabilities and their participation in sporting
activities enhance their confidence which helps parallel society to reach a
positive manner the issues of disability.
Conclusions
The socialization of students with disabilities (and students with
different types of disability), through their inclusion indicates that the Physical
Education and Sport Activities are helpers for the formation of the personality
of these students, proving that “... disability is not a barrier in development of
the personality of the students... “
References
1. Gallahue, D. L., & Ozmun (1997). Understanding motor development:
infants and children, Burr-Ridge: Mc Graw-Hill, Higner Education.
2. Koutsouki, D., (1997). Special Physical Education. Athens: Edition of
Simmetria.
3. Matsaguras, I.L., (2008). School classroom. Athens: Edition Gregori.
4. Sherill, C. (1997). Disability, indentity and involvement. Champaign,
IL.: Human Kinetics.
5. Sotiriadou, K. (1997). Children with Education Needs. Introduction
in Special Education. Athens.
6. Winnck, J. (2000). Adapted Physical Education and Sport. Human
Kinetics: State University of New York.
*Corresponding author: Evdokia Samouilidou, e-mail: [email protected]
121
SPORTS AND RECREATIONAL ACTIVITES – BOCCIA FOR
PEOPLE WITH CEREBRAL PALSY
Admira Konicanin
Higf School and Technical School,Tutin and State University of Novi Pazar,
Departmant of Sport and Physical Education, Novi Pazar, Serbia
Boccia is a sport most common for people with cerebral paralizy it is fully
adapted for persons with physical disabiities. The fact is that the least these people are
engaged in sports activities because of the severity of damage that requires effort and
practice od sport. Sports activities for people with disabilities include a widerange of
medically unavoidable and optional content, of those who are part of the process of
treatment and rehabilitation, to those having the basic task of raising the physical and
psychosocial health, and improving the quality of everyday life.
Key words: cerebral paralizy, sports, recreation, Boccia
Introduction
Children cerebral palsy is non-progressive syndrome with extremely
complex etiopatogenesis, clinical manifestations and therapeutic options.
Numerous psychological, social, and educational and professional problems of
patients, with their disturbed and damaged somatic integrity, put or the severity
and importance of the approach to the suffers from cerebral palsy. Almost as
much as the authors who have dealt with it, so is the definition of trying that
in a few words or sentences define. Only possible approach in dealing with
cerebral palsy children is integral approach. The treatment lasts for the entire
life of the child, 24 hours a day. It is therefore very important the appreciation
of the environment. Goal focuses on the performance of certain movements
and therefore patient needs to be functional recovered.
Cerebral palsy is not a disease with a specific etiology, pathogenesis and
clinical features, but a syndrome dominated by pyramidal or extrapyramidal
disorder, spastic paralysis or ataxy. Many studies have shown that persons with
impaired physical ability participating in physical activities generate numerous
psychological, social, health, functional and economic benefits.
Talk about today on analysis of the quality of work in applied kinesiology,
including the area kinezitherapy, is impossible without consideration of the
material conditions of work as fundamentals to implement any level of serious
kinesitherapeutic procedure.
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Sports and recreational activities
The application of motion in the form of various exercises, sports or
recreational activities are used since ancient times as a mean of healing. Date
about this are found in the book titled about Nature, “which was the foundation
of the ancient medical doctrine of Chine. In the book they are described and
used as a means of treatment: mass, breathing exercises, remedial gymnastics
and other exercises.
Before 3000 years,,Brahmanism” appears in India religious-physical and
learning does the physical activity (,,Yoga Hatha”) as a form of strengthening
human body, which ultimately contributed to the preservation of good health.
First international competition of disabled athletes held in 1963.the city of Linz
in Austria. Special contribution to the promotion of physical activity as the
current methods of paraplegics was given by the English physician Gutman. He
proposed that after each Olympics for healthy athletes organize competition
of paraplegic. It was first organized the competition of paraplegic after the
Olympics in Italy in 1960.
The largest contribution of sport and physical exercise is to readapting
themselves and re-socialization of people with disability. Involving sport and
physical exercises in treatment and rehabilitation of persons with disabilities
has multiple psychological engagement effect. This disabled people feel
satisfaction as they physical are involved, as the are in a group with their similar
and healthy people. There are the positive changes in terms of psychological
tension that fades so easily and overcome difficulties. The greatest importance
of sport and physical exercise is to readapting themselves and resocialization
disabled. Disability generated in the war or peace time leads to: violation of
psychophysical at men. Including sport and physical exercise in the treatment
and rehabilitation of disabled persons has get multiple psychological impact.
This preoccupying people with disabilities they feel statisfaction as they
physical are by engaged, as they are in a group, similar to them and people. There
are the positive changes at them in terms of vanishing of psychological tension
to help them to overcome the difficulties. The greatest importance of sport
and physical exercise is in readapting and resocializing the disabled persons.
Disability that occus in wartime or peacetime leads to: violation of human
psychophysical unity. Including sport and physical exercise in the treatment
and rehabilitation of disabled persons has got multiple psychological impact.
Active involvement in sport surge in confidence and faith at disabled persons,
noticing that they are not small, there is also knowledge that he is not useless
member of society and family that his skills and capabilities can be improved,
and reinforcing them by every day. Beside their disability he still has a need
for affirmation and for that reason self-approving. For those reasons sport
and physical exercise in the rehabilitation process have worthfull importance.
Through sports, he establishes a normal human relations, contributes to faster
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adaptation to disability, quickly coming to the body scheme and the new
ideas of body, so that ultimately leads to balancing psychological status and
functional capacity.
The optimum effect is achieved if these activities are conducted under
the supervision of a team of experts and the appropriate educational level and
appropriate speciality. The role of a doctor is of primary importance. Medical
control may be positive or optimal only when doctors are trained to work with
disabled people. Health permanent control with the cooperation of doctors: a
specialist in physical medicine, sports medicine, physical therapists and trainers
can result: optimal rehabilitation of disabled persons, successful participation
in various forms of physical activity, till the success of the Olympic Games.
Active doing sports increases self-esteem of people with disabilities and
faith in the ability to achieve their goal, the goal of victory. Sports and physical
exercises for people with disabilities is essentially a method of treatment for the
reason that in this way the maximum compensatory mechanisms are engage
that the modern rehabilitation is based.
Sport as a tool in the treatment and rehabilitation occupies a prominent
place. In order to understand this method it is necessary to understand the
mode of action of body exercises and sport an a body both healthy and sick
man.
Application of sport and physical exercises are classified as non-specific
therapy that has a significant effect in reactivating the body of people with
disabilities.
Sports training is one of the methods that is more successful by shows in
the rehabilitation and treatment of people with disabilities. Applying training
processes essentially is a complex process that gradually leads to enable people
with disabilities to increased physical workload. Sports training for people
with disabilities are optimaly dosed to the limited capabilities of people with
disabilities, aimed at bringing these capabilities to the optimum level.
Physical activities practiced by people with disabilities in the aim to
achieve results for the organized sports competitions, are includied in sports
and physical activities aimed at achieving results. These activities have a
competition system, which is organized at different levels (municipal, city,
regional, republic, federal and international). Trainings are organized several
times a week and in some sports two or more contests times daily. The final
goal is to achieve results that ensures victory and the higher placement can be
whether it is an individual or a team.
Physical activities that are performed in free time organized in groups and
individually, and are aimed at increasing the psycho physical properties beloug
to recreative group. Also it is the aim increaseing the functional capability of
124
organs and organ systems that is the organisms it the whole. It is recommended
that doing the recreational physical activities at least three times a week. These
activities are not aimed at the competition, but increasing its capacity of motor
and functional abilities.
Categorization of persons with disabilities

