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Ho
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I
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15
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4
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Au
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20
26
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293
1
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2932
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r
t,
an
d
lim
ited
ac
ce
s
s
to
s
p
ec
ialized
s
er
v
ices
[
4
]
.
I
t
is
also
n
ec
ess
ar
y
to
tak
e
in
to
ac
c
o
u
n
t
th
e
u
n
d
e
r
d
ev
elo
p
ed
e
d
u
ca
tio
n
a
l
in
f
r
astru
ctu
r
e
f
o
r
teac
h
in
g
ch
i
ld
r
en
with
h
ea
r
in
g
im
p
air
m
e
n
ts
an
d
th
e
s
h
o
r
tag
e
o
f
s
ig
n
la
n
g
u
ag
e
s
p
ec
ialis
ts
[
6
]
.
C
h
ild
r
en
with
h
ea
r
in
g
im
p
air
m
en
ts
f
ac
e
lim
ited
co
m
m
u
n
icatio
n
d
u
e
to
a
lack
o
f
s
ig
n
lan
g
u
ag
e
e
d
u
ca
tio
n
,
wh
ich
in
cr
ea
s
es
th
e
r
is
k
o
f
s
o
cial
is
o
latio
n
f
o
r
th
em
an
d
t
h
e
ir
p
ar
en
ts
.
Desp
ite
o
v
er
all
d
ec
lin
es
in
ab
u
s
e
in
th
e
g
en
er
al
p
o
p
u
latio
n
,
th
ese
ch
ild
r
en
r
em
ain
at
h
ig
h
e
r
r
is
k
o
f
n
e
g
lect
an
d
m
is
tr
ea
tm
en
t [
7
].
C
o
n
tem
p
o
r
ar
y
r
esear
ch
in
d
ica
tes
th
at
in
Kaz
ak
h
s
tan
,
s
o
cial
s
u
p
p
o
r
t
m
ea
s
u
r
es
f
o
r
f
am
ilies
with
d
ea
f
ch
ild
r
en
in
cl
u
d
e
f
in
an
cial
ass
is
tan
ce
,
p
r
o
v
is
io
n
o
f
h
ea
r
in
g
a
id
s
an
d
co
c
h
lear
im
p
la
n
ts
f
r
ee
o
f
c
h
ar
g
e,
as
well
as
th
e
estab
lis
h
m
en
t
o
f
s
p
ec
ialized
s
ch
o
o
ls
an
d
ea
r
ly
in
ter
v
en
tio
n
ce
n
ter
s
[
8
]
,
[
9
]
.
Ho
we
v
er
,
th
e
ab
s
en
ce
o
f
a
co
m
p
r
eh
e
n
s
iv
e
ap
p
r
o
ac
h
to
th
e
is
s
u
e,
lo
w
s
er
v
ice
ac
ce
s
s
ib
ilit
y
,
an
d
lim
ited
o
p
p
o
r
tu
n
it
ies
f
o
r
p
r
o
f
ess
io
n
al
d
ev
elo
p
m
e
n
t
h
in
d
er
th
e
ef
f
e
ctiv
en
ess
o
f
th
ese
m
ea
s
u
r
es.
A
s
ig
n
if
ican
t
n
u
m
b
er
o
f
p
ar
en
ts
ex
p
er
ien
ce
d
if
f
icu
lties
in
f
in
d
i
n
g
in
f
o
r
m
a
tio
n
ab
o
u
t
av
ailab
le
s
er
v
ices
a
n
d
f
ac
e
b
ar
r
ier
s
to
r
ec
eiv
in
g
q
u
alif
ied
ass
is
tan
ce
.
Ag
ain
s
t
th
e
b
ac
k
d
r
o
p
o
f
th
e
g
lo
b
al
in
cr
ea
s
e
in
h
ea
lth
ca
r
e
s
p
en
d
in
g
,
p
o
liti
ca
l
an
d
ac
ad
em
i
c
d
eb
ates
r
eg
a
r
d
in
g
in
d
iv
id
u
al
a
n
d
co
llectiv
e
r
esp
o
n
s
ib
ilit
y
f
o
r
h
ea
lth
an
d
h
ea
lth
ca
r
e
ex
p
en
d
itu
r
es a
r
e
in
te
n
s
if
y
in
g
[
10
].
T
h
e
is
s
u
es
r
elate
d
to
s
o
cial
s
u
p
p
o
r
t
f
o
r
th
is
ca
teg
o
r
y
o
f
f
am
i
lies
in
clu
d
e
n
o
t
o
n
ly
in
ad
eq
u
a
te
f
u
n
d
in
g
an
d
s
taf
f
in
g
b
u
t
also
in
s
u
f
f
ici
en
t
co
n
s
id
er
atio
n
o
f
p
s
y
ch
o
lo
g
ical
asp
ec
ts
.
Par
en
ts
f
ac
in
g
t
h
e
d
ea
f
n
ess
o
f
th
eir
ch
ild
o
f
ten
ex
p
e
r
ien
ce
s
tr
ess
,
an
x
iety
,
an
d
lo
n
elin
ess
[
8
]
,
[
11
]
,
[
12
]
.
I
n
o
r
d
er
to
o
v
er
co
m
e
th
eir
em
o
tio
n
al
an
d
p
r
ac
tical
d
if
f
ic
u
lties
,
th
ey
r
eq
u
ir
e
n
o
t
o
n
ly
f
in
a
n
cial
ass
is
ta
n
ce
b
u
t
also
ac
ce
s
s
to
p
s
y
ch
o
lo
g
ical
s
u
p
p
o
r
t
an
d
p
r
o
f
ess
io
n
al
ad
v
ice
.
T
h
e
p
r
o
b
lem
with
th
e
s
tu
d
y
,
th
er
ef
o
r
e,
lies
in
th
e
d
is
cr
e
p
an
cy
b
etwe
en
ex
is
tin
g
s
o
cial
s
u
p
p
o
r
t
m
ea
s
u
r
es
f
o
r
h
ea
r
in
g
p
a
r
en
ts
r
aisi
n
g
d
ea
f
ch
ild
r
en
in
Kaz
ak
h
s
tan
an
d
th
e
ac
tu
al
co
m
p
lex
n
ee
d
s
o
f
th
ese
f
am
ilies
,
wh
ich
af
f
ec
ts
th
e
ef
f
ec
tiv
en
ess
o
f
in
teg
r
atin
g
d
ea
f
ch
ild
r
en
i
n
to
s
o
ciety
an
d
th
e
q
u
ality
o
f
life
o
f
th
eir
p
ar
e
n
ts
.
T
o
ad
d
r
ess
th
e
id
en
tifie
d
p
r
o
b
lem
,
th
e
s
tu
d
y
u
s
es
a
m
ix
ed
m
eth
o
d
(
s
u
r
v
ey
a
n
d
in
ter
v
iew)
,
allo
win
g
f
o
r
a
s
im
u
ltan
eo
u
s
s
tu
d
y
o
f
th
e
q
u
alitativ
e
ex
p
er
ie
n
ce
s
o
f
f
am
ilies
an
d
q
u
an
titativ
e
in
d
icato
r
s
o
f
th
e
av
ailab
ilit
y
an
d
ef
f
ec
tiv
e
n
ess
o
f
s
o
cial
s
u
p
p
o
r
t,
wh
ich
p
r
o
v
i
d
es
a
co
m
p
r
eh
e
n
s
iv
e
u
n
d
er
s
ta
n
d
in
g
o
f
th
e
n
ee
d
s
an
d
ch
allen
g
es o
f
p
a
r
en
ts
.
T
h
i
s
ar
ticle
co
n
tr
ib
u
tes to
th
e
f
ield
b
y
an
aly
zin
g
th
e
cu
r
r
e
n
t iss
u
es in
s
o
cial
s
u
p
p
o
r
t
f
o
r
h
ea
r
i
n
g
p
ar
e
n
ts
r
aisi
n
g
d
ea
f
ch
ild
r
en
an
d
p
r
o
p
o
s
in
g
s
p
ec
i
f
ic
s
o
lu
tio
n
s
to
th
ese
is
s
u
es
w
i
th
in
th
e
co
n
tex
t
o
f
Kaz
ak
h
s
tan
.
Pra
ctice
s
f
r
o
m
o
th
er
co
u
n
t
r
ies
wer
e
ex
am
in
ed
f
o
r
ad
a
p
tatio
n
to
th
e
co
n
d
iti
o
n
s
o
f
Kaz
ak
h
s
tan
.
T
h
e
s
tu
d
y
’
s
r
elev
a
n
ce
is
d
eter
m
in
ed
b
y
th
e
n
ee
d
to
im
p
r
o
v
e
th
e
q
u
ality
o
f
life
f
o
r
c
h
ild
r
en
with
s
p
ec
ial
ed
u
ca
tio
n
al
n
ee
d
s
an
d
th
eir
f
a
m
ilies
,
wh
ich
h
as
lo
n
g
-
ter
m
i
m
p
licatio
n
s
f
o
r
s
o
cial
an
d
e
d
u
ca
tio
n
al
in
teg
r
atio
n
.
T
h
e
f
in
d
in
g
s
o
f
th
is
s
tu
d
y
m
ay
s
er
v
e
as
a
f
o
u
n
d
atio
n
f
o
r
d
e
v
elo
p
in
g
n
ew
p
o
licies
aim
ed
at
s
u
p
p
o
r
tin
g
f
am
ilies
r
aisi
n
g
ch
ild
r
en
with
h
ea
r
in
g
im
p
air
m
en
ts
.
2.
L
I
T
E
R
AT
U
RE
R
E
VI
E
W
M
o
r
e
t
h
a
n
5
%
o
f
t
h
e
g
l
o
b
a
l
p
o
p
u
l
a
t
i
o
n
e
x
p
e
r
i
e
n
c
es
d
e
a
f
n
es
s
o
r
h
e
a
r
i
n
g
l
o
s
s
,
a
n
d
b
y
2
0
5
0
,
o
n
e
i
n
t
en
i
n
d
i
v
i
d
u
a
l
s
w
il
l
b
e
a
f
f
e
c
t
e
d
[
13
]
.
I
n
2
0
2
1
,
o
v
e
r
9
7
.
8
m
i
l
l
i
o
n
c
h
i
l
d
r
e
n
a
n
d
a
d
o
l
es
c
e
n
t
s
w
e
r
e
r
e
p
o
r
t
e
d
t
o
h
a
v
e
h
ea
r
in
g
lo
s
s
,
with
th
e
h
ig
h
est
b
u
r
d
e
n
o
b
s
er
v
ed
in
c
o
u
n
tr
ie
s
with
lo
w
an
d
lo
wer
-
m
id
d
le
s
o
cio
d
em
o
g
r
ap
h
i
c
in
d
ices
[
14
]
.
Data
f
r
o
m
n
e
o
n
atal
s
cr
ee
n
in
g
in
d
icate
th
at
e
v
en
in
r
eso
u
r
ce
-
lim
ited
s
ettin
g
s
,
h
ig
h
le
v
els
o
f
co
v
er
ag
e
ca
n
b
e
ac
h
iev
ed
:
i
n
J
o
r
d
an
,
f
o
r
ex
am
p
le,
th
e
s
cr
ee
n
in
g
co
v
er
ag
e
in
2
0
2
3
r
ea
ch
ed
9
9
.
4
%,
with
a
p
r
e
v
a
l
e
n
c
e
o
f
p
e
r
m
a
n
e
n
t
h
e
a
r
i
n
g
l
o
s
s
a
m
o
n
g
n
e
w
-
b
o
r
n
o
f
0
.
1
4
%
[
15
]
.
I
n
t
e
r
m
s
o
f
r
e
h
a
b
i
l
i
t
a
t
i
o
n
,
a
p
p
r
o
x
i
m
a
t
e
l
y
8
1
%
o
f
c
h
i
l
d
r
e
n
r
e
g
u
l
a
r
l
y
u
s
e
h
e
a
r
i
n
g
a
i
d
s
,
an
d
e
a
r
l
y
c
o
c
h
l
e
a
r
i
m
p
l
a
n
t
a
t
i
o
n
h
a
s
b
e
e
n
a
s
s
o
c
ia
t
e
d
w
i
t
h
b
e
t
te
r
l
a
n
g
u
a
g
e
o
u
t
c
o
m
e
s
,
u
n
d
e
r
s
c
o
r
i
n
g
t
h
e
c
r
i
t
i
c
al
i
m
p
o
r
t
a
n
c
e
o
f
t
i
m
e
l
y
i
n
te
r
v
e
n
t
i
o
n
f
o
r
e
f
f
e
c
t
i
v
e
a
u
d
i
t
o
r
y
an
d
lin
g
u
is
tic
d
ev
elo
p
m
e
n
t
[
16
]
,
[
17
]
.
As
9
6
%
o
f
d
ea
f
ch
il
d
r
en
ar
e
b
o
r
n
to
h
ea
r
in
g
p
ar
en
t
s
[
3
]
,
wh
o
ty
p
ically
do
n
o
t
a
n
ticip
ate
r
aisi
n
g
a
d
ea
f
ch
ild
,
it
is
v
ital
th
at
f
am
ilies
b
en
ef
it
f
r
o
m
a
r
an
g
e
o
f
s
u
p
p
o
r
t
m
ec
h
a
n
is
m
s
an
d
in
ter
v
en
tio
n
s
.
I
n
th
is
co
n
tex
t,
s
u
p
p
o
r
t
ca
n
b
est
b
e
d
escr
ib
ed
as
en
co
u
r
ag
em
en
t
,
ass
is
tan
ce
,
an
d
em
p
o
wer
m
en
t
d
esig
n
ed
to
f
o
s
ter
s
u
s
tain
ab
le
s
u
cc
ess
an
d
co
n
f
id
en
ce
am
o
n
g
h
ea
r
in
g
p
ar
e
n
ts
an
d
th
eir
d
e
af
ch
ild
r
en
.
Fam
ilies
r
aisi
n
g
d
ea
f
ch
ild
r
e
n
r
eq
u
ir
e
s
p
ec
ial
atten
tio
n
f
r
o
m
b
o
th
th
e
s
tate
an
d
s
o
ciet
y
.
I
n
th
is
co
n
tex
t,
s
o
cial
s
u
p
p
o
r
t
s
er
v
es
as
a
cr
u
cial
to
o
l
f
o
r
e
n
h
an
ci
n
g
th
e
q
u
ality
o
f
life
f
o
r
s
u
c
h
f
am
ilies
,
en
s
u
r
in
g
th
eir
s
o
cial
ad
a
p
tatio
n
,
an
d
f
a
cilitatin
g
th
eir
in
teg
r
atio
n
in
t
o
s
o
ciety
[
18
]
.
