Volume 5 / Number 6 / 2011
EDITORIAL BOARD
Sadrzaj / Table of Contents
Editor-in-chief Execute Editor Associate Editor Editorial assistant Technical editor
Mensura Kudumovic Mostafa Nejati Azra Kudumovic Jasmin Musanovic Eldin Huremovic Members
Paul Andrew Bourne (Jamaica) Xiuxiang Liu (China)
Nicolas Zdanowicz (Belgique) Farah Mustafa (Pakistan)
Yann Meunier (USA)
Forouzan Bcryat Nejad (Iran) Suresh Vatsyayann (New Zealand) Maizirwan Mel (Malaysia) Budimka Novakovic (Serbia)
Diaa Eldin Abdel Hameed Mohamad (Egypt) Zmago Turk (Slovenia)
Bakir Mehic (Bosnia & Herzegovina) Farid Ljuca (Bosnia & Herzegovina) Sukrija Zvizdic (Bosnia & Herzegovina) Damir Marjanovic (Bosnia & Herzegovina) Emina Nakas-Icindic (Bosnia & Herzegovina) Aida Hasanovic(Bosnia & Herzegovina) Bozo Banjanin (Bosnia & Herzegovina)
Address of the Editorial Board
Published by Volume 5
Sarajevo, Bolnicka BB phone/fax 00387 33 956 080 healthmedjoumal@gmail.com http://www.healthmedjoumal.com DRUNPP, Sarajevo
Number 6,2011 ISSN 1840-2291
HealthMED journal with impact factor indexed in:
Chest associated to motor physiotherapy acutely improves oxygen saturation, heart rate and respiratory rate in premature newborns with
periventricular-intraventricular hem orrhage... 1381 L uiz Carlos deA breu, VitorE. Valenti, Oseas Florencio de M oura Filho, L uiz Carlos M . Vanderlei, Tatiana D ias de Carvalho, M aria A . F. Vertamatti, A driana G. Oliveira, Isadora L. M oreno, A n a Clara C. R. Gongalves, A rnaldo A.
F. Siqueira
The causes o f chest pain among Korean outpatients in primary care p ra ctice... 1389 Jongwoo Kim , Seon Yeong Lee, Kyunam Kim , Sun M i Yoo Are patient falls in the hospital associated with days o f the week and hours o f the day? A retrospective observational study using Rasch m o d elin g ...1395 Su-Chen H su, H uan-Fang Lee, Tsair-Wei Chien
Knowledge, Attitudes and Practices on Hypertension in patients attending Family Practice Clinics ... 1404 N adaA . Yasein, F arouqM . Shakhatreh,A hm adA . Sule
iman, Farihan F. Barghouti, Lana J. H alaseh, N oorK . A bdulbaqi
The analisys o f the syndroms appearing among children living with autism in H un gary...1415 Orsolya Tobak, M onika Balogh, K inga Lam pek
Health financing reform towards universal insurance coverage: a case study o f six cities
in China ... 1420 Cheng L i, Yuan Yu, K ieke G.H.Okma, M in Yu
Stories o f illness in a changing world of
m edicin e... 1430 M odesto Leite Rolim Neto, Alberto Olavo Advincula Reis, Irineide Beserra Braga, Cicero HedUberto Filguêiras Macado
- Thomson Reuters ISI web o f Science, - Science Citation Index-Expanded, - Scopus,
- EBSCO Academic Search Premier, - Index Copernicus,
- getCITED, and etc.