according to the mind of disabilities
According to the categorization of people with disabilities, according the
damage to the body (type of are found disabilities) must be taken into account
of the stage of rehabilitation at which the disabled persons. If this is a phase
of training it is necessary to ensure continued medical supervision in order
to make the choice and dosage of exercise in relation to the level preserved
function of organ systems (cardiovascular, respiratory and other) and the level
of local damage.
All physical activities are practiced with people with disabilities can be
divided into: rehabilitation, sports and recreational sports.
In practical work with disabled people it can also be used the next
classification of people with disabilities in groups:
I–Group: Traumatic defects, II–group: Amputations, group–II: Paraplegy,
IV–group Cerebral Palsy, V–group: Hemiplegy, Group VI: Peripheral nerve
palsy, VII–groups: congenital or acquired deformation localized in the trunk
or extremities, VIII–group diseases or damages of the lung, IX–groups:
deseasea or damage to the heart and blood vessels and X–group: Other diseases
of internal organs.
The above classification is not optimal, and there are also other possible
classifications. Positivity of the given classifications consists of a practical
applicability in the course of rehabilitation treatment as well as during sports
and recreational sports activities.
The assembly conducts various activities that has an aim to improve the
health of members, and one of the main activities is the sport. Bocce originated
in ancient Greece, and later in Italy in the 16th Boccia century when it became
popular and spread throughout the world. It was first introduced to the
Paraolympic Games in New York in 1984, and the games are included in the
official program of the event in the 1992 Barcelona Paraolympic Games, held
primarily for athletes with cerebral palsy. Boccia is a sport open to all athletes
with or without disability for athletes who use assistive devices to the games of
1996th Bowling as a sport did not give an advantage to any other sport on the
Olympic program.
125
Bocce is the wide spreaded sport for people with cerebral palsy because it
is completely suited to the people with motor difficulties that they can compete
on an equal basis with all other athletes (with or without disabilities). Boccia
is a sport at all levels, at the national and international level, by athletes who
require a wheelchair because of physical disability. Originally it was designed
for people with cerebral palsy to play but now includes athletes with other
severe disabilities affecting to motor skills. Boccia a become Paraolympic
sport 1984 and in 2008, it is practiced in more than fifty countries around the
world. Bowling for people with cerebral palsy is regulated by the International
Sporting Association (CPISRA) and is one of three Paraolympic sports that do
not give preference to any other sport, and compete in the Olympic program. In
assembly is a bowling section which brings together lovers of sport and bowling
and so recreate and meet their sporting needs. Boccia is practiced in over 60
countries. The aim of the game is to throw the ball – colored red or blue (which
side started the game id determined by a coin toss). To be eligible to compete
in bowling at the national or international level, athletes must have a disability
and must be in a wheelchair as a result of cerebral palsy, or other neurological
conditions that have similar effects, such as muscular dystrophy or traumatic
brain injury. Players are tested to determine their level of disability.
The competition in this sport is done individually, in pairs and teams
(three competitors in the team). Team competition are done in men, women
and mixed rivality.
Used by the racers wheelchair must meet certain regulations.
Before the competition, the players selection was done that are divided
into four group: BC1, BC2, BC3 and BC4.
BC4 group is intended for people who do not have cerebral palsy, but their
bowling skills are similar.The players are classified into one of four classes of
sports in Boccia: depending on their functional capabilities:
BC1 – Players in this class throw the ball with his hand or foot. They can
compete with the assistant who remains out of play in the field of competitors,
to stabilize and adjust his gave and give the game ball to the player when it is
asked for.
BC2 – Players in this class throw the ball from a side. They are not
appropriate for assistance.
BC3 – Players in this class have very severe locomotor disfunction in all
four. They may use assistive devices such as a ramp to deliver the ball. They can
not compete with his assistant, assistants must turn back, to the playground
they can not see the game.
126
BC4 – Players in this class have severe locomotor dysfunction of all four
limbs and trunk control, which is very weak. They can show sufficient dexterity
to throw the ball on the ground. Players are not allowed for assistance.
There are about 350-ranked international players bowling.
Bocceia is a game that requires extreme precision of muscle control,
precision and an intense focus and concentration.
Equipment and supplies