T
h
e
lack
o
f
a
d
eq
u
ate
s
u
p
p
o
r
t
ca
n
lead
to
s
ig
n
if
ican
t
d
if
f
ic
u
lties
,
as
o
b
s
er
v
ed
in
No
r
th
er
n
I
r
ela
n
d
,
wh
er
e
a
c
h
ild
ca
r
e
p
o
licy
h
as
b
ee
n
ab
s
en
t
f
o
r
o
v
er
a
d
ec
ad
e
[
19
]
.
I
n
co
n
tr
a
s
t,
in
v
estme
n
ts
in
th
e
ex
p
an
s
i
o
n
o
f
s
o
cial
s
er
v
ices
in
E
n
g
lan
d
,
Sco
tlan
d
,
an
d
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
J
E
v
al
&
R
es E
d
u
c
I
SS
N:
2252
-
8
8
2
2
S
o
cia
l su
p
p
o
r
t fo
r
h
ea
r
in
g
p
a
r
en
ts
r
a
is
in
g
d
ea
f c
h
ild
r
en
in
K
a
z
a
kh
s
ta
n
:
…
(
Zh
a
n
s
a
ya
J
a
n
p
eiso
va
)
2933
W
ales
h
av
e
allo
wed
p
ar
en
ts
t
o
r
ec
eiv
e
f
in
an
cial
s
u
p
p
o
r
t
to
co
v
er
ch
ild
ca
r
e
ex
p
en
s
es
[
19
]
.
I
n
I
r
an
,
th
er
e
is
also
a
p
o
s
itiv
e
an
d
s
ig
n
if
ican
t
r
elatio
n
s
h
ip
b
etwe
en
s
o
ci
al
s
u
p
p
o
r
t
an
d
th
e
q
u
ality
o
f
life
o
f
p
ar
en
ts
o
f
ch
ild
r
en
with
d
is
ab
ilit
ies [
20
].
So
cial
s
u
p
p
o
r
t
m
ea
s
u
r
es
f
o
r
p
ar
en
ts
o
f
d
ea
f
ch
ild
r
en
v
ar
y
f
r
o
m
c
o
u
n
tr
y
t
o
co
u
n
tr
y
a
n
d
r
e
f
lect
d
if
f
er
en
t
ap
p
r
o
ac
h
es
to
th
e
in
clu
s
io
n
an
d
s
u
p
p
o
r
t
o
f
f
am
ilies
with
ch
ild
r
en
wh
o
h
av
e
h
ea
r
in
g
im
p
air
m
en
ts
.
T
h
e
Un
ited
Natio
n
s
C
o
n
v
e
n
tio
n
o
n
th
e
R
ig
h
ts
o
f
Per
s
o
n
s
with
Dis
ab
ilit
ie
s
em
p
h
asizes
th
e
r
esp
o
n
s
ib
ilit
y
o
f
s
tates
to
id
en
tify
an
d
elim
in
a
te
b
ar
r
ier
s
to
th
e
e
x
er
cise
o
f
th
e
r
ig
h
ts
o
f
p
eo
p
le
with
d
is
ab
ilit
ies
[
21
]
.
T
h
is
in
clu
d
es
cr
ea
tin
g
a
p
o
liti
ca
l,
leg
al,
s
o
cial,
an
d
p
h
y
s
ical
en
v
ir
o
n
m
e
n
t
th
at
s
u
p
p
o
r
ts
th
e
f
u
ll
in
teg
r
atio
n
an
d
p
ar
ticip
atio
n
o
f
in
d
iv
i
d
u
als with
d
is
ab
ilit
ies,
in
clu
d
in
g
d
ea
f
ch
ild
r
en
an
d
th
eir
f
am
ilies
.
I
n
th
e
Un
ited
Kin
g
d
o
m
,
th
e
e
q
u
ality
ac
t
p
r
o
tects
th
e
r
ig
h
ts
o
f
in
d
iv
i
d
u
als
with
d
is
ab
ilit
ies
,
in
clu
d
in
g
ch
ild
r
en
with
h
ea
r
i
n
g
lo
s
s
.
T
h
is
law
p
r
o
tects
ag
ain
s
t
d
is
cr
i
m
in
atio
n
in
ar
ea
s
s
u
ch
as
em
p
lo
y
m
en
t,
ed
u
ca
tio
n
,
an
d
in
ter
ac
tio
n
s
with
g
o
v
e
r
n
m
en
t
s
er
v
ices
[
22
]
,
[
23
]
.
Fa
m
ilies
with
ch
ild
r
en
wh
o
h
a
v
e
s
p
ec
ial
n
ee
d
s
ca
n
ac
ce
s
s
v
ar
io
u
s
f
o
r
m
s
o
f
s
u
p
p
o
r
t,
in
clu
d
in
g
f
in
a
n
cial
b
en
ef
its
,
s
p
ec
ialized
ed
u
ca
tio
n
,
an
d
m
ed
ical
s
er
v
ices.
R
esear
ch
in
C
o
lo
m
b
ia
h
ig
h
li
g
h
ts
th
e
im
p
o
r
tan
ce
o
f
m
u
lt
id
im
en
s
io
n
al
s
o
cial
s
u
p
p
o
r
t,
in
clu
d
in
g
f
in
an
cial,
e
d
u
ca
tio
n
al,
an
d
p
s
y
ch
o
lo
g
ical
ass
is
tan
ce
[
24
]
.
P
s
y
ch
o
lo
g
ical
s
u
p
p
o
r
t
ca
n
h
el
p
p
ar
e
n
ts
o
f
d
ea
f
o
r
h
ar
d
-
of
-
h
ea
r
in
g
ch
ild
r
e
n
c
o
p
e
with
p
ar
en
tal
s
tr
ess
[
11
]
,
[
12
]
.
Ho
wev
er
,
f
am
ilies
o
f
ten
lack
s
u
f
f
icien
t
in
f
o
r
m
atio
n
an
d
r
eso
u
r
ce
s
to
ef
f
ec
tiv
ely
s
u
p
p
o
r
t
th
eir
ch
ild
r
en
,
f
ac
in
g
b
ar
r
ier
s
s
u
ch
as
li
m
ited
k
n
o
wled
g
e,
in
ac
ce
s
s
ib
le
s
er
v
ices,
an
d
d
if
f
i
cu
lties
n
av
ig
atin
g
th
e
h
ea
lth
c
ar
e
an
d
e
d
u
ca
tio
n
s
y
s
tem
s
[
4
]
.
I
n
Switzer
lan
d
,
ch
ild
r
en
with
h
ea
r
in
g
lo
s
s
h
av
e
th
e
o
p
p
o
r
tu
n
ity
to
atten
d
r
eg
u
lar
s
ch
o
o
ls
[
25
]
,
[
26
]
.
T
h
is
h
as
b
ee
n
m
ad
e
p
o
s
s
ib
le
th
r
o
u
g
h
th
e
ef
f
o
r
ts
o
f
o
r
g
a
n
izatio
n
s
s
u
ch
as
th
e
Sw
is
s
As
s
o
ciatio
n
o
f
th
e
Dea
f
,
wh
ich
ad
v
o
ca
tes
f
o
r
th
e
in
t
eg
r
atio
n
o
f
d
ea
f
ch
ild
r
en
in
t
o
th
e
g
en
er
al
ed
u
ca
tio
n
s
y
s
tem
.
Desp
ite
th
ese
o
p
p
o
r
tu
n
ities
,
th
e
ch
allen
g
e
r
em
ain
s
to
en
s
u
r
e
th
at
d
ea
f
s
t
u
d
en
ts
f
u
lly
u
n
d
e
r
s
tan
d
th
e
lear
n
in
g
p
r
o
ce
s
s
an
d
ac
tiv
ely
p
ar
ticip
ate
in
it.
I
n
t
h
e
Un
ited
States
,
th
er
e
is
als
o
an
estab
lis
h
ed
s
y
s
tem
o
f
ea
r
ly
in
ter
v
en
tio
n
an
d
s
u
p
p
o
r
t
f
o
r
d
ea
f
ch
ild
r
e
n
.
Sp
ec
ial
s
ch
o
o
ls
an
d
p
r
o
g
r
am
s
d
ed
icate
d
to
th
e
d
ev
elo
p
m
en
t
an
d
ed
u
ca
tio
n
o
f
ch
ild
r
en
with
h
ea
r
in
g
l
o
s
s
h
av
e
b
ee
n
im
p
lem
e
n
ted
f
r
o
m
ea
r
ly
ch
ild
h
o
o
d
[
27
].
A
s
tu
d
y
c
o
n
d
u
cted
i
n
C
h
in
a
in
d
icate
s
th
at
s
o
cial
s
u
p
p
o
r
t
r
ec
eiv
ed
b
y
f
am
ilies
o
f
c
h
ild
r
en
with
s
p
ec
ial
n
ee
d
s
is
r
elativ
ely
lim
i
ted
[
28
]
.
T
h
e
au
th
o
r
s
n
o
te
th
a
t
th
er
e
ar
e
r
eg
io
n
al
d
if
f
er
en
ce
s
in
s
o
cial
s
u
p
p
o
r
t,
d
ep
en
d
i
n
g
o
n
f
ac
to
r
s
s
u
ch
as t
h
e
p
ar
en
ts
’
lev
el
o
f
ed
u
ca
tio
n
,
m
o
n
th
ly
f
am
ily
in
c
o
m
e,
f
am
il
y
ty
p
e,
a
n
d
th
e
a
g
e
o
f
th
e
ch
ild
r
en
,
am
o
n
g
o
th
er
s
.
Ho
wev
er
,
n
o
s
ig
n
i
f
ican
t
d
if
f
e
r
en
ce
s
in
s
o
cial
s
u
p
p
o
r
t
wer
e
f
o
u
n
d
b
ased
o
n
t
h
e
f
am
ily
’
s
p
lace
o
f
r
esid
en
ce
,
p
a
r
en
tal
ag
e,
ch
ild
’
s
g
en
d
e
r
,
o
r
t
y
p
e
o
f
d
is
ab
ilit
y
.
I
n
Kaz
ak
h
s
tan
,
s
o
cial
s
u
p
p
o
r
t
f
o
r
f
am
ilies
is
co
n
s
id
er
ed
a
k
ey
in
s
tr
u
m
en
t
o
f
p
o
licy
.
T
h
e
co
n
ce
p
t
o
f
leg
al
p
o
licy
in
Kaz
ak
h
s
tan
em
p
h
asizes
th
e
n
ee
d
to
u
tili
ze
in
t
er
n
atio
n
al
leg
al
in
s
titu
tio
n
s
to
s
af
eg
u
ar
d
n
atio
n
al
in
ter
ests
,
in
clu
d
in
g
s
o
cial
in
t
er
ests
[
29
]
.
T
h
e
g
o
v
er
n
m
e
n
t
r
ec
o
g
n
izes
its
r
esp
o
n
s
ib
ilit
y
t
o
en
s
u
r
e
m
i
n
im
u
m
s
o
cial
s
tan
d
ar
d
s
,
as
r
ef
lecte
d
in
th
e
lo
n
g
-
ter
m
s
tr
ateg
ic
d
e
v
e
lo
p
m
en
t
p
lan
“
Kaz
ak
h
s
tan
2
0
5
0
”
[
30
]
.
Ho
wev
e
r
,
d
esp
ite
s
ig
n
if
ican
t
p
r
o
g
r
ess
in
im
p
r
o
v
i
n
g
s
o
cio
-
ec
o
n
o
m
ic
co
n
d
itio
n
s
,
p
o
v
er
ty
,
a
n
d
v
u
ln
er
ab
ilit
y
r
em
ai
n
s
er
io
u
s
is
s
u
es
f
o
r
m
an
y
f
a
m
ilies
.
I
n
ter
n
atio
n
al
s
ch
o
lar
s
ar
g
u
e
th
at
s
o
cial
ca
p
ital
h
as
a
d
ir
ec
t
an
d
p
o
s
itiv
e
im
p
ac
t o
n
im
p
r
o
v
i
n
g
th
e
q
u
ali
ty
o
f
life
f
o
r
in
d
iv
id
u
als [
31
].
R
ec
en
t
s
tu
d
ies
f
u
r
th
er
r
ev
ea
l
th
at,
d
esp
ite
ad
v
an
ce
s
i
n
s
cr
ee
n
in
g
,
f
am
ilies
o
f
ten
en
co
u
n
ter
d
if
f
icu
lties
in
n
av
ig
atin
g
am
o
n
g
d
iv
e
r
s
e
in
ter
v
en
tio
n
o
p
tio
n
s
an
d
co
m
m
u
n
icatio
n
ap
p
r
o
ac
h
es
[
32
]
.
At
th
e
s
am
e
tim
e,
an
aly
s
es
o
f
th
e
m
en
tal
h
ea
lth
an
d
q
u
ality
o
f
lif
e
o
f
ch
ild
r
en
an
d
ad
o
lescen
ts
with
h
ea
r
in
g
lo
s
s
h
av
e
h
ig
h
li
g
h
ted
v
u
ln
er
ab
ilit
i
es
in
th
e
em
o
tio
n
al
d
o
m
ai
n
,
w
h
ich
ar
e
d
ir
ec
tly
in
f
lu
en
ce
d
b
y
th
e
av
ailab
ilit
y
o
f
co
m
m
u
n
icatio
n
s
u
p
p
o
r
t:
th
e
co
m
b
in
ed
u
s
e
o
f
h
ea
r
in
g
tech
n
o
lo
g
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(
h
ea
r
in
g
aid
s
o
r
im
p
lan
ts
)
an
d
au
d
ito
r
y
-
v
er
b
al
th
er
ap
y
s
u
b
s
tan
tially
en
h
an
ce
s
in
teg
r
atio
n
o
u
tco
m
es
[
33
]
.
A
s
y
s
tem
atic
r
ev
iew
o
f
s
o
cial
p
ar
ticip
atio
n
d
em
o
n
s
tr
ated
th
at
ch
ild
r
e
n
with
au
d
ito
r
y
p
r
o
s
th
eses
ex
h
ib
it
m
ar
k
ed
ly
h
ig
h
er
lev
els
o
f
in
teg
r
atio
n
;
h
o
wev
e
r
,
s
o
cial
b
ar
r
ier
s
p
er
s
is
t
ev
en
wh
en
s
u
ch
tech
n
o
lo
g
ies
ar
e
em
p
lo
y
ed
[
34
]
.
