UN ESCAP Workshop on Women and Disability: Promoting Full Participation of Women with Disabilities in the Process of Elaboration on an International Convention to Promote and Protect the Rights and Dignity of Persons with Disabilities
18-22 August 2003, Bangkok, Thailand

Text Version of a presentation:

Definition, Early Intervention and Education for People with Disabilities

Presentation by Penny Price

CHILDREN WITH DISABILITIES: BASIC RIGHTS

Penny Price
Consultant, Disability Programme,
Emerging Social Issues Division

18 - 22 August 2003
Bangkok ,Thailand

Workshop on Women and Disability: Promoting Full Participation of Women with Disabilities in the Process of Elaboration on an International Convention to Promote and Protect the Rights and Dignity of Persons with Disabilities

CHILDREN WITH DISABILITIES

Who is responsible for ensuring the rights of children with disabilities?

• Governments
• NGOs
• Parents
• Community
• International community
• SHOs
• WWD

Children with disabilities are currently one of the most neglected groups in society.

• Denied access to basic services, early identification, early intervention and education, they lack all opportunity for future development, training, employment and social integration.
• They are at high risk for lives lived n exclusion and poverty.

Problems in service design and delivery

Focus on prevention of the causes of disability
Limited attention on services to promote full participation of people who live with disabilities

Focus on the needs of adults
Limited advocacy and concern for the situation and needs of children with disabilities

Need a twin-track approach:

• Prevent causes of disabilities
• Provide services which promote the full development of PWD, including children with disabilities

CAUSES AND PREVENTION OF DISABILITY
CAUSES - macro-level

Poverty means a significantly increased risk of impairment, disability and premature death.

Maternal malnutrition, ill health, frequent pregnancies, poor pre- birth and post-natal care, lack of support to family in care of disabled newborn - all major causes of disability in children.

Poverty means no time or resources to care for disabled family members - often resulting in premature death - particularly for infants and children - especially girl children.

Disabilities can be:

Physical
Sensory - deaf, blind, touch impaired
Intellectual
Psychiatric
Multiple

Present from birth
Acquired in childhood, youth, adult life, later life
Permanent
Temporary
Perceived

Causes of disabilities can be:

• Genetic - high cost prevention
• Environmental - includes poverty related disabilities

• Preventable - 80-90 %
• Known
• Unknown - many causes unknown; multiple causes
• Disabilities are increasing in developing and developed countries (120% by 2030)

Most common causes of disabilities:

• Malnutrition and maternal ill-health
• Lack of adequate health services - poor care during pregnancy and birth
• Communicable diseases -Rubella, meningitis, encephalitis, cerebral malaria, philaria, (polio), measles,
• Accidents - home; traffic; work related
• Violence; conflict
• Toxins (lead), medication, pesticides, drugs, alcohol
• Polluted environments - water, fish

Basic prevention of disabilities requires:

• Elimination of poverty - adequate nutrition and income
• Good community-based health care services even in remote areas and poor communities - urban and rural
• Well trained health care professionals with disability awareness and expertise in prevention, detection and care of disabled persons, particularly infants and young children
• Health, family planning and nutrition education for girls and women, including immunization and vitamin supplements
• Early intervention - family education and support
• Community-based services to include persons with disabilities and family members, and to generate community support.

Evaluation of the Asian and Pacific Decade 1993-2002

Prevention of the causes of disability

Positive outcomes

• Reduction in infant mortality
• Reduction in infant disability due to preventable causes
  eg. iodine deficiency
• Programmes for nutrition education
• Health and family planning for girls and women with disabilities
• Trained traditional birth attendants resulted in lower rates of infant mortality due to birth injury.
• Expanded immunization programmes.

HEALTH SERVICES FOR PERSONS WITH DISABILITIES

• Traditional service provision - centre-based, urban services
• Problems of access for urban poor and rural communities
• Services inadequate and often do not include needs of persons with disabilities
• Assistive devices limited
• Rehabilitation services limited - dominated by service providers - can be viewed as disempowering by persons with disabilities.
• Services for children and support to families extremely limited

NEEDS OF DISABLED CHILDREN - EARLY INTERVENTION and EDUCATION

EDUCATION is the defining social service which has the capacity to empower and provide opportunities for the development of children and youth with disabilities into independent and self-sufficient adult life.

Without EARLY INTERVENTION children with disabilities will be deprived of the opportunity to benefit from education, even if they are able to gain access to it.

"In many parts of the ESCAP region children are lying on mats on the floor, in need of

• assistance, stimulation and training,
• while their families are in need of assistance in
• developing knowledge to enable them to care more adequately for the development of their children" (ESCAP 1999).

EARLY INTERVENTION - NECESSARY STEPS

Train and sensitize medical and primary health care workers in the importance and expertise of identifying and helping disabled infants and their families.

Ignorance and negative attitudes lead to total neglect of child and lack of support to family

Develop Child Development checklists for use by MCHW to detect disabled children

Referral to CBR services/ home visitors with expertise in early intervention

Prevent secondary disabilities - contractures, lack of stimulation, nutrition

Support the family in the home and help them assess what the child can do

Decide what to teach next in consultation with family - simple developmental skills - teach through play and everyday activities

Teach the family how to teach the child - self-help skills, communication, physical activities, social skills, understanding

Link family with pre-school, informal mother/child groups

Prepare family and child -and school - for entry to school.

Early intervention is the most effective form of prevention of further disablement caused by lack of stimulation, and lack of opportunity to develop fully.

EDUCATION FOR CHILDREN WITH DISABILITIES

Education is a right for ALL children

International mandates include CRC (1989) Standard Rules (1993), Salamanca (1994),Dakar (2000)

Less than 10% of children with disabilities have access to ANY education

Lack of access to education remains the key risk factor for poverty and exclusion

The risk is higher for children with disabilities than for non-disabled children

Range of educational options:

Separate special schools

Separate units in regular schools

Integrated education
Can the child fit into the regular school?

Inclusive education
The school system must cater for ALL children - diverse ability range accepted

Barriers preventing children with disabilities from gaining access to education include lack of action by:

• The international community
• Governments
• NGOs
• Communities
• Organizations of persons with disabilities

Major barriers to quality education:

• Lack of early identification and intervention services
• Negative attitudes and exclusionary policies
• Inadequate teacher training
• Lack of support for teachers
• Lack of appropriate teaching materials and devices

Necessary steps to achieve quality inclusive education:

• Awareness raising to promote positive attitudes to the right of CWD to be educated in regular schools - public administrators and the community
• Awareness for families of the right to education of their disabled child
• Legislation and policy - inclusion of CWD in all national EFA plans
• Involvement of parents and community in inclusive schools

• Comprehensive pre- and in-service teacher training for ALL teachers to teach WIDE range of abilities
• Flexible child-centred curriculum, teaching and assessment strategies
• Select PWD to train as teachers
• Systems of support for teachers in urban and rural areas
• Accessible teaching materials and school buildings
• Accurate data for planning and monitoring purposes

See BMF pages 9 - 13.

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