Equipment for bowling make balls and balls ramp. Set of balls consists of
6 red, 6 blue and 1 white ball called balinceka. Ball balinčeka is smaller than the
other 12 balls. Balls used in competition must meet IBC (International Boccia
Comitee). Neccessary supply aid for players from the group BC3 assistant ramp
and sports assistant who manages an assistant ramp at the request of the player.
Ramp for its size must not be bigger than boxing action (2.5 m). Assistant
in the box is so set so his back is turned to the playground and can not see a
situation in playground. Instruction to route ramp gives the player exclusively.
For the trial judge used the game blades of any construction. It is important
that athletes always know which side is the right to play. It is used a variety of
measuring devices for determining the distance of the ball balancek. The game
competition is held indoors (gym or gym), playgroup maked on the whose
surface is flat, the surface can be wood, plastic or the material used in sports
halls or halls. Dimensions are 12.5 x 6m of the play ground. Each court has
a 6-fiel boxes in which during the duration of the competition are tes players
in the game-contest. The main objective of the game consists in the fact that
the ball (red or blue) is as close as balancek white ball. For each ball that is to
closest the from the opponent ball balancek ball that player or team get a one
point. The official preparations for the start of the competition takes place in
a separate room (waiting room) where 15 minutes before the event, players,
coaches, assistants and judges meet. In this room is toss done. Judges toss
coins performed on the basis of which is determined by which side will play
the red-blue sphere. In waiting room is done list of players, the judge has the
opportunity presentate team with rules of the game that is to presenthis way
of frial. Opposing teams can go over and change the globe. A team that does
not appear on the time in the waiting room the team is disqualified. During
the game players are in boxes whose dimensions are 1 x 2.5 m. Coaches are in
space determined for them, so that during the competition do not have contact
with the players. In the course of the game the coach or captain is entitled to
one time during the game to ask for a three-minute rest, which can be advice
of the players. Assistant of the team is usually located behind the playground,
or behind boxes of players. His task is to help players move from group BC1
if to collect dropped balls when is the end of the game. During the game it is
127
measured the time that the player spent. Allowed time during the competition
depends on the competing groups. Teams can have 6 minutes, 18 minutes
couples and individuals, 5 or 6 minutes. Communication between players is
allowed only when their team is in to play.
References
1. Grobelnik, S. (1971). The importance of sports for disabled. The
first Yugoslav symposium with international participation, sports
and recreation activities in the mental and physical rehabilitation of
disabled people, Proceedings, Belgrade,41-4.
2. Ječinac, R. (1983). Medical lexicon, Volume 2, “Vuk Karadzic”,
Belgrade.
3. Malajner, K. (2006). Boccia, športniki, Sarajevo.
4. Stevanović, M., Necić, M. (1969). Sport and recreation in the
rehabilitation of disabled persons, Association for Sport and
Recreation disabled Yugoslavia, Belgrade.
5. Ratomir, Đ., Dobrica, Ž. (2009). Sports persons with special needs,
Nis.
http://www.bocce.org/history.html History of Bocce
http://www.paralympic.org/release/Summer_Sports/Boccia/
http://www.boccia.org.nz/
http://www.sportingwheelies.org.au/doc.php?ID=218
http://www.cpisra.org/files/sports/boccia/Boccia_CPISRA_World_Ranking_
List_2010.pdf
http://www.2007bocciaworldcup.com/
http://www.fedmf.com/boccia/docs/CPISRA_Boccia_World_Cup_2007_
Intent_to_register.pdf
http://en.paralympic.beijing2008.cn/sports/boccia/index.shtml
Boccia at the Cerebral Palsy International Sport and Recreation Association
CP-ISRA Classification and Sports Rule Manual, 9th Ed., Cerebral Palsy International
Sports and Recreation Association, 2005.
Boccia at the International Paralympic Committee
*Corresponding author: Admira Konicanin, e-mail: [email protected]
128
WHEELCHAIR FENCING – AN ADAPTIVE SPORT FOR PERSON
WITH CEREBRAL PALSY
Danijela Vukicevic, Stevan Jovic, Dragan Vulovic, Aleksandra Sekulic