Mo
r
e
o
v
er
,
c
h
ild
r
en
w
h
o
r
ec
eiv
e
co
m
p
r
eh
e
n
s
iv
e
ea
r
ly
in
ter
v
en
tio
n
d
em
o
n
s
tr
ate
s
o
cial
well
-
b
ein
g
co
m
p
a
r
ab
le
to
th
at
o
f
t
h
eir
p
ee
r
s
with
o
u
t
h
ea
r
in
g
lo
s
s
,
u
n
d
er
s
co
r
in
g
t
h
e
ef
f
ec
tiv
en
ess
o
f
m
u
ltid
is
cip
lin
ar
y
p
r
o
g
r
a
m
s
[
35
]
.
Simu
ltan
eo
u
s
ly
,
r
ev
iews
o
f
p
ar
en
tal
p
s
y
ch
o
s
o
cial
s
tatu
s
h
av
e
d
o
cu
m
e
n
ted
s
ig
n
if
ican
t
s
tr
ess
lev
els,
wh
ich
ar
e
f
r
eq
u
en
tly
u
n
d
er
esti
m
ated
with
in
ex
is
tin
g
s
u
p
p
o
r
t
s
y
s
te
m
s
[
36
]
.
T
a
k
en
to
g
eth
er
,
c
o
n
tem
p
o
r
ar
y
r
esear
ch
c
o
n
s
is
ten
tly
em
p
h
asizes
th
at
ef
f
ec
tiv
e
s
u
p
p
o
r
t
f
o
r
ch
ild
r
e
n
with
h
ea
r
in
g
lo
s
s
an
d
th
eir
f
am
ilies
r
eq
u
ir
es
th
e
in
teg
r
atio
n
o
f
ea
r
ly
d
iag
n
o
s
is
,
tech
n
o
lo
g
ical
an
d
th
er
ap
e
u
tic
in
ter
v
en
tio
n
s
,
an
d
c
o
m
p
r
e
h
en
s
iv
e
s
o
cio
-
p
s
y
ch
o
lo
g
ical
p
r
o
g
r
a
m
s
.
Desp
ite
ex
ten
s
iv
e
in
ter
n
atio
n
al
r
esear
ch
,
th
er
e
is
a
lack
o
f
em
p
ir
ic
al
d
ata
o
n
th
e
av
ailab
ilit
y
,
q
u
ality
,
an
d
r
eg
io
n
al
d
if
f
er
en
ce
s
in
s
o
cial
s
u
p
p
o
r
t
f
o
r
f
a
m
ilies
with
ch
ild
r
en
wi
th
h
ea
r
in
g
im
p
air
m
e
n
ts
in
K
az
ak
h
s
tan
,
cr
ea
tin
g
a
s
ig
n
if
ican
t r
esear
ch
g
a
p
.
2
.
1
.
“
K
a
za
k
hs
t
a
n
-
2
0
5
0
”
dev
el
o
pm
ent
pla
n
T
h
e
“
Kaz
ak
h
s
tan
2
0
5
0
”
s
tr
ateg
ic
d
ev
elo
p
m
e
n
t
p
lan
o
u
tlin
es
m
ea
s
u
r
es
to
im
p
r
o
v
e
s
o
cial
p
r
o
tectio
n
f
o
r
v
u
ln
e
r
ab
le
p
o
p
u
latio
n
s
,
in
clu
d
in
g
ch
ild
r
e
n
with
s
p
ec
ial
ed
u
ca
tio
n
al
n
ee
d
s
.
T
h
e
d
o
c
u
m
en
t
id
en
tifie
s
k
ey
ar
ea
s
o
f
wo
r
k
in
th
is
r
eg
ar
d
:
cr
ea
tin
g
a
n
ac
ce
s
s
ib
le
ed
u
ca
tio
n
al
en
v
ir
o
n
m
e
n
t,
d
e
v
el
o
p
in
g
a
n
in
clu
s
iv
e
ed
u
ca
tio
n
s
y
s
tem
,
an
d
p
r
o
v
i
d
in
g
s
p
ec
ialized
s
o
cial
s
er
v
ices
to
f
am
ilies
r
aisi
n
g
ch
ild
r
en
with
d
is
ab
ilit
ies.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
SS
N
:
2
2
5
2
-
8
8
2
2
I
n
t
J
E
v
al
&
R
es E
d
u
c
,
Vo
l
.
15
,
No
.
4
,
Au
g
u
s
t
20
26
:
293
1
-
2
9
4
5
2934
Var
io
u
s
m
ea
s
u
r
es
ar
e
b
ein
g
im
p
lem
en
ted
as
p
ar
t
o
f
th
i
s
s
tr
ateg
y
.
I
n
p
ar
ticu
lar
,
ch
i
ld
r
en
with
h
ea
r
in
g
im
p
air
m
en
ts
ar
e
b
ein
g
i
n
teg
r
ated
in
to
g
e
n
er
al
e
d
u
ca
tio
n
th
r
o
u
g
h
th
e
cr
ea
tio
n
o
f
s
p
ec
i
alize
d
class
es,
th
e
tr
ain
in
g
o
f
s
ig
n
la
n
g
u
a
g
e
tea
ch
er
s
,
an
d
th
e
in
tr
o
d
u
ctio
n
o
f
m
o
d
e
r
n
tech
n
o
lo
g
ies
to
en
h
an
ce
ed
u
ca
tio
n
al
q
u
ality
.
Ad
d
itio
n
ally
,
t
h
e
p
la
n
in
clu
d
es
p
r
o
g
r
am
s
f
o
r
tr
ai
n
in
g
s
p
ec
ialis
ts
wo
r
k
in
g
in
th
e
f
ield
s
o
f
s
p
ee
ch
th
er
ap
y
an
d
th
e
ed
u
ca
tio
n
o
f
th
e
d
ea
f
,
wh
ich
s
h
o
u
ld
co
n
tr
ib
u
te
to
m
o
r
e
e
f
f
ec
tiv
e
r
eh
a
b
ilit
atio
n
an
d
s
o
cial
ad
ap
tatio
n
o
f
c
h
ild
r
en
.
Fin
a
n
cial
s
u
p
p
o
r
t
f
o
r
f
am
ilies
r
em
ain
s
a
k
ey
f
o
cu
s
,
in
clu
d
in
g
s
u
b
s
id
ies
an
d
tax
b
en
ef
its
.
T
h
e
ac
ce
s
s
ib
ilit
y
o
f
s
o
cial
s
er
v
ices
is
b
ein
g
ex
p
an
d
ed
,
s
u
ch
as
p
s
y
ch
o
lo
g
ical
ass
is
tan
ce
,
p
ar
en
t
co
u
n
s
ellin
g
,
an
d
p
r
o
v
id
in
g
c
h
i
ld
r
en
with
h
ea
r
in
g
im
p
air
m
e
n
ts
with
th
e
n
ec
ess
ar
y
tech
n
ical
d
ev
ices,
in
clu
d
in
g
h
ea
r
in
g
aid
s
a
n
d
o
t
h
er
ass
is
tiv
e
d
ev
ices.
So
m
e
o
f
th
e
m
ea
s
u
r
es
b
ein
g
i
m
p
lem
en
ted
h
av
e
h
a
d
a
p
o
s
itiv
e
im
p
ac
t.
Fo
r
ex
am
p
le,
th
e
tr
ain
in
g
o
f
s
ig
n
lan
g
u
ag
e
teac
h
er
s
an
d
th
e
cr
ea
tio
n
o
f
s
p
ec
ialized
class
es
im
p
r
o
v
e
th
e
lear
n
in
g
c
o
n
d
itio
n
s
f
o
r
c
h
ild
r
en
with
h
ea
r
in
g
im
p
air
m
e
n
ts
,
wh
ile
f
in
an
cial
s
u
p
p
o
r
t
in
th
e
f
o
r
m
o
f
s
u
b
s
id
ies
an
d
tax
b
en
e
f
its
h
elp
s
r
ed
u
ce
th
e
f
i
n
a
n
c
ial
b
u
r
d
e
n
o
n
f
a
m
il
ies
[
37
]
.
H
o
w
e
v
e
r
,
a
n
a
n
al
y
s
is
o
f
ex
is
ti
n
g
p
r
o
g
r
am
s
r
e
v
e
als
s
ig
n
i
f
ic
a
n
t
is
s
u
es.
Fi
r
s
t
an
d
f
o
r
e
m
o
s
t,
in
a
d
e
q
u
at
e
f
u
n
d
in
g
r
esu
lts
i
n
c
h
il
d
r
e
n
r
ec
ei
v
i
n
g
l
o
w
-
q
u
a
lit
y
h
e
ar
i
n
g
a
id
s
,
as
m
o
r
e
e
x
p
en
s
iv
e
a
n
d
ef
f
e
cti
v
e
d
ev
ices
r
em
ai
n
i
n
ac
c
ess
ib
le
d
u
e
t
o
b
u
d
g
eta
r
y
c
o
n
s
t
r
ai
n
ts
.
A
d
d
iti
o
n
a
ll
y
,
th
e
n
ee
d
f
o
r
co
m
p
r
eh
e
n
s
i
v
e
p
s
y
ch
o
-
p
e
d
ag
o
g
ical
s
u
p
p
o
r
t,
wh
ich
p
lay
s
a
k
ey
r
o
le
in
th
e
ad
ap
tatio
n
an
d
d
ev
elo
p
m
en
t
o
f
ch
ild
r
en
,
r
em
ai
n
s
u
n
m
et.
Fu
r
th
e
r
ch
allen
g
es a
r
is
e
f
r
o
m
t
h
e
u
n
e
v
en
d
is
tr
ib
u
tio
n
o
f
s
o
cial
s
er
v
ices a
n
d
lim
ited
ac
ce
s
s
.
2
.
2
.
P
ro
blem
s
t
a
t
e
m
ent
T
h
e
s
tu
d
y
d
r
aws
o
n
s
o
cial
s
u
p
p
o
r
t
th
eo
r
y
,
d
is
ab
ilit
y
r
esear
ch
,
an
d
f
a
m
ily
s
y
s
tem
s
th
eo
r
y
,
wh
ich
allo
ws
u
s
to
v
iew
th
e
f
am
ily
as
a
h
o
lis
tic
s
y
s
tem
an
d
as
s
es
s
th
e
im
p
ac
t
o
f
s
o
cial
s
u
p
p
o
r
t
o
n
its
well
-
b
ein
g
[
11
]
,
[
12
]
,
[
38
]
.
T
h
is
co
n
ce
p
t
u
al
f
r
am
ewo
r
k
d
ef
in
es
th
e
k
e
y
r
esear
ch
q
u
esti
o
n
s
:
th
e
a
v
ailab
ilit
y
,
q
u
ality
,
a
n
d
ad
eq
u
ac
y
o
f
s
o
cial
s
u
p
p
o
r
t
f
o
r
h
ea
r
in
g
p
ar
e
n
ts
o
f
d
ea
f
ch
ild
r
en
in
Kaz
ak
h
s
tan
an
d
th
e
d
if
f
i
cu
lties
th
ey
f
ac
e
in
o
b
tain
in
g
it.
T
h
e
aim
o
f
th
is
r
esear
ch
is
to
an
aly
ze
th
e
ex
p
er
ien
ce
s
o
f
h
ea
r
in
g
p
ar
e
n
ts
r
ais
in
g
d
ea
f
ch
ild
r
en
in
Kaz
ak
h
s
tan
in
r
ec
eiv
i
n
g
s
o
ci
al
ass
is
tan
ce
.
T
h
e
s
tu
d
y
f
o
cu
s
es
o
n
ev
alu
atin
g
t
h
e
ac
ce
s
s
ib
ilit
y
,
q
u
ality
,
a
n
d
ad
eq
u
ac
y
o
f
ex
is
tin
g
s
o
cial
s
u
p
p
o
r
t
m
ea
s
u
r
es,
as
well
as
i
d
en
tify
in
g
th
e
d
if
f
icu
lties
f
am
ilies
en
co
u
n
ter
in
ac
ce
s
s
in
g
ass
is
tan
ce
,
in
clu
d
i
n
g
th
e
s
h
o
r
tag
e
o
f
av
ailab
le
s
er
v
ices,
th
eir
u
n
ev
e
n
d
is
tr
i
b
u
tio
n
,
an
d
lim
ited
ac
ce
s
s
.
T
h
e
o
b
jectiv
es
o
f
th
e
s
tu
d
y
wer
e
as:
i)
t
o
an
aly
ze
th
e
ex
p
er
ien
ce
s
o
f
f
am
ilies
in
r
ec
eiv
in
g
s
o
cial
ass
is
tan
ce
;
ii)
t
o
ex
am
in
e
th
e
ac
ce
s
s
ib
ilit
y
,
q
u
ality
,
an
d
ad
eq
u
ac
y
o
f
s
o
cial
s
u
p
p
o
r
t
m
ea
s
u
r
es
f
o
r
f
am
ilies
;
iii)
t
o
a
n
aly
ze
t
h
e
d
if
f
icu
lti
es
en
co
u
n
ter
ed
in
r
ec
eiv
in
g
s
o
cial
ass
is
tan
ce
;
an
d
i
v
)
a
n
aly
ze
th
e
s
o
cio
-
d
em
o
g
r
a
p
h
ic
ch
ar
ac
ter
is
tics
o
f
r
esp
o
n
d
en
ts
t
o
c
o
m
p
ar
e
in
d
i
ca
to
r
s
o
f
ac
ce
s
s
to
s
o
cial
s
er
v
ices
an
d
awa
r
e
n
ess
o
f
p
r
o
g
r
am
s
.
3.
M
E
T
H
O
D
3
.
1
.
Study
des
ig
n
A
m
ix
ed
m
eth
o
d
s
ap
p
r
o
a
ch
was
ch
o
s
en
f
o
r
th
is
s
tu
d
y
.
A
co
n
v
er
g
e
n
t
m
ix
ed
-
m
eth
o
d
s
ap
p
r
o
ac
h
was
u
s
ed
,
in
wh
ich
q
u
alitativ
e
an
d
q
u
an
titativ
e
d
ata
wer
e
c
o
lle
cted
an
d
an
al
y
ze
d
in
p
ar
allel,
th
en
co
m
b
in
ed
to
p
r
o
v
id
e
a
m
o
r
e
co
m
p
r
eh
en
s
i
v
e
u
n
d
er
s
tan
d
i
n
g
o
f
s
o
cial
s
u
p
p
o
r
t.
