DOCUMENT RESUME

ED 411 637 EC 305 828

TITLE First Steps: Stories on Inclusion in Early ChildhoodEducation.

INSTITUTION United Nations Educational, Scientific, and CulturalOrganization, Paris (France).

REPORT NO ED-97/WS/39PUB DATE 1997-00-00NOTE 126p.; Photographs may not reproduce well.PUB TYPE Collected Works - General (020) -- Reports - Research (143)EDRS PRICE MF01/PC06 Plus Postage.DESCRIPTORS Case Studies; *Comparative Education; *Disabilities; Early

Childhood Education; Foreign Countries; *Inclusive Schools;Mainstreaming; Social Integration; *Special Education

IDENTIFIERS UNESCO; UNICEF

ABSTRACTThis publication presents papers from 13 nations that

describe the integration of children with disabilities into early childhoodeducation programs. The compilation of case studies will serve as a referencedocument for the International Consultation on Early Childhood Education andSpecial Educational Needs, organized by UNESCO in collaboration with UNICEF(Paris, France, September 1997). The papers are: (1) Australia: "The EthnicChild Care Family and Community Services Co-operative: Inclusive EarlyChildhood Education Programmes in New South Wales, Australia" (ViviGermanos-Koutsounadis and Meni Tsambouniaris); (2) Chile: "SpecialEducational Needs in Early Childhood Care and Education in the Junji (JuntaNacional de Jardines Infantiles) of Chile" (Erika Larraguibel Quiroz); (3)

Denmark: "Roskilde County's Services to Young Children with SevereDisabilities" (Specialradgivning for Smaborn, Roskilde amt); (4) France: "TheIntegration into Nursery Schools of Young Children with Special EducationalNeeds in the Haute-Garonne Department" (Fernande Valerie Flavier); (5)

Greece: "The Integration of a Visually Impaired Child in a MainstreamKindergarten" (Athena Zoniou-Sideri); (6) Guyana: "When There Is No NurserySchool: One Response to the Challenge in the Interior of Guyana" (BrianO'Toole and Shoma Stout); (7) India: "Special Educational Needs in EarlyChildhood Care: An Inclusive Early Childhood Education Programme" (IndumathiRao); (8) The Lao People's Democratic Republic: "Experiences in Provision forChildren with Disabilities Using the Kindergarten Sector" (Janet C.Holdsworth); (9) Lebanon: "The Hadicat-as-Salam Programme for SpecialEducation: Part of the Tadamoun wa Tanmia Association (Solidarity andDevelopment); (Rita Mufarrij Merhej, Jamal Chouaib, Rima Za'za); (10)

Mauritius: "Early Stimulation and Intervention in Special Needs Education:The APEIM Experience"; (11) Portugal: "Agueda's Experience: A Social Movementthat Made Its History in Integrating Socially Disadvantaged Children andGroups into the Community" (Rosinha Madeira); (12) South Africa: "Educationfor All: A Programme for the Inclusion of Children with Disabilities andOther Special Educational Needs into Early Childhood Development Programmes"(Judy Mckenzie); and (13) United States: "Inclusion for Pre-School Age

.Children: A Collaborative Services Model" (Mary Beth Bruder). An appendixlists contributors' addresses. (DB)

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Firsto,,StepsStories on Inclusion

in Early Childhood Education

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Stories r Inclusionin Early Childhood Education

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United Nations Educational, Scientific and Cultural Organization

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The views expressed in this documentare those of the authorsand do not necessarily reflectthose of UNESCO.

Cover photo by Janet HoldsworthText edited by Karen Dust

ED-97/WS/39

WHO

For information:

UNESCOSpecial Needs EducationDivision of Basic Education7 place Fontenoy75352 Paris 07 SPFrance

Fax: 33-1-45 68 56 27/8Tel: 33-1-45 68 11 37email: L.Saleh@unesco.org.

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Preface

Pe importance of early childhood development for all children,including those with special educational needs, was endorsed in

the World Declaration on Education for All. (Jomtien, Thailand, 1990)and the Convention on the Rights of the Child (1989).Specifically, the Convention on the Rights of the Child proclaimsthat 'Children have the right to life and the best possible chanceto develop fully' (Article 6), and 'Disabled children must be helped tobe as independent as possible and be able to take full and active partin everyday life' (Article 23). Furthermore, the World Conferenceon Special Needs Education (Salamanca, Spain, 1994) highlights earlyeducation as a priority area.

This early stage in life is not only crucial to a child's future develop-ment it can also be a time for children to discover differencesin a positive light, learning to live, to play and to learn together.These 'first steps' are extremely important in facilitating inclusionthroughout schooling.

UNESCO invited practitioners to share their experiences in the areaof inclusive early childhood education. The series of case studiespresented here are included because they

1) recognize the value of early detection and intervention,2) integrate children with special needs in regular care

and education, and3) have an early childhood component.

While some describe the content and application of inclusive earlychildhood programmes, others focus more on legislation, politicalcontext and the history of the effort, with less information on fieldapplication.

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6 The success of the inclusive school dependsconsiderably on early identification, assessmentand stimulation of the very young child with specialeducational needs. Early childhood care and educationprogrammes for children aged up to 6 years oughtto be developed and/or reoriented to promote physical,intellectual and social development and schoolreadiness. These programmes have a major economicvalue for the individual, the family and the societyin preventing the aggravation of disabling conditions.Programmes at this level should recognize the principleof inclusion and be developed in a comprehensiveway by combining pre-school activities and earlychildhood health care 9

The Salamanca Framework for Action, Article 53

The programmes can be compared within a variety of dimensionsand placed on several continua. For example, they vary in termsof the roles and responsibilities of different sectors, i.e. education,health and social services. This leads to quite different service models.The case studies can also be classified in terms of the degreeof government, non-governmental organization and communityinvolvement. While some are government programmes, others areprimarily developed by non-governmental organizations, althoughsometimes in partnership with the government. Some programmesrely heavily on the community, although a non-governmentalorganization may be the facilitator of the process.

A related dimension is the involvement of parents. Their role can beseen on a continuum, from 'needing to be taught', to 'needing support'to the other end of the continuum where the responsibility is placedalmost entirely on the parents to develop and deliver services.

Many of these stories illustrate important first steps' towardsinclusive early childhood education. As the practitioners and theirpartners move forward, they are facing challenges and constraints,learning important lessons along the way. We hope that theirexperiences may contribute something of value to others who areworking towards making inclusive education a reality.

* This compilation of case studies will serve as a reference document for theInternational Consultation on Early Childhood Education and Special Educational Needs,organized by UNESCO in collaboration with UNICEF (Paris, September 1997).

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Contents

1. AUSTRALIAThe Ethnic Child Care Family and Community Services Co-operative:inclusive early childhood education programmes in new South Wales, AustraliaBy Vivi Germanos-Koutsounadisand Meni Tsambouniaris

2. CHILESpecial Educational Needs in Early Childhood Care and Education in the Junji(Junta Nacional de Jardines Infantiles) of ChileBy Erika Larraguibel Quiroz

3. DENMARKRoskilde County's Services to Young Children with Severe DisabilitiesBy Specialridgivning for Sm Aborn, Roskilde amt

4. FRANCEThe Integration into Nursery \Schools of Young Children with Special Educational Needsin the Haute-Garonne DepartmentBy Fernande Valerie Flavier

5. GREECEThe Integration of a Visually-Impaired Child in a Mainstream KindergartenBy Athena Zoniou-Sideri

6. GUYANAWhen There is no Nursery School:one response to the challenge in the interior of GuyanaBy Brian O'Toole and Shoma Stout

7. INDIASpecial Educational Needs in Early Childhood Care:an inclusive early childhood education programmeBy Indumathi Rao

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8. The LAO PEOPLE'S DEMOCRATIC REPUBLICExperiences in Provision for Children with Disabilities using the Kindergarten Sector 65By Janet C. Holdsworth

9. LEBANONThe Hadicat-as-Salam Programme for Special EducationPart of the Tadamoun wa Tanmia Association (Solidarity and Development)By Rita Mufarrij Merhej, Jamal Chouaib and Rima Za'za'

10. MAURITIUSEarly Stimulation and Intervention in Special Needs Education:the APEIM ExperienceBy APEIM

11. PORTUGALAgueda's Experience: a social movement that made its history in integratingsocially disadvantaged children and groups into.the communityBy Rosinha Madeira

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12. SOUTH AFRICAEducation for All: A Programme for the Inclusion of Children with Disabilitiesand other Special Educational Needs into Early Childhood Development Programmes 101By Judy Mckenzie

13. UNITED STATESInclusion for Pre-School Age Children: A Collaborative Services ModelBy Mary Beth Bruder

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ANNEXAddresses of contributors 123

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AUSTRALIA

The ethnic child care familyand community services co-operative:inclusive early childhood education programmesin New South Wales, Australia

By VIVI GERMANOS-KOUTSOUNADIS

and MENI TSAMBOUNIARIS

This paper outlines the historical, political and policycontext for inclusive early child care in Australia.It provides demographic information about the typeof provision and its take-up by various groups andthen goes on to outline two specific initiatives runby the Ethnic Child Care Family and CommunityServices Co-operative (Ltd) in New South Wales. TheEthnic Child Care Family and Community ServicesCo-operative is a State-wide umbrella organisation,or "state peak". It is based in the State of New SouthWales and is a non-governmental community-basedorganisation with a membership of 45 ethnic andgeneralist organisations operating children's, wel-fare, social, health and other services. It is funded bythe Federal and State governments of Australia, tohelp ethnic children and families to obtain equitableaccess to children's and disability services. TheCo-operative's philosophy is driven by its commit-ment to multiculturalism in children's and disabilityservices.

It ACKGROUND INFORMATION

1. Childcare services in Australia

The Department of Health and Family Services(was Department of Human Services and Health) isresponsible for the Children's Services Programmeof the Commonwealth government which:

`assists families with dependent children toparticipate in the work force and the generalcommunity by ensuring that child care isaffordable for low and middle income families,and by improving the supply and quality ofchild care. The provision of such services is animportant contribution to the Government'slabour market and social justice objectives.'

The New South Wales (NSW) state government isalso involved in children's services. It is responsiblefor the setting of, and monitoring of compliance withregulations for the operation of services. Services aresubsidised to facilitate the employment of qualifiedstaff. In agreement with the Commonwealth, thegovernment contributes towards the capital costsand funds the out-of-school-hours care, vacation careand mobile services for remote and isolated areas.It also provides funding for special needs groups to beintegrated into pre-schools and this is being extendedto include funding for integration into other types ofchildren's services.

Census of child care services in Australia

A census of child care services is conducted regularlyby the Commonwealth government. The 1993 censusof child care services provided information aboutfour types of children's day care services fundedunder the Children's Services Programme: community-based long day care centres; private long day carecentres receiving childcare assistance; employer-sponsored and non-profit centres receiving childcareassistance; and family day care schemes.

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Questionnaires requesting information about theattendance of children for one week in August weresent to 2,908 of these services and responses werereceived from 2,807 services, a response rate of 96.5%.

The breakdown of services responding was as follows :

Service type Percentageof responses

Private long day care centres 45%

Community-based long daycare centres 37%

Family day care schemes 11%

Employer non-profit centres 7%

Attendance figures for 265,300 children were:

Service type Percentageof children

Private long day care centresreceiving childcare assistance 37%

In family day care schemes 30%

Community-based long daycare centres 29%

Employer-sponsored andnon-profit centres 4%

The average number of hours of operation per day ofthe four types of service was 10 hours.

The survey showed that 84% of children below schoolage (0-4 years) use Commonwealth-funded long daycare child care services. Of the children under 3attending Long Day Care Centres, 44% were caredfor in Employer Sponsored Non-Profit Centres, 39%in Community Based Long Day Care Centres and29% in Family Day Care Centres.

The high priority groups for funded child care wereworking parents, those studying or training for workor seeking employment and sole parents, whosechildren constituted 22% of all children in the Census.Other priority groups were parents of children withdisability, Aboriginal and Torres Strait Islander(ATSI) families, children from a non-Englishspeaking background (NESB), and children referredbecause of risk of serious abuse or neglect.

Children with Special Needs

The proportion of Children with Disabilities inthe total population of 0-4 years old, in Australia is4.4% (ABS Survey of Disability and Ageing, 1993).Of these children:

3.2% attend Community BasedLong Day Care Centres

1.8% attend Family Day Care Schemes1.8% attend Employer Sponsored

Non-Profit Centres1.6% attend Private Long Day Care Centres

Staffing

Eighteen per cent of responding services weresupported by supplementary workers during thesurvey week. The SUPS (supplementary workersprogramme) grants are provided to promote access,equity and quality care for special groups of children.More of the community-based long day care centres(28%) were assisted by SUPS workers than anyother service. The average hours per child assisted bySUPS in NSW was 2.3 hours per week for childrenwith disabilities, 1.24 for ATSI, 1.09 for NESB and1.3 for other children.

Of the children assisted by SUPS in NSW, 14% werechildren with disabilities , 14% ATSI, 61% NESBand 11% other. For Australia as a whole, the break-down is: children with disabilities 17%, ATSI 14%,NESB 57% and other 11%.

Australia wide, 16% of staff in community-basedlong day care centres are from a non-English speakingbackground, 9% of staff in private centres, 13% inemployer and non-profit long day care centres, and9% in family day care. Just 1% of staff are Aboriginaland Torres Strait Islander people and most of theseare employed in multifunctional Aboriginal childcare centres. For NSW, the proportion of staff fromNESB employed in the four types of services is18% and for ATSI it is 1%.

Children in New South Wales

The state of New South Wales, where the inclusiveearly childhood education programmes are conductedby the Co-operative, has a total of 1,046 serviceswith 85,745 children attending and 12,146 paid staff.The distribution of children in long day care for work-related versus non work-related reasons is:

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sole parent, work-related

both parents, work-related

sole parent, not working

14%

64%

5%

two parents or one ofboth parents, not working 17%

Of the children attending services in NSW, theproportion of children with special needs in eachis as shown below.

2. Policy/political context regarding childrenwith special needs

The 1972 Child Care Act

Back in 1972, the Australian Federal Government'ssocial policy included the aim of providing access tochild care for all parents who needed it. The Govern-ment wished to assist women to join the work force,and as the private sector was unable to meet the childcare needs of families, it introduced the Child CareAct (1972). This Act established the Children'sServices Programme and the Federal Government'sinvolvement in child care. The Act was based onthe central principle of community- based child care,where parents participated in the establishment,management and operation of services. The FederalGovernment provided capital funding and staff salarysubsidies to child care centres which were then ableto employ qualified staff to provide quality careand childcare assistance for low and middle incomefamilies.

Multiculturalism

Since World War II, Australia has provided a hometo 4.5 million people who migrated from some160 countries of the world, speak 90 languages andpractise 80 religions. One in every five Australianswas born overseas. Fifty percent of those who were

AUSTRALIA

born overseas came from a country where Englishis not their first language. Together with theirAustralian born children, people from a non-Englishspeaking background (NESB) constitute 25% ofthe Australian population. Australia has one of themost culturally, linguistically and ethnically diversesocieties in the world

To meet the challenges of a diverse population, theAustralian government introduced its policies onMulticulturalism at the beginning of 1980, whichacknowledged the diverse multicultural nature ofAustralian society and the importance of maintainingand promoting this cultural and linguistic resource.However, the mainstream service providers failed toreflect or meet the needs of migrants. Their serviceswere not equally accessible to migrants and theother 'special needs groups', namely people from anon-English speaking or Aboriginal and Torres StraitIslander background, those with disabilities and thosewho lived in remote and isolated areas.

In 1986, to facilitate equality and equal access toservices for all Australians, the Federal Governmentintroduced its Access and Equity policy as part ofits overall policy of Multiculturalism. The policyrequired all government departments and agencies toproduce three-year Access and Equity strategy planswhich included corporate goals, management andbudgeting statements and performance indicators.The Office of Multicultural Affairs was establishedto assist the departments in developing these plans,and to monitor and co-ordinate the implementationof the strategy.

Disability

Also in 1986, the Disabilities Services Act was intro-duced and Objective 5 of the Act states:

`Programmes and services should be designedand administered so as to meet the needsof people with disabilities who experience a"double disadvantage" as a result of their sex,ethnic origin, or Aboriginality.'

Service type

Percentage of children attending with special needs

DisabilityParent

with disability At risk NESB ATSI

Community-based long day care 4% 1% 1% 19% 1%

Private long day care 2% 1% 1% 15% 1%

Family day care 2% 0 1% 7% 1%

Employer/non-profit centres 2% 0 0 20% 2%

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The needs of children with disabilities from 0-5 yearswere to be considered within the children's servicesprogramme. Funding was allocated through theSpecial Services Programme for programmes likethe Casual Ethnic Workers Pool (CEWP) and SUPSto integrate disabled children into these services.

A National Agenda

In 1989, the National Agenda for MulticulturalAustralia was launched which expanded and furtherstrengthened Access and Equity as it included allpeople of Australia, including the Aboriginal andTorres Strait Islanders, who may face barriers relatingto their race, culture, religion, language, gender anddisability.

Mr. Sandy Hallway, Acting Secretary to the Departmentof the Prime Minister and Cabinet, states in his paper`Multiculturalism as Public Administration: Myths,Challenges and Opportunities', that the NationalAgenda for Multicultural Australia, clearly definesMulticulturalism as a public policy based on three fun-damental principles:

i) cultural identity the right of all Australiansto express their cultural heritage

ii) social justice the right of all Australians toreceive equal treatment and not suffer becauseof race, religion, language or gender.

iii) economic efficiency the effective use of theskills and talents of all Australians, regardlessof background.

Under the policy of Multiculturalism, the Children'sServices Programme of the Federal Government,which was run by the Department of Human Servicesand Health (now called Health and Family Services),responded to the needs of children and families withspecial needs, whose take-up of children's serviceswas proportionately lower than that of the rest of thepopulation. In order to facilitate access for thesegroups to Federal Government funded children'sservices, and as part of its three-year planning toimplement Access and Equity, the Department allo-cated funding to community groups to set up servicesto meet the special needs of these groups of childrenand families.

These services were:Ethnic Child Care Development Units in five statesof Australia, the first one being in New SouthWales, as part of the Ethnic Child Care Family andCommunity Services Co-operativeThe Casual Ethnic Workers. Pool(General and Disability)The Support Workers Programme (SUPS) forNESB, ATSI and DisabilityMulticultural Child Care/Resource UnitsThe Ethnic Children's Services Workers.

The government funds Aboriginal organisations andpeople to operate their own child care services as partof its policy to facilitate self-determination. Thesespecial services provide information, referral, advice,consultancy, advocacy and resources for multicultural

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programming. They also raise awareness amongchildren's services staff about the cultural/linguistic/disability and other needs of children and parents.They also assist staff in providing a more relevantand appropriate service for the benefit of the childrenand facilitate integration/inclusion of the needs ofthese children as an integral part of service delivery.

Multiculturalism has been further reinforced bythe United Nation's Convention on the Rights of theChild, to which Australia is a signatory. Article 30guarantees certain basic cultural, linguistic andreligious rights to ethnic minorities, indigenous anddiverse groups, and the programmes mentioned aboveare an attempt to implement this article. Article 23of the Convention on the rights of children withdisabilities ensures that their needs are considered ingovernment policies and in the allocation of resourcesin children's services and early childhood educationto facilitate their integration/ inclusion into main-stream service delivery.

3. Current situation of children/familiesof children with special needs

As the numerical data provided above show, childrenwith special needs do have access to early childhoodservices at pre-school level and provision is also madeby the education department for those who are over .five years old. Attempts are being made to integratechildren with disabilities into mainstream education,but owing to a lack of resources and support services,and difficulties with physical access, it is often notpossible and these children are still being placed inspecial schools.

The New South Wales State Department of CommunityServices provides funding to pre-schools to providespecialist support for children with special needs (SN).Funds are also allocated through the Home andCommunity Care Programme (HACC) for respite carefor people with disabilities, including children. Thisprogramme is jointly funded by the Commonwealthand state government. In addition, Commonwealthrespite carers funding provides for respite care forchildren with disabilities. There are also EarlyIntervention teams which offer support, the SUPSProgramme which is outlined in this paper and state-funded community services which provide assistanceand support to children with disabilities.

The Disability Services Act (1986, see above) andDisability Discrimination Act (1992) have beeninstrumental in creating an awareness at both serviceprovider and community level of the rights of peo-ple/children with disabilities. People with disabilitieshave had new opportunities to speak up about their

AUSTRALIA

rights and to demand to be treated as equal citizenswith equal rights. Some progress has been made as aresult of government initiatives; people with disabili-ties and their families and carers have organisedthemselves and set up advocacy and other specialistorganisations which they manage and operate bythemselves. Their visibility and participation in allareas of life has helped to break down barriers,negative attitudes and misrepresentations of peoplewith disabilities.

PROII;LEMS ANIB MAJOR ISSUESFOR FAMILIES WITH CHELDREN

WIETIHI SPECIAL NEEDS

1. Problems

Parents from a non-English speaking background(NESB) do not have adequate access to translatedinformation about services to meet their specialneeds.NESB pre-school children are forced to discardtheir home language as there are no bilingualprogrammes and facilities for home language main-tenance. This leads to children losing their cultureand identity with their parents and ethnic communi-ty. This often manifests itself as cross-culturalconflict between children and their parents in lateryears.For NESB children, not maintaining their homelanguage affects their interpersonal relationships,their bonding with their parents and the deeperemotional and psychological aspects of communi-cation and understanding between them and theirparents. In cases where parents cannot speakEnglish and the children cannot speak the homelanguage, there is no communication between themand misunderstandings result which sometimeslead to family problems and disintegration of thefamily.There is resistance from some parents andeducation authorities to including children withdisabilities in mainstream schools.The equipment and physical access for childrenwith disabilities in pre-schools is inadequateand prevents those with high support needs frombeing integrated in the centres.NESB and ATSI parents face difficulties in havingtheir child rearing/caring practices accommodatedin the pre-schools, as staff are often not sensitiveto these needs; these issues are not covered in theirtraining.States do not have inclusive education policies to

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enable children with disabilities to access the schoolsystem as a matter of course.Lack of access to transport for parents who havechildren with disabilities affects their ability toparticipate in programmes.The means testing of benefits for families withchildren with disabilities often precludes themfrom accessing services.Services are often not sensitive to cultural/linguis-tic/ethnic community needs and therefore NESBand ATSI families cannot gain equitable accessto the services which would help them gain inde-pendence and become self-sufficient.Families with children with disabilities are isolatedbecause of a lack of support. Families from anNESB are even more isolated because of languageand cultural barriers.The cost of caring for children with disabilitiesis high, especially for those on low and middleincomes, those who live in poverty, or are NESBand ATSI families.The needs of children with disabilities togetherwith NESB and ATSI are often marginalised andare not an integral part of the mainstream policiesand service delivery.For ATSI children who have lost their culture andlanguage as a result of the assimilation policies,it is important that they have the opportunity withintheir communities to relearn their culture, to regaintheir identity, the spiritual beliefs of their ancestors,to have their land back for self-determination andto be accepted as the indigenous Australian.People from NESB, ATSI people and, indeed, thegeneral community, lack an understanding of thedifferent types of disability and this often createsbarriers to their acceptance of families with childrenwith disabilities. There is a need for educationalprogrammes at the local community, service deliveryand government policy and decision-making levelsto create an awareness and foster interactionand understanding between these groups and thefamilies.