The Relationship between Weight Status and Self- reported Mental Health Outcomes in Korean
A dolescents... 1435 Seong-Ik Baek, W i-YoungSo
Sadrzaj / Table of Contents
An Oxygen-sensing Signal Cascade of Cardiomyocyte Adaptations to Moderate
Endurance T raining... 1440 Zong-Yan Cai, Cheng-Chen H su,M ei-C hich Hsu,
M ao-Shung H uang, Chao-Pin Yang, Yung-Yu Thai, B orchem g Su
Hematological and serological changes in the pre - and post-treatment breast cancer
p atien ts... 1449 Nadeem Sheikh, M aria M asood andN aila N az
Serum Leptin changes following a selected aerobic training program in un-trained Fem ales...1458 M asoumeh A zizi
Effect o f serum urea and creatinine levels in
aneurysmal subarachnoid hem orrhage...1463 Sayantani Ghosh, SaugatDey, M itchell M altenfort, Jack Jallo Stress coping among nurses in L a tv ia ...1468 L iana Deklava, Inga M illere, K ristaps Circenis
The Effects o f LPG Massage System on Delayed Onset Muscle Soreness and Muscular
Performance after Resistance E xercise...1474 Vahideh Kianm arz
Outcomes o f patients with low risk cardiac chest pain underwent immediate exercise testing: two months fallow u p ... 1479 SaeedAbbasi, Kamhiz Masounu, M ohsen Ebrahimi,
M ohammad Am in Zare, M ohammad JavadA lemzadeh Ansari Maternal obesity and preeclampsia ...1484 A zar Agham oham m adi
Perceptions regarding the use o f long-lasting insecticide -treated bed nets for preventing
malaria among rural females o f Pakistan ... 1488 N eloferA m ir, E jaz A hm ad Khan, H aris H abib, Hamayun Rathor
Study o f Catastrophic Health Expenditure in
China’s Basic Health Insurance... 1498 Zhongliang Zhou, Jianm in Gao
The Effect of Using Sauna (Dry and Steam) and Cold Water on BP (Systolic and Diastolic) and HR in Male A thletes...1508 A lireza Rahim i, Jaber Safarkhan M o’azeni, Zynalabedin
Fallah, A bbas Esfandiari
A Clinical trial to compare the effectiveness of Lavender essential oil and olive oil at healing
postpartum mother’s perinea ... 1512 Fereshteh Behm anesh, M aryam Tofighi, M ouloudA gajani Delavar, M ahtab Zeinalzadeh, A liA k b a r M oghadam nia, Soraya K hafri
Evaluating the problems o f mothers in exclusive breastfeeding and educational intervention for improving nutrition status in I r a n ... 1517 H adigheh Kazem i, Fatemeh Ranjkesh
R isk Factors Associated with Metabolic Syndrome in Iranian Middle Aged W o m e n ... 1522 M ouloud A gajani Delavar, M unn Sann Lye, G eokLin Khor, Syed Tajuddin B Syed Hassan, Parichehr H anachi
The effects of Vitamin C and E Supplements on eradication rate o f Helicobacter pylori
receiving omeprazol- clarithromycin-amoxicillin regim en... 1531 EhsaniA rdakani M J, Sandy S, Norouzinia M , M ostafavi SA, M ohaghegh Shalm aniH
Coeliac disease; Prevalence and Outcome in
Pregnancy... 1537 M ohsen Norouzinia, Kam ran Rostand, M arzyeh Andni, F arhad Lahnd, M oham m ad Roshani, H om ayoun Zojaji, M oham m ad R ostand N ejad, Chris J M ulder, M oham m ad Rezja Z ali
Criteria for Priority-setting in Iran Basic Health Insurance Package: Exploring the Perceptions
o f Health Insurance Experts ...1542 Reza Dehnavieh, Arash Rashidian, M oham m ad reza M aleki, Seyedjam alAldin Tabibi, H osein Ibrahind Pour, Somayeh N ooriH ekm at
Examination O f Critical Thinking Disposition In N ursing... 1549 Belgin Yildirim, §ükran Özkahraman, M edet Korkm az, Siddika Ersoy
Tuberculosis as an occupational disease: based on health care centers in Turkey... 1558 Abdurrahm an Abakay, Abdullah Cetin Tanrikulu, Odern Abakay, H adice Selim oglu §en