A
m
ix
ed
m
eth
o
d
s
ap
p
r
o
ac
h
was
ch
o
s
en
b
ec
au
s
e
it
allo
ws
f
o
r
a
co
m
b
in
atio
n
o
f
in
-
d
e
p
th
a
n
aly
s
is
o
f
p
ar
e
n
ts
’
ex
p
er
ien
ce
s
th
r
o
u
g
h
in
ter
v
iews
an
d
q
u
an
titativ
e
ass
ess
m
en
t
o
f
tr
e
n
d
s
th
r
o
u
g
h
s
u
r
v
ey
s
,
p
r
o
v
i
d
in
g
a
m
o
r
e
co
m
p
r
eh
en
s
iv
e
u
n
d
e
r
s
tan
d
in
g
o
f
s
o
cial
s
u
p
p
o
r
t.
T
h
is
m
eth
o
d
d
o
es
n
o
t
r
eq
u
ir
e
s
tr
ict
co
n
tr
o
l
o
v
er
all
v
ar
iab
les
an
d
is
th
er
ef
o
r
e
m
o
s
t
s
u
itab
le
f
o
r
s
o
cial
p
o
licy
r
esear
ch
,
wh
er
e
th
e
in
f
l
u
en
ce
o
f
v
ar
io
u
s
f
ac
to
r
s
ca
n
n
o
t b
e
f
u
lly
e
x
clu
d
ed
.
3
.
2
.
P
a
rt
icipa
nts
T
h
e
s
tu
d
y
in
v
o
lv
e
d
1
7
6
f
a
m
ilies
f
r
o
m
Kaz
ak
h
s
tan
,
wh
er
e
th
e
p
ar
en
ts
ar
e
h
ea
r
in
g
,
an
d
th
e
ch
ild
r
en
ar
e
d
ea
f
o
r
h
ar
d
o
f
h
ea
r
in
g
.
T
h
e
s
am
p
le
was
s
elec
ted
u
s
in
g
p
u
r
p
o
s
iv
e
s
am
p
lin
g
,
wh
i
ch
allo
wed
f
o
r
th
e
in
clu
s
io
n
o
f
th
e
m
o
s
t
r
elev
an
t
g
r
o
u
p
o
f
r
esp
o
n
d
e
n
ts
f
o
r
an
aly
zin
g
th
e
im
p
lem
e
n
tatio
n
o
f
s
o
cial
s
u
p
p
o
r
t
m
ea
s
u
r
es.
T
h
e
s
am
p
le
s
ize
(
1
7
6
f
am
ilies
)
was
d
eter
m
i
n
e
d
b
y
th
e
av
ailab
ilit
y
o
f
p
ar
ti
cip
an
ts
in
th
e
s
tu
d
y
r
eg
io
n
an
d
th
e
d
esire
f
o
r
r
ep
r
esen
tativ
en
ess
ac
r
o
s
s
citie
s
an
d
s
o
cio
ec
o
n
o
m
ic
g
r
o
u
p
s
,
y
ield
in
g
a
s
tatis
tical
p
o
wer
o
f
0
.
8
at
α
=0
.
0
5
to
d
ete
ct
m
ed
iu
m
ef
f
ec
ts
wh
en
an
aly
zin
g
b
etwe
en
-
g
r
o
u
p
d
if
f
er
en
ce
s
.
T
h
e
p
ar
ticip
an
t
r
ec
r
u
itm
e
n
t
p
r
o
ce
s
s
to
o
k
p
lace
in
s
ev
er
al
s
t
ag
es.
I
n
itially
,
a
lis
t
o
f
g
o
v
er
n
m
en
t
an
d
p
r
iv
ate
o
r
g
an
izatio
n
s
p
r
o
v
i
d
in
g
s
o
cial
s
u
p
p
o
r
t
s
er
v
ices
to
f
am
ilies
with
h
ar
d
-
of
-
h
ea
r
in
g
ch
ild
r
en
in
Kaz
ak
h
s
tan
was
co
m
p
iled
.
T
h
is
lis
t
in
clu
d
ed
s
p
ec
ialized
c
en
ter
s
,
b
o
a
r
d
in
g
s
ch
o
o
ls
,
p
u
b
l
ic
ass
o
ciatio
n
s
,
an
d
ch
ar
itab
le
o
r
g
an
izatio
n
s
.
I
n
f
o
r
m
atio
n
ab
o
u
t
th
e
s
tu
d
y
was
d
is
s
em
in
ated
th
r
o
u
g
h
th
ese
in
s
titu
tio
n
s
,
as
well
as
th
r
o
u
g
h
s
o
cial
m
ed
ia
an
d
o
n
lin
e
p
latf
o
r
m
s
tar
g
etin
g
p
ar
e
n
ts
o
f
c
h
ild
r
en
with
s
p
ec
ial
n
ee
d
s
,
s
u
ch
as
Face
b
o
o
k
,
I
n
s
tag
r
am
,
an
d
VKo
n
ta
k
te,
v
ia
th
em
atic
g
r
o
u
p
s
an
d
co
m
m
u
n
ities
f
o
r
p
ar
en
ts
o
f
h
ar
d
-
of
-
h
ea
r
i
n
g
ch
ild
r
e
n
.
T
ab
le
1
p
r
o
v
id
es m
o
r
e
d
etaile
d
in
f
o
r
m
atio
n
a
b
o
u
t th
e
p
ar
tici
p
an
ts
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
J
E
v
al
&
R
es E
d
u
c
I
SS
N:
2252
-
8
8
2
2
S
o
cia
l su
p
p
o
r
t fo
r
h
ea
r
in
g
p
a
r
en
ts
r
a
is
in
g
d
ea
f c
h
ild
r
en
in
K
a
z
a
kh
s
ta
n
:
…
(
Zh
a
n
s
a
ya
J
a
n
p
eiso
va
)
2935
Fam
ilies
w
is
h
in
g
to
p
ar
ticip
ate
u
n
d
er
wen
t
a
p
r
elim
in
a
r
y
s
elec
tio
n
b
ased
o
n
in
clu
s
io
n
an
d
ex
clu
s
io
n
cr
iter
ia.
T
h
e
r
ec
r
u
itm
en
t
p
r
o
c
ess
las
ted
two
m
o
n
th
s
,
r
esu
lt
in
g
in
a
r
ep
r
esen
tativ
e
s
am
p
le
o
f
1
7
6
f
am
ilies
.
T
o
en
s
u
r
e
g
e
o
g
r
ap
h
ical
d
iv
er
s
ity
am
o
n
g
th
e
r
esp
o
n
d
e
n
ts
,
th
e
s
tu
d
y
in
clu
d
ed
f
a
m
ilies
f
r
o
m
th
e
E
ast
Kaz
ak
h
s
tan
r
eg
io
n
o
f
Kaz
ak
h
s
tan
,
r
ep
r
esen
tin
g
b
o
th
lar
g
e
c
ities
an
d
s
m
aller
s
ettlem
en
ts
:
Ust
-
Kam
en
o
g
o
r
s
k
,
Sem
ey
,
Sh
ar
,
an
d
Ser
eb
r
y
an
s
k
.
T
h
e
s
am
p
le
co
m
p
r
is
ed
f
am
il
ies
with
v
ar
y
in
g
s
o
cio
-
ec
o
n
o
m
ic
s
tatu
s
,
d
if
f
er
en
t
lev
els o
f
p
ar
en
tal
ed
u
ca
tio
n
,
a
n
d
d
iv
e
r
s
e
ex
p
er
ien
ce
s
with
s
o
cial
s
u
p
p
o
r
t sy
s
tem
s
.
T
h
e
ag
e
o
f
th
e
ch
ild
r
en
was
also
tak
en
in
to
ac
co
u
n
t,
w
h
ich
allo
wed
f
o
r
th
e
a
n
aly
s
is
o
f
th
e
n
ee
d
s
an
d
ch
allen
g
es
p
ar
e
n
ts
f
ac
e
at
d
if
f
er
en
t
s
tag
es
o
f
ch
ild
d
e
v
elo
p
m
e
n
t.
I
n
clu
s
io
n
cr
iter
ia
f
o
r
th
e
s
am
p
l
e:
h
ea
r
in
g
p
ar
en
ts
r
aisi
n
g
h
ar
d
-
of
-
h
ea
r
in
g
o
r
d
ea
f
ch
ild
r
en
; p
er
m
an
e
n
t
r
esid
en
ce
with
in
Kaz
ak
h
s
tan
;
e
x
p
er
ie
n
c
e
ap
p
ly
in
g
f
o
r
s
o
cial
ass
is
tan
c
e
f
r
o
m
g
o
v
er
n
m
en
t
o
r
p
r
iv
ate
ag
en
cies.
E
x
clu
s
io
n
cr
iter
ia
f
r
o
m
th
e
s
am
p
le:
f
am
ilies
in
wh
ich
b
o
th
p
ar
en
ts
ar
e
d
ea
f
;
f
am
ilies
r
esid
in
g
o
u
ts
id
e
o
f
Kaz
ak
h
s
ta
n
; la
ck
o
f
e
x
p
er
ie
n
ce
with
s
o
cial
s
u
p
p
o
r
t sy
s
tem
s
.
T
ab
le
1
.
Data
o
n
p
ar
ticip
a
n
ts
P
a
r
a
me
t
e
r
U
st
-
K
a
me
n
o
g
o
r
sk
S
e
me
y
S
h
a
r
S
e
r
e
b
r
y
a
n
sk
To
t
a
l
G
e
n
d
e
r
M
e
n
18
11
33
7
6
9
(
3
8
%)
W
o
me
n
20
41
30
18
1
0
9
(
6
2
%)
P
a
r
e
n
t
s’
a
g
e
M
e
a
n
a
g
e
,
y
e
a
r
s
3
7
.
4
3
7
.
5
3
7
.
2
3
7
.
6
3
7
.
4
A
g
e
r
a
n
g
e
,
y
e
a
r
s
25
–
50
26
–
49
26
–
50
25
–
48
25
–
50
C
h
i
l
d
r
e
n
’
s a
g
e
w
i
t
h
h
e
a
r
i
n
g
i
m
p
a
i
r
me
n
t
s
M
e
a
n
a
g
e
,
y
e
a
r
s
9
.
1
8
.
7
8
.
9
9
.
3
9
.
0
A
g
e
r
a
n
g
e
,
y
e
a
r
s
3
–
16
3
–
15
4
–
16
3
–
16
3
–
16
To
t
a
l
n
u
m
b
e
r
38
52
63
23
1
7
6
3
.
3
.
Resea
rc
h t
o
o
ls
T
o
o
b
tain
q
u
alitativ
e
d
ata,
th
e
s
tu
d
y
em
p
lo
y
ed
s
em
i
-
s
tr
u
ct
u
r
ed
in
te
r
v
iews
an
d
q
u
esti
o
n
n
air
es
,
as
s
ee
n
in
T
a
b
le
2
.
T
h
e
i
n
ter
v
ie
w
q
u
esti
o
n
s
a
n
d
q
u
esti
o
n
n
ai
r
e
d
esig
n
wer
e
b
ased
o
n
s
o
cial
s
u
p
p
o
r
t
th
e
o
r
y
an
d
th
e
co
n
ce
p
t
o
f
f
am
ily
s
y
s
tem
s
.
T
h
is
allo
wed
to
e
x
am
in
e
th
e
in
f
lu
en
ce
o
f
d
if
f
er
en
t
f
o
r
m
s
o
f
s
u
p
p
o
r
t
(
f
in
an
cial
,
m
ed
ical,
ed
u
ca
tio
n
al,
an
d
p
s
y
ch
o
lo
g
ical)
o
n
f
am
ily
well
-
b
ein
g
an
d
th
e
d
y
n
am
i
cs
o
f
in
tr
a
-
f
am
ily
r
elatio
n
s
h
ip
s
; e
n
s
u
r
ed
a
d
ir
ec
t
lin
k
b
etwe
en
th
e
o
r
y
a
n
d
d
ata
c
o
llectio
n
.
T
h
e
s
em
i
-
s
tr
u
ctu
r
ed
in
ter
v
ie
ws
allo
wed
f
o
r
th
e
ex
p
lo
r
atio
n
o
f
th
e
ex
p
e
r
ien
ce
s
o
f
r
ec
ei
v
in
g
s
o
cial
s
u
p
p
o
r
t
an
d
th
e
id
e
n
tific
atio
n
o
f
s
u
b
jectiv
e
p
er
ce
p
tio
n
s
an
d
is
s
u
es
f
ac
ed
b
y
h
ea
r
in
g
p
ar
e
n
ts
o
f
d
ea
f
ch
ild
r
en
.
T
h
e
p
u
r
p
o
s
e
o
f
th
e
s
u
r
v
e
y
w
as
to
co
llect
q
u
an
titativ
e
d
ata
to
ass
es
s
th
e
ac
ce
s
s
ib
ilit
y
an
d
q
u
ality
o
f
s
o
cial
s
u
p
p
o
r
t
i
n
Kaz
ak
h
s
tan
.
T
h
e
s
e
m
i
-
s
tr
u
ctu
r
ed
in
ter
v
iews
h
elp
e
d
u
n
co
v
er
th
e
u
n
iq
u
e
e
x
p
er
ien
ce
s
an
d
c
h
allen
g
es
o
f
p
ar
ticip
an
ts
,
wh
ile
th
e
q
u
esti
o
n
n
air
es
p
r
o
v
id
e
d
s
tr
u
ctu
r
ed
in
f
o
r
m
atio
n
f
o
r
f
u
r
th
er
q
u
an
titativ
e
an
aly
s
is
.
All
1
7
6
r
esp
o
n
d
en
ts
p
ar
ticip
ated
in
th
e
s
u
r
v
e
y
.
Fo
r
th
e
q
u
alitativ
e
p
o
r
tio
n
(
in
ter
v
iews),
8
8
p
ar
e
n
ts
,
o
n
e
r
ep
r
esen
tativ
e
f
r
o
m
ea
c
h
f
am
i
ly
.
