Shaden /-

SHRI VEERABHADRESIHWARA SC ST VIDYA SAMSTIIE (R)

SHRI VEERABHADRESHWARA COLLEGE OF
TALAGUNDA - 577428
EDUCATIO,
SHIKARIPUR(T). SITMOGA (DIS
TOPIC: The study of children with orthopaedic challenges.
Name of the student teacher :Syet Reg No. :
Subject: Psychology ofthe learner: Class: 1st B.Ed.
Guide
Name of the Date
1. Identification:

Name of the child: Jayanh kom as k

Gender: Male
>Age: I8
Class vocattonal class Cle- 1? a )
Section
Register No. est3-9
Caste:

Date of Birth
lga
AHI2oo2
Address of the child s/o Subhamm 4,a post kelide
Shim eja laAsl-)
Type of the child Saqai, f a l ul
Menral Ae dasdaion ui eP
2. Family background:

Father's Name kalappa lla be).

Age: A5
Mother's Name: Subha mma
Age:
Name ofthe stepfather (If father is not alive): NO
NO
Name ofthe stepmother (If mother is not alive):
Address of the child's parents: S / 0 SUbhanMma c b pos- kelid

Type of the family: Saga Ta luk Shtvm og a s l )

Joint Family SepårateFanmily
Number of family members:
Number of brothers:
Number of Sister:
The position of the child in family:
Elder Middle Younger
 3. Socio-economic background:
NoE aline
Father's profession:
Caole
Mother's profession:
Father's qualification:
Mother Qualification:
Home:
Own 2 Rent
Number of rooms in the house:
Home change over last five years:-N6
Cleaning of home: well m a n f a i n e d

Annual income of the family:-2l.O06

Social level:
Good ) Average Low
3. The environment of home and neighbours:
The environment of neighbours:
Dirty Good Best
Home and infrastructure:
Normal Good Best
>Family relationship with neighbours:
Normal 0
Good Best
5. About health:

The health of the

child:
AverageZ Infirm
The physieal
development of the child:
Eyes: Normal Defective O
Ears : Normal
Defective
Hands and legs: Normal Defective
Voice: Normal Defective
Sexual development:
Normal
Are there medicines
Abnormal0
taken from long time:
Yes
No
Blood group: t
 about disabilities:
6. Question

What are your disabilities?

mentol Aetakda/Pon heflh cp

How does it interfere you with learning?

ie givs Atsponse, Pntsrsled Jeah ntng but nol
a ble fo eaphesS
When did the impairment occur?

Why are you disabled:

Because of disease/diseases
Because of accident
Have you beendisabled since birth
I got many disabilities when I was year/s old
How do you feel aboutyour disability?
I's okay O
I am happY
Other answers:
an 6inse fo seaek fo
He altd nobhare
hts P44a4Por
What caused the impairment?
Accident at home . Accident while playing 0
Accident in school Accident due to fire
llness D

Do you take lot of medicines?

/UD
Are you sick a lot?

yes
How many times a year do you go to the doctor?
10 3 1ems
2
Does your disability make do get angry with other people?
No
Do you need special arrangement when attending class?

yes
 D o you have special requirements during your studies?
Yes
D o you need extratimein examination?
yes
Does your school support you with your disability?
YS
D o other people accept you and your disability?
Yes

Joft
Name and signthre
the student teacher Namu sigiature of the observer-