2. Some strategies for overcomingthe problems

There is a need for support groups for parentsfrom particular NESB communities to enable themto talk about their needs with other parents andto ensure that the disability issue is on the agendaof their community organisations. Communitiescan be educated through the parents.Ethnic radio and TV, together with other ethnicmedia, are important tools with which to reach iso-lated NESB families with children with disabilitieswho are too ashamed to come forward.Ethnic welfare, health and educational workers are

important links in reaching families with childrenwith disabilities as they are the first contact pointfor the families who experience problems. Theseworkers can also disseminate relevant informationto these families and often act as mediatorsbetween them and the mainstream services.Ethnic and disability organisations play a rolein lobbying on a state and Commonwealth levelfor the needs of the children with special needsand their families. These organisations can involveparents in taking up the issues with both the gov-ernment and non-governmental sectors to ensurethat their needs are considered in policy anddecision-making and the allocation of resources.The unofficial networks in the local community,such as the priest, the local shopkeeper, thesocial/sporting/recreation clubs, an influentialcommunity leader, an interpreter, an ethnic schoolteacher, an ethnic organisation, an elder of a partic-ular community, etc., are all important in helpingto reach families and children with special needs.All groups need to lobby the CommonwealthGovernment to implement at the Commonwealthand state levels, the UN Convention on the Rightsof the Child, the Articles of which include safe-guarding the needs of children with special needs.The use of advocates whether they are familymembers, volunteers, friends or paid staff, is key inempowering families with children with disabilitiesto become advocates for their children.The provision of carers/volunteers from particularethnic backgrounds to liaise with NESB and otherfamilies with children with disabilities, and tobecome their mentors, is a cost-effective way ofproviding support.It is important to provide access for familiesto various ethnic and other community activitieswhich are offered by community organisationsas part of their service delivery.Regular consultations with the families are animportant way of obtaining information on gapsin service delivery and unmet needs. These consul-tations can be carried out using focus groups withfacilitators who are bilingual for NESB familiesor Aboriginal for ATSI families.The Ethnic Access Programme is a cost-effectiveprogramme which assists mainstream services tobecome more accessible to NESB people and thosewith disabilities. An ethnic access officer is placedwith a service for two days per week for six monthsand, together with the staff and management of theservice, reviews the structure of the organisation, itspolicies, procedures and practices. Ethnic communi-ties in the area where the service is based areinformed about the service, a profile of the popula-tion in the area is drawn up and a plan of action forimplementing changes to enable more NESB peopleto access the service is written. Training is provided

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to the staff and management on cross-cultural issues,the use of interpreters, Access and Equity policiesand how to reach NESB people in the community.This model has been successful with a number ofHome and Community Care Services.Other cost-effective programmes include theCasual Ethnic Workers Pool and the SUPSProgramme, which are described in detail below.

It is imperative for the government to provideresources; the needs of special needs groups are oftenextensive and costly and cannot be met by voluntaryeffort alone. Most importantly, children with specialneeds, and their families, according to the variousActs and Conventions, have a right like all otherpeople to have quality services which are relevant tothem and meet their individual needs.

PROGRAMME DESEGN ANDIMPLEMENTATION:

CASUAL ETHIC WORKERS POOL(GENERAL AND DIESAIIELIETY)

1. Project description

The Casual Ethnic Workers Pool (General and Disability)CEWP is sponsored by the Ethnic Child Care,

Family and Community Services Co-operative Ltd.,and funded by the Commonwealth Department ofHealth and Family Services.

The aim of the CEWP programme is to facilitate theprovision of culturally, linguistically and develop-mentally appropriate children's services to enablefamilies and children with special needs to have equalaccess to services which are appropriate to theirneeds. This is achieved through the placement ofcasual ethnic workers with the children's services.

The CEWP (General and Disability) offers specialisedtraining programmes for men and women to workwith children with additional needs (including childrenfrom NESB and children with disabilities). TheEthnic Child Care, Family and Community ServicesCo-operative offers casual employment, through theCEWP, to those who have successfully completed thetraining programme.

Children's services (including long day care centres,family day care schemes, out of school hours careprogrammes, occasional child care centres and play-groups) are eligible to apply to have a casual ethnic

AUSTRALIA

worker to be placed in their service to support them,free of charge, on a casual basis. Requests areplaced on a waiting list and are followed up as soonas possible.

2. Staffing

The Programme is staffed as follows:full-time CEWP Managerfull-time project officer/part-time project officerfull-time clerical/payroll officerpart-time clerical support workerapproximately one hundred and twentybilingual/bicultural ethnic workers.

The ethnic workers aim to facilitate the provisionof culturally, linguistically and developmentallyappropriate child care for all Australian children.

Allocation of casual ethnic workers to a servicedepends on various factors, including:

demand and availability of a particular languagespecific needs of a child with a disability ordisabilitiesnumber of requests from children's services,in relation to the quarterly quota or allocationscross-matching of language requested andgeographical areas involved in allocating workerto centrethe availability of hours/funds for allocations.

Casual ethnic workers undertake a range of duties andare required to:

assist in the development and implementation ofmulticultural and special needs programmes whichhave a multicultural/special needs focuspresent activities to staff, children and parents ofthe centre where they are workingpromote an awareness of diversityassist with the integration and inclusion of childrenfrom an NESB and children with disabilities froman NESB, into children's services, by providingone-to-one, hands on supportencourage and facilitate parental involvement inthe activities of children's servicesprovide information and support, and refer parentsto other relevant services for example, in relationto the assessment of a child with a disability ordisabilitiesconsult on the development of individualisededucational programmes with:

parentschild care servicesother relevant health professionalsSUPS programmesProject Officer(s) of the Ethnic Child CareDevelopment Unit

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the Ethnic People with Disabilities Programme'the CEWP Manager.

encourage, support, maintain and assist with achild's home languageprovide language assistance for children and fami-lies of an NESB, to facilitate better communicationbetween children and families.

Staff training programmes

The CEWP offers a specialised training programmeon working with children with additional needs(NESB and disability). Participation in the generalCEWP course is a pre-requisite for entry into thedisability course. A complete training programme(General and Disability) is offered over a period of22 weeks, free of charge to participants.

The CEWP (General and Disability) training coversa range of areas, including:

the role of the Ethnic Child Care, Family andCommunity Services Co-operativethe role of the casual ethnic workerthe multicultural perspective in early childhoodmulticultural programmingplanning and programming for children withspecial needsthe integration and inclusion of children withspecial needs into children's serviceschild developmentcultural awarenessdisability awarenesstypes of disabilitydisability in a cultural context the doubledisadvantagechild-rearing practicesbilingualism in early childhood and the importanceof home language maintenancethe aboriginal perspective in early childhood.

The CEWP (General and Disability) trainingprogramme is currently seeking accreditation with theVocational Education Training Authority Board.

3. Mechanisms of early identificationof children with special needs

By the time the casual ethnic worker becomesinvolved with a child with special needs, some sort ofearly identification has already taken place, as causalethnic workers are placed in centres on request.

' A programme sponsored by the Ethnic Child Care Familyand Community Services Co-operative

Early identification of children with special needscan occur through:

assessments by professionalsobservations milestones in children'sdevelopmentdevelopmental checklists undertakenby children's services staffconsultations with parents and other healthprofessionals, including early interventionservices, speech pathologists, psychologists,physiotherapists.

4. Partnerships and liaison

Specialist support services /referral services

The CEWP programme links with a wide rangeof support and referral services, including:

SUPS programmes and workers(disability and ethnic)migrant resource centresmulticultural resource centresspecialist ethnic workers and ethnic welfareagenciesinterpreter and translation servicesethnic mediaearly intervention teams (state-wide)specific disability agencies/associations forinformation, support, resources, assessments, earlyintervention services, parent support groupscommunity health centrescommunity resource teams for developmentaldisability, offering school and home-based therapy,social work, community nurse support, paediatricconsultations, assessment, information and referralserviceethnic disability support programmes, sponsoredby the Ethnic Child Care, Family and CommunityServices Co-operative.

Partnership with parentslcommunity

Parents play a significant role in the success of theCEWP programme. In many instances, parentsencourage centres to apply for casual ethnic workersto work with their children. Parents also providefeedback to workers and CEWP staff on the progressof their child and the effectiveness of the CEWPprogramme. Parents are usually instrumental in havinga placement extended.

Casual ethnic workers work closely with parents,by encouraging and facilitating parental involvementin the activities of the child care centre. Parents areencouraged to extend special needs, multicultural andbilingual programmes developed for their child(ren)to the home environment.

t 8

.j.

)*fist*

AUSTRALIA

of

Casual ethnic workers also provide language assis-tance for children and families of an NESB in orderto facilitate better communication between the centreand families.

Outreach Work

Outreach work takes the CEWP programme to thecommunity. Of particular importance is the promotionof the CEWP in the ethnic communities. A range ofpromotional tools is used, including parent informationworkshops which are held in community languages,ethnic print media and ethnic radio. The outreach workcreates an awareness about the programme amongstthe ethnic communities and encourages them toaccess the service. This, in turn, encourages NESBpeople with experience and/or qualifications in earlychildhood to apply to become casual ethnic workers.

CEWP staff also make presentations to ethnic, dis-ability and generalist children's services committeesto raise awareness, promote the CEWP and recruitpotential casual ethnic workers.

Further outreach and community development workis undertaken with the Co-operative's memberorganisations and ethnic and disability networks.Training is provided to children's services, disabilityand NESB communities on disability and culturalawareness, through CEWP and the Ethnic Child Care,Family and Community Services Co-operativeTraining Programmes.

5. Monitoring mechanisms

Annual workplans are produced together with actionplans, and both individual and organisational progressare regularly assessed against these.

Casual ethnic workers and CEWP staff are supportedand supervised by the CEWP Manager. Their workis evaluated by centres at the end of each placementusing evaluation forms. Written feedback is alsoprovided by parents. Centres, staff and parents providefeedback to the CEWP Manager on the success andeffectiveness of the programme as it progresses. Thisis normally done through meetings between the rele-vant parties.

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10

The CEWP Project Officer offers support and resourcesto CEWP workers while they are on placement, usingthe Multicultural and Special Needs Resource Van.The Project Officer also follows up any issues orproblems arising during a placement. All programmesrun by the Ethnic Child Care, Family and CommunityServices Co-operative are accountable to theExecutive Director and the Programmes Manager,who also supervise and offer support to CEWP staff.The Board of Directors meets monthly,and theProgrammes Manager and Executive Director reporton the progress of the Co-operative's programmesat these meetings. The funding body receives annualprogramme reports and reviews and the AnnualReport includes self-evaluation by the programmestaff.

SUPPLEMENTA Y WO KERSPis OG AMME (SUPS):

ANKSTOWN EA LYINTEG 19: ATION

AND NETWORKING G N OUP

This section describes how the SupplementaryWorkers Programme (SUPS) works in the Bankstownarea, Bankstown is a suburb of The Bankstown LocalGovernment Area in the State of New South Wales.The programme is delivered by the Bankstown EarlyIntegration and Networking Group.

1. The Bankstown area

The local government area of Bankstown has apopulation of approximately 154,000 of which32,371 are children aged 0-14 years, representing21% of the total population. Of these children,12,863 are aged 0-5 years old (8.4%) and 6,621are 0-2 years of age (4.3%).(City of Bankstown Community Profile 1994.Source: Australian Bureau of Statistics, 1991).

There are 51 private long day care centres comparedto just seven community based long day care services.(Commonwealth Department of Health and FamilyServices, NSW office 1994, updated 1996.)

According to data gathered by the Bankstown EarlyIntegration and Networking Group (September, 1996),approximately 4.5% of children accessing children'sservices in the Bankstown local government areahave a disability. Furthermore, approximately 30%of children and families accessing children's servicesare from a non-English speaking background.

Local experience has indicated that most children'sservices are available and accessible to children/families of children with special needs, particularlywhen the support of services such as SUPS and theCEWP are offered. Furthermore, there are specialistearly childhood services for children with specialneeds, focussing on early intervention and support.

2. Other support and assistance for childrenand families with special needs includes:

specific disability agencies/associations offeringearly intervention services, parent support groups,information, newsletters, support and resources,and parent/community education programmes

community health centres, offering assessmentservices and early childhood nursing staffcommunity resource team for developmentaldisability, providing physiotherapy, occupationaland speech therapy, social work, community nursesupport, paediatric consultation, psychologicalassessment, information and referral serviceEarly Intervention Association: an associationof parents and professionals involved in earlychildhood intervention, support, policy develop-ment and lobbyingethnic disability support programmes, such asthe ethnic people with disabilities programmeCasual Ethnic Workers Pool (CEWP).

Additional support is available for children andfamilies from a non-English speaking background,including:

interpreter services, including telephone interpreterservicestranslations of relevant early childhood/children'sservices and disability materialspecialist ethnic workers, supporting and resourcingNESB communitiesmigrant resource centres, offering services forNESB communitiesethno-sponsored welfare agenciesethno-sponsored children's services.

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PROGRAMME DESIGNAND IMPLEMENTATION

1. Project description

The Bankstown Early Integration and NetworkingGroup's programme is funded by the CommonwealthDepartment of Health and Family Services andsponsored by the Bankstown Community ResourcesGroup.

The Bankstown Early Integration and NetworkingGroup (BEING) is a team of developmental andmulticultural educators, who assist children's servicesin Bankstown by providing information, resources,support, newsletters, referrals and training on issuesrelating to working with children with disabilitiesand multicultural aspects in child care.

BEING works with centre staff, parents and otherprofessionals to promote multicultural and specialneeds programming for all children, particularlychildren from all NESB, and children withdisabilities. Multicultural and developmentaleducators can assist children's services in the localgovernment area by:

providing an advisory/consultancy. role on pro-gramming and caring for children with additionalneedsassisting children's services staff with the develop-ment and implementation of ongoing multiculturaland special needs programmes which reflect theneeds of all children and encourage integrationtraining and empowering staff to integrate childrenwith disabilities and children from an NESB intotheir servicesproviding and disseminating information andresources on disability, the integration of childrenwith additional needs, multicultural programming,etc.demonstrating appropriate education/care practicesfor individual children with disabilities andchildren from an NESB, to children's services staffand parents.

2. Staffing

The programme staff are:a part-time co-ordinatora full-time disability workertwo part-time ethnic workersa part-time ethnic and disability worker who assistschildren from a non-English speaking background,children from Aboriginal and Tones Strait Islander

AUSTRALIA

backgrounds and children with disabilities, to gainaccess to and become integrated into Commonwealth-funded children's services in the Bankstown localgovernment area.

Staff training programmes

The SUPS workers programme receives funding fromthe Commonwealth Department of Health and FamilyServices to conduct annual training for its workers.Training is offered in various forms including:

block training one week of keynote speakersand workshops. All SUPS disciplines(ethnic, aboriginal and disability) come togetherto discuss common areas and receive trainingacross the board.individualised worker training-workers are trainedon individual areas of need in relation to their role.Costs are covered by the employer.practical "hands on" experience under the supportof a more experience SUPS worker.

3. Monitoring mechanisms

Arrangements for project monitoring include:evaluation by the co-ordinator of the programmeevaluation by the organisational managementcommitteesix-monthly programme reports/review to fundingbodyannual workplans, yearly evaluations and plansof actionannual report/self evaluationperiodic assessments against workplans.

4. Partnerships and liaison

As with the CEWP programme, links are made withmany other specialist, support and referral services.Similarly, partnerships with parents and the widercommunity are important; they are involved in theSUPS programme on various different levels. Someparents request the support of developmental educa-tors to work with their child(ren) in child care.

Parents are encouraged to become involved in theoperation of the centre at Management Committeelevel and in the programming for the centre and theirchild. Parents are also encouraged to extend specialneeds programmes developed for their child(ren) tothe home environment.

Outreach work is also important. SUPS workersare involved in community development activities.They act as facilitators in the local area, developingresources and services to assist children's services

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12

and promote the concepts of multiculturalism andspecial needs. The SUPS workers create networksand assist in team liaison between children's servicesstaff, parents, the community and other agencies(ethnic and disability) that may be involved with thechild and his or her family.

The development of strategies for attracting potentialusers of children's services from NESB and familieswith children with special needs is considered crucialin improving access, as are the community educationprogrammes on children's and disability services.

5. Problems and major issues

In addition to the obvious need for adequate andon-going funding of the SUPS programme, thereare a number of factors affecting its impact.The following are key to ensuring that the programmeis effective:

the role of workers should involve providingcommunity development, advocacy, resourcingand support, complemented by 'hands on' support.In recent years, the focus of SUPS has moved awayfrom the 'hands on' role, towards the trainer/facili-tator role. That is, it has focussed primarily on thetraining and empowering of children's servicesstaff to enable them to work with children withspecial needs. This approach cannot work by itself:children with special needs and children from anNEBS need support at a 'hands-on' level.assistance to child care centre staff should beongoing and intensive. Staff need advice, supportand resources to enable them to develop and imple-ment multicultural and special needs programmes.Approaches to this should include targeting allstaff members, attending staff meetings, providing

information sessions to staff, and demonstratingappropriate activities/methods. This is a veryeffective strategy in assisting with the integrationand inclusion of children with special needs,as it focuses on advising, consulting, educatingand empowering staff to take on special needs andmulticultural programming themselves.the main aim must be to ensure that all the skills,ideas and resources provided to the centres continueto develop and extend after the SUPS workerleaves. The responsibility of working with childrenwith special needs and children from an NESBshould not rest with one person. It must be theresponsibility of all child care staff.

Occasionally, we may encounter negative attitudesfrom the community and child care sector.Some child care centres are not interested in either`taking on/integrating children with special needs',as it is 'too hard' or 'there are not enough resources inthe centre'. Other centres claim that they 'do not needmulticultural programmes, as all their children areAustralian'. In our opinion, these are the centres thatrequire the most support, and we try gradually tochange attitudes by offering disability and culturalawareness training and targeting these people throughnewsletters, workshops and informal discussions.

We have not experienced any problems regardingthe availability of trained personnel and there is agood response during recruitment. It is very importantto recruit highly-skilled, trained and experiencedworkers.

The SUPS programme has no problems identifyingand reaching children with special needs, as the modelis based on providing support to services that requestit thus it is responsive.

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LESSONS LEARNED

Lessons learned from the casual ethnic workerspool programme and the supplementary workersprogramme (SUPS).

Funding for the CEWP and SUPS programmesmust be adequate and on-going. Wages, resources,training and administrative costs are on-goingand should be earmarked within the budget, forefficient and effective service delivery.Adequate funding is essential for the type of serviceand support offered by the CEWP programme;the programme provides a unique, practical humanresource and 'hands on' , bilingual/bicultural sup-port. Lack of funds and limited resources can createfrustration and disappointment for child care centres,staff, parents and children.In order to establish better access to resources forcasual ethnic workers, a Multicultural and SpecialNeeds Resource Van was funded, as a componentof the CEWP programme. The Resource Van,driven by a CEWP project officer, visits child careservices where casual ethnic workers are placed,to provide resources and support.It is important to encourage cross-programmeliaison and collaboration. Both the CEWPand SUPS programmes should work together,where possible.Children's services need to be clearly informedabout the role of the casual ethnic workers,so that they are not misused as simply an extrapair of hands.SUPS programmes operate in pools and servicelarge regions. They therefore need co-ordinatorsto support, supervise, plan, monitor, review,co-ordinate and administer the project.The role of the SUPS sponsor has been a majorfactor in the success of this project. Community-based organisations are effective sponsors of SUPSprogrammes, as the existing community-basedstructure enables effective administration of theproject. It can offer the support, resources, adminis-trative, equipment and skills of other community-based workers/projects, which may not be availableto SUPS workers based in child care centres ormunicipal councils.

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CONCLUSIONS

The CEWP programme is a unique, practical,human, 'hands-on' resource which, in its 15 yearsof operation, has benefited a large number of children,families and children's services through facilitatingculturally, linguistically, and developmentally appro-priate, quality child care.

Furthermore, the programme is also an excellentstepping stone for people from a non-English speakingbackground who are interested in developing furthertheir careers in early childhood. As most of the casualethnic workers are women, it gives them an opportunityto expand their skills and fulfil their potential. Manygo onto find part-time and full-time employment in thechildren's services, welfare, health and other fields.

The CEWP is a cost-effective programme, servicinga number of centres, targeting a large number ofchildren and staff, not just those children with specialneeds. The casual ethnic worker works with the staffto encourage them to include the multicultural anddisability components as an integral part of the centre'soperation, planning and programming.

An effective SUPS team will achieve its aims to assistchildren from a non-English speaking backgroundand children with special needs, to gain access to andhave appropriate, quality care in child care services.The SUPS programme is extremely importantand vital, in order to facilitate Access and Equity andMulticulturalism in children's services.

SUPS programnies such as the Bankstown EarlyIntegration and Networking Group (BEING),create greater awareness among mainstream serviceproviders and continue to resource children's servicesstaff with the necessary skills to implement multicul-tural and special needs programming throughout allareas of the curriculum. Support for the integration andinclusion of children with special needs in children'sservices is also provided to those service providers.The BEING provides a focal point for children's ser-vices in the local area, by offering resources, support,advice, information, training, community developmentand hands-on help, in relation to special needs.

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REFERENCES

City of Bankstown Community Profile, 1994,Australian Bureau of Statistics, 1991.

Department of Community Services and HealthChild Care Office (1986), Response to the Review ofMigrant and Multicultural Programmes and ServicesPolicy Approach. "Provision of Child Care Servicesto Migrant Families". Canberra: AustralianGovernment Publishing Services.

Department of Human Services and Health (1993),1993 Census of Child Care Services, Family andChildren's Service Programme. Canberra: AustralianGovernment Publishing Service.

Department of Prime Minister and Cabinet, Officeof Multicultural Affairs (1988), Access and EquityPlan of the Department of Community Services andHealth Portfolio Three Year Plan 1987188 and1989190. "Access and Equity Report No. 2". Canberra:Australian Government Publishing Service.

Office of Multicultural Affairs, Department of PrimeMinister and Cabinet (1993), Access and EquityAnnual Report, 1993. Canberra: Australian Govern-ment Publishing Service.