T
h
e
p
ar
en
t
wh
o
i
n
ter
ac
ted
m
o
s
t
f
r
eq
u
en
tly
with
th
e
s
o
c
ial
s
u
p
p
o
r
t
s
y
s
tem
an
d
was
ac
tiv
ely
in
v
o
lv
ed
in
d
o
cu
m
en
t
p
r
o
ce
s
s
in
g
an
d
s
er
v
ice
u
tili
za
tio
n
was
g
iv
en
p
r
ef
er
en
ce
.
I
f
b
o
th
p
ar
en
ts
h
ad
co
m
p
ar
a
b
le
ex
p
er
ien
ce
,
o
n
e
p
ar
ticip
an
t
was
s
elec
ted
at
r
an
d
o
m
.
Data
co
llectio
n
th
r
o
u
g
h
in
ter
v
iews
co
n
tin
u
ed
u
n
til
d
ata
s
atu
r
atio
n
was
r
ea
ch
ed
,
th
at
is
,
u
n
til
f
u
r
th
er
in
ter
v
iews
n
o
lo
n
g
er
r
ev
ea
le
d
s
ig
n
if
ican
t
n
ew
th
em
es
o
r
ca
teg
o
r
ies.
T
h
e
r
eliab
ilit
y
o
f
th
e
r
esear
ch
in
s
tr
u
m
e
n
ts
was
ass
e
s
s
ed
u
s
in
g
C
r
o
n
b
ac
h
’
s
alp
h
a
r
eliab
ilit
y
c
o
ef
f
icien
t.
T
h
is
co
ef
f
icien
t y
ield
ed
v
alu
es
o
f
0
.
8
1
f
o
r
th
e
q
u
e
s
tio
n
n
air
e
an
d
0
.
8
7
f
o
r
th
e
i
n
ter
v
iews,
in
d
icatin
g
h
ig
h
r
eliab
ilit
y
o
f
th
e
to
o
ls
u
s
ed
.
T
ab
le
2
.
Qu
esti
o
n
s
f
o
r
s
em
i
-
s
tr
u
ctu
r
ed
in
ter
v
iews
N
o
.
Q
u
e
st
i
o
n
s
1
W
h
a
t
t
y
p
e
s
o
f
s
o
c
i
a
l
s
u
p
p
o
r
t
h
a
v
e
y
o
u
r
e
c
e
i
v
e
d
w
h
i
l
e
r
a
i
si
n
g
a
c
h
i
l
d
w
i
t
h
a
h
e
a
r
i
n
g
i
m
p
a
i
r
me
n
t
?
2
H
o
w
a
c
c
e
ss
i
b
l
e
w
a
s
t
h
e
i
n
f
o
r
ma
t
i
o
n
a
b
o
u
t
a
v
a
i
l
a
b
l
e
t
y
p
e
s
o
f
s
o
c
i
a
l
a
ss
i
st
a
n
c
e
t
o
y
o
u
?
3
H
a
v
e
t
h
e
r
e
b
e
e
n
i
n
s
t
a
n
c
e
s w
h
e
n
y
o
u
w
e
r
e
u
n
a
b
l
e
t
o
r
e
c
e
i
v
e
s
o
c
i
a
l
su
p
p
o
r
t
d
u
e
t
o
l
a
c
k
o
f
i
n
f
o
r
m
a
t
i
o
n
o
r
o
t
h
e
r
o
b
st
a
c
l
e
s
?
4
W
h
a
t
d
i
f
f
i
c
u
l
t
i
e
s
d
o
y
o
u
mo
s
t
o
f
t
e
n
e
x
p
e
r
i
e
n
c
e
w
h
e
n
s
e
e
k
i
n
g
s
o
c
i
a
l
a
ss
i
st
a
n
c
e
?
5
H
o
w
t
i
me
l
y
w
a
s
t
h
e
s
o
c
i
a
l
s
u
p
p
o
r
t
p
r
o
v
i
d
e
d
t
o
y
o
u
?
6
W
h
a
t
r
o
l
e
d
o
s
p
e
c
i
a
l
i
z
e
d
i
n
st
i
t
u
t
i
o
n
s
a
n
d
o
r
g
a
n
i
z
a
t
i
o
n
s
p
l
a
y
i
n
p
r
o
v
i
d
i
n
g
s
o
c
i
a
l
s
u
p
p
o
r
t
t
o
y
o
u
r
f
a
m
i
l
y
?
7
H
o
w
w
o
u
l
d
y
o
u
a
ss
e
ss
t
h
e
p
r
o
f
e
ss
i
o
n
a
l
i
s
m
o
f
t
h
e
sp
e
c
i
a
l
i
st
s
y
o
u
e
n
c
o
u
n
t
e
r
e
d
w
h
e
n
r
e
c
e
i
v
i
n
g
so
c
i
a
l
s
u
p
p
o
r
t
?
8
W
h
i
c
h
f
o
r
ms
o
f
s
u
p
p
o
r
t
(
f
i
n
a
n
c
i
a
l
,
p
s
y
c
h
o
l
o
g
i
c
a
l
,
e
d
u
c
a
t
i
o
n
a
l
)
h
a
v
e
b
e
e
n
mo
st
si
g
n
i
f
i
c
a
n
t
f
o
r
y
o
u
r
f
a
mi
l
y
?
9
D
o
y
o
u
c
o
n
si
d
e
r
t
h
e
a
ss
i
st
a
n
c
e
p
r
o
v
i
d
e
d
t
o
b
e
s
u
f
f
i
c
i
e
n
t
t
o
m
e
e
t
y
o
u
r
f
a
mi
l
y
’
s
n
e
e
d
s?
W
h
y
?
10
W
h
a
t
c
h
a
n
g
e
s
o
r
i
mp
r
o
v
e
me
n
t
s
d
o
y
o
u
b
e
l
i
e
v
e
a
r
e
n
e
c
e
ss
a
r
y
i
n
t
h
e
so
c
i
a
l
su
p
p
o
r
t
s
y
st
e
m
f
o
r
f
a
mi
l
i
e
s
w
i
t
h
c
h
i
l
d
r
e
n
w
h
o
h
a
v
e
h
e
a
r
i
n
g
i
mp
a
i
r
me
n
t
s
3
.
4
.
Resea
rc
h pro
ce
du
re
I
n
ter
v
iews
wer
e
co
n
d
u
cted
with
ea
ch
p
ar
ticip
an
t
i
n
d
iv
i
d
u
ally
in
a
c
o
m
f
o
r
tab
le
s
ettin
g
.
All
in
ter
v
iews
wer
e
co
n
d
u
cted
eith
er
in
p
er
s
o
n
o
r
o
n
lin
e
in
lo
ca
tio
n
s
th
at
en
s
u
r
e
d
co
n
f
id
en
tial
ity
an
d
co
m
f
o
r
t
f
o
r
th
e
p
ar
ticip
a
n
ts
,
s
u
ch
as
th
e
r
esp
o
n
d
en
ts
’
h
o
m
es
o
r
p
r
i
v
ate
r
o
o
m
s
in
in
s
titu
tio
n
s
.
Du
r
in
g
th
e
in
ter
v
iews,
th
e
Evaluation Warning : The document was created with Spire.PDF for Python.
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in
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itu
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ican
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e
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ticip
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ts
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ld
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an
aly
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llect
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ata,
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esp
o
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en
ts
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e
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iv
en
q
u
e
s
tio
n
n
air
es
,
as
s
h
o
wn
in
T
a
b
le
3
.
T
h
e
s
u
r
v
ey
was
co
n
d
u
cted
in
eith
er
wr
itten
o
r
elec
tr
o
n
ic
f
o
r
m
a
t.
T
h
e
q
u
esti
o
n
n
air
e
in
clu
d
e
d
b
o
th
r
atin
g
s
ca
les
(
L
ik
er
t
s
ca
le)
an
d
y
es/n
o
q
u
esti
o
n
s
to
o
b
tain
a
clea
r
u
n
d
er
s
tan
d
in
g
o
f
th
e
r
esp
o
n
d
en
ts
’
k
n
o
wled
g
e
an
d
ex
p
er
ien
ce
in
th
is
ar
ea
.
T
h
e
tim
e
allo
ca
ted
f
o
r
co
m
p
letin
g
t
h
e
q
u
esti
o
n
n
air
e
was
s
et
at
2
0
m
in
u
tes
to
en
s
u
r
e
th
at
p
ar
ticip
an
ts
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id
n
o
t
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ee
l
o
v
er
wh
elm
ed
.
All
in
ter
v
iews
a
n
d
q
u
esti
o
n
n
air
es
wer
e
co
n
d
u
cted
b
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esear
ch
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s
s
p
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ially
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ain
ed
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k
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h
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p
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r
esp
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n
d
e
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.
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ex
p
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with
ex
p
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wo
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k
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g
with
ch
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r
en
with
h
ea
r
i
n
g
im
p
air
m
en
ts
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p
s
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o
lo
g
is
ts
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an
d
s
o
cial
wo
r
k
er
s
.
All
r
esear
ch
e
r
s
u
n
d
er
wen
t
eth
ical
tr
ain
in
g
to
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n
s
u
r
e
co
n
f
id
en
tial
ity
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d
p
a
r
ticip
an
t c
o
m
f
o
r
t th
r
o
u
g
h
o
u
t th
e
p
r
o
ce
s
s
.
T
ab
le
3
.
Su
r
v
ey
q
u
esti
o
n
s
N
o
.
Q
u
e
st
i
o
n
s
(
a
n
sw
e
r
/
s
c
a
l
e
)
1
A
r
e
y
o
u
a
w
a
r
e
o
f
e
x
i
s
t
i
n
g
s
o
c
i
a
l
su
p
p
o
r
t
p
r
o
g
r
a
ms
f
o
r
f
a
mi
l
i
e
s wi
t
h
c
h
i
l
d
r
e
n
w
h
o
h
a
v
e
h
e
a
r
i
n
g
i
m
p
a
i
r
me
n
t
s
?
(
Y
e
s/
N
o
)
2
W
h
a
t
t
y
p
e
s
o
f
s
o
c
i
a
l
a
ssi
s
t
a
n
c
e
d
o
y
o
u
r
e
c
e
i
v
e
?
(
F
i
n
a
n
c
i
a
l
,
e
d
u
c
a
t
i
o
n
a
l
,
p
s
y
c
h
o
l
o
g
i
c
a
l
,
me
d
i
c
a
l
,
o
t
h
e
r
)
3
H
o
w
e
a
sy
w
a
s
i
t
f
o
r
y
o
u
t
o
f
i
n
d
i
n
f
o
r
mat
i
o
n
a
b
o
u
t
a
v
a
i
l
a
b
l
e
s
u
p
p
o
r
t
p
r
o
g
r
a
ms?
(
1
–
v
e
r
y
d
i
f
f
i
c
u
l
t
,
5
–
v
e
r
y
e
a
s
y
)
4
H
o
w
a
c
c
e
ss
i
b
l
e
a
r
e
ser
v
i
c
e
s f
o
r
y
o
u
r
f
a
mi
l
y
i
n
y
o
u
r
r
e
g
i
o
n
?
(
1
–
c
o
m
p
l
e
t
e
l
y
i
n
a
c
c
e
ss
i
b
l
e
,
5
–
c
o
mp
l
e
t
e
l
y
a
c
c
e
ss
i
b
l
e
)
5
P
l
e
a
s
e
r
a
t
e
t
h
e
q
u
a
l
i
t
y
o
f
t
h
e
s
e
r
v
i
c
e
s
p
r
o
v
i
d
e
d
.
(
1
–
v
e
r
y
l
o
w
,
5
–
v
e
r
y
h
i
g
h
)
6
H
a
v
e
y
o
u
e
n
c
o
u
n
t
e
r
e
d
l
o
n
g
w
a
i
t
i
n
g
t
i
mes
w
h
e
n
r
e
c
e
i
v
i
n
g
a
ssi
s
t
a
n
c
e
?
(
1
–
n
e
v
e
r
,
5
–
a
l
w
a
y
s)
7
H
o
w
w
o
u
l
d
y
o
u
a
ss
e
ss
t
h
e
p
r
o
f
e
ss
i
o
n
a
l
i
s
m
o
f
t
h
e
sp
e
c
i
a
l
i
st
s
p
r
o
v
i
d
i
n
g
s
o
c
i
a
l
s
u
p
p
o
r
t
?
(
1
–
v
e
r
y
l
o
w
,
5
–
v
e
r
y
h
i
g
h
)
8
A
r
e
y
o
u
sa
t
i
sf
i
e
d
w
i
t
h
t
h
e
a
m
o
u
n
t
o
f
a
ssi
s
t
a
n
c
e
y
o
u
r
e
c
e
i
v
e
?
(
1
–
n
o
t
sa
t
i
sf
i
e
d
a
t
a
l
l
,
5
–
f
u
l
l
y
sa
t
i
sf
i
e
d
)
9
H
o
w
o
f
t
e
n
d
o
y
o
u
u
se
so
c
i
a
l
s
u
p
p
o
r
t
s
e
r
v
i
c
e
s
?
(
1
–
n
e
v
e
r
,
5
–
r
e
g
u
l
a
r
l
y
)
3
.
5
.
St
a
t
is
t
ica
l a
na
ly
s
is
o
f
da
t
a
Mic
r
o
s
o
f
t
E
x
ce
l
was
u
s
ed
f
o
r
p
r
o
ce
s
s
in
g
an
d
an
al
y
zin
g
q
u
an
titativ
e
d
ata,
as
it
allo
ws
f
o
r
ef
f
icien
t
d
ata
h
an
d
lin
g
,
s
tatis
tical
ca
lcu
latio
n
s
,
an
d
r
esu
lt v
is
u
aliza
tio
n
.
Fo
r
q
u
alitativ
e
d
ata
an
aly
s
is
,
a
c
o
n
ten
t
an
aly
s
is
m
eth
o
d
was
em
p
lo
y
e
d
,
co
n
d
u
cted
m
an
u
ally
u
s
in
g
s
p
ec
ializ
ed
co
d
in
g
a
n
d
class
if
icatio
n
tech
n
iq
u
es.
C
o
d
in
g
was
co
n
d
u
cted
in
d
u
ctiv
ely
,
with
th
em
es
an
d
ca
teg
o
r
ies
i
d
en
tifie
d
d
ir
ec
tly
f
r
o
m
th
e
d
a
ta
an
d
s
u
b
s
eq
u
en
tly
ch
ec
k
ed
ag
ai
n
s
t
a
p
r
ed
ef
in
e
d
co
n
ce
p
tu
al
m
o
d
el.