and Jelena Stikovic
Clinic for Rehabilitation “Dr Miroslav Zotovic”, Belgrade, Serbia
Wheelchair fencing is one of the oldest sports for persons with disabilities. Dr
Guttman, founder of Paralympics games believed this sport was not only a continuity
of medical rehabilitation, but the good way for patient to build self-respect.
That was the reason that we started with the wheelchair fencing at the Clinic for
rehabilitation “Dr Miroslav Zotovic” in Belgrade in January 2011.
Wheelchair fencing is adjusted for body able persons, because participant seat
in wheelchairs fixed on a special metal construction. The upper body is in action, one
arm holds the sword and the other hand is used for holding the wheelchair.
The training system includes: strengthening of the trunk muscles and the arms;
multitask exercises with balls for increasing speed, skills and coordination; sticking
balls with sword; increasing concentration and endurance through individual
trainings with the fencing instructor and duels with the opponent.
Children at Clinic for rehabilitation children have one-hour trainings three
times a week. Children from Dental school have fencing trainings instead of physical
exercises classes 3 times of a week and they take part in the trainings at our Clinic
several times a month. This activity is a good example of inclusion. Their cooperation
is particularly emphasized in tournaments that are taking place every six months, with
participation of children with disabilities of the Clinic for rehabilitation and through
action for the popularization of sports for persons with disabilities.
Our experience in including children with cerebral palsy in this activity that
were on long-term stationary or outpatient treatment showed a greater motivation for
continued efforts and active participation in trainings, increase of muscle strength,
endurance and concentration, awareness of their own opportunities, improving
self-esteem.
Therefore, we believe that this is a good approach for children with cerebral
palsy to take active participation in all aspects of life and good social interaction in
the community.
Key words: wheelchair fencing, cerebral palsy
*Corresponding author: Danijela Vukicevic, e-mail: [email protected]
129
THE INCLUSIVE POTENTIAL OF APPLIED THEATRE IN ACTIVITIES
WITH PEOPLE WITH DISABILITIES
Jasmina Karic1, Vesna Radovanovic1 and Sladjana Andjelkovic2

