REHABILITATION P R O G R A M M E FOR W. T. V. ADISESHIAH* H A N D...
REHABILITATION P R O G R A M M E FOR
W. T. V. ADISESHIAH*
H A N D I C A P P E D P E O P L E I N M A D R A S
I INTRODUCTION
Physical Handicap. According to infor-
1. Speaking on the r e h a b i l i t a t i o n of m a t i o n available from census figures, there
physically h a n d i c a p p e d people at a Na-
are nearly one h u n d r e d a n d fifty t h o u s a n d
tional Seminar on R e h a b i l i t a t i o n Services persons in T a m i l N a d u , disabled by loss
a n d Research, Dr. M. N a t a r a j a n , Director of limb, affected muscle power, nerves
of the Artificial L i m b Centre, M a d r a s ob-
or bones. "Following the disability" says
served: " W e must realize t h a t this specia-
Mr. S. T. M a r k a n d e y a n , Vocational Coun-
lized work needs an army of specially train-
sellor at the Artificial L i m b Centre, Mad-
ed personnel like doctors physiotherapists, ras, " m a n y h a n d i c a p p e d persons experience
occupational therapists, medical social various p r o b l e m s in their life. A person
workers, vocational counsellors, a n d em-
whose legs are paralyzed as a result of in-
p l o y m e n t officers. It is true that one c a n n o t
j u r y in t h e spinal cord will have to r e m a i n
wait till a large n u m b e r of these are creat-
confined to his h o m e . T h e respect t h a t he
ed before starting o u r scheme. In most h a d been receiving from his family mem-
places we have to start on an ad hoc basis, bers may slowly w a n e out. He may be
ignored or sometimes be even neglected as
with partially trained personnel a n d start the family members feel him to be a bur-
the process." F r o m bold beginnings m a d e den. Thus, disability puts innumerable
in the D e p a r t m e n t of O r t h o Surgery at the blocks in every path of the life of the dis-
G o v e r n m e n t General Hospital, Madras, abled persons — physical, familial, social,
the Artificial L i m b Centre has bloomed and economical. These frustrating circum-
n o w i n t o a full fledged unit, complete with
stances lead to conflict, clearly manifesting
facilities for o r t h o surgery, a workshop for symptoms of hostility, aggressive beha-
the fabrication of artificial limbs, a n d a viour, submissiveness, dependency and with-
vocational evaluation u n i t staffed by voca-
drawal". T h e p r o b l e m becomes m o r e acute
tional counsellors, clinical psychologists when one considers the plight of ortho-
a n d biostatisticians, engaged in laboratory paedically handicapped persons, since the
a n d field work. T h i s m i n o r project on disability deprives them of their employ-
which this report is being written h a s been
m e n t o p p o r t u n i t i e s . T h i s would, of course,
sponsored by the University G r a n t s Com-
differ according to the type of occupation
mission; a n d it is related to the vocational in which an individual happens to be. In
evaluation of h a n d i c a p p e d people. It h a s the case of a watchman who loses three
been a i m e d at providing technical know fingers in one hand, the disability may not
how regarding psychological aspects of the be serious; but in the case of a typist, the
m a j o r project u n d e r t a k e n by the Artificial same handicap will be a serious impedi-
L i m b Centre.
m e n t in the efficient performance of his
j o b . He m i g h t have to look for some other
I I P R O B L E M
r e m u n e r a t i v e occupation.
2. Nature and Extent of the Problem of
* Dr. W. T. V. Adiseshiah, Consultant Psychologist, Artificial Limb Centre Madras 3.
The author is grateful to Dr. D. S. Kothari for his interest in the progress of this
Study and to Dr. M. Natarajan for facilities provided for data collection. Thanks
are also due to Thiru S. T. Markandeyan for help in administration of the tests and
the recording of scores.