Office of Multicultural Affairs, Department of PrimeMinister and Cabinet (1994), National Agenda forMulticultural Australia, The Year in Review, August

1989 to July, 1990, Canberra: Australian GovernmentPublishing Service.

Germanos-Koutsounadis, Vivi (1995), "EarlyChildhood Education and the Promotion of Accessand Equity in Australia". OMEP InternationalJournal, August 1995. World Organisation for EarlyChildhood Education, Institute of Education,University of London.

Germanos-Koutsounadis, Vivi and Di Giovanni,Partizia (1989), "FECCA Response on theImplications for Ethnic Communities in Australiaarising from the UN New Convention on the Rightsof the Child", AECA Journal, Vol. 14, Number 2.

Germanos-Koutsounadis, Vivi (1990), 'Fair Go'Access and Equity Issues for Australians withDisabilities who are from a Non-English SpeakingBackground (NESB), Aboriginal and Torres StraitIslanders, Women and From Remote Areas,DACA Access and Equity Forum. AustralianDisability Review, No. 3.

Holloway, Sandy (1991), Multiculturalism as PublicAdministration: Myths, Challenges and Opportunities,Keynote address to the Royal Australian Instituteof Public Administration National ConferenceProceedings.

Yeatman, Anna (1987), A Review of MulticulturalPolicies and Programmes in Children's Serviceswith Emphasis on Child Care Services. Canberra:Office of Multicultural Affairs, Department of PrimeMinister and Cabinet.

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CHILE

Special Educational Needsin early childhood care and education in the Junji(Junta Nacional de Jardines Infantiles) of Chile

By ERIKA LARRAGUIBEL QUIROZNational Coordinator of the JUNJI Programme in Chile

PRE SCHOOL EDUCATIONuN CHILE

1. The pre-school population

In Chile, the pre-school population (birth to six yearsold) is 1,714,810. Of these, 374,284 children (21.8%)attend a variety of state education programmes.

There is more provision for five and six year oldsthan for younger children. 217,371 of the five andsix year olds are in education programmes, whereasonly 10,843 children aged up to two years receivethis provision.

Forty-five per cent (775,094) of pre-school childrenlive in very poor conditions, and only 29.2%(226,370) of these receive any pre-school provision.

2. Educational policy

During the 1990s, education has been one of the majorpriorities of the state. Priority is given to policies aimedat overcoming inequities within the sector, particularlyfor people on a lower income. The aim is to improvetheir take-up of provision.

In relation to pre-school education, policies aim to:`Expand the coverage of pre-school education(children from birth to six years old) improving itsquality and its links with schools, especially in thosesectors of lower income'. The responsibility for

extending the coverage lies with the educationalcentres under the Ministry of Education, JUNJI(Junta Nacional de Jardines Infantiles) and theIntegra Foundation.

The social policy is focused on the process of socialparticipation and family promotion. There are nowsignificant advances in reducing: the undernourish-ment of children; levels of drop-out in the BasicEducation Programme (children from six to ten yearsold); and poverty generally.

Overcoming poverty has been given special priority;within this, education is recognised as being a funda-mental factor in the development of the country. Inparticular, there needs to be equality and better take-upof provision, with a focus on the Basic EducationProgramme.

In Chile, social programmes have given specialemphasis to the family, women as the head of a familyand to small children. With reference to the emphasisgiven to pre-school education: 'it is recognisedthat all activities developed are effective owing toits [pre-school education's] integral approach,not only for children's development during their keyyears but also for the family and community asa whole. Such actions have achieved a significantimpact, even in their future stages of development'.(Peralta, 1995)

A recent Ministry of Education survey (1995) showedthat there has been great investment in infrastructure,materials for children and parents, classroom librariesand training, and an increase in early childhood pro-grammes for children aged up to six.

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3. Law of social integrationfor people with special needs

The Law to Integrate People with Special Needs(January 1994) includes all social sectors of thecountry. There are more than 1,300,000 people withspecial needs in Chile and approximately 1,000,000live under poor conditions.

The law establishes that: 'the public and privatemainstream education centres should incorporate thenecessary innovations and curricular adaptations toenable access for people with special needs, providingthem with the complementary education required inorder to assure them of their permanence and progresswithin this system (Law of Social Integrationfor People with Disability, No.19.284, Chapter II,January 1994).

The National Programme to Overcome Povertyfor 1995/2000 states that people with special needsshould have priority in receiving provision.

The legislation therefore indicates the necessity forwider coverage and implementation of curricularinnovations, together with co-ordinated interdiscipli-nary support. This support involves the health, justiceand education sectors..

4. Families of people with special needs

For several years now, there have been a numberof organisations for parents and professionals whichhave been working for the integration of people withspecial needs. Such organisations arise from theinterests of families and professionals concerned withparticular types of disability. These organisations areinvolved in the development of training, workshops,lectures and documentation. These organisations havehad an important role in the support networks.

Poor families, especially those living in isolatedor rural areas have almost no medical/psychologicalcare. For example, there are no diagnostic facilitiesor treatments for children with special needs. Theseproblems are part of the social inequity existing inthe country, where there is also widespread rejectionand prejudice towards people with special needs.

The role played by the pre-school educational systemin integrating people with special needs is crucial,as it has become one of the first opportunities for inte-gration outside the family.

JUNG(JUNTA NACIIONAL DE

JARDIENES IINIFANTI[LES)

JUNJI is an independent organisation which wasestablished in April 1970.

Its responsibilities are to:i) create, plan, foster, stimulate and supervise the

development of nursery schools nationally;ii) stimulate, co-ordinate and supervise the public

and private pre-school sector, as well as supervisethe adequate use of resources assigned by the stateto pre-school education.

JUNJI makes provision for 92,014 children,aged from three months to five years, attending1,300 education centres in the 13 regions ofthe country. Six thousand employees work in JUNJI,including pre-school teachers, nutritionists, socialworkers, assistants to pre-school teachers and admin-istrative staff.

JUNJI is the most important educational organisationin the country for children between 3 months and6 years. Its educational plans contribute to thedelivery of the objectives for social developmentand quality of life covered by the National Plan toOvercome Poverty.

The criteria used to select the children provided forby JUNJI favour those known as: 'families that cannotsolve by themselves their poverty conditions andare unable to reach state or private social securityservices'. (Aranguiz and Jimenez, 1996)

JUNJI also creates innovative educational pro-grammes which enable it to ensure that its activitiestake into consideration the great range of needsdetected in pre-school children. For example, thereis the Family Garden programme, run by assistantsto pre-school teachers, with the participation of familymembers. The Home Nursery programme is alsorun by assistants who work with parents, sometimesin their homes.

In these and the other innovative programmes, aswell as in the traditional nursery school programmes,free and integrated provision is made for childrenfrom three months to five years of age.

2

THE JUNJ]IaNTEGRATEON PROGRAMME

1. Initiation

In June 1995, JUNJI designed a Programme ofIntegration which targeted the poorest children withspecial educational needs. This programme has beendeveloped in all thirteen regions of the country, and isincluded within all other Junji education programmes.

The Junji nursery schools have been taking childrenwith special needs for a long time. The integrationprogrammes also support professionals and specialistswho have accepted the challenge of integration.

The programme needed to marry the expectations andtheory with the reality of the situation in schools.First, it was important to establish policies and basicworking criteria related to:

CHILE

rolesshort, medium and long-term activitiesthe conditions needed to create a multidisciplinaryworking teamthe curriculumevaluation methods.

2. Design and developmentof the Integration Programme

The aim of this programme is to: 'Favour andfoster children's integration into the educationalprogrammes of JUNJI through short, mediumand long-term strategies'. Seven specific objectiveswere planned.

A description of each specific objective, togetherwith the strategies for its implementation, is givenbelow:

Objective 1.To support the integration of childrenwith special needs who attend the differenteducational programmes of JUNJI

Strategies

In order to achieve this objective, teachers were`sensitised' and trained. A monthly bulletin is dis-tributed to JUNJI's educational settings. In eachleaflet, different subjects are developed in a simpleand pedagogical way, for study and analysis by theparents and teachers in a workshop environment.Twelve bulletins will be published in total.Teaching materials were selected, after conductingan evaluation of possible materials in the field. Themain criteria applied were: a) that such materialshould stimulate the children; and b) that it shouldallow them to participate with other children withor without special needs. The selected material wasdistributed over a period of a year to the educationalinstitutions which were providing for children withspecial needs in each region.A book of 40 case studies was published. The casestudies represented examples of good practice inthe field of integration which had been developedby the educational community of JUNJI. There areparents' experiences and accounts from directorsand teachers. All of the case studies highlight thebenefits of children's experiences of integration.JUNJI purchased a video on the integration ofchildren with special educational needs into main-stream schools. Copies of the video were sent tothe 13 regions of the country for use by JUNJI staffand by people outside the organisation.JUNJI allocated funds to buy books dealing withintegration into mainstream education programmes.

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Those books were sent to the pedagogical centresin each of JUNJI's regional offices.

Objective 2.To co-ordinate joint support activities betweenministries and organisations which favourthe integration of children with special needs

Strategies

Three joint activities were co-ordinated in order tomeet this objective:

with the Special Education Department (DEE)of the Ministry of Education. An agreement wassigned between JUNJI and the DEE to entrust toJUNJI the early diagnosis and treatment of childrenwith special needs in all the JUNJI DiagnosisCentres and special schools in Chile. The agreementalso involves the development of information lec-tures and training courses for nursery school staff.JUNJI assists with the development of researchand studies which the DEE wants to carry out in itscentres.with the National Fund for Special Education(FONADIS). This is a state organisation in chargeof financing technical assistance such as wheel-chairs, prostheses and hearing aids for those peoplewith special needs who do not have the meansto fund these purchases themselves. The agreementis that through FONADIS, the JUNJI can obtaintechnical assistance when required.a mutual support agreement was signed withUNESCO which will provide a three- year trainingprogramme for the teachers and directors of nurseryschools in the thirteen regions of the country.UNESCO also offered to collaborate on the adapta-tion of evaluation instruments to record and assessthe achievements of children with special needs.UNESCO will also assist in identifying the educa-tional needs of the children, substituting themedical classification with educationally-baseddefinitions of need.

Objective 3.To develop principles and guidelines forthe integration of children with special needsinto JUNJI's educational programmes

Strategies

Library studies were initiated to deepen the under-standing of theory, curriculum methodology, others'experiences and the historical background of the inte-gration of children with special needs into mainstreameducation. From this base, study documents, readingreports and the definition of key concepts have beendeveloped.

Technical guidelines and principles have beendeveloped which provide a practical approach tointegration. These guidelines establish criteria forthe identification of children with special needs andfor the evaluation of these children's educationalachievements.

Objective 4.To identify curricular innovations to planthe integration of the children with special needsattending JUNJI's centres

Strategies

Training activities for the Regional TechnicalTeams (RTTs) have been designed and implement-ed. The RTTs supervise JUNJI's educational centresand advise on the adequacy of the curriculumwithin the integration process.Subjects such as curriculum planning, family work,work with multidisciplinary teams, and the role ofthe teacher and other educational agents, have beenrevised. Specific training has been provided onclassroom-based activity with children with mentaldisabilities.

Objective 5.To identify structural adaptations whichare needed in nursery schools in order to facilitatethe integration of children with special needs

Strategies

The structural department of our organisation(architects and civil engineers) has developed aproposal for basic modifications to improve accessfor children with physical problems to the centres.This proposal will be implemented this year as apilot project in three nursery schools in the metro-politan region of Santiago. The modifications willbe evaluated and then applied in other centres.

Objective 6.To identify financial resources to fundthe implementation of the programme for theintegration of children with special needs

Strategies

Private organisations interested in collaboratingwith JUNJI on the integration programme wereoffered projects for sponsorship. So far, fundinghas been obtained from an enterprise dealing withteaching materials; this is for publishing the text:New Experiences in Integration. UNICEF hascollaborated on the provision of teaching materialsand has part-funded training staff who providetraining in the regions.

r?. 8

2CHILE

0,4

At the time of writing, some projects are beingpresented for funding to other institutions andagencies. These projects are to provide regionaltraining, to assist with structural adaptations and todevelop seven videos for a training programme.

Objective 7.To evaluate the different strategiesapplied in order to inform future decisionsabout the Integration Programme

Strategies

Different evaluation instruments were designed,relating to the specific objectives and strategiesoutlined above, and taking account of the termsand timescale for their implementation.Evaluation guidelines developed by the NationalTechnical Department are being sent to the nurseryschools.The results of the evaluation were positive in thatall the activities proposed were accomplished withinthe terms and timescale agreed. The personnelworking in the nursery schools felt that these activitieswere very useful and necessary in their daily class-room work; they have appreciated this contributionto their professional practice.A 'diagnosis' evaluation of the integrated childrenhas now been developed. It was proven that morethan 40% of the children with special needsattending nursery schools entered the JUNJI thisyear. This indicates clearly the achievement ofthe Integration Programme to date. The results arehighly satisfactory, especially given that implemen-tation of this programme only began in June 1995.

3. Field evaluation

The above infOrmation provides a general view ofthe design and development of the IntegrationProgramme over a period of a year. The programmecontinues to develop and has some new strategieswhich have been adopted to ensure that it continuesto do so. This continuity and advance has been possiblebecause of the on-going self-evaluation of thenursery schools and the close contact maintainedwith the teachers in the centres.

A second important method of evaluation is beingdeveloped through monthly regional meetings,where we discuss what is happening in the classroomsand develop support mechanisms for dealing with theproblems which emerge.

In addition, observation visits to the nursery schoolsare organised, when there is discussion with the parentsand families of the children, as well as meetings withthe nursery school staff.

In this way, an objective overall evaluation of whatis really happening can be obtained, which facilitatesgood implementation of future decisions.

4. Attitudes of theeducational community

It is important to share the attitudes of the educationalcommunity and the children's families towards inte-gration.

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Most of them are open to the idea of integration andare well-disposed towards it. Teachers and staff sharewith their colleagues both the personal and profes-sional enrichment they have derived from this work.

There are still individuals who are reluctant to sharewith different people. This is often a consequenceof attitudes of rejection which have been maintainedover a period of years. It is therefore of great impor-tance to develop the 'sensitisation' work through fre-quent contact and the provision of current informationon integration.

Parents of children without identified special needs aresupportive of integration. This arises from the frame-work of solidarity existing among the poor sectors ofsociety. They feel themselves to be socially excluded;this kind of experience helps them to develop positiveattitudes towards 'difference'. For them, acceptingchildren with special needs occurs naturally, as partof their feelings of solidarity.

For the JUNJI children, any classmate is someonewith whom to play, share or disagree. They do notfeel barriers, they act naturally and without prejudice.It is children who best embody the meaning of livingin a society where each person has a right and theopportunity to participate.

Results obtained through a survey of families ofchildren with special needs show that most of thesefamilies (64.7%) have a supportive attitude towardstheir son or daughter, and that they are thereforecommitted to helping him or her achieve their potential.Twenty per cent of parents have an overprotectiveattitude towards their children with special needs. Justunder 14% of parents are indifferent, and 1.7% rejecttheir child with special needs.

5. Summary of achievements

At present, JUNJI has integrated about 600 childrenwith special needs which is equivalent to 0.6% of thetotal number of children for whom it provides (92,000).Most of the integrated children are between four andsix years of age (74.3%) and they are mostly boys(56.2%). They have a range of special needs, includ-ing physical, mental, visual and hearing disabilities.

The Integration Programme delivers quantitative datawhich show that almost 40% of them were integratedduring one year, which means a great success for theProgramme itself.

MAIN DIFFICULTIESAND PRO LEMS

The main problem we are currently facing is theacceptance of integrated children from JUNJI intothe mainstream basic education system, which isthe level that follows pre-school education.

Once children who have been integrated at nurseryleave school, they have no chance of being acceptedin mainstream basic education schools.

Another difficulty is the lack of financial resources.The initiation of the integration process into the main-stream education system needs additional funding.Resources are needed to purchase teaching materialsand technical documents, to physically adapt thebuildings, to provide training to both professionalsand parents and to contract specialists.

There is also a need for an organisation or institutionwhich can co-ordinate the different activities andintegration experiences already developed at a nationallevel. Such an organisation would establish supportnetworks for other organisations working in this area,to enable them to share their successes and difficulties.This would then contribute to the development ofintegration.

LESSONS LEARNED

Much has already been learnt. The key pointsaffecting the work described in this paper are outlinedbelow.

Participation in the programme was voluntary forboth teachers and technical officers. The principleunderlying the programme, that each citizen has theright to feel part of society, without discrimination,was underlined. JUNJI's experiences in integrationpractices led it to ensure that participation in theIntegration Programme was not obligatory. JUNJIhas also identified the need regularly to provideinformation to 'sensitise' those who are reluctant tobecome involved in integration and to reinforce thosealready working in it.

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JUNJI has not given any guidance on the levelor type of disability which it is feasible to integrate.This has been of benefit to children with verysevere disabilities who have integrated successfully

eg. blind and deaf children.

This has allowed the children (either with or withoutspecial needs) to utilise innovative communicationsystems and adaptation strategies. They make up fordeficiencies using other senses and develop skillsand abilities which compensate for them. Individuallanguage codes are developed which quickly become`the norm' in interaction between classmates. Thereis no peer segregation in the classroom of childrenwith special needs. They welcome and interact withpeople who do not conform to a limited definitionof 'normal'. It is possible that in the future, childrenwho have had this integrated experience, will be ableto integrate everyone into society, taking into consid-eration each one's individual contribution.

From the teachers' point of view, integration hasmeant entering a valuable field of rich professionalexperiences. Horizons have been widened and newand learning experiences encountered. The teachershave learned to differentiate classroom activities,plan and evaluate curriculum, discover new potentialin the children, and to deal with difficulties in controllingand supervising the children to ensure that they cansucceed.

The knowledge obtained by the teachers in thefield would have been impossible to acquire in mostspecialised courses.

The prospects are that there will be a continuity forthis work and its activities which are recognisedas adding to the values of Equity and Quality for allchildren coming from poor sectors, especially thosewith a double risk, those with special needs.

More important than any of these lessons is the factthat the educational community of JUNJI is growingin a personal and professional way within theIntegration Programme. We feel glad to be ableto share it with other persons and organisationsinterested in knowing about this type of educationalexperience.

CHELE

REFERENCES

Eduardo Frei Ruiz Tag le (May 1996),Message to the Congress.

Victoria Peralta (1995),Propositions of Politics for Chilean Children.

B. Hermosilla (1995),Dialogue for the Education of Child Educators.

Chilean Law, N°17.301.

E. Aranguiz-R. Jimenez (1996),How to Select Children Equity and Focalization.

Law of Social Integration of People with Disabilities,No.19.284, chapter II, January 1994.

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3DENMARK

Roskilde County's Servicesto Young Children with Severe Disabilities

By SPECIALRADGIVNING FOR SMABORN, ROSKILDE AMT

DESCRIPTION OF TIHIEORGAMSATEONAL STRUCTURE

OF ROSKI[LDE COUNTY

Denmark has a population of about five millionpeople. The country has a two-tier system of localgovernment, being divided into 14 counties and275 municipalities. Both levy income-taxes. Thecounty of Roskilde is geographically small, and ratherdensely populated, with 220,000 inhabitants. Thereare 11 municipalities in Roskilde and about half thepopulation lives in just three of these. The remainingseven municipalities are predominantly rural.

Delivery of many services in Denmark is shared bya county and its municipalities, each covering specificareas of responsibility. In the field of special educa-tion, county and municipal responsibilities are closelyintertwined. In the social field, the county has anobligation to provide advice and a policy lead,while the municipalities are responsible for practical/economical assistance. The county is required to offerspecial pedagogical assistance to the child and hisor her parents until the child begins school, and thisis provided free of charge.

About 1% of Danish children are born with a severedisability. As the number of children with severedisabilities is relatively limited, services are providedacross a county area and it is usually the countieswhich employ specialists to assist both the municipal-ities and the children and their parents.

Roskilde County has a large number of creches andkindergartens which are run by the municipalities.The county itself runs two special kindergartens foryoung children with disabilities; one kindergartenwhich is open during weekends and two smallerinstitutions which take the children for respite care.In addition, the county also runs two residentialestablishments for children who cannot stay withtheir families.

By law, all disabled young children in Denmarkare entitled to education and social assistance. InRoskilde County, education and support for disabledchildren and their parents is offered until the childreaches school age (at six years). A multi-disciplinaryteam is employed by the county and comprisesspecialist early years advisers, a psychologist,a paediatrician, a sight-therapist, social workersand a special education adviser. If the child hasa disability which is beyond the scope of the multi-disciplinary team, he or she is referred elsewhereto the appropriate specialists.

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SETHE SPECIAL ADVISORYVICE FOR YOUNG CIELD

WITH DMA CILI[TY

1. The aims of the service

EN

The arrival of a child with a severe disability funda-mentally alters the life of any family. Living anddeveloping with a severely disabled child requirescontinuous foresight, flexibility and reappraisalas the child, the family and the society in which theylive change and develop.

It is now accepted that the disabled child's chanceof living a 'good' life does not solely depend on thedegree or the nature of his or her specific disability.The family's ability to cope with living with adisabled child is just as important, as is the way inwhich society views and meets the needs of disabledchildren and their parents.

This vision of disability, coupled with the knowledgethat early intervention provides the best chance ofachieving a child's developmental potential, meansthat the Special Advisory Service for Disabled YoungChildren has a twofold job:

first, to reinforce the parents' role and responsibili-ties and to enable them to cope with the task ofliving and developing with a disabled child. Thework with parents is given high priority; they areseen as the most important resources in the livesof their children and are the only people who arepermanently present in the child's life.second, the team ensures that an early, multi-disci-plinary and well-coordinated intervention is startedand maintained. The aim is that the interventionprocess will gradually be taken over by profession-als working at municipal level. This will certainlybe the case by the time the child starts school. Thecounty team discusses goals and outcomes withthe municipal team to enable them to take over atthe appropriate stage.

The county describes its policy as follows:`Starting from the general social aim of givingdisabled persons a life as close to normal aspossible, the county works from the basicassumption that everyone regardless of thedegree of their disability is a citizen of equaldignity, with a right to the same quality of lifeas others. That means that they should havethe right to housing, education, medical andother care, employment and opportunities fordevelopment.'

2. Service provision

Assistance to children and their families includes:direct, home-based pedagogical counsellingthe establishment of individual plans for educationand care, comprising communication, interactionand daily livingmaking suitable day-care availableadvice and counselling for parentsrespite care provisiongrief/crisis therapy for parentscounselling for staff in county and municipalinstitutionstraining courses for parents and grandparentsweekend seminars for parentstoy-lendingwarm-water-swimming for the children.

THE FAMILYAND THE YOUNG CHILD

1. The family situation

As mentioned earlier, the parents of a disabled childare placed in a life situation which will often bringsevere pain and complex problems in connection withthe care and upbringing of their child.