1
2
University of Belgrade – Faculty of Geography, Serbia
It is difficult to define applied theatre since many theatrical forms are played
under that name; however, what they have in common is that they take place in “non-
theatrical conditions”, when working with children, adults, people with disabilities,
minorities and socially maladjusted people, with the aim to make the audience or the
participants aware of the events or topics of personal or public importance. Uniformity
cannot be found in the reference literature on the theatrical forms which belong to the
applied theatre. Some of the accepted, recognizable forms of applied theatre are socio-
drama, theatre in education, theatre in development, playback theatre and the theatre
of the oppressed.
Different forms of applied theatre are described in this paper as well as the
organizations which promote the applied theatre with the aim of social inclusion of
people with disabilities, with a special retrospect to the people with cerebral paralysis.
The applied theatre is becoming an increasingly important means of social inclusion
of people with disabilities, which is confirmed by a great number of organizations
worldwide and a great number of projects they carry out. The theatrical techniques
these organizations apply are diverse and adapted to the specific needs of people with
disabilities. People with cerebral paralysis, depending on their mobility, can more or
less take part in most of these techniques.
The applied theatre is developing increasingly and it is getting a more important
role in the development of the inclusive society.
Key words: applied theatre, people with disabilities, inclusion, people with
cerebral paralysis
*Corresponding author: Jasmina Karic, e-mail: [email protected]
130
DIGITAL MEDIA WORKING WITH CHILDREN WITH MULTIPLE
DISABILITIES
Vojislav Todorovic1 and Slobodan Vuletic2