258
W. T. V. ADISESHIAH
3. Psychological Considerations. Physical him dependent on his family and on so-
handicap almost invariably leads to psy-
ciety. The process of vocational guidance
chological problems. Hence the need for consists of six steps:
correct vocational assessment and approp-
(a) First, the individual has to be care-
riate occupational placement which will fully examined by the administration of
turn out to be satisfying to the client. suitable tests which will give a reliable
Medical facilities in hospitals do provide measure of his abilities and aptitudes. It is
artificial limbs which certainly help the necessary, also, that he should be inter-
patient to compensate for the deficiency viewed, so that the vocational counsellor
resulting from loss of limb, but this is only may gain a clear idea as to where his true
the beginning of the process of rehabilita-
vocational interests lie.
tion which must necessarily culminate in
the placement of the medically rehabilitat-
(b) Secondly, on the basis of the data
ed individual in an occupation which emerging from the tests and interview, a
makes him once more a useful member of realistic evaluation of his vocational poten-
society. "In India", observes Dr. M. Nata-
tialities has to be made.
rajan, "where unemployment is so high
(c) The third step is the vocational
even among the physically fit, the competi-
counselling procedure, which seeks to
tion for gainful employment is far more create in the mind of the client an aware-
serious and ruthless We must remem-
ness of his capabilities and limitations.
ber that these personnel could effectively The vocational counsellor is bound by the
function only when the proper environ-
golden rule of the client's right to self
ment is created in terms of institution, determination.
equipment, and other ancillary and sup-
(d) After the client has made a tenta-
portive requirements". In short, it is vitally
tive choice of his preferred vocation, the
necessary to direct the handicapped person fourth step will be to provide for the
into the choice of an occupation which he client opportunities for pre-vocational or
will accept as his vocation; and will find vocational training. In the case of persons
satisfaction not only in what he earns but who are fit to return to their former occu-
also in what he does, along with those who pations, the guidance process will end at
happen to be his co-workers. All this under-
this stage.
lines the need for systematic planning and
a scientific assessment of vocational pos-
(e) Fifthly, on completion of training,
sibilities.
the client will have to be placed in a job
for which he has been duly trained. This
III PROCEDURAL REQUIREMENTS
will have to be done with the collabora-
tion of an employment agency. It may not,
4. Process of Vocational Guidance for however, be that at the end of the training
the Handicapped. The aim and purpose of period, an individual has developed all the
vocational guidance, as it applies to handi-
skills needed for adequate performance of
capped people, is to help the individual to the job. Hence a period of on-the-job
settle in a job for which he is fit, despite training is usually necessary.
his handicap, so that he may be able to
earn a living, restore his independence and
(f) The sixth step in the vocational
self respect, and overcome the depressing guidance procedure is to follow up the in-
feeling of the basic deficiency which made dividuals placed in different jobs, and to

REHABILITATION PROGRAMME FOR HANDICAPPED PEOPLE IN MADRAS
259
ascertain the gain in job proficiency result-
prior to imparting counselling to the client.
ing from experience on the job.
The data now available from the Artificial
It will be evident from this that the re-
Limb Centre, based on testing carried out
habilitation of physically handicapped between August 1969 and January 1971,
persons is not a random process, but one consist of scores based on seven tests, which
which calls for career planning, and fore-
fall into three groups:
seeing accurately what a person is capable
(a) First, the measurement of intellig-
of doing. Psychological tests are tools which
ence, based on the administration of
point to different possibilities; but in the Bhatia's battery of intelligence tests. From
last analysis, much would depend on the the scores on this battery, consisting of five
insight of the vocational counsellor; and tests, the intelligence quotient of each per-
the way in which the client cooperates with
son tested was calculated. A total of fifty
him in the effort to achieve a solution to clients was tested, and their respective in-
the problem created by the bodily defici-
telligence quotients worked out.
ency.
(b) Secondly, the following psycho-
IV METHOD
motor aptitude tests, drawn from the group
of nine initially recommended for use were
5. Psychological Techniques. In Janu-
administered:
ary 1969, when the request was made by the
Director, Artificial Limb Centre, Govern-
(i) Test No. A.P. 11 (Pegboard
ment General Hospital, Madras, for assist-
Test), administered to 67 per-
ance in connection with the psychological
sons.
evaluation of amputees, a scheme of tests
(ii) Test No. A.P. 14 (Mirror Dot-
was drawn up, and a complete set of test
ting Test), administered to 54
equipment was made available on loan to
persons.