The parents of severely disabled children are forcedinto crises that never end. The grief and distress recureach time there is a relapse, or when their childreaches a stage of transition, such as starting school,leaving school and leaving home. Parents may needprofessional assistance to help them cope with theirfeelings and reactions, in order to be able to managetheir lives and cope with the problems they have toface.

Likewise, parents need the expertise of the profes-sionals in order to learn how to stimulate theirdisabled child. Parents' knowledge of how bestto stimulate and support a child's development isusually insufficient if their child is severely disabled.The parents of our severely disabled children mostoften require qualified and comprehensive advice asto how they, as a family, can best support the positivedevelopment of their particular child. They needand demand precise knowledge about their child'sspecific disability and about his or her limitationsand potential. They need very concrete adviceon how they can best stimulate their child, and yetremain parents.

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Usually, the greatest difficulties families face are:coping with people's reactions (shocked, aggrievedrelatives, prejudice of strangers in the street, etc.),having to adjust to a new set of circumstances, theirdependence on 'the system' and the assistance theyreceive or don't receive. When a disabled childarrives, the family automatically becomes a part of

or user of the social services system, though undernormal circumstances the family would never haveneeded public support. The family has to learn to findits way around the system and to cooperate witha large number of professionals. Just participatingin meetings with pedagogues, home counsellors andteachers, and seeing doctors, physiotherapists and soon, can put considerable strain on a family.

In Denmark, there is now general agreement that anearly, well-coordinated, holistic and multi-disciplinaryintervention is a requirement if a disabled child isto develop to his or her maximum potential. Adheringto this policy and organising its delivery is verydemanding on the system. Unfortunately, the parentsoften find the coordination of this service inadequate.In several country-wide surveys, parents have statedthat this specific part of the service is completelyinadequate. They state that often they themselves haveto take on this coordination, which is an enormous extraundertaking, partly because of the time it involves, butprobably mainly because they do not know enoughto find their way through the system. The parentscomplain that they do not get sufficient informationabout their rights and to what services they couldhave access.

2. Cooperation between the countyand the municipalities

The county has worked in cooperation with themunicipalities many times and generally found theseexperiences to be positive. There is direct cooperationover individual children and their families, wherethe county team's expertise is used appropriately andthe division of labour between municipal and countystaff is agreed on the merits of the individual case.This means that municipal staff undertake areas ofwork they are able to shoulder adequately.

The experience of members of the county team isthat the professionals in the municipalities appreciateand use the advice and guidance they provide.The expertise of the Special Advisory Team is seenas a necessary and important complement to the workof the municipal teams. The cooperation is unprob-lematic, and new joint initiatives are often developedbetween the county team staff and the municipalprofessionals.

DENMARK

The municipalities often apply for various trainingcourses for their staff or suggest new initiatives;for example, working with parents to set up parents'groups or networks for parents with disabled children.

The 11 municipalities have very different require-ments of the Special Advisory Service, both qualita-tively and quantitatively. The smallest municipalitiesare the greatest users of the team's services; some-times a particular unit can be too small to containthe necessary experience and expertise. The smallestunits, despite the best intentions, cannot cope withall the different areas of work.

In the past few years, in order to get the best use ofthe experience that has been accumulated, the largermunicipalities have established disability teams.This work is viewed positively by both parents andpoliticians, but is in reality limited by a shortage ofresources. The aim is that services should be deliveredat as local a level as possible, but apparentlywe are facing a movement back towards the largermunicipalities again considering use of a centralteam, because of a shortage of resources.

There is no doubt that a lack of resources impacts onearly intervention and that economic considerationsoften overrule the pedagogical ones in deciding if andto whom early intervention should be available.

It can often be difficult to ensure that staff responsiblefor the day-to-day work are kept up to date. Teammembers can advise and supervise, point to areaswhere training is needed and sometimes deliver thetraining, but if time and money are not madeavailable, the question is again: how can we solvethe problem in the best possible way within theavailable resources?

3. Methods for early diagnosisof the young child

When a child is born with a visible disability, is pre-mature or ill at birth, the hospital notifies the relevantmunicipality and ensures that it is aware that the familywill need assistance. For children who do not showsigns of problems at birth, it is the parents, the healthvisitor and day-care staff who will observe that thechild is not coping as expected.

Once the municipality has been alerted to the pres-ence of a disabled child, a social worker will investi-gate the material needs of the family, and a personfrom the pedagogical/psychological service (PPS) willinvestigate the child's need for special pedagogicalassistance.

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At this stage, the PPS often contacts the county earlyyears advisers who, together with a psychologistand a health visitor, contact the family and establishan overview of the developmental problem.

The developmental problems of the child, and whatpedagogical assistance he or she needs, are uncoveredthrough talks with parents, health visitors and our ownobservations. Besides various tests, 'developmentdescriptions' are created, which describe the assessors'perceptions of the child's difficulties and, veryimportantly, highlight the child's strengths and devel-opmental potential.

The motor-perceptual development descriptionis a neuropsychological/neurophysiological observa-tion. It was developed by Britta Holle et al in 1977.The observation material was standardised using1,206 'normal' children, and is, despite its age, stillmuch used by physiotherapists and pedagogues.

The developmental description gives the backgroundfor a thorough observation that can help the pedagoguechart the child's potential for development from depen-dence to independence and autonomy. It enables you tosee the child's difficulties and potential, and to identifyhis or her 'developmental zone'. The pedagogical workcan then be planned on the basis of this assessment.

We also use Kuno Bellers' development descriptionof young children which was translated and adaptedfor Denmark by Hans Weltzer in 1984. This materialis not standardised.

In our daily work with severely disabled youngchildren we use publications, films and lectures fromthe Knowledge Centre for Children and YoungstersWith Multiple Handicaps and Without VerbalLanguage. Led by senior lecturer Birgit Kirkbaek, thiscentre has gathered and coordinated knowledge aboutpedagogical methods which have been developed,tested and analysed by Danish teachers, pedagogues,physiotherapists, ergotherapists etc.

We know that all human beings are born with thepotential for communication and interaction with theirenvironment and this is one of the fundamental princi-ples of our work. We spend a lot of time uncoveringthe child's potential for communication, investigatingthe child's ability to use eye-contact, pointing, usingsounds or self-made signs.

When we observe that the child has severe contactproblems, we will investigate the child's social devel-opment and his or her communication and interactionskills. If there is also deviant behaviour, we will referthe child for investigation for autism or other severe

developmental disturbances. These tests are done atthe Centre for Autism and/or paediatric hospitaldepartments.

4. Daily work in the home

Early stimulation and pedagogical intervention arestarted as soon as possible after identification of achild's disability. The early years advisers assess anddescribe the child, and, together with the parents,develop stimulation programmes for the child.The parents are the key people in the life of the childand it is therefore important that they understand thepedagogical intervention and that it takes accountof the family's psychological, emotional and physicalresources.

The family is visited according to its needs, usuallyonce a month. During the visits, the adviser and theparents play with the child, and the developmentof the child and the family since the last visit emergethrough observation and conversation. In earlyintervention, the accent is placed on the developmentof the child's communication skills and the interactionbetween the parents and their child. When discussingour observation with the parents, we thus put theaccent on the child's strengths and on the positiveexperiences the parents describe. Where the childexpresses pleasure and seems to be doing well,we suggest new areas for stimulation. To further thedevelopment of the child's ability to communicate,we show the parents how alternative means ofcommunication (e.g. sign-to-speech, the Bliss SymbolSystem, body-language pictures and use of sensorymaterials) which can support and further the child'sunderstanding and develop his or her ability for self-expression.

During the visits we introduce suggestions for playand other activities which can stimulate specificdevelopment areas, and the parents are able to borrowtoys and other resources. They also have the opportu-nity to participate in warm-water-swimming, whichincludes guidance on developing the child's motorskills and how to further the development of commu-nication skills/interaction through playing in water.

During the home visits, parents can also discuss theeveryday life of the family and can raise any problemsrelated to the general upbringing of their child: eating,sleep problems, relationships with siblings etc.

There are also frequent progress meetings betweenparents and professionals during which the whole pro-gramme is discussed and the need for supplementaryeducation and treatment is assessed.

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5. Courses for parents

Once a year, the Special Advisory Service arrangesa weekend seminar for whole-family groups. Thereare places for eight families with disabled children ofup to two years of age. The aim of the seminar is togive the parents the opportunity to meet and exchangeexperiences, and to give the parents some 'tools'which will help them to handle their new life.An important part of the seminar is to talk over thefeelings of grief and crisis which accompany thearrival of a disabled child.

While the parents are taking part in the programme,their children are looked after by respite-care staff,and older siblings have activities arranged for them.

In addition, parents and pedagogues are taughtsign-to-speech and attend seminars on a wide rangeof pedagogical issues, including sessions on liftingtechniques, the Peto method (conductive education)for children with motordisabilities, swimming etc.

The early years advisers run a regular seminar on`play-contact and communication'. This activitytakes place once a week during winter and focuses

DENMARK

on interaction between parents and their disabled chil-dren. Parents attend with their disabled child and workon this area with the instructors. Video-recordings ofparent-child interaction are made and used as a basisfor discussion.

6. Grief/crisis assistance

The grief/crisis assistance is therapeutic assistance,which can be provided during individual sessions withthe parents or in groups. Parents are offered assistancein dealing with their grief over the arrival of a disabledchild. They receive guidance on how they can liveas normal a life as possible with their disabled child.

Our attitude is that parents of disabled children arenormal people like you and me. Their basic confi-dence in life has been hit, i.e. their whole existencehas been shattered. They have suddenly lost theirillusion of control and invulnerability, and have thushad to realise that life carries no guarantees. The aimof the grief/crisis assistance is to help the parentsregain their confidence in life and to help themto live with the difficulties associated with the birthof a disabled child.

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7. Grandparents' seminar

Over the last four years we have also offeredseminars for grandparents. They are a great successfor all concerned.

Once a year, the Special Advisory Service arrangesa four-evening seminar for grandparents of disabledchildren. Like the parents' weekend, the aim is to givegrandparents the opportunity to meet and exchangeexperiences. The taught programme is the sameas that for the parents. One evening is reserved forgiving the grandparents ideas on how to play withtheir grandchild.

From time to time, grandparents are offered courses invarious subjects; for instance, in how to communicatewith a deaf child.

8. Respite care

We believe that parents of very demanding childrenand severely disabled children usually are very

demanding should be relieved from caring for theirchild for at least one evening a week, one weekend amonth and for a vacation period of three weeks a year.

Respite care, or 'relief stays' can be provided inone of the county's relief institutions or with relief-families, employed by the municipality. Another typeof relief can be the provision of practical help in thehome; for example, with cleaning.

If the breathing spaces provided by the respite care areinsufficient, the families may instead need residentialcare for their disabled child. Contact with the homeis maintained, with the child going home wheneverthe parents can manage it. There is a close cooperationbetween the residential institutions and the parents,including a joint approach to the child's daily life.

THE STAFF OF THESPECEAL ADVISORY SERVIRCE

FOR YOUNG CHILDREN

1. Professional background

The Special Advisory Service for Young Childrenis staffed by professionals from a wide range ofdisciplines and training backgrounds. Members of theteam come from the education sector, the social sectorand health services and they have usually been trainedas special pedagogues, social workers, doctors andpsychologists. The team members share a professionalinterest in and focus on the field of disability.

Given that many parents experience a lack of coordi-nation between the various experts, the SpecialAdvisory Service sees it as part of its work to ensurethe development of multi-disciplinary workingmethods with its partners in the municipalities.This is done partly by adopting best practice whenworking with individual cases and through seminarsfor various municipal staff.

2. In-service training of staff

The staff of the Special Advisory Service all haveexperience from previous employment in the munici-palities. They thus have a considerable culturalknowledge on top of their specific professional exper-tise and use both in their counselling and guidanceof the staff in the municipalities. Being employed inthe county's Special Advisory Service for YoungChildren implies that there is on-going postgraduateeducation and training to maintain an up-to-dateknowledge of developments within the relevant areasof practice. This happens through participation inconferences and seminars, and contacts with nationalresource or 'knowledge' centres and colleaguesworking in similar areas. The exchange of experiencebetween practitioners and theoreticians is also impor-tant. Securing a combination of theoretical insight andpractical research/empirical evidence is facilitated bythe weekly internal meeting in the Special Advisory

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Service. Where the need for further training is identi-fied, the necessary funds are normally made available.For example, the two social workers have justcompleted training as grief/crisis therapists, and thepsychologist is undergoing postgraduate trainingto be a supervisor.

3. The staff's cooperation withother institutions

The early years advisers cooperate with institutionsoutside the county, such as 'knowledge centres'which have the latest information about a wide rangeof disabilities. In our work with the parents, we usepublications, films and lectures from the knowledgecentre for children with multiple disabilities andwithout verbal language.

This centre has collected and coordinated knowledgeabout pedagogical methods which Danish teachers,pedagogues, physiotherapists, ergotherapists etc. havedeveloped, tested and analysed.

THE SPECIAL ADVISORYSERVICE'S AIMS

FOR FUTURE WORK

1. Visions for future work with disabledyoung children and their families

As can be seen from the above, the challenge of pro-viding a holistic, well-coordinated intervention forseverely disabled young children has not yet been metadequately. High priority is given to improving thissituation and to training the staff in the municipalitiesto assume responsibility for the service.

The ultimate goal is to ensure a life that is as closeto normal as possible for our disabled fellow citizens.This is attempted through a holistic, coordinatedintervention which occurs 'horizontally' as well as`vertically, i.e. from infant to adult and across profes-

r

DENMARK

sional and administrative boundaries. When theSpecial Advisory Service for Young Children isgiving advice and counselling, it also takes the child'scoming school-life and life as a young adult intoconsideration. The county hands over responsibilityfor the disabled child to the municipalities when he orshe reaches school age. The Special Advisory Servicealways has this in mind throughout the early years,training municipal staff and passing on the principleof close cooperation between parents and professionals.

For several years now, Roskilde County has beendeveloping its services to parents, realising thatparents who feel good are better able to cope withthe extremely heavy burden of bringing up a severelydisabled child. The continuing development of theseservices is given the highest priority.

We aim to make a gradual change from providingadvice and counselling in the home to giving adviceand counselling in small groups. In this way, we hopeto strengthen the formation of networks betweenfamilies in similar situations. Many families withdisabled children find that their network of familyand friends slowly disintegrates: our alleviationof isolation and loneliness focuses on developing andworking with networks. The county's effort in thisrespect also includes the establishment of grief/crisisgroups, seminars and conversation groups, with sub-sequent evaluation, so that the parents' experiencesand needs are taken into consideration when planningthe next round. Further, the county's provision isconstantly adapted to the needs and wishes of parents,identified through parent interviews.

The hope and the aim are to strengthen the families,to make them even more able to cope with theupbringing of their children, to enable them to findtheir way through the system more effectively,to know their rights and voice their claims. Active,articulate parents are good cooperators! We are nowable to identify a trend which shows that parentsof disabled children are more conscious of their rightsand better able to speak up against the system.Reinforcing and developing this is a challenge for allprofessionals, a challenge which we seek to meet inpart by further strengthening the networks which havebegun to give parents a voice.

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FRANCE

The Integration into Nursery Schoolsof Young Childrenwith Special Educational Needsin the Haute-Garonne Department

By FERNANDE VALERIE FLAVIER

Audrey, France, Aline, David, Myriam, Pierre,Sebastien and many others come to mind. Each namebrings back a story, a life, a child and his or her family,who agreed to let me travel some of the way withthem. However far back the first step goes, I have notforgotten that it was thanks to them that I truly graspedthe meaning of many words like tolerance, difference,solidarity, citizenship and democracy.

This paper describes early years integration work inthe Haute-Garonne department of France and discussessome of the issues informing and arising from that work.

THE LEGAL FRAMEWORK,A POLITIECAL WILL:

SCHOOLING FOR ALL IN FRANCE

The schooling of all children living on French soiltakes place within a favourable institutional framework.The 1989 Education Act established the principle of aright to education, guaranteed for everyone from the ageof two in districts included in Priority Education Zones,and from three onwards everywhere else. Article 1 ofthe Act makes the educational integration of childrenwith disabilities one of the responsibilities of public(state) education, to be discharged in co-operation withschools themselves and health-care services; it is acrucial factor in the educational, social and occupationalintegration of those with special needs.

The term used in France is 'pupils in difficulty' andthis covers children experiencing cognitive or behav-ioural difficulties, but does not touch on the realm ofmental disability involving intellectual 'deficiency' orsevere psychological disorders. The standards adoptedare based on the World Health Organisation's classifi-cation of impairments, disabilities and handicaps.

A rapid overview will give us a few reference pointsprior to 1989. In June 1975, the Act governing mea-sures to be implemented on behalf of disabled peoplelaid down their fundamental right to education, healthcare and employment. Integration became a priority;it was seen as the nation's duty to achieve integration.The existing support facilities were to be supplementedby arrangements for assistance in the normal sur-roundings of persons with special needs. The cost ofthis policy of inclusion was borne by the state, localauthorities and sickness insurance funds.

Since 1975, the relevant ministries have brought theirservices into line with this policy. For example, theMinistry of Education issued circulars on integrationin 1982,1983 and 1991. In the latest of these,integration is interpreted as the right to mainstreamschooling and is linked to the right to care, definedas educational and therapeutic support. Educationalinstitutions have a duty to admit all pupils from theirsector, including those with special needs, and arerequired to plan accordingly. The children withspecial needs and their families work with the profes-sionals on drawing up an individual educational andtherapeutic strategy, setting the goals and determiningthe resources that will be needed.

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The principle of schooling for each and everyindividual has called into question the tendencytowards standardisation in the organisation of theeducation system. It is now recognised that there isa need to adapt the educational environment to makeinteraction, and therefore learning, possible. The ideaof standardised outcomes is being replaced by adifferentiated approach working with scales ofachievement. The 1989 Education Act highlights thisaspect: 'The right to education is guaranteed for allindividuals to enable them to develop their personality,to raise their standard of basic and further training,to take their place in social and occupational life, toexercise their citizenship'. As we can see, politicalwill, organisational patterns and financial guidelinesall exist and there is a clear trend towards philosophical,social and economic insistence on integration and theacknowledgement of special educational needs. Yeta closer look will show that, despite the enabling legalframework, implementation varies from one regionto another, from one town to another, and even fromone school to another in the same neighbourhood. Canit be that attitudes carry more weight than the law?

How can we best move on from mere observationand convince people that, quite apart from any ques-tion of obligation, an integrated approach is the bestway of educating all our children? Perhaps by backingup the educational teams and, more than anythingelse, by publicising examples of good practice.Ignorance, misapprehension, lack of informationand even misinformation are the biggest obstacles toa policy of education based on fellowship.

SC WOOING FOR EACH ANDEVERY I[NMVEDUAL

1. Special needs education inthe Haute-Garonne

The Haute-Garonne department includes Toulouse,which is the fourth largest French city, the secondacademic centre and a growth area for research andtechnology. The department has over 180,000 pupilsfrom two to 18 years of age (baccalaureate year),including 40,000 in public and private nurseryschools.

There has been a policy on special educational needsfor a long time in this department; the first institutionfor the deaf and dumb dates back to 1826. Today,there are 39 specialist establishments for children with

mental disabilities, whether motor or sensory. Thepolicy of inclusion in an open setting began in 1973.Various types of special classes operate in the main-stream school environment, at both elementary(primary) and secondary level. Children with specialeducational needs therefore have access to educationand every effort is made to correlate their educationalprovision with the care they require.

Furthermore, individual instances of integration havebeen proceeding apace. The ideal is that children withspecial needs should attend their local school, whichis given the means of making the adaptations neces-sary to ensure that children with special needs can beeducated there.

In 1995-1996, over 800 children recognised as havingspecial educational needs attended nursery or elemen-tary school; this does not include pupils with learningdifficulties or immigrant children, for whom othersupport arrangements are in place.

One of the principles involved in this approach toeducation is that of long-term commitment. Childrenwith special educational needs, and their parents,must feel confident that the answers put forward havenothing short-term or provisional about them; theymust be able to invest in the future, in the knowledgethat the notion of integration, and the means ofachieving it throughout the various stages of educa-tion, are here to stay.

2. Early years education

In the Haute-Garonne, the school enrolment of childrenfrom two to six years old is straightforward and theproportion of children enrolled reaches 100 per cent bythe age of four. School attendance is very good, evenin the case of infants. Children up to three years old areprovided for in one of three ways: in the family homeor that of a registered child-minder; in day nurseries; atthe state nursery school. Since the latter is the only formof provision/care which is free of charge for parents, thedemand is high. Furthermore, the information given toparents about the value of early schooling and its linkswith educational achievement prompts parents to enroltheir children very early.

The Haute-Garonne department possesses specialistsupport and care facilities for young children withdisabilities. However, the health and medical-socialauthorities pursue the same goal of integration ineveryday life and therefore assist parents in theirsearch for a nursery school which will accept theirchild as soon as he or she is old enough. The enrol-ment process is then carefully organised. Meetings are

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held, an integration scheme is drawn up and specialarrangements are made, covering:

the adaptation of premisesmaterial assistanceconsultancy servicesorganisation of the child's timecontent of the educational programmehealth care.

The approval of this scheme by the special educationcommission guarantees respect for the rights of thechild regarding his or her education and health care.

In other instances, when a child with a disabilityor suffering from a chronic illness has never had thebenefit of public child-care services, the parentsthemselves go through the process of enrolling thechild in school. Nowadays, few parents fail to seekhelp for the problems that come with a disability,even when the disability is not obvious. Nevertheless,it sometimes happens that on the first day of term,a new child arrives who has very serious physicalor psychological difficulties about which the schoolhas not been told, despite the parents being perfectlyaware of their child's special needs. This remainsthe exception: the medical and social services doexcellent back-up work in gaining acceptance for andcoping with difference in the lives of young children.

When there is no health-care service involvement inmanaging the disability, the educational team assiststhe parents in ensuring that the work of the school andof the health-care service complement one another.The first questions are always about achieving inclu-sion in the school system. Is it the best educationalresponse? Is there no more pressing priority? Are thenecessary physical alterations to the school feasible?Will the school management be equal to the task?Are neighbourhood services capable of coping withthe medical emergencies that may arise in the caseof diabetic or haemophilic children?

Time has shown that very few obstacles remain.The local planning authorities have always come upwith the necessary resources for alterations to premis-es, adaptation of equipment and supervision. Theeducational teams have understood, aside from theirobligation to apply the law, the educational value foreach and every person of being in a mixed learningcommunity. If some teachers query their ability tocope with a child with special educational needs, thisis a good thing. The institution must be capable ofresponding by giving them the necessary assistance,particularly in the realm of specific teaching tech-niques. This is the role of the support teachers whooriginally worked in the specialist establishments;some of these teachers are now assigned to the

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integration back-up services. Another response liesin training. One of the centres specialising in the areaof visual impairment regularly offers training forteachers in mainstream classes catering for visually-impaired children.