Quality assessment o f primary care guidelines in Turkey... 1565 Aylin B aydar A rtantas, R abia Kahveci, D idem Sunay, Ay$e Caylan
The effect methods to cope with stress in high school students on hopelessness and self-esteem ...1573 D ilekK ilig, Giilcan Erol, B attalK ihg
The Effects o f Acute Submaximal Exercise on Trace Element Metabolism ...1580 Ersan Kara
The effect o f planned education given to students on their menstrual hygiene behaviors: learning and forgetting... 1586 H atice Kum cagtz, IlknurA ydinA vci
Sadrzaj / Table of Contents
Problem solving skills related with baby care o f mothers who have normal and premature
newborns* ... 1593 KuguogluS, CinarN, ErgunA
Incidence o f smoking among the primary school students in Turkey and its reasons ... 1597 N adi Hacialioglu, Afife Yurtta§, M eral Kilig
Characteristics o f patients who are newly diagnosed with cancer after visiting the
emergency departm en t... 1605 Neslihan Yiicel, Feride SinemAkgün, CemErtan, Meltem Serin, Karcwglu Özgür
An evaluation o f self-efficacy and nicotine-addiction levels o f smoker university stud en ts... 1613 N ur Ödem Kiting, Ayfer Tezel
The investigation o f life styles adopted by women living in Erzurum as regards
cervical cancer r is k ... 1625 Ôdem Karabulutlu, Nesrin Reis
How Much Residents “Don’t Know” About
Feeding Children 6 - 2 4 Months o f A g e ...1632 Rabia Kahveci, tlknur Bostanci, Yildiz Dollar
Nursing Students’ Perception o f the Internet in Turkey: A Questionnaire S u r v e y ... 1636 Sevinc Tastan, Birhan Tastan, Emine Iyigun, Hat ice Ayhan An investigation into the knowledge about the
menstruation period among the female university students at Eastern Black Sea region of Turkey... 1643 B irsel Canon Demirbag, Zeynep Güngôrmüç
Free radicals and intrinsic skin aging: basic
principles ... 1647 Raja Dah mane, Borut Poljsak
Microbiological finding o f urine in patients
with benign prostatic hyperplasia... 1655 Vineta Vuksanovic, Natasa Terzic, Danijela Vujosevic Effects o f air pollution on red blood cells in
pregnancy... 1664 Stankovic A , Nikolic M, Arandjelovic M.
Pheochromocytoma in pregnancy, a diagnosis not to m is s ... 1670 Bogavac Mirjana, Stojic Sinisa, M alenkovic Goran, Medic Stojanoska M ilica
Mid-life women’s knowledge about
perimenopause in V ojvodina...1674 Dragana Milutinovic, Aleksandar Curcic, Sonja Sumonja, Dragana Simin, Bronislava Brestovacki
Cryopreservation - challenge o f platelet
concentrates long time preservation... 1683 Radmila Jovanovic, Jasmin a Grujic, Vladan Radlovacki, Bato Kamberovic
Oral fungal and bacterial infection in
sm ok ers... 1695 Cankovic M, Bokor-Bratic M, Cankovic D
Patients’ satisfaction as key point in
healthcare services...1701 Radmila Janicic, Danica Lecic-Cvetkovic, Vinka Filipovic, Zoran Vukasinovic, Vesna Jovanovic
Implementation influence o f antibiotic prescribing guidelines on their usage and
costs o f th er a p y ...1710 Sandra Stefan-Mikic, Sinisa Sevic, Radoslava Doder, Dejan Cvjetkovic, Natasa Jovanovic, M aja R ude
Secondary Lymphedema o f the arm in breast carcinoma at the Oncology institute o f Vojvodina:
2 0 0 1 - 2 0 0 6 ... 1719 Svetlana Popovic-Petrovic, M iroslav Nedeljkovic, Lazar Popovic, VasaPetrovic
Assessment o f air quality impact on human
health in the city o f Novi Sad ...1725 Sanja Bijelovic, Budimka Novakovic, Ljiljana Trajkovic- Pavlovic, M ilorad Bijelovic
T4 Glottic carcinoma: oncological results and
survival rate... 1737 Slavisa Jancic, Misko Zivic, Zoran Radovanovic, Biljana M ilicic, Natasa Djindjic, Boris Djindjic, Snezana Jancic Peripartal Cardiomyopathy - alwaus