1
Elementary School “Dusan Dugalic“, Belgrade, Serbia
2
Elementary School “Kosta Trifkovic“, Novi Sad, Serbia
Digital media play an important role in education. They integrate in the process
of teaching and influence the system of education. One of the leading elements of
digital media in education is digital – interactive whiteboard. The digital whiteboard
can be used in all school subjects for presentation of prepared content or playing
music. This form of digital media helps the children with disabilities in development
by giving them a further possibility to learn through expansion of visual, auditory
and tactile- kinesthetic perceptions. In primary school “Dusan Dugalic” in Belgrade
pupils from I to VIII grade are included in curricular and extracurricular activities
through the digital whiteboard. The total number of pupils in school is 83, – 60 boys
(72,29%) and 23 girls (27,71%). The students who attend our school are divided into
the following categories: moderate mental retardation – 12 pupils (14, 56%), mild
mental retardation – 9 pupils (10,84%), autism – 40 pupils (48,19%) and multiple
disability – 22 pupils (26,51%).
Key words: digital media, digital whiteboard, pupils with disabilities
*Corresponding author: Vojislav Todorovic, e-mail: [email protected]
131
POSSIBILITY OF USING NEW TYPES OF MUSICAL ELECTRONIC
INSTRUMENTS FOR ASSISTIVE TECNOLOGY
Kurt Coble, Martin Kalamkovic, Slavica Markovic and Radmila Ristovski

Special School for Primary and Secondary Education”Milan Petrovic”,
Novi Sad, Serbia
People with cerebral palsy are encapable to perform certain variety of activities
that are available to other people. One of the almost impracticable activities for people
with cerebral palsy is to play music instruments. Modern assistive technologies partly
ménage to help people with cerebral palsy to live a quality life and to overcome everyday
obstacles (common problems). The problem is availability of modern technology,
its complexity and its price. This research would present a new idea for people with
cerebral palsy and their possibility to perform some elementary music activities. The
advantage of this technological solution is its simplicity and its market price. One more
advantage is the most direct contact between the user and the instruments possible.
The instruments work by sensors and servo motors, which represent the hand of
the musician. The sensors can be activated by many “triggers”, like, light, touch,
movement… By activating sensors the signal is translating to the servo motor, which
depence on the instrument: pulls string, hits the drums or does any activity to create
sound. For pretty short time that we had for testing, the instruments showed really
good. We tested how much musical knowledge did the children get. We conformed
that the children really improved. There is one more thing that we can’t measure, but
it means a lot. That is children’s smiles and the possibility for them to create music
Key words: cerebral palsy, music, assistive technology
*Corresponding author: Martin Kalamkovic, e-mail: [email protected]
132
AUTHOR INDEX
A Drcelic Marica 106