3. Detection and diagnosis

It should also be noted that school is usually the placewhere disability or a degree of difference that callsfor special arrangements is revealed. How is thisfirst diagnosed and how can schools cope with it?

It is usually the child's class teacher who perceives thefirst signs, in the shape of clumsiness, susceptibilityto fatigue, lack of attention, isolation, listlessness,inability to memorise and other symptoms. If some-thing is to be done about it, the teacher must first raisethe issue. The course teachers' councils (which arecharged with the follow-up of the children in eacheducational cycle in order to ensure the coherence ofeducational policy) can provide initial assistance andthe school has a number of resources available to helpit in approaching the problems. First, there are theparents, who have to be involved; nothing can bedone without them, not only from a legal standpoint,but also from an ethical and a practical point of view.Doctors have an essential part to play in detection:child-health doctors in the case of infants, and schooldoctors thereafter.

Nursery schools are also able to call upon neighbour-hood resource persons, including members of specialassistance networks for pupils with learning difficul-ties, educational psychologists, remedial teachersor rehabilitation instructors. Their work in nurseryschools is of an essentially preventative nature; theytry to prevent an initial difficulty from becoming amajor problem, but also assist in decision-making ifit proves necessary to reorganise a child's schooling.Such staff were at the forefront of efforts to supporteducational teams when young children with disabili-ties were first included in nursery schools. This wasbefore back-up services were organised on the basisof specialist institutions or health-care services.It was also before it was fully realised that, even inthe case of infants, partnership was needed betweenthe health-care services and teachers.

Before presenting the two essential forms of integra-tion in nursery schools, we can outline the variousstages in the process of adapting schooling to the needsof the individual child, as practised in the nurseryschools of the area for which I am responsible.It is a proposal, rather than a model, respecting legalprocedures and involving the school's partners.

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4. The process following identification

This would be the process if a teacher encountersprofessional difficulty because of a child clearlyrequiring special needs education.

Possible courses of action:

a) Evaluation of the deficiencies in the child'sschooling brought about by this situation.

b) Educational solution sought at classroom levele.g. adaptation of educational approaches,

differentiated teaching.c) Study of the child's case at a course teachers'

council meeting: possible solution withinthe school through differentiated teaching, withassistance for the teacher if necessary.At nursery school, it is important not to over-dramatise what might simply be a case of psycho-genetic development being different from`the norm', where there is no question of this 'lag'or 'difference' becoming permanent.If there are unmistakable signs of the need forpsychometric and clinical assessment, theprocedure continues, with the authorisation andco-operation of the parents, as follows:

d) Involvement of relevant professionals/services.The special assistance network for pupilsin difficulty, for observation and assessment.The doctor concerned, to give a full medicalcheck-up.The social services, to provide informationand family support if necessary.

These three steps are not simultaneous; theydepend on the information received in the processof identifying factors which will contribute to thechoice of a suitable course of action.

e) Review to decide on future action:mainly instructional assistancemainly remedial assistanceinput for an out-of-school consultationidentification of partners for inclusion in theschool system.

f) Examination of the file by the special educationcommission, for validation and release ofthe necessary resources. This is the district ordepartmental commission, as appropriate.Presented in this way, the procedure looks cumber-some and formal. In reality, each stage representsa time of exchange, discussion and soul-searching.It is never easy to take decisions that change thecourse of a child's life and, indeed, of a family'slife. As soon as this process begins, the path fol-lowed by such children becomes an extraordinaryadventure. It is, of course, with the intention ofhelping them that we undergo this process, yet it

is important to try to ensure that the situation isnot over-dramatised and that this intervention isnot too early. The academic challenge can all tooeasily affect the psychological balance of thesechildren, who receive so much attention and yetare unlikely to play a central role in their own`story' when they first enter the social scene.There is nothing wrong with soul-searching,as long as it does not inhibit action by educators,and such action has to take the form of continuousassessment of the integration process. Assessmentis a difficult exercise, which should focus onobjective indicators, while also taking accountof emotional factors.

EXAMPLESOIF GOOD PRACTI[CE

1. Individual inclusionin a mainstream class

`The nursery school occupies a special place in theoverall facilities available for young children. Beingcomplementary to family education and a preparationfor elementary schooling, it is the source of essentialexperience and training that helps children to"grow up".' (Primary school curricula, 1995.)

Clearly, all children need the experience describedabove. They are taken into a community in order toenhance their ability to communicate. Socialisation isas important as the learning of language. The nurseryschool is a place of discovery and action. 'Livingtogether, learning to speak and to construct one's lan-guage, making a start with the written word, takingaction in the world, discovering the world, imagining,feeling, creating' (Programmes of the primary school,Decision of 22 February 1995 fixing the programmefor each educational cycle at the primary level):all these seem to be relevant objectives for childrenwith disabilities as well. At this level there is no needto think in terms of adapting the system.

The mandate given by the nation to its nurseryschools therefore enables the great concept of inte-grating all children to be put into practice. At thesame time, it does not rule out special provision forthose in need of it.

A personalised approach is therefore the key toindividual integration, whether those concerned arechildren with disabilities as classified by WHOor children suffering from severe chronic illnesses.

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The process of integration

The first stage will depend on the origin of the requestfor integration. If it comes from the family, there willhave to be an initial period of investigation and infor-mation-seeking to make sure that any action is basedon a full knowledge of the facts. Account will alsohave to be taken of the response of the teachers. It isknown that a positive response from the class teacherencourages a supportive attitude in the other pupilsand therefore makes for more successful integration.

After an 'observation' period and confirmation thatconditions are manageable for both the child and theschool, the head calls a staff meeting, to which theparents and partners involved in health-care provisionare also invited. The resulting personalised planconstitutes an agreed contract between them, whichis both a moral commitment to and clear plan for theactive promotion of the child's development.

Individual cases of integration do not always call fora major mobilisation of resources within the nurseryschool. Care must nevertheless be taken to ensurethat the children genuinely participate in the learningprocess. For example, deaf children will need aneffective means of communication in order to pursuetheir studies. Blind children will need help in findingtheir way around; they will have to be assisted byclear oral communication, make a first acquaintancewith the written word through Braille, and receivespecial tuition-in recognising objects by touch.For children with motor disabilities, care must betaken in formulating the concepts of time and space.These are just a few examples. In other cases, supportteachers will be called upon extensively in order tofacilitate adaptation to and of the school.

We also have to think of other aspects of daily life.As the need arises, we can turn to the regular orspecialised staff of the nursery school, or we canbring in health-care personnel or a member of thechild's family, depending on what has to be done.

The teachers co-operate willingly; they have to bewell-briefed and understand what is expected. Whenenrolling a diabetic child, for instance, we draw upwhat we call an individualised admission agreement,which indicates any medical requirements in accor-dance with the circulars of November 1991 and July1993(Bulletin Officiel de l'Education Nationale, no. 3,16 January 1992 and no. 27,29 July. 1993).

The teacher is alerted to the need for daily checks atfixed times, to nutritional and physical needs and toperiods of physical effort. We cannot take exceptionto this when we consider that it will enable a childto grow up in his or her own, everyday environment.

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Great care had to be taken in drafting this documentto avoid breaching medical confidentiality; wenevertheless felt it necessary to know what the alarmsignals were and the steps to be taken if a problemarose, precisely in order to forestall the risk.

The system versus the individual

Enrolling all children in mainstream schools callsfor a flexible education system. Structures cease to bepredicated on the assumption that pupils must matchup to an expected common standard; instead, struc-tures are regarded as resources for the benefit of all.The crucial principle of the whole schooling processis: 'placing the child at the centre of the educationsystem'. This phrase is particularly meaningful in thecase of young pupils with special educational needs.

For each of them, an 'institution' is reinvented, andthis is no chimera, even though it might appear sofrom the outside. The whole process is triggered by anencounter between a child, and his or her parents, andan educational establishment and its health-care partners.This notion may have something of the fabulousnature of the chimera, but it is neither an illusion nora utopia. The aim is to set identifiable limits corre-sponding to the observation of the needs and abilitiesof the child.

Any 'institution' has a clearly-defined programme,with its aims and objectives, resources, scheduleand process of 'accountability'. As the operator of asystem which serves no purpose unless it producessuccessful learning outcomes, it is regularly evaluated:internally by the educational team responsible for itsoperation and compliance with mutual commitments;and externally by the special education commissionacting as guarantor and responsible for regularlyinspecting the ongoing integration activities.

We have, incidentally, created a new role in theimplementation of integration projects; a referee,specialising in educational adaptation and integrationmatters, who will usually be one of the members ofthe network of persons providing specialist assistancefor pupils in difficulty. As requested by the educationalteams, these referees are not directly involved inthe project, but are familiar with it. They are closelyacquainted with the school environment and theteachers, and have functional links with them inaddressing learning difficulties. The referee is moreof an ombudsman than a supervisor and is someone towhom any of the persons involved may apply shouldthey feel that the contract is not being respected. Wehave observed that children fully grasp this role.

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2. Inclusion in a special classin the mainstream school

Another form of integration is that of the specialclass operating within a mainstream nursery school.Though standard practice at elementary level, thistype of arrangement is less common in nurseryschools. The nursery school is usually able to caterfor all children in accordance with its objectives,but sometimes the decision is taken to set up specificclass groups.

In the Haute-Garonne department there is a nurseryclass for deaf children and another for autisticchildren. The latter is the only one working in thisway in France.

The educational mainstreaming of young autisticchildren began on an individual basis, but the limitsof this approach were soon reached and the first classat elementary level opened in 1990. A few years later,with the benefit of our experience and of an evalua-tion of the admissions mechanism, run in partnershipwith a child psychiatric service, we started up asecond class in a nursery school. Each child admittedto the class (five being the upper limit) is also caredfor by the hospital unit responsible for diagnosis andtherapeutic follow-up. In the class itself, a specialistteacher and a specialist health educator, both from thestate system, work in tandem. Supervision is providedby a psychologist from the child psychiatric service.Parents are closely associated with the design andapplication of the scheme; there is daily liaison bymeans of a logbook, in which both parents and profes-sionals record all significant facts, information andquestions.

The school's educational team is very much involved.The young autistic children take part in all areas ofcollective life, including recreation and meals. Theyjoin other groups for activities matching their interestsand capabilities. The teachers in charge of this type ofclass are appointed after an interview with a joint com-mission of the education and health authorities, andthey then undertake to follow the necessary training.

Seeing these young children live their school lives isencouragement enough to continue working for andwith them. Listening to the parents, we understandeven better the significance that enrolling a child withspecial educational needs in a mainstream school canhave for the whole family, as it begins to view andexperience education like other families.

As with the other special classes operating in main-stream conditions, we had no difficulty in finding ahost school for this initiative. The proposal came froma team already very much attuned to the issue, havinghad practical experience of individual integration.

There was also a favourable response from the localauthority, which built a classroom to the specificationsof the team formed by the partners. It is a specially-designed space providing facilities for highly individu-alised attention, rest, lessons and all the routine activitiesof daily life. An adjoining room with two-way mirrorsenables parents and staff from the education and healthministries to engage in training without disturbing theclass. This forms part of the European training schemefor those caring for autistic children.

The project is backed by France Telecom, the statetelecommunication authority, through its sponsorshipprogramme.

In France, we distinguish between children comingunder the responsibility of the health sector such asthe young autistic children just mentioned and childrensuffering from severe chronic illnesses 'handicapped'children coming under the medical-social sector, andchildren with learning difficulties. It is sometimes hardfor the uninitiated to find their way around thesedistinctions, but the main consideration lies elsewhere.It is simply that we need these definitions in orderto determine which authority, institution or ministryis responsible for funding. What really matters is thequality of the educational environment offered.

It is important to remember that the integration ofa child into a mainstream school will affect not onlythat particular school, but also the other educationaland leisure centres in the neighbourhood, such as thelibrary and theswimming pool, which will also haveto cater for children with special educational -needs.On this point, while we need to be vigilant, we haveno major anxieties, since the specialist institutionsare also regular users and this co-operation has helpedto create the knowledge and understanding necessaryto provide for these children.

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SOME ISSUESFOR CONSIDERATION

1. The principles of integration

After three years of exchanges, subject group 2 of theEuropean Helios programme (on the admission ofyoung children to infant, nursery and elementaryschools) drew up a list of basic principles for educa-tional integration.

Principle 1:A value to defend and a choice for society.Principle 2:Ethical and professional standards of all thoseinvolved.Principle 3:A choice available for parents.Principle 4:Collaboration between all those involved.Principle 5:Essential budgetary implications.Principle 6:Training and recognition of teachers.Principle 7:Only one limit: that imposed by the child.

This list can be used as a preliminary check on anyintegration scheme to make sure that children's rightshave been respected, that the necessary resourceshave been found and that the educational communitywill be encouraged and supported in its commitmentto the policy of education for all.

The integration of young children with disabilities mayseem straightforward at school since social learningobjectives are the most pressing. But care should betaken not to paint a false picture which is detrimentalto and undermines children and their families. Werealised that, while the education system was capableof addressing and coping with difference, it shouldhave nothing to do with denying it.

2. Parental choice and involvement

The choice of parents must be an informed one.We are not obsessively in favour of total integration.We work with specialist institutions which still admitseverely disabled children. This is what some familieschoose, and sometimes it is also what the child needs.

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While we, for our part, are sure that the right courseis that of integration, not all attitudes have evolvedas fast; not all educational partners have had the goodfortune to follow or initiate successful integrationprojects.

We have been helped even impelled by parents benton exercising their rights and playing their part in theeducation of their child. It was they who prompted usto be innovative and who finally enabled us to developnew solutions, obliging us to seek the necessaryalliances with the health authorities. Those particularparents were resolved; other parents must be properlyinformed if they are to exercise their rights andresponsibilities to the full.

One of the difficulties encountered is that parentaldemand is not always enlightened and therefore takesa lot of time to discuss and resolve time that thechild does not necessarily have. Initial demand needsstrong support for the sake of close co-operation andmutual trust at a later stage.

We can inform these parents, and the parents who arealready involved are able to pass on their knowledge,experience and arguments. Reflection and developmentare still needed if we are to devise the best means ofproviding the necessary information and training,which will undoubtedly entail work within a networkof partners. The debate continues.

3. Training the teachers

Teacher training is one of the keys to success incatering for young children with special educationalneeds in the mainstream school.

The training programme for future teachers takes thiselement into account, but the time allotted allows nodevelopment of the subject and the result falls farshort of requirements. There is no question of turningevery teacher into a specialist in all disabilities andall learning difficulties; the aim is rather to enableeach teacher to address and cope with difference forthe benefit of the class group, and to be capable ofpractising individualised approaches and of devisingand managing educational projects.

In my work with future teachers, I have noticed thatthe general public is deeply concerned and worriedabout not being able to 'cope', but seldom hostile.Interest is expressed in both theoretical and practical

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matters. When providing information, we shouldinclude contributions from health-care partners andinterviews with parents.

4. Evaluation

Another difficulty is that of validating activities.The obligation to evaluate means that suitable toolshave to be developed. It seems that, at the moment,evaluation is objectives-related but we have difficultyin evaluating the processes and effects of interaction.This is a research area that will have to be taken upin co-operation with the universities.

CONCLUSION

Although the ultimate aim of education for all admitsto no opposition, its implementation calls for thecourage to innovate and the willingness to heed thecall of every child.

The integration of all children into the school systemmobilises the educational, social and family environ-ment and leads to co-operation. It benefits the entireeducational community and, even if this is not itsprime purpose, it provides benefits for everyone.

Integration arouses pedagogical 'curiosity' and bringsabout an improvement in personal performance. Itencourages exchanges across frontiers and ultimatelyemerges in the form of demand.

REFERENCES

Circulaire no. 91.302, 18.11.1991; "Integrationscolaire des enfants et adolescents handicapes".Bulletin Officiel de l'Education Nationale, no. 3,16.01.1992.

Circulaire no. 93.248, 22.07.1993; "Accueil desenfants et adolescents atteints de troubles de la Santeevoluant sur une longue periode dans les etablisse-ments d'enseignement publics et prives sous contratdes premier et second degres"; Bulletin Officiel del'Education Nationale, no. 27, 29.07.1993.

Decree np. 90.788, 06.09.1990; "Organisation desecoles maternelles et elementaires". Bulletin Officielde l'Education Nationale, no. 39, 25.10.1990.

Programmes de l'ecole primaire. Arrete du22.02.1995 fixant les programmes pour chaquecycle de l'ecole.

Travail de recherche publie par le &roupe thematique 2du programme Helio-Secteur de l'Education pourle compte de la commission europeenne D6XXII.

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GREECE

The Integration of a Visually-Impaired Childin a Mainstream Kindergarten

By ATHENA ZONIOU-SIDERIAssistant Professor of Special EducationUniversity of Athens

lip ACKGROUNDIn Greece, pre-school education is provided by kinder-gartens and infant schools. Kindergartens care for chil-dren who are aged four to six and are the responsibilityof the Ministry of Education. The Ministry of Healthand Welfare is responsible for infant schools which arefor children aged two-and-a-half to six. All the childrenattending kindergarten or infant school follow theNational Curriculum. Children have to .attend kinder-garten before they can enter primary school.

Seventy-five per cent of four to six year-olds attendkindergarten. 21% of three to six year-olds attend infantschool (Polyhronopoulou-Zaharogeorga, S. 1993).Parents are able to select a kindergarten but this choiceis limited because the kindergartens do,not operatewaiting lists. In the academic year 1995-1996,123,161 children attended state kindergartens andinfant schools and 4,786 children attended privatekindergartens and infant schools.

1. Children with special needs

There has to date been no accurate assessment of thenumber of children with special needs in Greece.According to international figures relating to disability,it is possible to estimate that 289,000 childrenbetween the ages of three and 19 have special needs(Polyhronopoulou-Zaharogeorga, S. 1993). TheMinistry of Education information bulletin (1988)states that the total student population was 1,800,000

En COPY MAMA

in 1988, including 180,000 children with specialneeds. According to the information bulletin issuedin 1992, most students with special needs wereattending mainstream schools. However, the statedoes not provide special programmes to assistchildren with special needs in gaining access -to theNational Curriculum.

There are five kinds of school provision in Greecefor children with special needs:

special schoolsclasses in parallelunits in mainstream schoolsclasses of children who are integratedcentres for vocational education.(Zoniou-Sideri,1996)

The concept of integration was introduced in theGreek education system for the first time in 1974.The decision to begin the process of integrating chil-dren with special educational needs into mainstreamsettings did not come as a result of pressure fromconcerned groups of teachers or parents; rather, it wasa result of legislation (Patsalis, 1994).

In 1976, the Ministry of Education assumed soleresponsibility for special education, and children withspecial needs gained the right to attend mainstreamschools (Kalantzi-Azizi, 1989). Legislation in 1981established the integration of children with specialeducational needs, underlining that these childrenshould obtain: 'equal opportunities in education,social integration and preparation for the successfultransfer from school to life'.

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However, it is very difficult to translate the notionof integration as written in a piece of legislation intoeffective practice. It is worth mentioning that eventhough the principle of integration was establishedin 1981, the number of special kindergartens actuallyincreased during the period 1988-1989; there were10 in 1985 and by 1989, there were 37.

2. The issue of integration

In Greece, we have identified a number of difficultieswhich have to be taken into consideration when tryingto integrate children with special educational needsinto mainstream education.

Lack of a common policy regarding the advicegiven to parents by diagnostic centres, of whichthere is one in every region.Stereotypes and prejudices in the community.Research has shown that the parents of childrenwho do not have special needs do not accept theidea of children with special needs being taughtalongside their own children. Parents of childrenat secondary school are particularly concerned aboutthis, feeling that it may impede their children'sprogress.There is often no physical access to the schoolbuildings.Once children with special educational needs attenda special school, they are not periodically assessedfor suitability for reintegration into a mainstreamschool.There are few available assessment tests.Teachers in mainstream schools are not trainedto cope with the different teaching and learningstyles appropriate for children with special needs .

Local authorities are not interested in strategiessuch as early intervention and integration as theycost too much to implement.Support for families of children with special needsis provided by the state or private organisations.The level and nature of the support availabledepends on regional policies and priorities and thefinancial position of the authorities. It also dependson the child, the nature and degree of disabilityand on the parents. Financial, psychological and/oreducational support may be offered. However,there is a lack of centres which provide all theservices needed to support children with specialneeds: that is, physiotherapy; speech and languagetherapy; ergotherapy; psychological support; legaladvice for the parents, and so on.

THE INTIEG ANION OFA VISUALLY-IIMPAff ED CIHIIILD

1. Aims of the programme

The basic idea of early intervention is very closelyrelated to the theory of the 'sensitive phases' in earlychildhood. This theory is based on new thinkingthat aspects of the child's future development are`moulded' during these phases, which therefore havea considerable influence on the child's later life(McDaniels, 1977). This realisation was an importantstep in understanding the value of providing stimula-tion for children with disabilities as early in their devel-opment as possible. There is now broad agreementamongst professionals that the earliest possible stimula-tion of children is a successful method for furtheringa child's development and his or her integration intoschool and social life (Helios Report, 1996).

Taking this approach as our starting point, we begana programme of integration in an area of Athens,working in collaboration with a team of specialists.The idea was to introduce a way of achieving theearly integration of children with special needs inpractice; we were trying to introduce ways of imple-menting the legislation. It was clear that legislationpromoting the educational integration of youngchildren with disabilities is not in itself sufficient:it must be accompanied by practical approaches andexamples of good practice.

The programme involved the following targets.

1. The integration in a mainstream school of a blindchild who was selected based on her cognitiveand social ability to function in an ordinary schoolenvironment. Her integration was based on thepremise that a child with special needs must beconsidered as a 'whole person' and not justlabelled and treated as a 'special need'.Children with special needs should be a mainpriority within the school.

2. The establishment of measures concerningthe early intervention and integration of childrenwith special needs in kindergarten.

3. Developing a quality school environment,good teaching practices and relevant materials.

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4. The evaluation of the integration programmes,focussing on the difficulties of implementingintegration strategies, and including the school'sand teachers' reactions, the community's attitudes,financial considerations and the need for adequatestructures.

5. The development of the educational policy andprocedures concerning the national and localagents involved in integration (an attempt to self-evaluate these pilot programmes).

2. The programme in action

The visually-impaired child

The main focus of the project was the integrationof a blind girl of five years old who was attending aspecial kindergarten. The child, whom we shall callMaria, was assessed in a number of fields suchas the psychokinetic, the intellectual (language level,pre-maths) and the social. The team and the girl's

parents decided that Maria's needs could be met in amainstream class.

The programme began in September 1994 but priorto this there was almost a year's preparatory work,involving consultation with the community, the localauthority, the teachers, the parents of the non-specialneeds children and Maria's parents, the children in thekindergarten and Maria herself. A number of issueswere discussed and key decisions taken. Most importantwas the selection of the kindergarten. The followingpoints had to be considered.