the Vocational Testing and Evaluation
Laboratory set up at Government General
(iii) Test No. A.P. 51 (Manual
Hospital, Madras. A battery of nine tests
Dexterity), administered to 55
was initially recommended for use. These
persons.
were Tests Nos. A.P. 10, 11, 12, 13, 14, 15,
(c) Thirdly, a group of standardized
50, 51, and 52. Details regarding test ad-
aptitude tests was also administered. These
ministration, scoring, and evaluation were were the O'Connor Tweezer Dexterity
provided in the handbook entitled, Psycho-
Test, the Bennet Hand Tool Dexterity
motor Aptitude Tests in the Tower System Test, and the O'Connor Finger Dexterity
of Vocational Evaluation for Handicapped Test. The use of these tests, standardized
People. (No. C. Psy. 69015). The Voca-
in the USA, was recommended by advisers
tional Counsellor, who was given full from the Vocational Rehabilitation Ad-
training in the administration of these
tests, was advised to select tests appropriate
ministration of the United States Depart-
to each individual case, and to use any ment of Health, Education and Welfare.
other standardized tests which would be
6. Counselling Technique. All the tests
helpful in assessing the vocational potential
were reported to be working satisfactorily.
of his clients. It was also emphasized that The Vocational Counsellor based his
test administration should invariably be counselling techniques on test indications
supplemented by a vocational interview, and interview findings. During the period

260
W. T. V. ADISESHIAH
under review, altogether 75 persons were
TABLE I
counselled by him.
LEVELS OF BASIC INTELLIGENCE
Intelligence Quotients according to
7. Purposes of this Report. The pur-
Bhatia's Test
poses of this report are :
(a) First, to analyze the findings of test
data based on the psychological tests ad-
ministered by the Vocational Counsellor.
(b) Secondly, to see how the scores ob-
tained from tests administered to handi-
capped people, who constitute the experi-
mental group, compare with those to
college students, who make up the control
group in this experimental study.
this test was to pick up one inch metal
(c) Thirdly, to evaluate the usefulness pegs and fit them into slots on a board.
of these tests as a basis for effective Voca-
The score, expressed as a percentage is
tional Counselling.
determined by the speed with which pegs
are inserted, first by the right hand, then
V ANALYSIS OF DATA
by the left, and finally by both hands. The
8. Measurement of Intelligence. It is summary of data, for handicapped and
believed that intelligence is the best single normal persons, appears in Table II.
predictor of occupational success. Although
TABLE II
this has not been established in the case of
SCORE VALUES ON THE FINGER
individuals covered by this research study
DEXTERITY TEST
since measures of occupational success of
the persons tested have yet to be made, the
Values
Handicapped
College
claim has been accepted tentatively, and
Persons
Students
the assessment of intelligence levels has
Number Tested
67
98
been undertaken by the administration of
Score Ranges (Percent)
28 to 57
24 to 69
Bhatia's battery of intelligence tests, which
Mean Value of Score
50.09
56.24
have been standardized for use in India.
Standard Deviation
1013
9.12
The summary of data is shown in Table I.
From such a small sample, no real con-
Individuals were graded on a five point
clusion can be drawn, but it is evident that scale, depending on their respective scores.
more than half the number of persons The numbers falling in each of the five
tested fall below the normal level of in-
gradings are shown in Table III.
telligence. One underlying factor might
Although the difference between the ex-
be that these have been drawn from the perimental and the control groups is not
semi-skilled and unskilled occupations. As very striking, it will be evident that the
such most of them have been advised to mean scores and gradings of college stud-
change from one type of unskilled occupa-
ents are distinctly higher than those of
tion to another.
handicapped persons.