diagnostic dilemma: clinical and therapeutic
procedures... 1744 M irjana Bogavac, Olivera Rankov, Jadranka Dejanovic, M ilica Medic-Stojanoska
Digital radiography in root canal working
length determination... 1749 Tatjana Brkanic, Ivana Stojsin, Karolina Vukoje, Duska Blagojevic, Vladan Osatovic
Surgical wounds complications in two different techniques o f a cesarian sec tio n ... 1754 Vejnovic T, GrahovacM, VeselovskiA, Koledin S
Measuring health o f countries: a novel
app roach... 1762 Veljko Jerendc, Kristina Seke, Zoran Radojicic, Danka Jeremic, Aleksandar Markovic, Dragoslav Slavic, AcaAteksic Psychopathological response of torture victims ... 1767 Alm a Bravo-Mehmedbasic, Senadin Fadilpasic
Effects o f dispersed radiation on the thyroid
and the gonads during m am m ography...1774 Suad Kunosic, Denis Ceke, Adnan Beganovic, Begzada Basic,
Qualitative methods o f identification of acetylsalicylic acid by differential scanning
calorimetry and melting point m e th o d ...1782 Ekrem Pehlic, Aida Sapcanin, M irza Nuhanovic, Bozo Ba- njanin, Huse in Nanic, Safeta Redzic, Am ir Muric, Cazim Salimovic, M elita Poljakovic, M ajda Srabovic
Incidence o f urinary tract infections o f male paraplegics population compared to the way
o f bladder treatment ... 1788 Selimovic M, Hiros M, Spahovic H, Sadovic S,
Mehmedbasic S, Cavaljuga S
Therapeutic Approach to Large Jaw C y sts...1793 Naida Hadziabdic, H alid Sulejmanagic, Edin Selimovic, Nedim Sulejmanagic
Evaluation o f methods in identifying hilar supernumerary renal arteries originating
near the a o r ta ... 1800 Elvira Talovic, Alm a Voljevica, Amela Kulenovic
VAP frequency at central intensive care unit o f Canton hospital Zenica within the period
2008/2009... 1806 Ranka Filipovic, Ism et Suljevic, Ismana Surkovic, Azra Kudumovic
Assessment o f quality o f life in patients with heart failure using Minnesota questionnaire... 1811 Sadat Kurtalic, Fahir Barakovic, FaridLjuca, Zumreta Kusljugic, M idhat Tabakovic, Zlatko M idzic, Nermina Kurtalic, Dzenan Halilovic
New simplified formula for RPl-reticulocyte
production in d e x ... 1815 SecicD , OmerbasicA, D rljoM , DizdarevicA
Anti-Suicide effects o f clozapine in treatment of schizophrenia and schizoaffective disorder...1821 Saida Fisekovic, Damir Celik, Svjetlan a L oga-Z ec Contribution to the epidemiology prolonged
forms hepatitis “A” ... 1829 Dauto vic-Krkic S, Hadzic A, M esic A
Instructions for the authors...1835
Uputstvo za autore 1836
Health /IED - Volume 5 / Number 6/2011
The analisys of the syndroms
appearing among children living with autism in Hungary
Orsolya Tobak1, Mónika Balogh2, Kinga Lampek3
1 University of Szeged, Faculty of Social and Health Science, Health Visitor Labor and Methodology Department, Hungary,
2 Universitas of Szeged, Pedagogy PhD School, Hungary,
3 Universitas of Pécs, The Faculty of Health Sciences, Institute of Health Insurance, Department of Health Promotion, Hungary.
Abstract
Present results are part o f an overall explora
tory research dealing with the quality o f life in the families bringing up children with autism, which aims to support the effectiveness o f health visitor (Hungarian speciality) nursing care.
Our goal was to map the symptoms, which can be the basis o f a professional guideline for health vi
sitors and professional nurses. During our research among families in Hungary raising children living with autism 276 families were asked by a questio
nnaire. The age o f the children were between 3-18.