All
in
ter
v
iews
wer
e
tr
an
s
cr
ib
ed
an
d
t
h
en
co
d
e
d
in
s
u
ch
a
way
t
h
at
r
esp
o
n
s
es
co
u
ld
b
e
class
if
ied
in
to
t
h
em
atic
ca
t
eg
o
r
ies.
T
wo
r
esear
ch
e
r
s
wer
e
tr
ain
ed
in
co
d
in
g
m
eth
o
d
s
an
d
co
d
ed
2
0
%
o
f
t
h
e
in
ter
v
iews
twice
to
e
n
s
u
r
e
co
n
s
is
ten
cy
.
I
n
ter
-
r
ater
r
elia
b
ilit
y
was
ass
es
s
ed
u
s
in
g
C
o
h
en
’
s
k
ap
p
a
c
o
ef
f
ici
en
t,
wh
ich
was
0
.
8
2
,
in
d
icati
n
g
a
h
ig
h
d
e
g
r
ee
o
f
ag
r
ee
m
e
n
t
b
etwe
en
co
d
e
r
s
.
T
h
e
an
aly
s
is
p
r
o
ce
s
s
in
clu
d
e
d
s
ev
er
al
s
tag
es:
i
)
id
en
tify
in
g
in
itial
s
em
an
tic
u
n
its
in
th
e
in
ter
v
iew
tex
ts
;
ii
)
co
d
in
g
an
d
g
r
o
u
p
in
g
th
em
in
to
th
em
es;
iii
)
in
teg
r
atin
g
th
em
es
th
at
wer
e
s
im
ilar
in
m
ea
n
in
g
in
to
b
r
o
ad
er
ca
teg
o
r
ies;
an
d
iv
)
id
e
n
tify
i
n
g
n
ew
p
atter
n
s
an
d
m
ea
n
in
g
s
th
at
g
o
b
e
y
o
n
d
th
e
i
n
itial
ass
u
m
p
tio
n
s
.
Fo
r
ex
am
p
le,
q
u
esti
o
n
s
ab
o
u
t th
e
av
ailab
ilit
y
o
f
s
o
cial
s
u
p
p
o
r
t
wer
e
d
iv
id
e
d
in
to
ca
teg
o
r
i
es
s
u
ch
as
“
f
in
a
n
cial
s
u
p
p
o
r
t
”
,
“
in
f
o
r
m
atio
n
r
eso
u
r
ce
s
”
,
an
d
“
p
s
y
ch
o
lo
g
ical
s
u
p
p
o
r
t
”
.
T
h
is
en
a
b
led
a
d
ee
p
er
ex
p
lo
r
atio
n
o
f
h
o
w
r
esp
o
n
d
en
ts
p
e
r
ce
iv
e
s
o
cial
s
u
p
p
o
r
t a
n
d
h
el
p
ed
id
e
n
tify
k
e
y
is
s
u
es.
Descr
ip
tiv
e
s
tati
s
tics
wer
e
u
s
ed
to
an
aly
ze
th
e
q
u
an
titativ
e
d
ata
co
llected
v
ia
th
e
s
u
r
v
ey
s
.
T
h
is
in
clu
d
ed
ca
lcu
latin
g
m
ea
n
v
a
lu
es
an
d
s
tan
d
ar
d
d
e
v
iatio
n
s
f
o
r
ea
c
h
s
u
r
v
ey
q
u
esti
o
n
.
De
s
cr
ip
tiv
e
s
tatis
tics
p
r
o
v
id
e
d
a
co
m
p
r
e
h
en
s
iv
e
p
ic
tu
r
e
o
f
h
o
w
r
esp
o
n
d
en
ts
ass
ess
ed
th
e
ac
ce
s
s
ib
ilit
y
an
d
q
u
alit
y
o
f
s
o
cial
s
u
p
p
o
r
t.
T
h
e
an
aly
s
is
o
f
r
esp
o
n
d
e
n
ts
’
s
o
cio
d
em
o
g
r
ap
h
ic
ch
a
r
ac
ter
is
tics
wa
s
co
n
d
u
cted
b
y
c
o
m
p
ar
in
g
in
d
icato
r
s
o
f
ac
ce
s
s
to
s
o
cial
s
er
v
ices
an
d
awa
r
en
ess
o
f
av
ailab
le
p
r
o
g
r
am
s
ac
r
o
s
s
g
r
o
u
p
s
d
if
f
er
en
tiated
b
y
h
o
u
s
eh
o
ld
in
c
o
m
e
lev
el
an
d
t
y
p
e
o
f
s
ettlem
en
t
(
u
r
b
an
/r
u
r
al)
.
T
h
e
an
aly
s
is
was
b
ased
o
n
d
ata
co
llected
d
u
r
in
g
p
ar
ticip
an
t
r
eg
is
tr
atio
n
a
n
d
s
u
m
m
ar
ized
in
T
ab
le
1
.
C
o
r
e
v
ar
iab
les
in
clu
d
ed
p
lace
o
f
r
esid
en
ce
(
u
r
b
an
)
,
p
ar
en
tal
g
e
n
d
er
an
d
ag
e,
as
well
as
th
e
ag
e
o
f
c
h
ild
r
en
with
h
ea
r
in
g
im
p
air
m
e
n
ts
.
D
escr
ip
tiv
e
s
tatis
tica
l
m
ea
s
u
r
es
(
m
ea
n
s
,
p
er
ce
n
ta
g
es)
an
d
in
ter
g
r
o
u
p
c
o
m
p
ar
is
o
n
s
wer
e
em
p
lo
y
ed
t
o
id
e
n
tify
d
if
f
er
en
ce
s
in
ac
ce
s
s
to
an
d
u
tili
za
tio
n
o
f
s
o
cial
s
u
p
p
o
r
t
ac
co
r
d
in
g
to
th
e
s
o
cio
ec
o
n
o
m
ic
s
tatu
s
an
d
g
e
o
g
r
a
p
h
ical
lo
ca
tio
n
o
f
f
am
ilies
.
T
o
en
s
u
r
e
t
h
e
r
eli
ab
ilit
y
an
d
v
alid
ity
o
f
th
e
d
ata,
m
eth
o
d
o
lo
g
ical
tr
ia
n
g
u
latio
n
was
u
s
ed
—
a
co
m
b
in
atio
n
o
f
s
em
i
-
s
tr
u
c
tu
r
ed
in
ter
v
iews
an
d
q
u
esti
o
n
n
air
es,
wh
ich
allo
wed
f
o
r
a
co
m
p
ar
is
o
n
o
f
q
u
alitativ
e
an
d
q
u
a
n
titativ
e
r
e
s
u
lts
.
T
o
r
ed
u
ce
b
ias,
th
e
q
u
al
itativ
e
an
aly
s
is
was
co
n
d
u
cte
d
in
d
ep
en
d
en
tly
b
y
s
ev
er
al
r
esear
ch
er
s
.
Af
ter
th
at,
th
e
co
d
es a
n
d
ca
teg
o
r
ies we
r
e
ag
r
ee
d
u
p
o
n
co
llectiv
ely
.
3
.
6
.
E
t
hica
l principles
o
f
re
s
ea
rc
h
T
h
r
o
u
g
h
o
u
t
th
e
s
tu
d
y
,
s
p
ec
ial
atten
tio
n
was
p
aid
to
ad
h
er
in
g
to
eth
ical
p
r
in
cip
les
to
p
r
o
tect
p
ar
ticip
an
ts
’
r
ig
h
ts
an
d
well
-
b
ein
g
.
All
p
ar
ticip
an
ts
wer
e
in
f
o
r
m
ed
a
b
o
u
t
th
e
p
u
r
p
o
s
e
o
f
th
e
r
esear
ch
an
d
t
h
e
u
s
e
o
f
th
e
d
ata
c
o
llected
.
Par
ticip
atio
n
in
th
e
s
tu
d
y
was
v
o
lu
n
tar
y
,
an
d
p
ar
ticip
an
ts
co
u
ld
with
d
r
aw
at
an
y
tim
e
with
o
u
t
co
n
s
eq
u
en
ce
.
Prio
r
to
th
e
in
ter
v
iew
an
d
s
u
r
v
ey
,
all
r
esp
o
n
d
e
n
ts
s
ig
n
ed
a
co
n
s
en
t
f
o
r
m
Evaluation Warning : The document was created with Spire.PDF for Python.
I
n
t
J
E
v
al
&
R
es E
d
u
c
I
SS
N:
2252
-
8
8
2
2
S
o
cia
l su
p
p
o
r
t fo
r
h
ea
r
in
g
p
a
r
en
ts
r
a
is
in
g
d
ea
f c
h
ild
r
en
in
K
a
z
a
kh
s
ta
n
:
…
(
Zh
a
n
s
a
ya
J
a
n
p
eiso
va
)
2937
co
n
f
ir
m
in
g
th
ei
r
ag
r
ee
m
en
t
to
p
ar
ticip
ate
in
th
e
s
tu
d
y
an
d
allo
win
g
th
e
u
s
e
o
f
t
h
eir
r
esp
o
n
s
es
f
o
r
s
cien
tific
p
u
r
p
o
s
es.
T
o
e
n
s
u
r
e
c
o
n
f
id
e
n
tiality
,
p
ar
ticip
an
ts
’
p
er
s
o
n
a
l
d
ata
was
n
o
t
d
is
clo
s
ed
,
a
n
d
all
r
esu
lts
wer
e
p
r
esen
ted
in
an
ag
g
r
eg
ated
f
o
r
m
.
I
n
d
iv
id
u
al
id
en
tific
atio
n
o
f
p
ar
ticip
a
n
ts
was
ex
clu
d
ed
,
en
s
u
r
in
g
d
ata
an
o
n
y
m
ity
.
All
co
llected
d
ata
was
u
s
ed
ex
clu
s
iv
ely
f
o
r
th
e
p
u
r
p
o
s
es
o
f
th
is
s
tu
d
y
an
d
w
as
n
o
t
s
h
ar
ed
wit
h
th
ir
d
p
ar
ties
.
4.
RE
SU
L
T
S
4
.
1
.
Su
rv
ey
re
s
ults
T
h
e
s
u
r
v
ey
d
ata
wer
e
co
llec
ted
u
s
in
g
th
e
L
ik
er
t
s
ca
le
(
f
o
r
m
o
s
t
q
u
esti
o
n
s
)
,
as
well
as
y
es/n
o
r
esp
o
n
s
e
o
p
tio
n
s
an
d
an
o
p
e
n
-
en
d
e
d
q
u
esti
o
n
.
Fig
u
r
e
1
p
r
esen
ts
th
e
r
esp
o
n
s
es
to
th
e
f
ir
s
t
q
u
esti
o
n
o
f
th
e
s
u
r
v
ey
:
8
9
%
o
f
r
esp
o
n
d
en
ts
ar
e
awa
r
e
o
f
e
x
is
tin
g
s
o
cial
s
u
p
p
o
r
t
p
r
o
g
r
a
m
s
f
o
r
f
am
ilies
with
ch
ild
r
e
n
wh
o
h
av
e
h
ea
r
in
g
im
p
air
m
e
n
ts
,
in
d
icatin
g
th
at
o
v
er
all
awa
r
e
n
ess
o
f
th
ese
p
r
o
g
r
a
m
s
is
r
elativ
ely
h
ig
h
.
Ho
wev
e
r
,
1
1
%
o
f
r
esp
o
n
d
e
n
ts
ar
e
n
o
t
a
war
e
o
f
th
ese
p
r
o
g
r
a
m
s
,
h
ig
h
l
ig
h
tin
g
th
e
n
ee
d
f
o
r
in
c
r
ea
s
ed
awa
r
en
ess
.
T
h
ese
f
in
d
in
g
s
s
u
p
p
o
r
t
th
e
p
r
o
p
o
s
itio
n
s
o
f
s
o
cial
s
u
p
p
o
r
t
t
h
eo
r
y
r
eg
ar
d
in
g
th
e
im
p
o
r
tan
ce
o
f
a
war
en
ess
an
d
ac
ce
s
s
to
m
u
ltid
im
e
n
s
io
n
al
s
u
p
p
o
r
t
i
n
r
e
d
u
cin
g
s
tr
ess
an
d
in
cr
ea
s
in
g
f
a
m
ily
r
esil
ien
ce
.
E
v
e
n
wh
en
p
r
o
g
r
am
s
ar
e
f
o
r
m
ally
ac
ce
s
s
ib
le,
th
e
lack
o
f
in
f
o
r
m
atio
n
r
e
m
ain
s
an
in
d
e
p
en
d
en
t
f
ac
to
r
in
th
e
v
u
ln
er
ab
i
lity
o
f
f
am
ilies
.
Fig
u
r
e
1
.
R
esp
o
n
d
en
ts
’
an
s
wer
s
to
q
u
esti
o
n
1
o
f
th
e
s
u
r
v
ey
T
h
e
s
ec
o
n
d
q
u
esti
o
n
o
f
t
h
e
s
u
r
v
ey
f
o
cu
s
ed
o
n
th
e
ty
p
e
s
o
f
s
o
cial
ass
is
tan
ce
r
ec
eiv
ed
b
y
th
e
r
esp
o
n
d
en
ts
.
T
h
e
a
n
s
wer
s
to
th
is
q
u
esti
o
n
r
ev
ea
led
wh
i
ch
ty
p
es
o
f
s
u
p
p
o
r
t
ar
e
m
o
s
t
in
d
em
an
d
an
d
co
n
s
id
er
ed
m
o
s
t
im
p
o
r
tan
t
b
y
f
am
ilies
o
f
ch
ild
r
en
with
h
ea
r
i
n
g
im
p
air
m
e
n
ts
.
T
h
e
m
o
s
t
f
r
e
q
u
en
tly
m
e
n
tio
n
e
d
f
o
r
m
s
o
f
s
u
p
p
o
r
t
wer
e
f
in
an
ci
al
(
5
0
%)
an
d
m
ed
ical
(
4
5
%)
ass
is
tan
ce
.
T
h
is
h
ig
h
lig
h
ts
th
e
i
m
p
o
r
tan
ce
o
f
s
u
ch
s
u
p
p
o
r
t
f
o
r
f
am
ilies
o
f
ch
ild
r
en
with
h
ea
r
in
g
im
p
air
m
en
ts
.
E
d
u
ca
tio
n
al
s
u
p
p
o
r
t
was
m
e
n
tio
n
ed
b
y
3
0
%
o
f
r
esp
o
n
d
en
ts
,
wh
ich
is
also
an
im
p
o
r
tan
t
asp
ec
t,
th
o
u
g
h
less
p
r
o
n
o
u
n
ce
d
.