Adamovic Milosav 55,60,114 Ducic Bojan 98
Aleksandrovic Marko 59
Andjelkovic Sladjana 130 E
Arango Maria 56 Ellouz Emna 53
Ayadi Ines 53 Eminovic Fadilj 21,62,70,71,105
B G
Babajic Damir 40 Gavrilovic Mirjana 70
Babajic Mirela 40 Gesoski Blagoje 48
Banjac Lidija 73 Gligorovic Milica 80
Bankovic Slobodan 97 Glumbic Nenad 97
Bataska Zivka 116 Golubovic Spela 46,85
Bekic Vera 45
Ben Othmen Houda 53 H
Bocka-Pepelcevic Ofelija 47 Hsairi Ines 53
Borkovac Daliborka 45 Hentati Nejmeddine 53
Boskovic Mirjana 28 Hettiarachchi Shyamani 76
Bugarski Vojislava 85 Hoque Roksana 44,64
C I
Causevac Dragan 58 Ilankovic Andrej 54
Coble Kurt 132 Ilankovic Nikola 54
Colic Gordana 71 Ilankovic Vera 39,54
Colovic Hristina 59 Ilankovic-Kambeitz Lana Marija 54
Cuk Miran 49 Ilic Snezana 67
Ilic-Stosovic Danijela 21,72
D Iric Nada 62
Das Ajay 76 Ivanovic Lidija 99,106
Davcevska Marija 74
Demesi-Drljan Cila 29, 45 J
de Oliveira Armando Monica 103 Jerkovic Ivan 63
Dimitrijevic Lidija 29,59 Jovanovic Nadica 68
Djilas-Ivanovic Dragana 105 Jovic Stevan 129
Djordjevic Lucija 78
Djordjevic Milos 71 K
Djordjevic Mirjana 97 Kalamkovic Martin 132
Djordjevic Srboljub 78 Kaljaca Svetlana 98
Dragojlovic-Ruzicic Radica 106 Kamoun Fatma 53
133
Karic Jasmina 130 Nedovic Maja 48
Knezevic Marija 71 Nikic Radmila 70
Kojic Zvezdana 104 Nikolic Snezana 72
Konicanin Admira 122 Nikolovska Lence 42
Kos Renata 75 Nisevic Snezana 73
Kovacic Anita 72
Krasnik Rastislava 45 O
Krstevska-Kokormanova Biljana 41 Obradovic Biljana 43
Krstic Tatjana 43 Odovic Gordana 86,98
Kulic Milan 69 Oros Marina 63
L P
Likic Dejan 71 Pacic Sanela 70,71
Panov Nenad 42
M Panova Gordana 42
Major Agota 63 Panova Blagica 42
Maksic Jasmina 72 Pausic Vesna 61
Maltar Blazenka 75 Pavlovic Andrijana 67
Marinkovic Dragan 69 Pisaric Danijela 105
Markovic Slavica 117,132 Poljic Azem 40
Martins Isabel Catarina 103 Potic Srecko 39,67
Mastilo Bojana 67
Medenica Veselin 99,106 R
Mehmedinovic Senad 40 Radic-Sestic Marina 79,80
Mergon Snjezana 107 Radovanovic Vesna 79,130
Mikov Aleksandra 29,45,59,61 Radulovic Andrijana 47
Mikovic Suzana 62 Rapaic Dragan 15,86,99
Milankov Vesela 115,117 Ristic Sinisa 104
Milanovic-Dobrota Biljana 79,80 Ristovski Radmila 132
Milicevic Milena 39,67
Milosevic Neda 58 S
Milovanovic-Minic Milka 62 Samouilidou Evdokia 118
Mirkovic Snezana 70 Saric Edina 40
Miscevic Dragana 85 Savic Kosta 115
Mitrovic-Djordjevic Ivana 84 Savkovic Nada 108
Monjurul Karim Mohammad 44,64 Scepanovic Marinela 99
Mouratidis Constantine 118 Sekulic Aleksandra 129
Skrbic Renata 85
N Slavkovic Sanela 46,47
Nazarkin Aleksandar 30 Sretenovic Ivana 86
Nedovic Goran 15,21,68,69 Stanic Jelena 29,61
134
Stanimirov Ksenija 97
Stanisavljevic Jelena 86
Steenbergen Ber t 103
Stikovic Jelena 129
Stoilova Rosica 116
Storey Keith 35
Stosljevic Miodrag 55,60,114
Svraka Emira 40,83
T
Terzic Ivana 68
Tesanovic Dusanka 105
Todorovic Vojislav 131
Trajkovski Vladimir 41
Trgovcevic Sanja 15,48,69,99
Triki Chahnez Charfi 53,
U
Uzunovic Katarina 106
V
Valkova Hana 77
Velickova Nevenka 42
Veselinovic Mila 117
Vukicevic Danijela 129
Vukovic Mile 68
Vuletic Slobodan 131
Vulovic Dragan 129
Vulovic Mirela 45
Z
Zecevic Ivana 67
Zelic Mirna 58
Zgur Erna 49
Zolnjak Marienka 71
135
CIP - Каталогизација у публикацији
Народна библиотека Србије, Београд
616.831-009.11(048)
INTERNATIONAL Scientific Conference Special

Education and Rehabilitation - Cerebral Palsy
(2 ; 2012 ; Belgrade)
Book of Proceedings and Summaries / II
International Scientific Conference Special
Education and Rehabilitation - Cerebral
Palsy, Belgrade 2012. ; [organizers
University of Belgrade - Faculty of Special
Education and Rehabilitation ... [et al.] ;
editors Milan Kulic, Srecko Potic]. -
Belgrade : Society of Special Educators and
Rehabilitators of Serbia, 2012 (Beograd :
Planeta print). - 133 str. ; 24 cm
Tiraž 200. - Registar.
ISBN 978-86-84765-40-8
1. Faculty of Special Education and
Rehabilitation (Belgrade)
a) Церебрална парализа - Апстракти
COBISS.SR-ID 193901580

Zbornik Rezimea Novi Sad 2012

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II International Scientific Conference