The qualitative data collection occurred in three fo
cus groups (parents, autism specialists and health visitors), some elements o f which are described in the study. No similar social-demographic backgro
und can be recorded among the examined families, all o f them have to face many challenges with only a very little help. The appearance and the frequency o f the symptoms are the same as mentioned in the literature. They have different expectations toward the professionals taking care o f them, which are presented in this study in details.
Key words: Autism, health visitor, symptoms, health care
"In a perfect world, everyone is healthy and happy, people understand and care about each other.
In a perfect w orld there are no ill people, no dam aged ones.
In a perfect world, everyone has equal oppor
tunity to fu lfill their latent talent.
B ut our w orld is fa r from being p e rfe c t..."
a disabled youth
Introduction
The number o f people living with deficienci
es is increasing year by year in Hungary, due to the development o f diagnostics there are more and more opportunities for early detection and to be
gin intervention as soon as possible. These deve
lopmental interventions, can support and improve the quality o f life for families, increase the cohesi
on and the cooperation, o f the family, and they can help solve the problems.
One o f the major problems in connection with the families is the prejudices and stereotypes aga
inst the mentally handicapped, and autistic people which usually comes from ignorance and the fear o f them. An important experience o f social scien
ces is that negative attitudes prevent cooperation.
It means that primarily the approach o f helping professionals needs to be changed, which may af
fect the positive attitudes o f the immediate and wi
der environment toward people with disabilities.
The efforts o f solving the problems have intensifi
ed over the past 10-15 years. Legislation has been defending the interests o f people with disabiliti
es in Hungary, many advocacy organizations are working, mainly in big cities, and more and more attention is being paid to integration. However pe
ople often avoid families with disabled children, and an active attitude to help in the vast majority o f the population has not been characterized yet.
Journal o f Society for development in new net environment in B&H 1415
HealthMED - Volume 5 / Number 6/2011
Objectives
The present study aims to introduce the current situation o f the 3-18 year-old autistic children li
ving in Hungary, especially in light o f demographic data. This way we are going to have an overview o f the residential, age distribution, marital status, educational attainment and financial situation o f the families as well as the appearance o f the frequent symptoms. The results o f focus group interviews can inform us about their daily lives and the pro
blems that hinder them from social integration. We can also get an idea about how they feel about the work o f professionals dealing with children.
Introducing Approaches
The quantitative analysis uses the data o f the National Autism Research (OAK) prepared by the Jelen (Present) Institute. In the research the aimed and comprehensive sampling procedure covered all the people in the population living with autism, and members o f an organization, or association in Hungary.
The written interview method that was applied by OAK, used two types o f questionnaires. One detailed questionnaire covering several areas was filled out by interviewers, the other was a self-fi
lled one sent by mail to the parents. In my own sur
vey I used the data from the postal questionnaires, specifically the families who are raising children between the ages o f 0-18. Due to the sampling procedure 276 valid questionnaires were returned.
The focus group study (qualitative) occurred in three groups, where I used the same questionnaire catalogue. Beside the parent group I asked health visitors and a group o f heterogeneous professionals dealing with children with autism in their work.
The SPSS version 15 was used for the data analysis.
Analysis
Among the qualitative results o f the survey the present study covers only the presentation o f the demographic variables and the present situation.
On the basis o f the literature the clinical picture o f autism can be summarized as follows.
Social isolation, which can be noticed sin
ce infant age. Children with autism do not make physical contact with their parents, they „freeze”
if anyone touches them. Do not keep eye contact, show a complete indifference to other people, even to their mothers. Strongly linked to objects which they can do the same movements with for hours. (Ranschburg 1997)
M ental lag behind: Today's researches show that 70% o f the autistic are mentally handicapped some degree. Their verbal intelligence is low, whereas during performational tests they signifi
cantly outperform their peers. (Ranschburg 1997) Language and communication inadequacy is characterized by the autistic. H alf o f the children do not learn to speak, and those who do in most cases it is echolalia when they repeat what they heard exactly, but mechanically. Although they learn to speak, but unable to communicate, they can not follow the constant change o f perspecti
ves. Another common peculiarity o f speech is to switch pronouns. (Ranschburg 1997)
Their fantasy game is poor and shallow, they can not play spontaneously and creatively, especi
ally with others. The upset o f their usual agendas the slightest change in the furniture o f the room or the usual people confuse them and drives to despair.