9. Psychomotor Test of Finger Dexte-
10. Psychomotor Test of Eye Hand Co-
rity. (Test No. A.P. 11). T h e task set in ordination. (Test No. A.P. 14). T h e task

REHABILITATION PROGRAMME FOR HANDICAPPED PEOPLE IN MADRAS
261
TABLE III
TABLE V
GRADINGS BASED ON SCORES IN FINGER
GRADINGS BASED ON SCORES IN THE EYE-
DEXTERITY TEST
HAND COORDINATION TEST
Gradings
Handicapped
College
Gradings
Handicapped
College
Persons
Students
Persons
Students
A
0
5
A
2
7
B
4
27
B
14
23
C
39
52
C
13
44
D
23
14
D
14
21
E
1
0
E
11
3
set for this test was to insert dots with a
11. Psychomotor Tests of Manual Dex-
pencil, on a star pattern of small circles, terity. (Test No. A.P. 51). The task set in
under the guidance of the reflection of the this test was to fill a matchbox with thirty
printed paper in a mirror. Since the image matchsticks, using a safety razor blade to
on the mirror reflects the reverse of what lift the sticks and drop them in the box.
is on the paper, the movement of the hand The score is determined by the time taken
has to be adjusted by a watchful use of the to complete the task. The summary of
eye. The score in this test is determined data for handicapped persons and college
by the number of dots correctly inserted students is given in Table VI.
within a time limit of sixty seconds. Score
values are shown in Table IV.
TABLE VI
TABLE IV
SCORE VALUES ON THE MANUAL
DEXTERITY TEST
SCORE VALUES ON THE EYE-HAND
COORDINATION TEST
Values
Handicapped
College
Persons
Students
Number Tested
54
98
Score Range (Percent)
2 to 72
12 to 75
Mean Value of Scores
38.84
42.71
Standard Deviation
7.19
7.89
Here again, individuals were graded on a
five point scale, depending on their res-
In this test, also, individuals were graded pective scores. Numbers falling in each of
on a five point scale, depending on their the five gradings are shown in Table VII.
respective scores. The numbers falling in It will be evident here that the mean
each grade are in Table V.
score of the experimental group is not
Although the mean score of the experi-
very much lower than that of the control
mental group is not very much lower than group, and that the proportion of persons
that of the control group, the proportion in both groups, placed in the five different
of handicapped persons falling in the gradings is more or less on par. In brief,
lower gradings, D and E, is distinctly there is no marked difference between
higher than that of those belonging to the handicapped persons and college students
group of college students.
with regard to manual dexterity.

262
W. T. V. ADISESHIAH
TABLE VII
Since no data for college students is avai-
lable, it is not possible to compare the
GRADING BASED ON SCORES IN THE
MANUAL DEXTERITY TEST
performance standards of handicapped
people in these tests with a control group.
Gradings Handicapped College
However, wide differences in the mean
Persons Students time taken to complete the three different
A 2 5
tasks are evident. The Hand Tool Dexte-
B 27 31
rity Test is the most complex task, involv-
C 21 47
ing unwinding from one end and fixing
D 3 14
on the other end of the test device. The
E 2 1
Tweezer Dexterity Test is less complicat-
ed, and the Finger Dexterity Test is the
12. Aptitude Test Scores. The three simplest. These tests have been found use-
standard tests of aptitude, used in connec-
ful in deciding how well the individual is
tion with the project on vocational evalua-
likely to do when put on work involving
tion of handicapped people were the Ben-
the handling of machinery and machine
net Hand Tool Dexterity Test, the tools. Individual differences appear to be
O'Connor Finger Dexterity Test, and the most marked in the case of the hand tool
O'Connor Tweezer Dexterity Test. The dexterity test and least in respect of the
Bennet Test was administered according tweezer dexterity test.
to the procedure laid down by George
Bennet, and published by the Psycho-
VI DISCUSSION
logical Corporation, USA. T h e two O'Con-
13. Evaluation of Test Programme.
nor Tests were administered according to Three questions of practical concern, merit
instructions given in the publications of attention in this connection:
Messrs Stoelting Co., Chicago, USA. Scores
(a) How well do the tests used in this
were recorded according to the number of
programme measure psychomotor capa-
seconds taken to complete the tasks set for bilities and aptitudes of the handicapped
these three tests. On this method of scor-
persons?
ing, those taking less time to complete the
(b) Is there a workable relationship
job would rank higher than those taking between test findings and vocational coun-
more time. T h e summary of data for the selling procedures?
three aptitude tests is in Table VIII.
(c) Has vocational counselling been of
some avail in the rehabilitation of handi-
TABLE VIII
capped persons?