It was thought that the kindergarten should bein Maria's neighbourhood to enable her to socialisemore easily with local children. Furthermore, theschool could be used as a starting point for Mariain getting to know her environment.The choice of the kindergarten was linked to theneed to find the right kindergarten teacher. Anumber of kindergartens in the area of Nea Smyrniwere considered, looking at their proximity toMaria's house and whether there was a teacher whowas interested in the programme. The kindergarten

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teacher also had to be available to collaborate withthe specialist teacher in assessing his or her ways ofteaching and developing new approaches accordingto Maria's needs.The kindergarten had to be physically accessible.The lack of funding was a problem that had tobe solved. The Ministry of Education funded onlythe specialist teacher. All other expenses werecovered by the University, and the team participatedvoluntarily.A kindergarten teacher specialising in the field ofspecial education/integration for blind children wasselected.

The next step was to brief the central educationalauthority on the project. The basic structure andobjectives of the programme were presentedby the team of specialists who took part. The teamconsisted of a psychologist, a speech and languagetherapist, the specialist kindergarten teacher anda social worker.

The team's psychologist and social worker madea presentation about the project to the parents of theother children. They were given information aboutthe child's abilities and there was discussion not onlyabout children who have special educational needs,but also about children who come from differentcultural backgrounds. Particular emphasis was placedupon this aspect of the project, since integrationoperates on the basis of a dynamic of assumptions.We have therefore also mobilised parents' associa-tions, groups/associations of people with disabilities,teachers' cultural societies and so on to helpus achieve a higher level of understanding and theparticipation of the residents.

Preparation of the children at the kindergarten, throughplay and other activities, enabled them to understandand accept the 'difference' of the blind child. Theyexchanged visits with the children at the special kinder-garten which Maria was attending. This strategy aimedto enable the acknowledgment of the other's individualparticularity without suppressing the contradictoryfeelings which are often experienced when meetinga person with disabilities.

Maria was assessed and prepared for transfer to amainstream class. During the assessment, it becameobvious that she understood the 'difference' andthat she was educationally and socially ready to attendthe mainstream class. Simultaneously, she attended acourse on Braille and a course for mobility orientation.She visited the Museum of Touch on many occasions.

She also visited the mainstream kindergarten to famil-iarise herself with the environment prior to her transfer.After the assessment phase the specialist teacher createdthe teaching material and framework necessary to giveMaria access to the National Curriculum. She evenprepared areas of the school in order to make Maria'smovement autonomous by using the idea of multi-sensory environments.

Maria's parents participated as partners in the creationof the programme and its implementation.

The specialist team took an interdisciplinaryapproach, collaborating with the local authority andthe local education authority. The team met every15 days. At these meetings, the support teacher whowas with Maria every day discussed her social andeducational progress and any problems which hadarisen. In this way, they worked together to assessher needs and develop new ways of working to meetthose needs. They kept Maria's parents informedand offered continuous support. They also informedother members of the school and local neighbourhoodabout Maria's needs.

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Content of Maria's educational programme

The specialist support teacher and the kindergartenteacher included the following approaches in Maria'sclassroom-based activities:

social learning creating an environment of accep-tance, team acceptance, friendships, through playand educational interactions;intellectual development the teaching of notions.Introducing skills such as pre-number, pre-writingand pre-reading skills;psychokinetic area emphasis was placed on theteaching of space and autonomy;creative area participation in play, drama androle-play activity.

EVALUATION OPTIME PROGRAMME

The effectiveness of the programme was supportedby the results of the evaluation. During the pro-gramme's implementation, a number of improvementswere observed in all areas of Maria's development.

In the area of social learning, Maria was voluntarilyinvolved in interactions with the.school's staff and thechildren. At the beginning, she established friendshipswith some of the children who were interested inmeeting their new classmate. Ultimately, however,she chose her friends according to her interests andneeds. She even had good relationships with themoutside the school environment. The child felt freeand able to express her feelings in a variety of ways.

In the psychokinetic area, Maria was autonomousin her movement within the school environment;she was self-sufficient and independent.

In the intellectual domain, Maria followed the kinder-garten's curriculum without difficulty; the teachingmethods were adapted to her needs. The way in whichMaria adapted to and accommodated the kindergarten'severyday demands on her was particularly significant.She showed an increasing desire to participate inthe peer group work and a reduced interest in individualactivities.

In the creative area, Maria showed an improvementin her imagination, which was developed throughpainting, music and drama.

GREECE

The activities were not designed to promote herlearning in discrete areas; they were planned in amore integrated and holistic way, although assess-ments were made separately in each area.

The other children in the kindergarten showed agreater degree of acceptance of and empathy withchildren with disabilities.

This year Maria is attending the first class of a main-stream primary school and her assessment showsprogress in all areas of development.

Families (both those having a child/children withspecial needs and those without) also benefited fromtheir participation in the programme. During theinitial phase of the project, we experienced a numberof negative reactions from the parents, but accordingto answers given in the questionnaire which wasdistributed one year later, the majority felt positiverather than negative about the experience. Someof them expressed admiration for Maria's abilities.

Teachers, who were initially hesitant, graduallybecame involved and not only supported, but alsodeveloped; the programme. They felt that their teachingof all children had improved. The implementationof new methods of working would appear to causeanxiety and apprehension and it may be helpful to tryto address this problem before such programmes areimplemented.

Finally, we hope that despite the bureaucratic andfinancial difficulties, we succeeded in persuading theauthorities in charge of the relevant institutions aboutthe necessity of integration and its positive effects.

51

GUYANA

When there is no Nursery School:one response to the challenge in the interiorof Guyana

By Dr BRIAN O'TOOLECBR Programme Director

and Ms SHOMA STOUTUCB-UCSF Joint Medical Programme

BACKG's OUND IINFORMATI[ N:THE RUPUNUNI

BEM ON OF GUYANAI<

The Rupununi region of Guyana is in the south westof the country and covers an area of 33,000 squaremiles. There are approximately 17,000 people inthe region living primarily in 42 Amerindian villagesand settlements which are spread throughout theRupununi. Eighty percent of the population is classi-fied as indigenous or Amerindian. Nearly everyonecan speak English as there has been a significant mis-sionary presence in the region since the early 1900s.Unfortunately, this exposure has also led to a greatdeal of cultural erosion. Many people can no longerread or write the traditional languages; the old songs,dances and arts are in danger of being forgotten.

The Rupununi region of Guyana has under-developedstructural, capital, and human resources. It is the secondpoorest region in Guyana and has grown increasinglyimpoverished over time. The main industries in theregion are farming and cattle ranching. Half of the landis covered by rainforest; the rest is savannah. Becausethe economy is subsistent and agricultural, rather thanindustrial, cash is limited. The problem is heightenedby the lack of transport infrastructure, which increasesthe cost of basic goods. Unfortunately, the presenceof a flourishing economy in neighbouring Brazil hasled to a high level of emigration, further depleting theeconomic and human resources of the region.

EST COPY AVAIIABLE

The Rupununi region's health system also suffers as aresult of the chronic underdevelopment of transporta-tion and communication. The crude mortality rate isreported at 2.94% and infant mortality at 35/1000 livebirths (Geula,1994). The Rupununi has the highestincidence of low birth weight in the country, with41.8% of infants born below 2.5 kg. The predominanthealth problems of the region are malaria, diarrhoea]disease, acute respiratory infection, and accidents(Ministry of Health, 1994). The Rupununi region isthe only region in Guyana where leishmaniasis,tuberculosis, and conjunctivitis present significanthealth problems (Ministry of Health, 1994: 35-6).Approximately 25% of children under five areimmunised. In medical emergencies, patients musttravel to the nearest health centre by foot, bicycle,or bullock cart, a trip which might take an averageof eight to ten hours to complete.

The challenge presented by people with special needshad largely been ignored within the health sector untilrecently. In most villages, people with disabilities werehidden away or shunned because the indigenous folkloreattributed disability to possession by evil spirits.There was a general consensus that disability wasnot an important issue in the region. A participatorysurvey carried out by the Guyana Community BasedRehabilitation (CBR) Programme in 1994, however,found that the prevalence of people identified asdisabled was roughly comparable with other areasof the country: 0.76% in the Rupununi, as comparedwith 1.5% nation-wide.

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Education in the region, though buttressed by a coreof extremely dedicated teachers, is compromised bothby the lack of availability in some areas of basicresources (books, paper, etc.) and by a lack of trainedteachers, which leads to a system of 'trickle-down'education provided by untrained teachers. This meansthat the people of the region are not fulfilling theireducational potential. Transportation, communication,income and climate problems all combine to makeservice provision in this region extremely difficult.

PROGRAMME DESIGNAND IMPLEMENTATION

1. The Guyana CBR Programme

The Guyana CBR Programme views development asan organic, empowering process for the community.More traditional rehabilitation approaches are criticisedfor reaching only the privileged few in urban areas andfor being too capital and technology-intensive, too spe-cialised, too isolating from normal life and too Westernin origin, practice, and prejudice.

The Guyana CBR Programme recognises the needto see the problems of people with disabilities in thewider context of poverty, malnutrition, ignorance,prejudice, superstition, conflict and war. All of theseinterrelated factors affect the quality of life of aperson with disability.

CBR is based on the idea that someone from thecommunity should be trained to design individual,simplified rehabilitation programmes for peoplewith disabilities, which will then be run by parentsor family members who have been trained to do so.

The goal of CBR is to demystify the rehabilitationprocess and give responsibility back to the individual,family, and community. The basic premise of CBR isthat the greatest resource in developing countries forhelping disabled people to lead lives which are fulfilledand productive, is a well-advised and supported family.The goal is for rehabilitation to be perceived as partof community development, whereby the communityseeks to improve itself. In such a process, rehabilitationbecomes one element of a broader community integra-tion effort.

The CBR Programme is committed to a processwhich helps people to recognise that they can set theirown development agendas.

2. 'Hopeful Steps'

The name of the Rupununi CBR Programme is`Hopeful Steps in the Rupununi'. This programmeevolved into an empowering process which transcendsthe literal definition of rehabilitation', affirmingindigenous culture and putting control of the processof development back into the hands of the community.Thus rehabilitation is addressed in the context of widercommunity issues, through integration with existinginfrastructure and the education of parents and commu-nity members, rather than through a top-down deliverysystem.

`Hopeful Steps' attempts to formulate a simplifiedmodel of rehabilitation that could deliver services torural areas of Guyana, where the vast majority of thecountry's disabled people live. The programme focuseson empowering communities and community membersto care for their people with disabilities and to valuethem as a resource, while at the same time, encouragingthem to discover or reveal their special talents to theircommunities. Within the context of the Rupununi,the focus shifted dramatically in response to prioritiesidentified by the people living there.

Getting started

The CBR Programme began considering an expansionto the Rupununi region of Guyana in early 1992, eventhough it had concerns about the applicability of a morespecialised programme in an area where basic subsis-tence needs governed people's lives. Brian O'Toolemade an initial visit to the region in early 1992, duringwhich he was invited to make a presentation about thenational programme to a conference of Rupununi head-teachers. The headteachers' response was lukewarm:while they were interested in development effortsin general, they felt that the focus on people with dis-abilities would have very little relevance because,as they put it, there were no people with disabilitiesin the Rupununi.

The Director of the programme decided to make sixone-week visits to about 20 of the 42 villages to get asense of community needs. The response of thevillagers to these visits was warm and enthusiastic;the Rupununi region had been isolated for so long thatvery few groups visited it and those who did rarelybothered to travel outside the one or two main adminis-trative centres. As a result, people seemed sincerelyto appreciate the effort that the CBR Programme madeto get out into the Amerindian communities. Thepeople of the Rupununi, however, identified health,transportation, and education as their most importantneeds. Out of this discussion, early physical and mentalstimulation of children emerged as an area within

the scope of the CBR Programme which would be ofconsiderable interest to both teachers and healthworkers. It was also during these visits that a trainingvideo about disability was filmed in the Rupununi.

In October 1992, the CBR Programme ran two week-long workshops in association with the Ministry ofHealth. Designed for community health workers, theworkshops provided basic information about earlystimulation, the identification of children with disabil-ities and simple rehabilitation methods. The aim wasto raise awareness among the health workers aboutthese issues and provide them with the educationaltools necessary to expand their capacity in this area.The first one-week event included toy-making andpuppet-making workshops, a cultural show, the train-ing video which was filmed previously in the region(see above), and adapting educational resources forearly stimulation which were developed on the coastand needed to be made more relevant to Amerindianpeople. The participants responded to the workshopwith such enthusiasm and interest that the CBRProgramme met with its funders and asked to developa long-term vision for the Rupununi region, beginningwith four more workshops on early stimulation.

The second phase: team building

For the second phase of the project, community vol-unteers were recruited. Teams of three, comprisingthe community health worker, a teacher, and a villageleader, from each of 36 villages, were invited to theworkshop being held in their subdistrict. Each of theparticipants was automatically enrolled in a three-yeartraining programme in CBR through the Universityof Guyana. Many people made great sacrifices to attendthe workshops; for example, some teams travelledby foot and canoe for 13 days and nights to reach themeeting.

The formation of CBR teams in each village had anumber of valuable functions. It formalised partner-ships between the existing education and health sectorswithin the village, and the inclusion of a villager inthe team allowed more general issues concerning thevillage to be heard. Essentially, the three people in avillage team began to serve as representatives of theprogramme at village level, thereby increasing people'sawareness of the programme. Moreover, the CBRteam members began to develop a sense of ownershipof and identification with the programme. The selectionof a team of people from each village, rather than anindividual, eased the burden of work on the volunteers.A team could be seen as part of the accepted, regularsystem of village committees and was thereby integratedinto the existing administrative infrastructure of thevillage. Many CBR teams were given time duringmonthly village meetings to report to the public and

GUYANA

raise awareness of the programme. As a result of allof these factors, the CBR Programme very quicklyachieved name recognition, identification, and accep-tance by the majority of villagers.

The programme of action

Initially, the emphasis of the programme remainedon early stimulation. The first series of subdistrictworkshops focused on different ways of stimulatingchildren through play. The workshops showed partici-pants how to make stimulating toys out of locally-available and inexpensive materials. This componentsubtly affirmed the value of Amerindian resourcesand culture.

A second series of workshops focusing on normaland delayed child development was held in eachof the subdistricts. Each workshop made specialreference to the applicability of the material to chil-dren with disabilities to raise awareness of the needsof disabled people in the area. During the secondseries of workshops, participants' villages tookpart in an art competition on disability. Hundreds ofchildren submitted entries.

The last workshop in the second series proved to bean historic one: at their own behest, one of the CBRteams brought seven people with disabilities to theconference; the workshop began by exploring whatcould be done to help these people. This openacknowledgment that there are people with disabili-ties within the Rupununi, and the way in which theCBR teams seemed prepared and even excited aboutdealing with the issue, now gave the CBR Programmethe confidence it needed to address the issue moredirectly in other sub-regions.

Focus on disability

This shift in direction was agreed by the CBR teamsduring a region-wide conference held in Lethem.During this conference, the participants assessed theiraccomplishments and made new plans for the future;these plans reflected an increasing emphasis onaddressing the needs of people with disabilities.

The third CBR workshop series reflected this newfocus on disability. The workshops dealt with screen-ing, early identification of disabilities, integration ofchildren with disabilities within the mainstream school,toy making and simple physiotherapy. A video series,called 'A New Tomorrow', highlighting disabilityneeds specific to the Rupununi region and filmed in theRupununi itself, was produced and shown. A storybookcontaining stories about people with disabilities waswritten and translated into the two main indigenouslanguages.

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Over the next few months, CBR teams systematicallyexplored the region for people with disabilities.It became clear that there are disabled people in theRupununi who, having been hidden away all theirlives, may have needs which transcend their physicalor mental disability.

The process of carrying out this survey brought theCBR teams in the villages face-to-face with the magni-tude of the problem within their own communities.Many began to formulate specific plans to address theneeds of disabled people in their communities. Asa result of this more intense focus on disability, about20 children of school-age who had previously beenkept at home started attending school.

The CBR teams began to work actively to promote theintegration of people with disabilities into every aspectof village life. At health clinics, health workers beganencouraging mothers to bring their children with dis-abilities to clinic. A number of CBR teams acted at thevillage education level. One CBR team made sure thatevery disabled person in their community was alwaysbrought to village events and meetings.

These acts of integration, which broke down age-oldbarriers, profoundly affected the attitudes of villagersin the Rupununi about disabled people: 60% ofrespondents in Stout's (1996) research sample,(N=20), identified changing attitudes towards and helpfor disabled people as a major impact of the CBRProgramme; 35% felt that disabled people were betteradapted and less shy; and 27% (N=15) identified theintegration of disabled people into village life as themain strength of the programme.

The formulation of village-level plans to integrate dis-abled people into village life had another unexpectedeffect, however. Until then, the CBR teams seemedto have responded largely to programme-level sugges-tions; the act of initiating their own plans to respondto the needs they had documented within their owncommunities helped the CBR teams to begin to ownthe process and to identify themselves as CBR agentsrather than as CBR recipients.

The CBR Programme did not however abandon itscommitment to addressing broader developmentpriorities in the region as it took advantage of the newfocus on disability. At the time that the third seriesof workshops was being held, three other major focusareas were emerging as a result of needs expressedby villagers or identified by the programme. These threeareas were: health education, literacy and culturalaffirmation.

Heath education

The focus on health education developed as a collabo-ration with the Band'i Community Health Partnership(BCHP). A 50-minute video called 'Facts for Life',depicting the key health messages in the UNICEFdocument of the same name, was filmed using scenesfrom the Rupununi. Over the next months, CBRregional coordinators travelled throughout the regionand, using portable video equipment, showed the filmin each of the villages. The key messages in the`Facts for Life' film were also summarised in a simple,pictorial pamphlet and distributed to every home in theRupununi through village visits made by the BCHP.

A series of 'Facts for Life' festivals was held in everysubdistrict and at regional level. Hundreds of poems,songs, skits, stories, and drawings were submitted to anarts competition and UNICEF funded the publicationof a book featuring the winning entries. The combina-tion of video, teaching manual, and art competitionproved to be extremely effective both in communicatinghealth messages to the general public and empoweringhealth workers to teach these messages themselves.

Literacy training

Rupununi residents also identified the literacy trainingwhich developed during this same period as having asignificant impact. This aspect of the programme aroseout of the recognition that general education and literacywere major areas of need. There was a lack of booksto read and insufficient knowledge of how to teachchildren to read beyond the rote repetition method.The CBR Programme devoted part of the third seriesof workshops to the promotion of literacy and developeda 'Steps to Reading' package. This consisted of a15-book series, including workbooks, teachers' manualsand story books, which took teachers step-by-stepthrough the process of promoting literacy.

Cultural affirmation

The final area which reflected the broadening of theCBR Programme's initiatives in the Rupununi iscultural affirmation. Use of locally available materials,particularly those utilising cultural craft forms, wasencouraged in the early stimulation programme.Cultural shows and art competitions were used toencourage people to translate programme themes intotheir own culture and environment. A book of storiesaround CBR themes was written and translated intoMacushi and Wapishana. Several videos were filmedusing people and places in the Rupununi as bothconsultants and active participants. All of these steps

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A

showed respect for the culture of the Rupununi peopleand helped to make the programme and process cultur-ally relevant. The programme invested a great deal oftime and energy in preserving and affirming the cultureof the Rupununi people for its own sake. One exampleof this was the production of a tape of indigenoussongs and stories which are on the verge of being lost.For the people in this region, who for the last 100 yearshave been beaten for speaking their traditionallanguage in school, who are seeing their culture andway of life rapidly die out with the new 'modem'generation, this work represents a badly-needed reaffir-mation of the integrity and value of their culture.

The development within the Rupununi region of thisbroad vision of the role and purpose of CBR, whichaddresses the needs of people with disabilities withinthe context of addressing the needs of the largercommunity, echoes the model of CBR as part of anintegrated development process, as mentioned earlier.There are many reasons why such broadness of vision

has been possible with the CBR Programme in theRupununi, but several elements may be particularlyimportant:

the creation of a forum or process in which theevolving needs of people can be discussed

the willingness of people in the Rupununi to sharetheir perception of their needs with the programme

the willingness of the CBR Programme to listenand respond to the needs expressed rather than toany preconceived agenda

the supportiveness of the programme's fundersprincipally, Amici di Raoul Follereau (AIFO) in

Italy for the flexibility and broadness of theprogramme, which requires in turn a great deal offlexibility and broadness of vision on their part.

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MAJOR ISSUES

Two major challenges emerge in a project of thisnature in an isolated part of the country. First, the iden-tification and training of human resources and second,the development of an appropriate infrastructurethrough which to work.

1. Identification and trainingof human resources

Human resource development took place in two forms:the training of people to carry out the programme'sgoals and objectives, and the training of people to takeover the process of development. Both of these operatedat two different levels: at the grassroots, communitylevel and at a higher, leadership level.

Community level

Human resource development at the grassroots leveltook place in four different contexts:

workshops held by the CBR Programme for CBRteam membersworkshops held by CBR team members for theirvillagesprogramme-initiated projects carried out at thevillage levelprojects initiated by CBR teams to be carried outwithin their own communities.

CBR team members learned the knowledge and skillsnecessary to carry out the programme's immediateobjectives. For instance, for early stimulation, theylearned how to make toys; for literacy, they learnedhow to teach phonics; for health education, theylearned the key 'Facts for Life' messages.

In 1995, the CBR Programme developed a new focus:instead of simply teaching CBR workers about varioustopics and asking them to apply this learning in theirvillages, each CBR team was given the necessaryskills and materials to enable workers to transmit thatinformation on a larger scale at village level. EveryCBR team was asked to organise and lead a workshopin its village about early stimulation, having had arefresher workshop on the topic. The process of organ-ising a workshop was one which taught the participantsthe fundamental organisation/management skillswhich are needed to continue the CBR Programmein its current form. It also taught the team membershow to teach others, so that they were not mere vesselsof knowledge but active participants in the educationprocess.

Programme-initiated CBR projects that were imple-mented at the village level also taught CBR teammembers the necessary skills and knowledge to runthe programme at grassroots level. These effortsimproved programme sustainability by increasingidentification with the programme and increasing thecommunity base of skills necessary to run it.

The CBR teams have also had an opportunity to applywhat they have learned about process sustainabilityat a practical level, through the process of identifyingcommunity needs (independent of those suggested bythe CBR Programme), designing projects and imple-menting them. The projects which were identified andthe process of implementation varied enormously andillustrate the extent to which people were empoweredby this process. Projects include:

setting up nursery schools for children and theirmothersupgrading or creation of health poststhe improving of water supplies and sanitationestablishing a sewing cooperative to sewmosquito nets. .