The ritual nature o f motor activity and abnor
mal reactions to external stimuli.
Some autistic people have special skills on tho
se areas where social skills are not required.
During the research, the situation o f families raising children with autism was examined. To get to know this the accurate assessment o f the serio
usness o f autism is essential. However, there were no objective means to establish this, since the ICD codes and medical report could not be known. We could only rely on the subjective opinion o f the parents, which is not always plausible, but it can serve as clues for further analysis.
The 50% o f the parents nurturing their children considered the problem o f their children as serious only 13.4% o f them as very serious, and a third as mild. This data may have an impact on institutio
nal care, parental employment, recreational pro
grams, discrimination etc. This ratio can be con
sidered as good in the light o f foreign researches and other statistical data. This could have several reasons, but in most cases can be traced back to
1416 Journal of Society for development in new net environment in B&H
HealthMED - Volume 5 / Number 6/2011 the child's age. The society accept the behavior o f
the younger children experienced by parent more easily than o f adolescents'. During childhood the parents still hope that this state is reversible, can be improved.
In the following, I present the data, based on the results o f the studied population, which are typical or atypical symptoms o f autism that have a great influence on the family life, and their "well being".
One such area is the speech, which can be ju d ged in itself, but also can be divided into two se
parate parts, speaking, and comprehension. 30%
o f the children speak well, but 18% do not speak at all. In the case o f children at the age o f 3-4 it can happen as a result o f development that later they will be able to formulate words or short sen
tences. 29% o f them express themselves simply, in words and short sentences while 22% o f them in most cases only repeat information what they already heard.
The problematic function going beyond speech among autistic people is comprehension. It expla
ins the reason for the fact that we got different proportions than in the previous question. In 77%
o f the cases they understand well, or almost well what is said to them. Around 22% the proportion o f those who have little understanding o f the in
formation they received, even in one case, accor
ding to the parent, that child does not understand what they say to them. In this case another disabi
lity is probable that prevents comprehension (eg, deafness, severe mental disability).
Autism may affect the sleep-wake cycle. It was not experienced by the 63% o f the parents and 32% experienced mild cases o f sleep disturbance, in 14 cases the child's problem was considered as serious by the parents. In parallel, the eating disor
der must be examined as well. During focus group interviews it appeared several times as problem worsening with the age. Present study shows that the eating disorder is more common than sleep problem. In 51.4% there was no reported eating problems so far, 37.7% have already detected nu
trition-related problems o f the child while 11%
causes very serious problems for parents and children alike. The most common eating disorder mentioned by the parents is the lack o f appetite, and in this context, the rejection o f certain foods (because o f shape or color).
In addition to the speech behavior disorders are another big problem for parents. The survey also highlights a number o f specific behavioral problems such as short-tempered behavior, which
"never occurs" in 31% o f the children, 59% o f the parents "experience it sometimes" and is frequent in 9%. Rage often occurs in 19% o f the children, at 54% o f the cases rarely and it "never can be seen" at 25%."Strange, stereotyped movements"
are often found by 49% o f the parents, rarely de
tected in 33% and 17% did not experience such symptoms at all. This is a typical characteristic o f autism symptoms, which can be evident even to a lay observer. Gets a similar proportion o f "com
pulsive behavior" which is often in 57% it is rarely encountered in 31% and 12% are common.
The "embarrassing behavior before others"
does not show any outstanding rates, 58% some
times, 23% frequent and 18%, there is none. Self harm is not typical at the 63% o f the examined children, , 30% sometimes, and only 7% o f the parents experience it often. The research did not address the ways o f self-harm behavior. The study suggests that the most common habits at most children are stereotypical, strange movements, but self-harm behavior, rage and angry, embarrassing behavior is rare.