SCORE VALUES ON APTITUDE TEST
Although it may not be possible to fur-
Values
Hand Tool Finger Dex- Tweezer
nish conclusive answers to these questions,
Dexterity
terity Test Dexterity
it ought to be possible to detect a few
Test
Text
pointers from the limited range of evid-
No. of Persons
32
38
35
ence now available. It must be remember-
Time Ranges
227 to 2141 227 to 489 316 to 820
ed that this study has been in the nature
Secs
Secs
Secs
of a pilot study; and that future work on
Mean time
925 Secs
271 Secs
516 Secs
this problem will need to be adapted in
Standard
the light of the conclusions emerging from
Deviation
231 Secs
54 Sees
86 Secs
this study.

REHABILITATION PROGRAMME FOR HANDICAPPED PEOPLE IN MADRAS
263
14. Psychomotor and Aptitude
Artificia
Tests.
l Limb Centre at the Government
In the first place, it would be useful to General Hospital, Madras. All the same,
consider the relationship between the Psy-
the scores of the handicapped persons
chomotor Tests and the Standard Apti-
tested in this study compare favourably
tude Tests administered in this study, with the scores of college students, who
since it is important to know whether those have been taken as a control group. For
who scored high on Psychomotor Tests practical purposes, then, the mean values
fared just as well in the Aptitude Tests. of test scores obtained so far may be tenta-
The relationship between the scores in tively accepted as a fair representation of
these two types of tests has been determin-
the performance levels of handicapped
ed by calculating the coefficients of corre-
persons. A few illustrative cases, recorded
lation between different tests, using the by Mr. S. T. Markandeyan, Vocational
rank difference formula. T h e values are Counsellor at the Artificial Limb Centre,
shown in Table IX.
Madras, are given in Appendix 'A', attach-
ed to this report.
TABLE IX
15. Test Findings and Counselling Pro-
CORRELATION BETWEEN PSYCHOMOTOR AND
cedures. In the second place, when one
APTITUDE TESTS
goes into the question as to how far the
Tests
Hand Tool Finger
Tweezer
test data have helped the vocational coun-
Dexterity Dexterity Dexterity
sellor to pitch his ideas at the right level,
NS
one has to depend for the answer on the
A.P. 11 Finger
*
*
Dexterity
0.210
testimony of the vocational counsellor, Mr.
0.325
0.681
S. T. Markandeyan, who has reported that
A.P. 14 Eye-Hand
*
*
*
all the six tests were found to work satis-
Coordination
0.413
0.386
0.395
factorily. With regard to his own respon-
A.P. 51 Manual
**
NS
*
sibilities in the matter, Mr. Markandeyan
Dexterity
0.536
0.136
0.409
says: "Only to a certain extent it was pos-
* Significant; NS — Not Significant; DF=27
sible to identify the vocational problems
** Highly Significant.
of patients. From the analysis of the un-
From the above table, it is evident that settled patients it was found that 65% of
there is generally a satisfactory relation-
them had difficulties in adjusting with
ship between the psychomotor tests and their jobs. If these patients are evaluated
the standard aptitude tests. Only two by means of psychological tests, the voca-
values out of nine are not statistically tional guidance of the orthopaedically
significant. All things considered, it would handicapped would bring about good re-
be fair to say that this battery of six tests sults." In addition to the use of psycho-
hang reasonably well together. Neverthe-
logical tests, the vocational counsellor is
less, the sample of cases examined in this also engaged in making pre-vocational
study is exceedingly small as compared evaluation of his clients by taking work
with the total of 1,43,872 cases of handi-
samples which could be used according to
capped persons in Tamil Nadu. In this the specific vocational preferences of his
study, between 32 and 67 persons were patients. "Finally", observes Mr. Markan-
given the different tests. Only 29 persons deyan "On-the-job training for a short
took all the six tests. This study has in period will also be given to find out the
fact been restricted to cases treated at the work potentialities of the patients. All these

264
W. T. V. ADISESHIAH
steps are expected to help amputees for set-
17. Tests Versus Interwiews. In general,
tling with some suitable jobs".