Ps
y
ch
o
lo
g
ical
s
u
p
p
o
r
t
was
m
en
tio
n
ed
less
f
r
eq
u
en
tly
(
2
0
%),
as
s
h
o
wn
in
Fig
u
r
e
2
.
T
h
e
d
is
tr
ib
u
tio
n
o
f
s
u
p
p
o
r
t
ty
p
es
r
ef
lects
th
e
co
n
ce
p
t
o
f
f
a
m
ily
s
y
s
tem
s
,
s
h
o
win
g
h
o
w
th
e
ef
f
ec
tiv
en
ess
o
f
d
if
f
er
e
n
t
s
u
p
p
o
r
t
elem
e
n
ts
af
f
ec
ts
t
h
e
o
v
e
r
all
well
-
b
ein
g
o
f
th
e
f
am
ily
.
I
n
p
r
ac
tice,
th
is
u
n
d
er
s
co
r
es
th
e
n
ee
d
f
o
r
co
o
r
d
in
atio
n
o
f
s
u
p
p
o
r
t
m
ea
s
u
r
es,
as
th
e
p
r
ed
o
m
i
n
an
ce
o
f
f
in
a
n
cial
a
n
d
m
e
d
ical
ass
is
tan
ce
with
o
u
t
ac
co
m
p
an
y
i
n
g
p
s
y
ch
o
l
o
g
i
ca
l
an
d
ed
u
ca
ti
o
n
al
s
u
p
p
o
r
t lim
its
th
e
o
v
e
r
all
ef
f
ec
tiv
en
ess
o
f
in
ter
v
en
tio
n
s
.
Alth
o
u
g
h
5
0
%
o
f
r
esp
o
n
d
e
n
ts
m
en
tio
n
ed
f
in
a
n
cial
s
u
p
p
o
r
t
as
a
f
o
r
m
o
f
ass
is
tan
ce
,
m
an
y
ex
p
r
ess
ed
d
is
s
atis
f
ac
tio
n
s
wi
th
th
e
ex
ten
t
o
f
th
is
s
u
p
p
o
r
t
d
u
r
in
g
th
e
in
ter
v
iews.
Fin
an
cial
d
if
f
icu
lties
r
em
ain
a
s
ig
n
if
ican
t
is
s
u
e
f
o
r
f
am
ilies
with
ch
ild
r
e
n
wh
o
h
a
v
e
h
ea
r
in
g
im
p
ai
r
m
en
ts
.
Ma
n
y
o
f
th
es
e
f
am
ilies
m
ay
f
ac
e
ad
d
itio
n
al
e
x
p
en
s
es
f
o
r
m
ed
ic
al
ca
r
e
a
n
d
s
p
ec
ialized
eq
u
ip
m
en
t,
an
d
l
o
s
s
o
f
in
co
m
e
wh
e
n
a
p
ar
e
n
t
is
f
o
r
ce
d
to
r
ed
u
ce
w
o
r
k
in
g
h
o
u
r
s
to
ca
r
e
f
o
r
th
e
ch
ild
.
T
h
er
ef
o
r
e,
f
in
a
n
cial
s
u
p
p
o
r
t is o
f
g
r
ea
t im
p
o
r
tan
ce
.
Ad
d
itio
n
ally
,
4
5
%
o
f
r
esp
o
n
d
en
ts
m
en
tio
n
ed
h
ea
lth
ca
r
e
as
a
b
en
ef
it
r
ec
eiv
ed
,
in
d
i
ca
tin
g
th
e
s
ig
n
if
ican
ce
o
f
th
is
ar
ea
o
f
s
u
p
p
o
r
t.
Ho
wev
er
,
d
esp
ite
th
e
av
ailab
ilit
y
o
f
m
ed
ical
s
er
v
i
ce
s
,
p
ar
en
ts
r
ep
o
r
t
in
ad
eq
u
ate
s
er
v
ices
an
d
f
r
e
q
u
en
t
d
if
f
icu
lties
ac
ce
s
s
in
g
s
p
ec
ialized
ca
r
e.
R
esp
o
n
d
en
ts
also
n
o
te
th
at
waitin
g
tim
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f
o
r
ex
am
in
atio
n
s
an
d
tr
ea
tm
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e
to
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g
,
an
d
th
e
q
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ality
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f
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ed
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er
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ices
o
f
ten
d
o
es
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o
t
m
ee
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th
eir
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p
ec
tatio
n
s
.
T
h
is
p
er
t
ain
s
n
o
t
o
n
ly
to
r
e
g
u
lar
p
r
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ce
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u
r
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d
m
ed
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c
h
ec
k
-
u
p
s
b
u
t
also
to
r
eh
ab
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ativ
e
m
ea
s
u
r
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s
u
ch
as
s
p
ee
ch
th
er
ap
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d
au
d
io
th
er
ap
y
.
Fro
m
a
s
o
cial
p
o
li
cy
p
er
s
p
ec
tiv
e,
th
e
r
esu
lts
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icate
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ep
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etwe
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u
p
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th
e
ac
tu
al
av
aila
b
ilit
y
o
f
s
p
ec
ialized
s
er
v
ices.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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2
2
5
2
-
8
8
2
2
I
n
t
J
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v
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&
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d
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c
,
Vo
l
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15
,
No
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4
,
Au
g
u
s
t
20
26
:
293
1
-
2
9
4
5
2938
Fig
u
r
e
2
.
R
esp
o
n
d
en
ts
’
an
s
wer
s
to
q
u
esti
o
n
2
o
f
th
e
s
u
r
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Mo
r
eo
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er
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3
0
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o
f
r
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o
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en
t
s
r
ep
o
r
ted
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ec
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e
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p
o
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t,
in
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icatin
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th
at
s
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c
h
s
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p
p
o
r
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ex
is
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alth
o
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g
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er
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ten
t
th
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f
in
an
cial
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d
m
ed
ical
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s
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ce
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Pro
b
lem
s
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ela
ted
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ca
tio
n
al
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u
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o
r
t
in
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d
e
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s
p
ec
ialized
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h
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g
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ater
ials
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d
d
if
f
icu
lties
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ad
ap
tin
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ed
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ca
tio
n
al
p
r
o
g
r
am
s
f
o
r
ch
ild
r
en
with
h
ea
r
in
g
lo
s
s
.
T
h
ese
in
clu
d
e
in
d
i
v
id
u
alize
d
p
r
o
g
r
am
s
,
s
u
p
p
o
r
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in
p
u
b
lis
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g
ed
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ca
tio
n
al
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ater
ials
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d
p
ar
ticip
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n
in
in
clu
s
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e
e
d
u
ca
tio
n
al
p
r
o
c
ess
es.
R
e
s
p
o
n
d
en
ts
’
ex
p
r
ess
d
is
s
atis
f
ac
tio
n
with
lim
ited
ac
ce
s
s
to
q
u
alif
ied
tea
ch
er
s
,
wh
ich
im
p
ac
ts
th
e
lear
n
in
g
p
r
o
ce
s
s
.
On
ly
2
0
%
o
f
r
esp
o
n
d
en
ts
in
d
icate
d
p
s
y
ch
o
lo
g
ical
s
u
p
p
o
r
t
am
o
n
g
th
e
s
er
v
ices
th
ey
u
til
ized
.
T
h
is
s
u
g
g
ests
an
u
n
d
er
esti
m
atio
n
o
r
in
ad
eq
u
ac
y
o
f
p
s
y
c
h
o
lo
g
i
ca
l
s
u
p
p
o
r
t
f
o
r
f
am
ilies
with
ch
ild
r
en
wh
o
h
av
e
h
ea
r
in
g
im
p
air
m
en
ts
:
alth
o
u
g
h
m
an
y
f
am
ilies
f
ac
e
p
s
y
ch
o
l
o
g
ical
ch
allen
g
es
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s
tr
ess
,
d
ep
r
ess
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n
,
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d
s
o
cial
is
o
latio
n
)
,
th
e
n
ee
d
f
o
r
p
s
y
ch
o
lo
g
ical
s
u
p
p
o
r
t
is
n
o
t
alwa
y
s
p
r
io
r
itized
.
T
h
is
m
a
y
b
e
lin
k
ed
to
s
ter
eo
ty
p
es
ab
o
u
t
th
e
in
ad
e
q
u
ac
y
o
f
p
s
y
c
h
o
lo
g
ical
s
er
v
ices
o
r
a
lack
o
f
awa
r
en
ess
o
f
th
e
im
p
o
r
tan
c
e
o
f
p
s
y
ch
o
lo
g
ical
s
u
p
p
o
r
t
in
th
e
ea
r
ly
s
tag
es
o
f
in
ter
ac
tin
g
with
th
e
s
o
cial
s
u
p
p
o
r
t
s
y
s
tem
.
Ho
wev
er
,
th
o
s
e
wh
o
s
o
u
g
h
t
p
s
y
ch
o
lo
g
ical
h
elp
ex
p
r
ess
ed
d
is
s
atis
f
ac
tio
n
with
th
e
q
u
ality
an
d
lack
o
f
ac
ce
s
s
to
q
u
alif
ie
d
s
p
ec
ialis
ts
.
I
s
s
u
es
r
elate
d
to
p
s
y
ch
o
l
o
g
ical
ass
is
t
an
ce
in
clu
d
e
a
s
h
o
r
tag
e
o
f
s
p
ec
ialized
p
s
y
ch
o
lo
g
is
ts
an
d
a
lack
o
f
in
f
o
r
m
atio
n
ab
o
u
t th
ese
s
er
v
ices.
T
h
e
s
u
r
v
ey
r
esu
lts
in
d
icate
t
h
at,
in
g
en
er
al,
r
esp
o
n
d
en
ts
ar
e
ca
u
tio
u
s
ab
o
u
t
th
e
ac
c
ess
ib
ilit
y
an
d
q
u
ality
o
f
s
o
cial
s
u
p
p
o
r
t
a
n
d
e
x
p
r
ess
co
n
ce
r
n
s
a
b
o
u
t
v
ar
io
u
s
asp
ec
ts
o
f
th
e
s
o
cial
s
u
p
p
o
r
t
s
y
s
tem
as
s
h
o
wn
in
T
ab
le
4
.
T
h
e
a
v
er
ag
e
s
co
r
e
f
o
r
th
e
q
u
esti
o
n
a
b
o
u
t
h
o
w
ea
s
ily
in
f
o
r
m
atio
n
o
n
av
ailab
le
s
u
p
p
o
r
t
p
r
o
g
r
am
s
ca
n
b
e
f
o
u
n
d
was
3
.
2
,
in
d
icatin
g
m
o
d
er
ate
d
if
f
icu
lty
in
f
in
d
i
n
g
in
f
o
r
m
atio
n
.
T
h
is
is
also
co
n
f
ir
m
ed
b
y
th
e
s
tan
d
ar
d
d
e
v
iatio
n
o
f
1
.
1
,
wh
i
ch
s
u
g
g
ests
a
s
m
all
v
ar
iab
ilit
y
in
o
p
in
i
o
n
s
.
T
h
e
ass
ess
m
en
t
o
f
s
er
v
ice
ac
ce
s
s
ib
ilit
y
f
o
r
f
am
ilies
ac
r
o
s
s
d
if
f
er
en
t
r
eg
io
n
s
y
ield
ed
a
s
c
o
r
e
o
f
3
.
5
,
in
d
icatin
g
m
o
d
er
ate
ac
ce
s
s
ib
ilit
y
.
W
ith
a
s
tan
d
ar
d
d
e
v
iatio
n
o
f
1
.
3
,
it
is
e
v
id
en
t
t
h
at
th
er
e
ar
e
s
ig
n
if
ican
t
d
if
f
er
en
ce
s
in
th
e
p
er
ce
p
tio
n
o
f
s
er
v
ice
ac
ce
s
s
ib
ilit
y
d
u
e
to
r
eg
io
n
al
v
ar
iatio
n
s
in
th
e
d
e
v
elo
p
m
en
t
o
f
s
o
cial
s
u
p
p
o
r
t
s
y
s
tem
s
.
T
h
e
a
v
er
ag
e
s
co
r
e
f
o
r
th
e
q
u
ality
o
f
s
er
v
ic
es
p
r
o
v
i
d
ed
was
3
.
8
,
in
d
icatin
g
g
e
n
er
ally
p
o
s
itiv
e
p
er
ce
p
tio
n
s
b
u
t
also
h
ig
h
lig
h
t
in
g
s
o
m
e
is
s
u
es
in
th
is
ar
ea
.
T
h
e
v
ar
iab
ilit
y
in
r
atin
g
s
was
r
elativ
ely
h
ig
h
,
as
in
d
icate
d
b
y
th
e
s
tan
d
a
r
d
d
ev
i
atio
n
o
f
1
.
2
.
Fo
r
t
h
e
q
u
esti
o
n
r
eg
ar
d
in
g
lo
n
g
waitin
g
tim
es
f
o
r
ca
r
e,
th
e
av
e
r
ag
e
s
co
r
e
was
3
.
1
,
s
u
g
g
esti
n
g
th
at
r
esp
o
n
d
en
ts
f
r
e
q
u
en
tly
e
x
p
er
i
en
ce
lo
n
g
waitin
g
p
er
io
d
s
,
wh
ich
is
a
s
ig
n
if
ican
t
is
s
u
e.
T
h
e
s
tan
d
ar
d
d
e
v
iatio
n
o
f
1
.
4
p
o
i
n
ts
in
d
icate
s
a
h
ig
h
l
ev
el
o
f
v
a
r
iab
ilit
y
in
r
esp
o
n
s
es.
T
ab
le
4
.
Descr
ip
tiv
e
s
tatis
tics
f
o
r
th
e
s
u
r
v
ey
Q
u
e
st
i
o
n
M
e
a
n
v
a
l
u
e
S
t
a
n
d
a
r
d
d
e
v
i
a
t
i
o
n
H
o
w
e
a
sy
w
a
s
i
t
f
o
r
y
o
u
t
o
f
i
n
d
i
n
f
o
r
mat
i
o
n
a
b
o
u
t
a
v
a
i
l
a
b
l
e
s
u
p
p
o
r
t
p
r
o
g
r
a
ms?
3
.
2
1
.
1
H
o
w
a
c
c
e
ss
i
b
l
e
a
r
e
ser
v
i
c
e
s f
o
r
y
o
u
r
f
a
mi
l
y
i
n
y
o
u
r
r
e
g
i
o
n
?