In order to evaluate the possible incidence o f behavioral problems better, I created a new vari
able. The obtained data shows that in case o f two children behavior problems were not experienced by the parent. They are likely to show signs o f mild autism in other areas as well. The assump
tion that they are little children is not confirmed, because one o f them is 8 the other is 10 years old.
Aggregating the scores on behavior it can be seen that the more problem they have and the more severe they are the more points the respondent gets.
It can be said that a few problems can be experi
enced at the 15% o f the children while in case o f 41% o f them a slight difference can be experienced all areas or one or two cases we can meet more se
rious disorders. The third group (36% of) always have a slight problem for sure, but more than one also occurs more frequently. At 7% o f the children behavioral problems often occur in all areas.
The questionnaire took down experiences in the field o f autonomy o f the child based on the needs. Using toilets works at 86.5% o f the tested
Journal o f Society for development in new net environment in B&H 1417
HealthMED - Volume 5 / Number 6/2011
children with autism alone or with a little help. A lot o f help is required in this area by 13% who are probably younger, not yet housebroken, as it can be said and also mentioned in the literature, that the usage o f toilet appears later among them.
In the field o f other hygiene needs 66% of them is self-sufficient or requires less assistance while 33% o f them is in need o f assistance. This ratio can be observed in the healthy groups as well with similar age distribution. Dressing is completely independent at 28% o f them, 47% requires smaller assistance while 25% o f them needs more. What is meal concerned 93% o f them is completely self- sufficient only 7% o f them requires more help.
The data shows that these ratios are almost the same as at the healthy population o f similar age. If we compare the results with the age o f the children one or two years o f lagging behind can be expe
rienced but we can say that at the examined areas in most cases these children become independent at elementaiy-school-age or only little help is nee
ded. Each o f the four variables (dressing, eating, grooming, toilet use) were taken into account du
ring aggregating the scores, so the higher the va
lue o f a child is, the more likely to require more frequent assistance in certain areas. In cases where a lower number is received, we can say that the child can fulfill their own needs alone. Fully inde
pendent in all areas or just a little help is needed by the 44.9% o f the children while 38.4% o f them requires at least some help in all areas. 16.7% o f them certainly needs a lot o f help or support to meet their needs.
After the distribution o f the symptoms we ad
dress the review o f qualitative test results.
The analysis o f focus group interviews The aim o f the interview was to reveal the opi
nion o f parents and professionals to define shared goals and plans and to improve the quality o f life for children with autism.
Three groups were studied during our research:
concerned parents, health visitors, and professio
nals (psychiatrists, health visitors, special educati
on teacher, teacher).
The results obtained during the research are the following.
The families o f disabled children encounter the prejudices o f society. It regularly occurred in the families surveyed that they got negative ver
bal opinions declaring that the parents could not discipline their children. The prejudices from out
side affect the acceptation o f the diagnosis as well.
According to the opinions o f the health visitors the parents who have already accepted the child's problem, they actually use the term autism, while those who have not identified with the status o f their children yet use the word disabled in every
day conversations. "If they hear autism, two things occur to them: Oh my God, how serious it is, the other is w hat he is a genius in. Two extremes. Per
haps a talented genius, but he can not exist in this world. "(A parent)
The prejudice and a general lack o f knowledge make it more difficult and in some cases prevents, or even destroys the social relations o f the children and families. They try to move to a place where the immediate environment is acceptant and tole
rant to the contingent filming and screaming o f the child. Several people have said that the previous relations are worn, and the only really good frien
ds remained. "The precious people who accept us, remain." (A parent)
The symptoms o f autism, obvious to the experts interviewed, can be stated in general that while the parents mentioned positive and negative symp
toms, the experts can only point out the negative characteristics. The experts particularly see the pro
blems and their knowledge can be linked only to the difficulties. These are good foundations o f tran
smitting the prejudices and explain their stability.
Besides approaching this primarily emotional way, a wider range o f knowledge can also be observed in the case o f parents, since being concerned leads them on a constant learning endeavor.