CBR team members also had to secure funding forthese projects. In several cases, the CBR Programmedirectly supported this process by helping the teamsto locate materials or funding. However, team mem-bers mostly had to learn how to seek this funding andsupport. themselves. This base of human resourcesmatured even further as subdistrict and regional com-mittees formed to carry out larger projects.

Leadership level

Human resource development at the leadership leveltook place through a 'Training of Trainers' coursedeveloped by the CBR Programme to create a groupof workers who could introduce the programme toneighbouring regions of Guyana and serve as humanresources within their own region. This training tookthe form of a one-week workshop in Georgetown. Theworkshop taught the diverse range of skills necessaryto teach and maintain the educational outcomes of theprogramme, including literacy education, healtheducation and disability identification, awareness,and management. Once they completed the workshop,these new trainers were immediately brought into theprocess of co-organising and co-leading workshopsin their subdistrict, along with the regional and nationalcoordinators. This provided trainers with on-going`on-the-job' training, enabling them to practise theirnewly-learned skills and to develop those necessary toallow them to take over coordination of the pro-gramme.

In summary, the CBR Programme has been able todevelop human resources to support both programme

6

and process sustainability by combining educationalworkshops with practical projects to enable thosetrained to apply, develop, and gain confidence in theirnew skills. A group of resource people capable oftraining others has been identified, trained, and is nowworking on the programme. As the programme hasevolved and people have become more and more confi-dent, it has been able to support participants in develop-ing and carrying out their own projects. This hasempowered people to learn the skills necessary to sus-tain the process of the CBR Programme. The abilityof the CBR Programme to combine practical educationwith immediate application has been instrumental inpromoting both programme and process sustainabilitythrough the development of human resources.

2. Development of anappropriate infrastructure

The development of human infrastructure constituteda critical component of the CBR Programme. Initially,there was just a national director and the village-levelCBR teams, each containing a community healthworker, teacher and villager.

Initially, village visits were made through a partner-ship with the Baha'1Community Health Partnership,which already provided a mobile health servicethroughout the region. With the purchase of a LandRover, the formation of what essentially becamea mobile resource unit added another element to theCBR infrastructure. It also made the programme andits resources far more accessible to the people andhelped the programme to understand the communitybetter.

As the programme grew in scope and participantsgained more and more power to define their owndevelopment agenda, a parallel system of planning,organisation, and administration developed whichfocused on initiatives coming up from the grassrootslevel. This system, which had its early roots in thevillage CBR teams, reached fruition in October 1995,which symbolically marked both the graduation ofCBR team members from the IACE training pro-gramme and the election of subdistrict and regional-level CBR committees, each of which would carryout its own projects independently of the support ofprogramme staff.

The development of this parallel infrastructure reflectsa critical transfer of responsibility for the developmentprocess in the Rupununi into the hands of the commu-nity. One example of what this means in practice isthe regional CBR committee's organisation of the con-struction, staffing and resourcing of a school in anextremely isolated village that did not have any way

GUYANA

of providing education for its children. The projecttook from October 1995 to March 1996 to completeand now 66 children are attending school for the firsttime in their lives. The most important aspect of thisachievement lay in the fact that the CBR regionalcommittee was able to undertake the project com-pletely on its own. People now know how to identifya need, make plans to meet the need, and carry outthe plans in an effective, empowering and unifiedway.

The programme staff works in partnership with theresource people trained through the 'Training theTrainers' model to run a continuing series of work-shops in literacy, early stimulation etc. It is expectedthat these resource people will eventually be ableto sustain this programme themselves within theirregion. They will be assisted in this process by theCBR teams.

The CBR infrastructure does not duplicate existinggovernmental or non-governmental infrastructure;rather, it works in partnership with other agencies.All CBR workshops in the Rupununi are carried outin partnership with the Ministries of Health andEducation. These agencies periodically reviewthe programme's plans, release teachers and healthworkers to participate in workshops, and sometimesco-sponsor workshops. Other NGOs also collaboratewith the programme on transportation planning,and programme implementation.

CBR has become integrated into existing village,regional, and national systems of organisation. This isbecause CBR participants are drawn from the existinghealth and education infrastructure and becauseregional and national authorities were consultedduring the planning process. The CBR team in eachvillage is part of the village system of committees.At monthly meetings of headteachers throughoutthe region, CBR work is discussed as a standard partof the agenda. Reports of on-going CBR work areincluded in subdistrict and regional reports in healthand education. It is even included in national plansin the health and education sectors. The new healthplan for Guyana, articulates CBR as the centrepieceof rehabilitation care in Guyana:

`A programme objective will be to increaseaccess to rehabilitative care by introducingCommunity Based Rehabilitation as the mainstrategy for delivering rehabilitative servicesat the primary care level.'(Ministry of Health, 1994, p. 120)

This inclusion of CBR in the health and educationsystems adds greatly to the acceptance and sustain-ability of the CBR Programme at the political level.

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LESSONS LEA NED

The following points have emerged as laying thefoundation for the project.

1. The importance of a profound faith andrespect for the people of the region

A major goal of the project was to help the indigenouspeople of the Rupununi to bring about change in theirown condition and, in the process, to take more respon-sibility for their own affairs. A significant element ofthe Rupununi programme has been the identificationand training of human resources from within the region.The term 'empowerment' is now used in every articleon development. Whilst the CBR workers in this regionmay not know the term 'empowerment' , they never-theless feel a sense of satisfaction that they are integralto the introduction of an extensive health and educationprogramme to their own people. The goal throughoutthe project has been to reinforce and nurture, ratherthan supplant, the authority of the teachers, healthworkers and community leaders of the region.Education and training are at the core of the project,rather than the provision of services by some externalagent from the coast. This focus has been reflectedin the relative amounts of time invested by the resourcepeople in training and development on their visits tothe region.

Efforts have been invested in helping each person torecognise the role they can play in the developmentof their community. At the beginning of the project,the prevailing attitude of many of the participants wasthat they were poor, passive recipients of what otherswould donate to their region. The philosophy whichpermeated this project asks each individual to playa more active role in his or her own development andto inspire people to realise that they can indeed playa key role.

2. The promotion of sustainability throughthe avoidance of dependency

In each village a Local Health Board (LHB) has nowbeen elected, providing a medium through whichthe community can be involved in all phases of theproject. The goal of sustainability is the touchstoneof all development interventions. Only time will tellwhether this project can be sustained beyond theinputs of external interventions. However, the emer-gence of the CBR teams and the LHBs, and the heavyemphasis given to training these groups in the skills

of consultation, leadership, problem-solving anddecision-making has established a promising base forlong-term development.

Some features of the project which have promotedsustainability include:

the clear match between regional needs andprogramme objectivesthe use of the existing health and educationinfrastructures rather than creating new groupsof workersbasing the management of the programme inthe regionthe focus on involving and empowering communities.

3. Development which is respectfulto the local culture

The project was guided by a respect for the culture ofthe region and an appreciation that for development tobe effective it needs to proceed in harmony with thelocal culture. Considerable time was spent at the outsetof the project to meet people throughout the region tolearn about the needs of the area. One of the majoractivities of the first year of the project was to producea set of training materials on child development andearly stimulation , in consultation with the teachers andhealth workers of the region, which reflected practicein the region. These materials illustrate a profoundrespect for the local communities.

A diverse series of materials have been produced aspart of the 'Hopeful Steps' programme. These includerecordings of music and oral traditions, story books inlocal languages and festivals of local poetry and song,all of which reflect the rich cultural heritage of thepeople of the region.

4. Consultation

The programme brought together people from diversebackgrounds and perspectives to discuss their needsand concerns. They were given access to the decision-making process at every level of the intervention.Consultation with and participation by the communitywas facilitated at every level of the decision-makingprocess. Facilitators listened carefully to communityinput and then acted on what they heard. There wasno 'script' at the outset of the project: the actionsof the project emerged out of the dynamic consultativeprocess. In adopting this process we were fortunatethat our funders, AIFO, realised that such a processtakes time and cannot be hurried. The programmethat was subsequently developed was thereforecharacterised by flexibility and responsiveness tosuggestions from within the region.

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EPLICAOTHE

ILITY INA" EAS

The model of development outlined could be duplicatedelsewhere, given certain conditions:

the promoters of the initiative must have a beliefin the potential of the people they are serving

the initiators should have the ability to guideindividuals, who for so long have traditionally beenled by others, to take charge of their own affairs

the active participation of the subjects ofdevelopment must be achieved at all phases ofthe development process

the community should have a desire for change

the programme developers must be willing andable to listen to people who may not be articulatein the traditional sense

the initiators should be experienced in the art ofconsultation

the funders should allow those implementing theinitiative sufficient time throughout the programmeto facilitate the consultative process

effective partnerships between all the key playersand the major government agencies should beestablished.

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CONCLUSION

The 'Hopeful Steps' programme has attempted todevelop a management style which allows the loftyconcepts of 'community participation' and`empowerment' to be nurtured. There was nopredetermined script for the project; many of themost creative features of the programme emergedfrom the participants over the course of time.This process has resulted in a programme whichhas grown from a modest beginning in the area ofearly stimulation to a wider, integrated developmentprogramme involving many people.

REFERENCES

Guela,N. (1994), Base line health data of theRupununi district in Guyana, University of Berkeley

Ministry of Health (1994), Health statistics onGuyana, Ministry of Health, Guyana.

Stout,S. (1996), Sustainability of CBR and BCHPprogrammers in Guyana, University of Berkeley.

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INDIA

Special Educational Needs inEarly Childhood Care:An Inclusive Early ChildhoodEducation Programme

By INDUMATHI RAORegional Coordinator,CBR Network and Director, Seva in Action

II, ACKGROUNDINFORMATION

Bangalore District is located in the south-easterncorner of Karnataka, one of the southern statesof India. This district is divided into three revenuesubdivisions for administrative purposes. Bangaloreis also the capital city of Karnataka. According to the1991 census, the total population of the district is fourmillion, with children making up to 12% of the totalpopulation. A survey conducted by the Governmentof Karnataka in 1993 showed that six per cent ofthe child population (0-14 years) is in need of somespecial support.

India is a developing country with a predominantlyagricultural base. With recent but rapid urbanisationand globalisation of the market economy, India'sindustrialisation has taken a giant leap.

The economy of Bangalore District is a blend of thetraditional and the modern. The traditional occupa-tions comprise agriculturally-based work such asfloriculture, horticulture and so on. Sericulture, andsilk weaving, are gaining momentum as an alternativesource of work for rural families.

POLICY ANDPOILIITIICAL CONTEXT

India was one of the signatories of the Declaration andPlan of Action in the 1990 World Summit for Children.This has resulted in the formulation of policies andstrategies which recognise the rights of children toshare in the nation's economic resources. The planningmeasures are initiated by the relevant governmentdepartments such as health, primary education andwelfare. The needs of children with disabilities is oneof the 'special' issues on which planning is focussed.

Some of the special issues are:preparation of children in primary schoolssupport services to girls and working childrenThe Early Child Care Education plan of actionhas included children with disability.

The national policy for education (1986) places aspecial emphasis on the need to equalise educationalopportunity by meeting the specific needs of thosewho have so far been denied equal opportunities.Outlining the steps for ensuring equal educationalopportunities for disabled children, the national policystates that the objective should be to integrate thosewith physical and mental disabilities with the generalcommunity as equal partners, to prepare them fornormal growth and enable them to face life withcourage and confidence. The strategy includes thefollowing points for action:

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Wherever it is feasible, the education of childrenwith motor disabilities and other mild disabilitieswill be shared with others;Special schools with hostels will be provided as faras possible at district level for severely disabledchildren;Adequate arrangements will be made to providevocational training;Teacher training programmes will be developed;in particular, for teachers of primary classes to dealwith special difficulties;Voluntary effort for the education of children withdisabilities will be encouraged in every possibleway.

This plan of action resulted in the implementationof an integrated education scheme by the Directoratefor State Education, Research and Training(DSERT), at state level. (N.K.Jangira and SudeshMukhopadhyay, 1987).

The plan of action was used as a basis for the prepara-tion of the Karnataka State plan of action for children,in 1992. The plan focussed on the opening up ofelementary education to everyone and the integrationof disabled children by the year 2000. In 1996, a newdraft plan of action was prepared by the IntegratedEducation for Disabled Children (IEDC) AdvisoryCommittee which was set up by the EducationMinister in 1992. The plan of action for Karnatakastate on inclusive education was jointly prepared bythe government and voluntary organisations.

1. Objectives of inclusive educationin Karnataka state:

Universal enrolment of all disabled childrenin mainstream schools by the year 2001.To prescribe a minimum level of learning,with curricular adaptations, for disabled childrenin mainstream schools.Reduction of the 'drop out' rate for disabledchildren in IEDC schools, both mainstream andspecial.To provide access to secondary education fordisabled children, with resource support.To provide access to vocational training for chil-dren with intellectual disabilities both in specialschools and IEDC mainstream schools.To focus on developing pre-service and in-serviceteacher training, in order to meet the special needsof disabled children in mainstream schools.To provide an access to education and vocationaltraining for disabled and other deprived children,through non-formal education (NFE) programmes.To extend educational and vocational services fordisabled adults through adult education.

The Department of State Education, Research andTraining stated in 1996 that: 'To achieve the aboveobjectives in rural Karnataka, a scheme has to bedrawn-up to promote community-based rehabilitation(CBR) for all disabled persons by the year 2001'.

Comprehensive legislation was passed in 1996 bythe Indian government on 'protection, equalisationof opportunities and the rights of disabled persons inIndia', which has emphasised the need for integratededucation and community-based rehabilitation.

2. Recommended steps to achieveuniversalisation of education bypromoting early child-care education:the Karnataka state model

Goal

Ensuring the effective participation of childrenup to six years of age in Early Child Care Education(ECCE).Strategies:

New cost-effective designs of ECCE to be intro-duced in existing Integrated Child DevelopmentScheme (ICDS) projects.Improvement in the quality of the programmeto be assured by:

providing Anganwadi (pre-school) workerspractical refresher training;providing materials for use of trainersand the trainees;providing materials for children such as picturebooks, picture posters and essential playmaterials which are replenished periodically;developing the Child Development ProjectOfficer's office into a resource centre.

Further qualitative improvement of six ongoingECCE programmes to be achieved by encouragingthe design of low-cost, effective home-basedmodels, and models for day-care centres and familyday-care centres. Using play-centred methods willbe encouraged rather than focussing on the earlyteaching of the 3 Rs. Pre-primary schools andclasses focussing on the play-centred method oflearning are to be provided with community support.Day-care centres will be strengthened throughtraining. Goals are: adequate, safe and hygienicspace; reasonable child-worker ratio; safe drinkingwater; supplementary nutrition; paramedic careunder medical supervision; basic equipment to beprovided, including linen, cradles, toys and playmaterials; the adequate training and supervisionof workers.Links between ECCE and primary schools to beencouraged through interaction betweenAnganwadi workers and school teachers. Electronic

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media support to be utilised for conveying to theparents and community the significance of ECCE.ECCE training facilities (pre-service and inservice)made available to ECCE workers and supervisors.DSERT to provide technical support and academicinput.A suitable monitoring and evaluation system to beevolved. A unit to be established within DSERT formonitoring ECCE programmes.

3. Children and families of childrenwith special needs

In India, early child care and education is provided forchildren between two-and-a-half and six years of age.ICDS is one of the largest pre-school infrastructuresin the rural and under-developed areas, and there are100 ICDS 'blocks' in the Bangalore district. The edu-cation department also runs pre-school programmes inthe district. Besides, there are a number of privately-managed pre-schools called balwadi, or nurseryschools. The objective of these pre-schools is mainly toprepare children for primary education and to providenutrition and care. ICDS projects also identify and referchildren with disability to mainstream schools if thechild is over five years. If a child with disability isbelow five they are usually referred to distriCt hospitals,as there is no government programme at village levelto meet the special needs of children with disability.

Only a fraction of the children with disability receiveany meaningful support through the existing pro-grammes. The major problem faced by the rural andpoor families is accessibility to the existing services.

Children with disability are not accepted in ICDS orother pre-school centres, although identification andreferral is one of the components in the training ofAnganwadi workers. There is also a lack of motiva-tion on the part of the pre-school and Aganwaditeachers. The existing Aganwadi centres are primarilydealing with basic nutritional and care needs, whichleaves them with very little time for early stimulationor other educational development activity. The preva-lence of malnutrition, owing to poverty, requiresmajor attention in these areas; disability is thereforenot a 'priority' problem, because there are other,more pressing problems.

However there are plans to meet the pre-schooleducational needs within the ICDS system. Existingproviders have yet to decide whether the ICDS shouldlimit itself to identification and referral (as thereis nothing much available at village level) or whetherICDS workers should be trained in inclusive educa-tion so they can meet the special educational needswithin the ICDS system.

INDIA

Having said this, the perception of disability as amedical problem is also preventing the establishingof village-based services to meet the pre-school edu-cational needs of children with disabilities. It is onlythree or four years ago that the ICDS started lookingat the pre-school educational needs of non-disabledchildren's care for example, needs in nutrition andimmunisation. Therefore, the ICDS must ensure thatit is ready to assume new responsibilities.

SIEVA EN ACTON:THE C MR PROGRAMME

1. Basic organisation

Seva in Action (SIA) is a community-based rehabili-tation programme, set up as an organisation, whichhas made an attempt to prepare the communityto meet all needs of people with disabilities usingexisting infrastructures.

SIA was started in 1985 in Bangalore district. It hasinitiated village-level community-based rehabilitation(CBR) committees which are responsible for theplanning and management of the programme. Thesecommittee members include people with disabilities,families, school teachers, priests and doctors, repre-senting a cross-section of the village communities inwhich they are based.

SIA is supported by the Norwegian Agency forDevelopment (NORAD), and the GovernmentMinistry of Human Resources. However all fieldservices are sustained by the village committees,except the integrated education support services.

The CBR committees raise funds from the localpeople and they support the early intervention pro-gramme. The CBR committees also fund the CBRworker's salary, medical rehabilitation and activitiessuch as conducting awareness at local level.

2. Objectives

To provide early intervention and education fordisabled children through appropriate communityroutes, taking into account the community's socio-cultural needs.To train mothers, Anganwadi workers and CBRworkers in early intervention programmes.To influence government programmes by assistingin the training of personnel to provide inclusive

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pre-school education. Training includes: mecha-nisms for the early identification and assessmentof children with special needs; identification througha multi-disciplinary approach.

Early identification is the key factor for the successof inclusive education and the rehabilitation process.Identification is not a one-off event in the project;it is a continuous process, identifying disabledchildren in the early years of their life. SIA conductsmuti-disiplinary camps for first-level identificationand assessment. Professionals visit the villages, wherethe children with special needs are identified and anassessment is made. They are only asked to visit thedistrict centres if they need detailed assessment.

Local CBR workers, health workers and Anganwadiworkers play an important part in early identification.Regular visits to the local practitioner and referralsfrom the health worker also facilitate early identifica-tion. SIA has developed and tested a detailed ques-tionnaire for the identification of children aged frombirth to six years and from six to 14 years. Thesequestionnaires can be used by local CBR volunteerAganwadi workers and primary school teachers in asimple way. The objective of the questionnaireis to identify and categorise children with disability.Middle and high school children have also assistedin these surveys.

AM.

3. SIA services

Preparation of children for integration intomainstream schools using both home-based andself-help group services.Integrated education in mainstream schools.Pre-vocational training and vocational training.Economic rehabilitation by using self-employedpeople and business promotion of family trades.Community organisation.Appropriate aids and appliances for disabled peopleliving in rural areas.Training of families and siblings.

4. Staffing

Trained local facilitators who are known as `CBRChamps' are chosen by the village committees andpaid by them.

These SIA local facilitators have ten years of school-ing, and receive six weeks' training which includestraining in Portage.

They are chosen and paid by the village CBR commit-tees and their role is to meet the special needs of peoplewith disabilities in their area. They visit homes toprovide support for children under three years of age.

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The facilitators organise multi-purpose, self-helpgroups which have five objectives. These are:

helping families to care for severely disabledchildrenmeeting the special needs of children and preparingthem for mainstream education and employmentpromoting self and group advocacy movementsassisting families and disabled persons to help andsupport each other in times of crisismotivating the community to sustain the pro-gramme.

5. Human resource development

SIA conducts training programmes to develop person-nel in CBR processes and trains resource teachers forintegrated education programmes.

Training programmes offered by SIA

Certificate course for teachers in IntegratedEducation of Disabled Children-approved courseby National Council for Research and Training;duration nine months.Diploma in CBR Planning and Management;duration nine months.Short-term courses for teachers and parents(a six-level workshop programme which enablesfamilies with disabled children to meet the needsof their disabled children and eventually helps themto form self-help advocacy movement)Training programmes for government educationdepartment staff at district and state level(on request from the government).

SIA also trains personnel from other developingcountries in the planning and management of CBR.

For SIA Staff

Each village CBR worker has received six weeks'training and there are refresher courses. The trainingprogrammes enable the CBR workers to plan andimplement identification and early interventionprogrammes for the children. SIA also conducts multi-category resource training for teachers responsible forthe integration of children at pre-school, primary andmiddle school level. This is a one-year training pro-gramme. These teachers also assist the CBR workersin monitoring the progress of children. There is trainingfor Anganwadi workers for which SIA has developeda curriculum on the early education and care of childrenwith disability, working to the goal of early educationfor these children and not just identification and referral.This training has been given to child developmentofficers placed at taluk level (sub-division of District)

INDIA

District Institute for Educationand Training (DIETs)

SIA has conducted a number of training programmesin inclusive education for personnel from the districtlevel. Training has been supported at state and districtlevel to prepare mainstream school teachers to meetthe needs of disabled children in mainstream schools.

Teachers are also trained in the use of the UNESCOTeacher Education Resource Pack.

SIA has developed appropriate technology in CBRin the form of developing appropriate aids andappliances and education programmes for disabledchildren.

STRATEGIES OF EARLYINTERVENTION AND ASSESSMENT

1. Early intervention

After identification there are various strategies toprovide appropriate early education support where theneeds of the families are given a priority. The variousapproaches in early intervention are :

home-based (0-3 yrs)self-help groups (3-6 yrs)Anganwadi centres (3-6yrs)

Home-based programmes

This service is available for children with specialneeds up to three years of age. The CBR worker visitshomes to provide early stimulation programmesand training to parents or to the family membersresponsible for taking care of the child, perhapsa sibling or grandparent. This enables them to lookafter their children at home more effectively.

Self-help groups

The self-help group is a multi-purpose disabilitycentre which uses any place that is available in thevillages, including temples, community halls or main-stream schools. The self-help groups meet the needsof children from three to five years of age and preparethem for primary education.

A self-help group also acts as a pre-school in villageswhere there are no pre-schools. It also provides pre-vocational training for children over 16 years of age.

