Thailand’s education strategy focuses on developing all Thai children to have skills in the 21st century, including children in areas at risk due to the effects of heavy metal industries. A study in 2016 found the incidence of non-organic arsenic in children’s urine to be 36.1%. Heavy metals such as arsenic are toxic substances with effects causing intellectual impairment, which led to the objective of this study to monitor the situation of intellectual, cognitive and learning impairments among children in addition to studying familial and social factors related to the aforementioned impairments in order to lead to rehabilitation of children’s intellectual and learning impairments with teacher participation in addition to raising awareness and knowledge about self-protection from toxins among children in Grade 4-6 from 6 schools which were originally located in risk areas with heavy metal industries of Pichit, Phitsanulok and Phetchaboon.
The findings revealed the children’s family characteristics to be medium-sized families with parents not living with children in the village because the parents worked outside the village (82.60%). Most of the children were raised by grandparents (38.70%) and most of the parents had primary education levels. The families were in poverty with a mean monthly income of 5,000 – 10,000 baht (49.60%). In the area of media use, the children played with mobile phones for more than 1 hour per day (67.10%). When the children were happy, sad or had problems with learning, friends or teachers, the children were found to neither reveal nor consult parents (34.30%). Furthermore, the parents (45.80%) responded that the environments of homes and communities included the use of chemicals, toxins or heavy metals. From health examinations of 199 children, the incidence of contact with non-organic arsenic in the urine was found to be higher than usual (4.5%), a reduction by nearly 12 times in boys and girls of every class and school when compared to a previous survey in 2016. Furthermore, incidence of contact with manganese in blood was higher than normal criteria (41.2%). Cyanide was not found in the sample’s blood and no association was found between contact with non-organic arsenic, manganese and intellectual, cognitive and learning impairments (P-value > 0.05). According to assessment of cognitive and learning skills in 212 students, students were found to have learning impairments in 4 areas, namely reading, spelling, sentence comprehension and mathematic calculations. The sample had learning impairments in one or more areas (81.60%). Of 126 children with normal intelligence quotients (IQ) (IQ > 90), 28 children were found to have learning impairments (22.22%) in 4 areas, namely reading, spelling, sentence comprehension and mathematical calculations (50.0%). Survey results in 2016 found learning impairments at a rate of 38.9%, which was higher than in 2019. When the results following rehabilitation among children with learning impairments were compared before and after rehabilitation, the children who had rehabilitated were found to have higher reading, spelling, sentence comprehension and mathematical calculation skills with statistical significance. In the area of intelligence assessment, the children were found to have normal intelligence (average criteria) (59.4%) and lower intelligence than normal criteria (40.6%). After the rehabilitation of 106 students, students were found to have a mean score of 85.43 for intelligence before rehabilitation, which was below average. After rehabilitation, however, the children were found to have higher mean scores for intelligence with statistical significance. According to assessments of executive function behaviors and skills among children by teachers, the children were found to be in need of promotion (68.2%). From rehabilitation, the executive function skills of more children were found to be normal in the areas of accurate memory, concentration and speed of response in tasks. Results from the assessment of visual-motor perception showed the sample to meet criteria (58.49%) with some of the sample having results lower than criteria (41.51%). When results were compared before and after rehabilitation, no differences were found. Furthermore, in asking the children about knowledge on self-protection from toxins in the environment, most of the children (64.2%) were found to have low knowledge about self-protection from arsenic, manganese and cyanide. After participation in environmental awareness skill promotion activities, most of the sample (41.9%) was found to have higher knowledge on self-protection from toxins at a medium level. After rehabilitation, the sample had significantly different levels of knowledge. Concerning attitude about self-protection from toxins, more of the sample was found to have changed from “Not Sure” to “Agree”. Furthermore, the project disseminated research findings and expanded effects for society on a broad scale with announcements of news, research findings and conclusions of preliminary research findings for 15 government agencies and the societal sector in order to push work at the policy and social levels, which will lead to monitoring, prevention, problem-solving, rehabilitation of intellectual skills and learning in children, thereby giving children awareness about self-care and protection, which will solve problems with sustainability.