The diagnosis o f children often occurs only at the kindergarten age. The reason for this is that it is difficult, geographically limited, and slow to reach the health care system for diagnosis. Another rea
son may be that health visitors, as primary preven
tion professionals do not have sufficient knowledge so that they could help in the early diagnosis and effective treatment, however according to parents and professionals early diagnosis has greater de
velopmental efficiency. The opinion o f the parents is that they are not satisfied with the nursing care
1418 Journal of Society for development in new net environment in B&H
Health /IED - Volume 5 / Number 6/2011 o f the health visitors can be supported by the facts
mentioned above and that they except more help from their health visitors. The situation could be improved by the expansion o f the nurses' knowled
ge, and development o f the professional protocols.
Parents o f autistic children are doing their best in order to help their child, assume all the burden, but they do not receive adequate social assistan
ce. Less public assistance and support is given in Hungary to the families involved than in other EU countries. The financial burden o f development is gradually increasing, but the subsidies are sta
gnating. In spite o f this, parents are looking for opportunities to develop the children as much as possible. Each o f the families surveyed participate in programs organized by the Autism Association, which help the integration o f children.
The vision o f families bringing up children with autism is uncertain due to the weaknesses in the Hungarian health care system. There is no adequate institutional care for autistic adults. All goes well, until they go to school, but after that there are only day-care institutions, which relive the burden o f the parents. There is no solution to the situation where the parents are no longer able to stand beside them. We can read a lot about well
functioning autistic farms abroad, but only a few attempts were made to implement them in our co
untry. " The parents sacrifice themselves as long as they can hut w hat happens after that ...Theparent w ould like to accustom their children to an insti
tution where they w ould provide fo r the child." (A health visitor)
Summary
The autistic children mainly live in the Central Region o f Hungary, with a Budapest center. It can be said that they are brought up mainly in frill fa
milies. The financial situation o f families is more difficult due to the special needs o f the children, and because o f the fact that only 45% o f parents are able to work besides taking care o f the child.
Objective symptoms, the age o f the parents, the number o f siblings, the current age o f injured chil
dren and the measure o f the help they can expect in caring the child have an effect on judging the severity o f the conditions.
The parents are the ones who usually detect the first symptoms, but the professionals ask them to be patient "this kid is developing a bit slower." It is an important lesson for health care professionals to consider the signals coming from the parents in all cases.
The presented results and the parents reactions show the actual problem we are facing with. It is necessary to speak o f autism, to help in early detec
tion, to support parents in child development and to lobby the government for the health care o f adults with autism and to improve social conditions. Besi
des training professionals it should be mentioned as an important objective to expand the knowledge o f lay people as well in order to prevent the discrimi
nation o f disabled people in society.
"We w ant it to be accepted as a special thing that is com pletely different than a m ental disabi
lity. You can live with it, live together with it, and they can be adorable, but you can go insane beca
use o f them. "(A parent)
References
1. Bánfalvy, Cs. (2005). A fogyatékos emberek és a munka világa. Szakképzési Szemle, 2, 180-193.
2. Chikán, Cs. (2001). Esélyegyenlőség, fogyatéko
sság. Budapest, Hungary: Mozgáskorlátozottak Pest Megyei Egyesülete (Publisher)
3. Ranschburg J. (1998). Pszichológiai rendelle
nességek gyermekkorban. Budapest, Hungary:
Nemzeti Tankönykiadó.
4. Kőpatakiné Mészáros, M., & Salné Lengyel, M.
(2001). Fogyatékos tanulók helyzete az ezredfordu
lón. Új Pedagógiai Szemle, 7-8, 20-29.
5. Petri, G., & Vályi R (2009). Autizmus — Tények
— Képek. Budapest, Hungary: AOSZ, Jelenkutató Alapítvány
6. Szabó L. (2003). A boldogság relatív - fogyatéko
sság és szubjektív életminőség. Szociológiai szemle, 3, 86-105.
Corresponding author Orsolya Tóbak,
University o f Szeged,
Faculty o f Social and Health Science,
Health Visitor Labor and Methodology Department, Hungary,
E-mail: tobako@etszk. u-szeged. hu
Journal o f Society for development in new net environment in B&H 1419