it may be said that although it is not easy
in every case to reconcile the indications
16. Vocational Choices based on Inter-
of test findings with the clients preferred
view Techniques. Vocational interview interests, as expressed in the interview,
with the counsellor is a very important every possible effort was made by the voca-
stage in the rehabilitation programme. tional counsellor to arrive at a reasonably
These interviews have been conducted with
satisfactory vocational choice which usually
meticulous care, with due regard for the fitted with test indications. There can be
client's preferred interests and also for the no doubt, then, that vocational counselling
evidence regarding his vocational slants, procedures have proved to be meaningful
gauged from test results. T h e fundamental to the client and generally in accordance
consideration has been to arrive at a rea-
with psychological test findings.
listic appraisal regarding what the person
can do and what he is incapable of doing.
18. Vocational Counselling as an Aid to
In some cases, the patient has had to be Rehabilitation. The third question of prac-
tried out on a job and assessed not only tical concern is regarding the extent to
by the Vocational Counsellor, but also by which the techniques of vocational coun-
an expert in the profession before a deci-
selling have proved to be helpful to handi-
sion was reached. An example of this is capped persons in finding suitable occupa-
given in Appendix 'B', entitled Vocational tions. In this matter, the vocational coun-
Evaluation Study in the Work Situation. sellor has to depend on the cooperation of
In this particular instance it was found the Employment Officer. Merely to find
that aptitude test indications were borne that an individual possesses aptitude for
out by observation of the case in the work the job, let us say, of an electrician, and
situation. Out of 75 persons tested, inter-
to issue a fitness certificate or letter of re-
viewed, and recommended for different commendation is not enough. The indivi-
occupations during the period under re-
dual has to be placed in a job suitable for
view, the occupation-wise distribution is as him. According to the latest Report on the
follows:
Research and Demonstration Project of the
Artificial Limb Centre at Madras, "among
TABLE X
the 104 persons who received our fitness
JOB CLASSIFICATION OF HANDICAPPED
certificate and Recommendation letter only
PERSONS TESTED AND INTERVIEWED
31 could get jobs. Some of them could not
Types of Occupation
Number
resettle even after assistance and they
found employment by themselves". In some
1. Shop Keeper / Shop Assistant
18
cases, it was possible for the client to re-
2. Pre Vocational Training/Studies
14
turn to his former occupation after under-
3. Industrial Employment
15
4. Agricultural Work
3
going treatment. In others, it has been
5. Clerk / Office Assistant
6
found necessary to put the client through
6, Tailoring
4
a period of pre-vocational training before
7. Laundry Work
1
fitting him into a job. In yet a few cases
8. Barber
1
it has been found possible to effect a
9. Contractor / Store Keeper
2
10. Milkman
1
change of occupation without imparting
11. Manual Labour (unskilled)
6
pre-vocational training. A small percentage
12. Unspecified
4
of individuals have found their initial

REHABILITATION PROGRAMME FOR HANDICAPPED PEOPLE IN MADRAS
265
placements based on vocational counselling than half the number of persons receiving
to be unsuitable, and were therefore oblig-
vocational guidance had to make a change
ed to make a change on their own. As is to of occupation after undergoing treatment,
be expected, there have been some who and not more than one in ten continued
were not able to settle down in any job. to remain unemployed. From these facts,
These were, of course, psychological prob-
it would follow that vocational inter-
lem cases. The distribution of cases is viewing has been quite helpful in the pro-
shown in Table XI.
cess of rehabilitation.
19. Work Samples. Psychomotor tests
TABLE XI
and Aptitude Tests do no doubt indicate
PERCENTAGES OF HANDICAPPED PERSONS
a person's slants, but even so they are of
CLASSIFIED BY OCCUPATION
a general nature; and the potentiality for
skills evident from scores on these tests
may not always tell exactly what job a per-
son will best fit into. Thus, a high level
of finger dexterity is called for in several
occupations such as typing, printing, tai-
loring, machine assembly and so forth.