3
.
5
1
.
3
H
o
w
w
o
u
l
d
y
o
u
r
a
t
e
t
h
e
q
u
a
l
i
t
y
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.
S
u
g
g
e
s
t
i
o
n
s
f
o
r
i
m
p
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o
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m
P
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t
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h
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d
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mi
n
a
t
i
o
n
o
f
i
n
f
o
r
ma
t
i
o
n
a
b
o
u
t
s
o
c
i
a
l
p
r
o
g
r
a
ms,
si
m
p
l
i
f
y
i
n
g
a
d
m
i
n
i
st
r
a
t
i
v
e
p
r
o
c
e
d
u
r
e
s
,
i
n
c
r
e
a
s
i
n
g
f
i
n
a
n
c
i
a
l
a
ss
i
st
a
n
c
e
,
a
n
d
e
x
p
a
n
d
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n
g
sp
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i
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z
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d
p
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o
r
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n
w
i
t
h
h
e
a
r
i
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g
i
mp
a
i
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m
e
n
t
s.
K
e
y
i
ss
u
e
s
-
I
n
su
f
f
i
c
i
e
n
t
a
c
c
e
ssi
b
i
l
i
t
y
a
n
d
q
u
a
l
i
t
y
o
f
i
n
f
o
r
ma
t
i
o
n
a
b
o
u
t
s
o
c
i
a
l
a
ss
i
st
a
n
c
e
;
-
B
u
r
e
a
u
c
r
a
t
i
c
b
a
r
r
i
e
r
s
a
n
d
d
e
l
a
y
s
i
n
p
r
o
v
i
d
i
n
g
a
ssi
s
t
a
n
c
e
;
-
La
c
k
o
f
q
u
a
l
i
f
i
e
d
s
p
e
c
i
a
l
i
st
s
;
-
Li
mi
t
e
d
a
v
a
i
l
a
b
i
l
i
t
y
o
f
p
s
y
c
h
o
l
o
g
i
c
a
l
s
u
p
p
o
r
t
;
-
I
n
su
f
f
i
c
i
e
n
t
f
i
n
a
n
c
i
a
l
a
ssi
s
t
a
n
c
e
t
o
c
o
v
e
r
a
l
l
n
e
e
d
s.
B
u
r
ea
u
cr
atic
o
b
s
tacle
s
an
d
d
elay
s
in
r
ec
eiv
in
g
s
u
p
p
o
r
t
w
er
e
also
r
ep
o
r
ted
.
As
o
n
e
r
e
s
p
o
n
d
en
t
ex
p
lain
ed
,
“
I
n
o
r
d
er
to
o
b
ta
i
n
a
s
s
is
ta
n
ce
,
yo
u
h
a
ve
to
co
llect
s
o
ma
n
y
d
o
cu
men
ts
th
a
t
it
ta
ke
s
mo
n
th
s
.
”
Dif
f
icu
lties
in
o
b
tain
in
g
u
p
-
to
-
d
ate
in
f
o
r
m
atio
n
a
b
o
u
t
s
er
v
ices
wer
e
lik
ewise
u
n
d
er
s
co
r
ed
,
“
I
s
p
en
d
h
o
u
r
s
o
n
lin
e,
b
u
t
s
till
ca
n
n
o
t
fin
d
w
h
a
t
I
n
ee
d
.
”
R
esp
o
n
d
en
ts
al
s
o
p
o
in
ted
to
th
e
lack
o
f
p
s
y
ch
o
lo
g
ical
s
u
p
p
o
r
t:
“
A
co
n
ve
r
s
a
tio
n
w
ith
a
p
s
yc
h
o
lo
g
is
t wo
u
ld
h
elp
me
a
lo
t,
b
u
t su
ch
s
ervices a
r
e
n
o
t a
va
ila
b
l
e
in
o
u
r
city
.”
W
ith
r
eg
ar
d
to
th
e
q
u
ality
o
f
s
p
ec
ialis
t
s
,
s
o
m
e
p
ar
en
ts
r
ep
o
r
ted
in
s
tan
ce
s
o
f
i
n
s
u
f
f
icien
t
awa
r
en
ess
am
o
n
g
s
er
v
ice
p
r
o
v
id
e
r
s
.
As
o
n
e
r
esp
o
n
d
en
t
o
b
s
er
v
ed
:
“
Th
ere
a
r
e
ve
r
y
g
o
o
d
d
o
cto
r
s
,
b
u
t
s
o
metime
s
yo
u
en
co
u
n
ter th
o
s
e
w
h
o
th
emselv
es d
o
n
o
t k
n
o
w
w
h
ich
d
o
cu
me
n
ts
n
ee
d
to
b
e
s
u
b
mitted
.
”
All p
ar
ticip
an
ts
o
f
f
er
e
d
s
u
g
g
esti
o
n
s
f
o
r
im
p
r
o
v
in
g
th
e
s
y
s
tem
,
em
p
h
asizin
g
th
e
n
e
ed
f
o
r
s
im
p
lifie
d
p
r
o
ce
d
u
r
es,
g
r
ea
ter
awa
r
en
ess
,
an
d
en
h
an
ce
d
f
in
an
cial
s
u
p
p
o
r
t.
As
o
n
e
p
ar
e
n
t
s
tr
ess
ed
th
at
,
“
Th
e
fir
s
t
p
r
io
r
ity
i
s
to
ma
ke
th
e
s
ystem
clea
r
er
a
n
d
fa
s
ter
.
”
Fro
m
a
p
r
ac
tical
an
d
p
o
liti
ca
l
p
er
s
p
ec
tiv
e,
th
e
in
ter
v
iews
h
i
g
h
lig
h
t
t
h
e
n
ee
d
t
o
s
im
p
lify
ad
m
in
is
tr
ativ
e
p
r
o
ce
d
u
r
es a
n
d
in
cr
ea
s
e
tr
an
s
p
ar
en
c
y
in
th
e
s
o
cial
s
u
p
p
o
r
t sy
s
tem
.
Evaluation Warning : The document was created with Spire.PDF for Python.
I
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J
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Au
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20
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293
1
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2940
T
h
e
tr
en
d
s
in
r
esp
o
n
d
en
ts
’
a
n
s
wer
s
in
d
icate
th
at
t
h
e
m
aj
o
r
ity
o
f
p
ar
ticip
an
ts
f
ac
e
d
if
f
icu
lties
in
ac
ce
s
s
in
g
s
o
cial
s
u
p
p
o
r
t
an
d
ar
e
d
is
s
ati
s
f
ied
with
th
e
v
o
lu
m
e
an
d
q
u
ality
o
f
s
u
p
p
o
r
t,
p
ar
ticu
lar
ly
in
th
e
f
in
an
cial
an
d
p
s
y
ch
o
lo
g
ical
a
r
ea
s
.
R
esp
o
n
d
en
ts
em
p
h
asize
th
at
th
e
ex
is
tin
g
s
o
cial
welf
ar
e
s
y
s
tem
r
eq
u
ir
es
s
ig
n
if
ican
t
im
p
r
o
v
em
en
ts
,
esp
ec
ially
in
ter
m
s
o
f
s
im
p
lify
in
g
p
r
o
ce
d
u
r
es
an
d
en
h
a
n
cin
g
t
h
e
q
u
ality
o
f
ca
r
e
.
Par
en
ts
h
ig
h
lig
h
t
th
e
n
ee
d
f
o
r
im
p
r
o
v
em
en
ts
in
th
e
s
y
s
tem
th
at
co
u
ld
lead
to
m
o
r
e
e
f
f
ec
tiv
e
an
d
tim
ely
s
u
p
p
o
r
t f
o
r
f
a
m
ilies
with
ch
ild
r
en
wh
o
h
av
e
h
ea
r
in
g
im
p
air
m
en
ts
.
4
.
3
.
Resul
t
s
o
f
t
he
a
na
ly
s
is
o
f
re
s
po
nd
ent
s
’
s
o
cio
dem
o
g
ra
ph
ic
cha
ra
ct
er
is
t
ics
A
co
m
p
ar
is
o
n
o
f
in
d
icato
r
s
o
f
ac
ce
s
s
to
s
o
cial
s
er
v
ices
an
d
awa
r
en
ess
o
f
s
o
cial
s
u
p
p
o
r
t
p
r
o
g
r
am
s
r
ev
ea
led
t
h
at
f
am
ilies
with
h
ig
h
er
i
n
co
m
e
lev
els
g
en
e
r
ally
h
a
d
b
etter
ac
ce
s
s
to
i
n
f
o
r
m
atio
n
an
d
u
tili
ze
d
a
g
r
ea
ter
n
u
m
b
e
r
o
f
s
o
cial
s
er
v
ices
co
m
p
ar
ed
to
f
am
ilies
with
lo
w
o
r
m
id
d
le
in
co
m
e
,
as
s
h
o
wn
in
Fig
u
r
e
3
.
An
aly
s
is
b
y
ty
p
e
o
f
s
ettlem
e
n
t
in
d
icate
d
th
at
r
esid
en
ts
o
f
lar
g
er
u
r
b
an
ce
n
ter
s
,
s
u
ch
as
Ust
-
Kam
en
o
g
o
r
s
k
,
Sem
ey
,
an
d
Sh
a
r
,
wer
e
m
o
r
e
l
ik
ely
to
ac
ce
s
s
v
ar
io
u
s
f
o
r
m
s
o
f
s
u
p
p
o
r
t
an
d
d
em
o
n
s
tr
ated
g
r
ea
ter
awa
r
en
ess
o
f
ex
is
tin
g
p
r
o
g
r
am
s
.
I
n
co
n
tr
ast,
f
am
ilies
f
r
o
m
s
m
aller
s
ettlem
en
ts
,
p
ar
ticu
lar
ly
Ser
eb
r
y
a
n
s
k
,
f
ac
ed
lim
ited
ac
ce
s
s
to
b
o
th
in
f
o
r
m
atio
n
a
n
d
s
er
v
ices.
At
th
e
s
am
e
tim
e,
th
e
a
v
er
ag
e
ag
e
o
f
p
ar
e
n
ts
an
d
c
h
ild
r
en
d
id
n
o
t
h
av
e
a
s
u
b
s
tan
tial
im
p
a
ct
o
n
th
e
lev
el
o
f
awa
r
en
ess
;
h
o
wev
e
r
,
ag
e
d
if
f
er
en
ce
s
am
o
n
g
ch
ild
r
e
n
b
etwe
en
3
an
d
1
6
y
ea
r
s
r
ef
l
ec
ted
v
ar
y
in
g
n
ee
d
s
f
o
r
s
o
cial
s
u
p
p
o
r
t
ac
r
o
s
s
d
if
f
er
en
t
s
tag
es
o
f
d
e
v
elo
p
m
e
n
t.
T
h
u
s
,
th
e
f
in
d
i
n
g
s
u
n
d
er
s
co
r
e
th
e
im
p
o
r
tan
ce
o
f
co
n
s
id
er
in
g
s
o
ci
o
ec
o
n
o
m
ic
a
n
d
g
e
o
g
r
a
p
h
ical
f
ac
to
r
s
in
th
e
p
lan
n
in
g
an
d
im
p
lem
e
n
tatio
n
o
f
s
o
cial
s
u
p
p
o
r
t
p
r
o
g
r
a
m
s
f
o
r
f
a
m
ilies
r
aisi
n
g
ch
ild
r
en
with
h
ea
r
i
n
g
im
p
ai
r
m
en
ts
.
T
h
e
o
r
i
g
in
ality
o
f
th
is
s
tu
d
y
lies
in
its
co
m
p
r
eh
e
n
s
iv
e
co
m
b
in
atio
n
o
f
q
u
alitativ
e
an
d
q
u
a
n
titativ
e
an
aly
s
is
o
f
s
o
cial
s
u
p
p
o
r
t
f
o
r
h
ea
r
in
g
p
a
r
en
ts
o
f
d
ea
f
ch
ild
r
e
n
in
Kaz
ak
h
s
tan
.
T
h
e
s
tu
d
y
id
e
n
tifie
d
th
e
c
o
m
p
lex
n
ee
d
s
o
f
t
h
ese
f
am
ilies
ac
r
o
s
s
p
s
y
ch
o
lo
g
ical,
in
f
o
r
m
atio
n
al,
an
d
b
u
r
ea
u
cr
a
tic
d
im
en
s
io
n
s
.
T
h
e
r
esu
lts
r
ev
ea
l
r
eg
io
n
al,
in
co
m
e
-
r
elat
ed
,
an
d
p
lace
-
of
-
r
esid
en
ce
d
if
f
er
en
ce
s
in
ac
ce
s
s
to
s
o
cial
s
er
v
ices,
en
ab
lin
g
t
h
e
d
ev
elo
p
m
en
t
o
f
s
p
ec
if
ic
r
e
co
m
m
en
d
atio
n
s
f
o
r
ad
ap
tin
g
th
e
n
atio
n
al
s
o
cial
s
u
p
p
o
r
t sy
s
tem
.
Fig
u
r
e
3
.
An
al
y
s
is
o
f
ac
ce
s
s
to
s
o
cial
s
er
v
ices a
n
d
awa
r
en
ess
o
f
p
r
o
g
r
a
m
s
ac
co
r
d
in
g
to
r
esp
o
n
d
en
ts
’
s
o
cio
d
em
o
g
r
ap
h
ic
c
h
ar
ac
ter
is
tics
5.
DIS
CU
SS
I
O
N
T
h
e
s
u
r
v
ey
r
esu
lts
o
f
th
e
s
tu
d
y
r
ev
ea
led
th
at
8
9
% o
f
r
esp
o
n
d
en
ts
ar
e
awa
r
e
o
f
e
x
is
tin
g
s
o
cial
welf
ar
e
p
r
o
g
r
a
m
s
,
wh
ile
1
1
%
h
av
e
n
o
in
f
o
r
m
atio
n
ab
o
u
t
s
u
ch
p
r
o
g
r
am
s
.
W
h
en
co
m
p
a
r
in
g
th
ese
d
ata
with
in
ter
n
atio
n
al
s
tu
d
ies
f
r
o
m
C
h
in
a,
it
b
ec
o
m
es
ev
i
d
en
t
t
h
at
ac
ce
s
s
to
in
f
o
r
m
atio
n
a
b
o
u
t
s
o
cial
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.
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t:
in
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p
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e
d
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ticip
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th
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[
39
]
.
T
h
u
s
,
a
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ily
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eq
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f
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