Special Education and Rehabilitation – Cerebral Palsy

Book of Proceedings and

Book of Proceedings and Summaries

Processing and printing

Scientific Committee of Conference: Organizing Committee of Conference:

October 26th 2012

History of the development of children’s

Aleksandra Mikov, Cila Demesi- Therapeutic possibilities in the

Sports and recreational activites –

Vojislav Todorovic and Slobodan Digital media working with children

10.00-11.00 Closing of the Conference

Dragan Rapaic1, Goran Nedovic1 and Sanja Trgovcevic2

Motor and cognitive functioning of children with cerebral palsy are

*Corresponding author: Goran Nedovic, e-mail: [email protected]

Goran Nedovic, Danijela Ilic-Stosovic and Fadilj Eminovic

*Corresponding author: Goran Nedovic, e-mail: [email protected]

Special Hospital for Cerebral Palsy and Developmental Neurology in Belgrade

*Corresponding author: Mirjana Boskovic, e-mail: [email protected]

Aleksandra Mikov¹, Cila Demesi-Drljan¹, Jelena Stanic² and Lidija Dimitrijevic³

Cerebral palsy (CP) describes a group of disorders of the development of

*Corresponding author: Aleksandra Mikov, e-mail: [email protected]

In the complex clinical-instrumental and morphological studies, performed

*Corresponding author: Dejan Likic, e-mail: [email protected]

*Corresponding author: Keith Storey, e-mail: [email protected]

Cerebral Palsy, Etiology and

Milena Milicevic1, Srecko Potic2 and Vera Ilankovic3

Interest of professional and scientific public has been focused on adverse

Corresponding author: Milena Milicevic, e-mail: [email protected]

Mirela Babajic1, Emira Svraka2 , Senad Mehmedinovic3, Edina Saric4,

*Corresponding author: Mirela Babajic, e-mail: [email protected]

Vladimir Trajkovski1 and Biljana Krstevska-Kokormanova2

Education and Rehabilitation, Skopje, Republic of Macedonia

*Corresponding author: Vladimir Trajkovski, e-mail: [email protected]

Gordana Panova, Nevenka Velickova, Blagica Panova, Nenad Panov and

*Corresponding author: Gordana Panova, e-mail: [email protected]

Tatjana Krstic and Biljana Obradovic

*Corresponding author: Tatjana Krstic, e-mail: [email protected]

Roksana Hoque1 and Mohammad Monjurul Karim2

Corresponding author: Roksana Hoque, e-mail: [email protected]

Cila Demesi-Drljan, Aleksandra Mikov, Mirela Vulovic, Vera Bekic,

*Corresponding author: Cila Demesi-Drljan, e-mail: [email protected]

Spela Golubovic and Sanela Slavkovic

Numerous classification of cerebral palsy have been proposed in literature but

*Corresponding author: Spela Golubovic, e-mail: [email protected]

Ofelija Bocka-Pepelcevic, Andrijana Radulovic and Sanela Slavkovic

Cerebral palsy causes permanent disorders of posture, movement and motor

*Corresponding author: Sanela Slavkovic, e-mail: [email protected]

Sanja Trgovcevic1, Blagoje Gesoski2 and Maja Nedovic3

*Corresponding author: Sanja Trgovcevic, e-mail: [email protected]

Erna Zgur1,2 and Miran Cuk2

*Corresponding author: Erna Zgur, e-mail: [email protected]

Treatment of People with

*Corresponding author: Ines Ayadi, e-mail: [email protected]

Vera Ilankovic1, Andrej Ilankovic2 , Lana Marija Ilankovic-Kambeitz 3 and

Medical College of Professional Studies “Milutin Milankovic”, Belgrade, Serbia

*Corresponding author: Vera Ilankovic, e-mail: [email protected]

Miodrag Stosljevic and Milosav Adamovic

Rehabilitation of children with cerebral palsy is complex and often involves

*Corresponding author: Milosav Adamovic, e-mail: [email protected]

*Corresponding author: Maria Arango, e-mail: [email protected]

Mirna Zelic, Neda Milosevic and Dragan Causevac