Again, manual dexterity of a high order
is demanded in jobs like carpentry, brick-
laying, materials handling, spot welding
and the like. It will therefore be use-
ful to supplement the findings of apti-
tude tests by further tests based on work
samples. A Work Sample Test is based on
specific action patterns involved in a parti-
cular job. The job has first to be analyzed
and broken down into basic movements of
From the above table it will be evident hand and foot. The test has then to be
that nearly one fourth of the clients studied constructed so that the sequence of opera-
during the period under review, and pro-
tions in the performance of the job is
vided with vocational counselling, found it simulated in the design of the test. This
possible to continue in the same occupa-
has to be done for a number of occupa-
tion in which they were engaged before tions, so that an individual who shows
undergoing treatment. All that they requir-
promise, as judged by his score in the apti-
ed was some sort of assurance from the tude test, or who expresses preference for
vocational counsellor that they could, a particular job such as tailoring, carpentry
with some minor adjustments, cope with or welding, could be given the work sample
their jobs. As many as 16%, that is about test, and he may be told which specific
one in every six clients interviewed, settled occupation would be the most suitable for
down satisfactorily in a changed occupa-
him. T h e Artificial Limb Centre is now
tion, and about one fifth awaited change developing tests based on Work Samples,
of occupation. One tenth went on to pre-
and these tests are being standardized for
vocational training. If these numbers were future use.
put together, it would appear that more

266
W. T. V. ADISESHIAH
III SUMMARY OF CONCLUSIONS
(e) The Vocational Counsellor found the
tests to be helpful in guiding his
20. This study, relating to vocational
clients in making appropriate occupa-
evaluation of handicapped people, at the
tional choices.
Artificial Limb Centre, Government Gene-
ral Hospital, Madras, covered a total of (f) Although it was not easy in every case
seventy-five cases of persons fitted with
to reconcile test findings with the
artificial limbs. An intelligence Test bat-
client's preferred vocational interests,
tery and six Psychomotor and Standard
counselling procedures have been
Aptitude Tests were administered to groups
guided largely by test indications.
varying in size between thirty-two and (g) In more than half the number of
sixty-seven individuals. The main findings
cases, a change of occupation was
emerging from the analysis of data are as
found necessary after treatment at the
follows:
Artificial Limb Centre. One in four
(a) With regard to levels of basic in-
were able to continue in the same
telligence, more than half the num-
occupation, and one in ten remained
unsettled.
ber tested fell below the normal level
of intelligence, presumably because (h) Now that a satisfactory position has
they were drawn from persons engag-
been reached with regard to aptitude
ed in semi-skilled occupations.
testing, Vocational Evaluation will
in future be based on Aptitude Test
(b) In psychomotor tests of finger dexte-
findings supplemented by indications
rity, eye hand coordination, and
of tests based on Work Samples.
manual dexterity, the mean scores of
the experimental group, consisting of
handicapped people, did not fall far
APPENDICES
below the scores of the control group, Appendix 'A' — Illustrative Cases.
consisting of College Students.
Appendix 'B' — Vocational Evaluation
(c) In the standard Aptitude Tests of
Study in Work Situations.
Hand Tool Dexeterity, Finger Dexte-
'APPENDIX 'A'
rity and Tweezer Dexterity, wide dif-
ferences were evident in the mean
ILLUSTRATIVE CASES
time taken to complete the tasks set
(Extract from Report by Thiru S. T.
in the tests. Hand Tool Dexterity Markandeyan, Vocational Counsellor Arti-
was the most complex and finger ficial Limb Centre, Government General
dexterity was the simplest of the tests. Hospital, Madras)
(d) Correlations between psychomotor Case No. 1
aptitude and standard aptitude tests
Patient K. B., 39 years old, is an above
were statistically significant in seven knee amputee. He lost his leg in an accid.
out of nine cases. The six tests appear-
ent while at work in Madras. He could
ed to hang together well, and they not go back to his former job, on account
have been accepted by the Vocational of his disability, and he needed guidance
Counsellor as a useful indicator of in the choice of a suitable alternative job.
potentiality for vocational training.
He was educated up to the eighth standard

R E H A B I L I T A T I O N PROGRAMME FOR HANDICAPPED P E O P L E IN MADRAS
267
a n d he showed interest in skilled work. Centre, G o v e r n m e n t General Hospital,
All t h e six tests were administered. T h e Madras)
scores indicated t h a t he h a d a fairly sound
T h e p a t i e n t was taken by t h e Vocational
m a n u a l dexterity.
Evaluators to Mr. J a y a r a m a n , T a i l o r ,
Case No. 2
Madras-1. T h e tailor h a d n i n e years of ex-
P a t i e n t G. B., 16 years is a bilateral am-
perience. T h e object of the study was to
p u t e e (both lower l i m b s ) , who h a d find o u t w h e t h e r the p a t i e n t could take up
studied Up to the t e n t h standard. He h a d tailoring work, in which he h a d six m o n t h s
n o previous work experience. H e w a n t e d of apprenticeship.
to do any k i n d of suitable j o b . In the in-
T h e following tasks were given a n d the
terview, he evinced an interest in mechanic-
time noted. It was checked against per-
al jobs. Results of a p t i t u d e tests revealed formance by the tailor. T h e following
t h a t he was comparatively better placed in table shows it clearly.
mechanical a p t i t u d e .
Precautions Taken: T h e tailor was re-
Case No. 3
quested to do t h e task as quickly as he
P a t i e n t R. D., 18 years, is a bilateral could, and not to sympathise with the
a m p u t e e , who lost his r i g h t leg below knee patient, slow the rate a n d equalise his time
level a n d left h a n d at below elbow level as with that of the patient.
a result of an electric shock. H i s education
Was up to the sixth standard. He h a d no Tailor's Opinion: " F o r six m o n t h s ex-
Work experience. In the vocational inter-
perience, the p a t i e n t h a s picked up a lot
view, he expressed preference for any k i n d a n d his work i s neat a n d tidy. H e w o u l d
of repetitive j o b such as packing. He was do well in tailoring".
just average in all the a p t i t u d e tests.
Analysis of Data: For pressing the pedal,
e q u a l a m o u n t of time is taken, b o t h by t h e
Case No. 4
p a t i e n t a n d the tailor. For stitching ver-
P a t i e n t R. N., 22 years, is a bilateral tically also, equal' amount of time is taken.
a m p u t e e , w h o lost one leg a n d one h a n d In fact, the tailor has taken 0.01 sec more,
in a train accident. H i s education was up for stitching with the left leg. For stitching
to the seventh standard. In the vocational an oval shape, however, the patient has
interview, he gave indications of good moti-
taken more time t h a n the tailor. T h o u g h
vation a n d expressed interest in assembling
t h e time taken by the p a t i e n t for Kaja a n d
work. He h a d been a gas welder on the buttoning is more, it is compensated by
Railways. He was given the manual: dexte-
neatness of work, manifested in well shap-
rity test a n d the m i r r o r d o t t i n g test. Re-
ed intervals of the stitched yarn, close knit-
sults showed t h a t he was slightly above ting etc. For cutting, the patient has taken
average.
more time. He needs m o r e practice in this.
For inserting the yarn in the needle, the
A P P E N D I X 'B'
p a t i e n t has taken just 0.01 sec m o r e t h a n
VOCATIONAL EVALUATION STUDY IN W O R K
the tailor. ( T h e stitched m a t e r i a l etc. a r e
SITUATION
preserved in a file).
(Reported by T h i r u S. T. M a r k a n d e y a n , Evaluators' Assessment: (1) T h e p a t i e n t
Vocatonal Counsellor, Artificial L i m b could take to tailoring work w i t h some

268
W. T. V. ADISESHIAH
more practice. He has the necessary dexte-
reveal that the patient possesses above aver-
rity and interest. It is to be admitted that age finger dexterity and tweezer dexterity.
the prosthesis will only be a support while
His mechanical aptitude is also up to the
pressing the pedal, and effective operation mark. All these go to show, along with his
cannot be performed by the prosthesis. The
proficiency shown in tailoring, that he has
observation reveals that with the normal a noticeable aptitude for tailoring. Finger
leg alone, pressing could be done more dexterity is necessary for running the cloth
effectively. If both legs are used, the artifi-
along, while stitching, and the tweezer
cial limb slips off and becomes a hindrance dexterity comes into play in cutting jac-
to speed.
kets, shirts and pants. Mechanical aptitude
(2) The test results of psychomotor tests however is an additional factor.