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Curriculum used for 0-5 years

Portage is adapted to Indian rural conditions andtranslated into seven local languages. Both the check-list and 'how to do it' cards are available in locallanguages with local adaptations. Individual educationplans and group educational plans are prepared by localfacilitators. Recording boxes are used by illiterateparents. These boxes are multi-purpose and also usedfor monitoring epilepsy.

Comprehensive individual child dairies are maintainedby local facilitators. These dairies have records on:

base-line data on different aspects of development(eg: socialisation, cognition, language and commu-nication, self-help skills, motor development)and school curriculum areas (eg: science, language,social studies, mathematics, etc).annual, quarterly, monthly, and weekly targets

those set, and those achieved.support to families parents' training, parents'meetings, sibling support.preparation after school years a training packageentitled Training adults to live in the communityis used by the local facilitator.a six-level family training workshop programmewhich helps families to understand and meet theneeds of their children and to get involved inadvocacy, to find solutions to practical and seriousproblems such as 'what happens to disabled childrenwhen parents are no more?'

Anganwadi centres

An Anganwadi centre is a government-run pre-school,run through the education or social welfare depart-ments and providing children with early care andeducation. The objective of such centres is to providesupplementary nutrition and education. SIA alsointegrates children in these centres; children also havethe opportunity to participate in various activities.SIA has developed a curriculum for identification andearly education programmes for children integratedinto these Anganwadi centres.

2. Assessment

Following identification, disabled children go througha process of medical and educational assessment,the main focus of which is the assessment of theirstrengths and weaknesses. Educational assessmentis conducted in the resource centres attached to main-stream schools or in self-help centres. Parents playan important role in the assessment of their child.Informal assessment is done by the parents who list

the strengths and weaknesses of the child accordingto their knowledge and experience. The teacher alsoundertakes an informal observation, which takesbetween a week and 15 days. Following the informalassessment there is a formal assessment, based onthe adapted version of the Portage check, which istranslated into the local language. This is a criterion-referenced checklist used by SIA for both assessmentand planning purposes. This checklist is able to assessthe child in the following areas:

language developmentmotor developmentsocialisationself-help skillscognitive development.

This is recorded in a home-school dairy which ismaintained for each child.

PLANNINGAND MANAGEMENT

1. Planning

There is comprehensive planning, based on theidentified strengths and weaknesses of the child.This planning is done for a full year, which is thentask-analysed into quarterly, and, finally, weeklyplans. The planning is based on the adapted version ofthe Portage checklist and curriculum for pre-vocationaltraining. An individual education plan is drawn upfor children with particular moderate and severe diffi-culties, and those with problems in areas as cognitionand language. Group Educational Planning is morecommon, as it is a more effective use of local facilita-tors' time. Although the teaching is in small groupsettings, the evaluation and assessment are alwayscarried out on a one-to-one-basis.

Local facilitators are trained to choose targets relevantto the families and village community, and thishas helped to increase acceptance of education forchildren with special needs.

Behaviour modification techniques are used with alldisabled children. These children are prepared forintegration into mainstream schools. If they are noteligible for integration, perhaps if they have moderateor severe learning difficulties, then they are preparedfor vocational training.

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2. Monitoring mechanisms

Overall programme monitoring

Village level committee ze ae ae IE Director0

Field coordinators0

Multi-purpose resource teachers0

Local facilitators (CBR Workers)

Monitoring of self-help groups

Once the individual and group education plans havebeen written, the CBR workers monitor their imple-mentation on a daily basis, using the targets andadditional information from the individual diaries tomeasure outcomes. There are monthly monitoringmeetings of the local committee and additional monthlyreporting by the field coordinator. The monitoringrecords and staircase developed by Dr Helander, fromthe WHO Manual, are the main instruments used.

Home-based monitoring

Recording boxes for illiterate families.

Besides diaries, there are recording boxes maintainedby the parents if they are the teachers at home. Thisensures daily monitoring of targets planned.

Box 1: RedCan Do

Box 2: BlueCan do

with help

Box 3: GreenCan do

very well

Box 4: BlackCannot Do

How to use recording boxes: trainers drop a pebbleor a stone for different responses. CBR workers countthem once a week and record them in the diary. Theboxes are also used for epilepsy monitoring, as it isdifficult to get information as to whether medicinesare being given regularly.

INDIA

Local CBR Committees

Local committees are formed at the communitylevel which are ultimately responsible for sustainingthe CBR programmes. These committees are alsoequipped to monitor all the services of SIA.The monitoring is done through a standard proformawhich they complete and send to SIA once a month.There is also a central meeting of all the committeesto discuss the problems and issues faced in imple-menting the programmes.

3. Links with specialists/support system/referral system

Education is the only service which is available inevery Indian village. No other support system forrehabilitation exists in rural areas. The SIA emphasishas been on the demystification of rehabilitationtechnology in order to make it accessible, appropriate,affordable and relevant to rural areas. Eighty per centof rehabilitation services are available in the villages;in the field of education, 100% support is availablefrom the CBR system at community level.

PARTNERSHIPS

1. Parents

As far as caring is concerned the Indian family, withits closely-knit structure, provides a caring environ-ment for the majority of its children. Thus SIAhas been able to utilize this strength and has madeself-help groups a forum to bring families together inplanning and managing the programmes. The familymembers are members of the local CBR committeeswhich are responsible for running the programmesat community level. The parents have been trained tomanage their disabled child at home. They are alsoresponsible for providing a monitoring support to theCBR teacher.

2. The community

CBR builds on the strengths and potential inherent inthe community. CBR committees are the backbone ofSIA's programme. There are eleven CBR committeesin the rural areas of Bangalore District. These com-mittees have been formed over a period of time by

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local people from a variety of backgrounds: teachers,doctors, principals of schools, social workers, agricul-turists, members of women's organisations, and alsoparents of disabled people. These committees havecome together and are bound by a common socialconcern for and social accountability to children withdisability.

The major responsibility of the community is tomobilise resources and to plan and implement theprogrammes at the community level. The communityis also being prepared to monitor the rehabilitationservices so that there is less dependency on profes-sional and district input. Each CBR committee wouldmeet once a fortnight to review the services of themonthly village committees.

?RC IlLEMSAND MAJOR ISSUES

The communities have played an extremely importantrole in sustaining the SIA programme. During10 years of SIA programme activity, there has beena considerable change in attitudes towards disability.

Some of the major problems faced by SIA are:sub-standard government schoolsa less than positive attitude from policy makerstowards the education of disabled childrenprescriptive curriculum in primary schools andcompulsory levelling of all childrenspecial education is still planned on the basis oflabelling children according to disability, ratherthan being based on levels of abilitydisabled children are scattered throughout ruraland tribal areasaccess, whether physical, educational or social,is a limiting factor in promoting inclusive educationa complex association between poverty anddisability, where we find mothers are over-burdenedwith field workhouse work/the demands of bringingup a disabled child

Single-teacher schools are generally viewed as anegative factor for integrated education, but SIA seesthem as a plus point as they allow mixed ability levellearning.

A classroom for all is still a dream which is yet to beachieved in Indian village schools.

Specific problems

Parental attitudes

The head of the family, who is also male, has adominating role in the family and society. Therefore,the attitude of the father towards the child influencesthe attitudes and actions of other members of thefamily too.

The basic issue for the parents and the communityis time. The majority of the parents are dependent onagriculture and self-employment, and each and everyminute is crucial in sustaining their livelihood andmeeting their basic needs. Therefore, they are not ableto give time to their child and parents' responsibilities,meetings and so on.

The attitude of the Anganwadi teachers

Although a policy decision has been taken to promoteinclusive early childhood education, the priorityis still taking care of the basic needs, like nutrition.Education is still not always seen as a priority forthe children.

Availability of trained personnelat middle level management

Monitoring of programmes by trained personnelis one of the major factors in sustaining quality.It is seen as a necessary evil to maintain the qualityof services.

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LESSONS LEARNT

Disabled children need trained community workersto meet early intervention needs.Early intervention programmes cannot be sustainedunless the families are active partners.The best possible support should be available atvillage level 90% of special educational needsshould be met at community level.Integrated education should be seen as a way into improving existing primary education. Inclusiveschools, with an inclusive curriculum, provide acost-effective education.In Karnataka state, the government has set anadvisory committee for IEDC. This committee hasplayed a major role in bringing about policychanges, introducing integrated disability contactin mainstream teacher training programmes, andsetting up an ICDS workers' training programme.Action groups on IEDC at state level are necessaryto promote IED in developing countries.In CBR, people have the misconception that thereis no need to look at special educational needs.It is important that the CBR programme should seeIED as an integral component, as 80% of the needsof children with disabilities are educational ratherthan medical.

REIFERENCES

Johnsson, T., Inclusive education UNDP InternationalProgramme for Disabled People, Geneva.

Helander, E.; Mendis, P.; Nelson, G.; Goerdt, A., (1991),Training in the Community for People with Disabilities.4th ed., Geneva: WHO.

Jangira, N.K.; Mukhopadhyaya, S., (1987), Planning& Management of IED Programme A Handbook

for Education Officers. New Delhi: National Councilof Educational Research and Training.

Rao, I., (1993) Portage its Relevance in Indian RuralContext. Paper presented at the 4th World Conferenceon Portage, Jamaica.

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INDIA

LAO PEOPLE'SDEMOCRATIC REPUBLIC

Experiences in Provision forChildren with Disabilitiesusing the Kindergarten Sector

By JANET C. HOLDSWORTHIntegrated Education Adviser SCF(UK), Lao PDR

and PHANNALY THEPPHAVONGSASenior Technical Support Staff, Ministry of Education, Lao PDR

`DON'T USE MATURE WOOD IF YOU WANT TO BEND IT;DON'T PICK OLD MUSHROOMS IF YOU WANT TO EAT THEM'

(Lao proverb)

INTRODUCTION

In 1992, in a cooperative venture with the LaoMinistry of Education (MoE), the National Centrefor Medical Rehabilitation in the capital city ofVientiane opened a small school for children withsensory impairments. In all, 27 deaf children and10 blind children enrolled. The centre was staffedby retrained physiotherapists. This was the firstever special education available in the country.

One year later, Sapanthong Primary School inVientiane became the first Lao primary school to beable to cater for the needs of children with disabilities.In 1995, six more primary schools and four kinder-gartens were included and in September 1996, afurther six kindergartens and seven primary schoolsopened their doors to children with disabilities,bringing the total to 25. This pilot project unites threedistinct but related concepts school improvement,education for all and early intervention.

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II)ACKGROUND

Laos: the country

Eight years ago, no thought was given to the needsof children with disabilities when the government ofthe Lao People's Democratic Republic (PDR) beganthe process of school improvement. Rather, schoolimprovement was a response to the particular difficul-ties of quality and access to basic education faced bythe Lao Education service at that time.

Laos is a small and very beautiful country in south-east Asia. Except for the plain bordering the southernreaches of the Mekong River it is largely mountainousand forested. It shares borders with China, Vietnam,Cambodia, Thailand and Myanmar. It has one of thelowest population densities in Asia (19 per squarekilometre) and a total population estimated at 4.5 mil-lion in 1993. This population is scattered and ethnicallydiverse with between 38 and 68 different ethnicgroups (depending on the definition used), many ofwhich speak languages other than the national Lao

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Box 1THREE FACTORS

School improvement`School improvement may be the result of the introduction of integrated education, or provide theopportunity for integrated education to happen, but whichever route is taken, school improvementmust take place'

Towards Inclusion: SCF(UK)'s Experience in Integrated Education, 1995

Education for all`Create conditions for the handicapped children who are willing to study and give them a chanceto study in integrated classes with non-handicapped children.'

Art 13: Policy on Compulsory Education; Lao PDR 1996

Early intervention`The pre-school is the strong central post round which the house of primary education is built.If we compare the children who have had access to pre-school with those who did not, we can see veryclearly how well they do later on. Integration is so beneficial for young children [with special needs].It helps the children to overcome their difficulties, to be independent; itprevents isolation and givesthem access to a social life'

MONE KHEUAPHAPHORN, Director, Dong Dok Kindergarten, September 1996

language. These are generally linked into 3 broadgroups: the majority, 55%, are Lao Loum (lowlandpeople); 27% are Lao Theung (midland people) and18% are Lao Soung (highland people).

Laos has rich natural resources in its many riversand forests which are largely undeveloped, althoughelectricity is being produced and hardwood harvested.Further forest is lost annually through slash and burnfarming methods in the mountains. Indicators showthat Laos remains the poorest country in the region,with 85% of the population relying on subsistenceagriculture supplemented by hunting, fishing and foodgathering in the forests (Asian Development Bank:1993). In the last 10 years, there has been some manu-facturing and light industry development, but only inthe lowland areas where the necessary infrastructureexists.

Prior to the 1975 revolution, Laos had experienced50 years of colonial rule and 30 years of uninterruptedcivil war, culminating in devastation from Americanbombing in the period 1965-75. The new LaoPeople's Democratic Republic was faced with formi-dable tasks: 800,000 displaced people; little infra-structure; insignificant financial resources; a seriouslack of skilled personnel, as many of the educatedelite had fled; a post-war withdrawal of American aid;and a trade embargo from its most easily-reachedneighbour, Thailand (UNICEF Children and Womenin Lao PDR: 1992).

The education system

In the last twenty years, remarkable progress has beenmade, particularly since 1986 with the adoption ofthe New Economic Mechanism and the related PublicInvestment Programme with its emphasis on the needfor skilled personnel to fuel economic and socialdevelopment. In 1975, fewer than 30% of Lao childrenhad access to primary education. By 1990 this hadrisen dramatically with the enrolment of 85% of urbanchildren, 72% of children in non-mountainous ruralareas and 38% of children in the remoter mountainousareas (Lao PDR MoE: 1990). Geography, ethnicityand gender continue to affect enrolment rates, withLao Soung girls in the mountains least likely to be inschool.

It is acknowledged, however, that this increasedaccess was not matched by an improvement in quality.Schools are still often rudimentary and may lackmaterials, teaching aids and books. Many teacherslack any training and may even have received onlya primary education themselves. With very low pay,most teachers have to supplement their income withsecond jobs or by growing food. Teaching methodshave relied on rote learning and are based on anoutmoded curriculum which relates little to the livesof the children. The repeater and drop-out rates haveconsequently been very high. In 1990, it took anaverage of 13 years for children to complete primaryschool and fewer than half of enrolled childrenachieved this (Lao PDR MoE: 1990).

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Following the five-year primary programme, somechildren move through to a three-year junior highschool programme and then a three-year senior highschool programme or vocational training course,although access is limited.

Higher education is available at a university orpolytechnic. Teacher training for the priniary and pre-school sectors is offered in various forms for instancea three-year course following junior high school(8+3 system) and a one-year course following seniorhigh school (11+1 system).

After the revolution, the pre-school sector was veryrapidly developed, primarily to enable Lao women towork and thus achieve greater equality. Many kinder-gartens (3-6 years) and nurseries (3 months to 3 years)were attached to the workplace. Kindergartens werenevertheless seen as places of education, althoughthe quality was poor, often reproducing the formalteaching methods of the primary school.

Lao culture is warm and accepting. Children havenever been arbitrarily turned away from schoolbecause of some perceived deficiency, but neither hasa school felt a responsibility to teach such children.If parents thought their child should be in school andcould get them there, they were enrolled in grade 1.But for those children who needed more than the rotelearning, formal system on offer, failure, repetitionand repeated failure inevitably led to withdrawal atsome stage. Children with clear and obvious disabili-ties faced greater problems. If, for instance, it is goingto take weeks of patient teaching for a child to learn asimple skill, and if parents have no concept of whatmight be possible or have never come across another

LAO PEOPLE'SDEMOCRATIC REPUBLIC

child 'like ours' who has learned, small wonder thatthe sensible response is to feed and care for the childand accept the inevitable: nothing can be done.This is the same response as that of a teacher whoaccepts, without question, that many children will failand assumes their own actions cannot change thissituation.

SCHOOL IMPROVEMENT

Development of a new programme

In 1989, as well as continuing to work on the issueof access, plans were laid to start the process of qualityimprovement through addressing teacher educationand the curriculum. The government sought variouspartners, including Save the Children Fund (SCF) UKwhich helped with the pre- and in-service teachertraining programmes in both pre-school and primarysectors, and with the introduction of more child-centered teaching methods in schools. This work ledto the development of the current integrationprogramme. The interaction between the variouselements of the improvement programme can beseen in Box 2 below.

The issue of teaching methodology (how best to pro-mote learning within the school) grew through theconsideration of the curriculum (what to-teach) andhow best to prepare teachers for the job (what teachertrainees should learn and where they can best learn

Box 2DEVELOPMENT OF INTEGRATED EDUCATION (IE) PROGRAMMESIN THE CONTEXT OF SCHOOL IMPROVEMENT

1990 1993 1995 1997

SCHOOLIMPROVEMENTCONTINUUM

Primary Curriculum and Teacher Training Reform

Pilot IE Project Established

Project

Pre-school Curriculum and Teacher Training Reform

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the necessary skills). One report on the changes takingplace in the primary sector was entitled 'Learning toSee' and for those involved this was certainly the keyto the introduction of new methodology. Key questionswere: what is happening in the classroom? Why do somany children fail? How can we teach in ways that limitfailure and enhance learning within our limited resources?A variety of strategies were employed, including:

the adoption of more child-centred active teachingapproachesthe use of home made visual aidsgreater involvement of childrenbetter interaction in the classrooma wider variety of activitiesmore and better planning and recordingon-going assessmentabove all, a new attitude in which children's differ-ences were acknowledged and teachers took respon-sibility for the learning going on in the classroom.

It was this process that highlighted the clear needsof those children who had failed to learn and the needto consider the issue of those children whose parentsdid not enrol them at all.

Pre-schools do not, as a rule, 'fail' children and makethem repeat grades, and so the introduction of aplay-based curriculum and active teaching did notimmediately highlight children with learningproblems. Nor is pre-school compulsory, so the factsome children were 'missing' was never an issue.Nevertheless, the growth in thinking about the devel-opment of the child and giving attention to the wholechild helped pre-school teachers become aware ofdifferences in children. The changes brought aboutwere far reaching (see Box 3). Furthermore, onceintegration had started in the primary school sectorit became very clear what pre-school could offerchildren with disabilities.

Box 3KINDERGARTEN IMPROVEMENT

Before improvementThe teaching was based on an old curriculum and conducted subject by subject with the teacher atthe centre of the process. Teachers did a lot of talking and the children could only be listeners; theyhad very little chance to participate. The teaching and learning outcomes were not satisfactory becausethe teachers dominated the whole classroom. Teaching aids and toys were not usually available and,if there were any, they didn't relate to the topic and weren't attractive to children. There was someindoor and outdoor play for them, but it wasn't well organised. The activities were controlled by teachersand the children had no access to free play or choice. During class time all the children sat on thebenches and listened carefully to the teacher's instructions. Assessment of teaching and learning waspoor because there was a low understanding of children's psychology the teaching and recordingwas not in sequence'.

After`With the [improvement] project new teaching methodologies came in which helped the teachers developtheir knowledge, their concepts and their practical work. This was continued with the introduction ofthe new kindergarten curriculum. The methodology had changed from putting the teacher at the centre,to putting the students at the centre because it is based on an understanding of four aspects of childdevelopment (physical, mental, emotional and social) and the need to develop child participationin the teaching and learning process. The philosophy is 'learning through play' which includes manyactivities. Teachers use a variety of methods and teaching aids and organise and decorate the class-room according to the teaching topic. During play times teachers take the lead at first and then allowfree play both indoors and outdoors. To sum up: the new way of teaching helps children become happy,healthy and creative. Since the implementation there have been regular whole school meetings andmonthly classroom meetings with parents so as to ensure parents can support their children's learningand also contribute to the school when it is needed. Parents are happy to see their children's skills andbehaviour change and that the school has become an attractive place for children.'

Mone Kheuaphaphorn, Director Dong Dok Kindergarten, September 1996

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Main elements of the school improvementprogramme

The main elements of the pre-school improvementprogramme include

the study and understanding of the developmentof Lao children across four aspects of development:physical, mental, emotional and social. This is nota one-off 'external' study, but an active engagementof teachers and teacher trainers. In 1995, thekindergarten sector produced the first Lao bookon child development and assessment which wasbased on this growing body of knowledge. This isthe first time it has been possible to see clearlywhich children might be falling behind and so needadditional help. This work continues with growingunderstanding of the cultural differences within thepopulation;planning, recording and assessment proceduresbased on child development;play and activities as a basis for the pre-schoolprogramme;use of all the senses to reach children concretethings for children to touch, smell, explore, senseand feel so that the balance between the modalitiesis changed from the over-dependence on listening;variety of group size, particularly the use of 'circle'(small group) sessions;attention to the environment so that the school isboth safe for children and attractive this includesdecorating the classroom, the use of interest cornersand play corners;very flexible use of the indoor and outdoor space

children use tables for some activities, sit on thefloor for others, work or play under a tree etc.;the build up of teaching aids and play equipmentmade by teachers from available materials bothnatural (of which there is an abundance) and junkwhich is now becoming more available in citiesand small towns;much greater use of the oral culture which surroundsthe children stories, poems, songs and dances;building strong interactive relationships with childrenby ensuring that teachers and children are in closecontact. As the teacher moves away from the black-board at the front to engage in the activities she hasset up, interaction increases;seeking the highest level of involvement from chil-dren as possible, so that children are busy and active;creating new types of sharing partnerships withthe families so that their role is not just to deliverchildren at school and provide a little extra money;rather, they are engaged together with the teachers,in the learning and development of their children;strengthening the management of the school so thatit can, from small beginnings, develop and improvethe education and care of the children.

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Implementing the programme

These changes were first introduced by the 'demon-stration' kindergarten attached to the teacher traininginstitute, which enabled the new pre-service trainingto include practical skills training for the students.It also provided administrators and teacher trainerswith an experimental classroom situation withinwhich they could devise the programme and in-servicetraining that would be needed. This in-service trainingcontinues through regional and provincial centres,actively encouraging and supporting new youngteachers to hand on their knowledge from the newcourse. The programme enlists the help of teachertrainers and head teachers to support and monitorchange, produce training material, train regionaltrainers and help in the setting up of administrativesystems.

All this has been accomplished with relatively modestbudgets. Since 1990, costs have included:

enabling learning from outside through study toursand visits for the team of MoE administrators,teacher trainers and head teachersgiving access to written material and research,including translation costsfunding an external adviser for two years to supportthe team's learning and planningfunding the production of new study materials forteachers and studentsfunding short in-service training courses at variouslevels.

Working in this way, Lao educationalists have beenable to use relevant international research and experi-ences when trying to find ways forward which areconsistent with Lao culture, needs and opportunities.The process has been quite different from theimportation and imposition of external models thatcan result from short-term consultancies.

One very important side effect of this way of workinghas been the establishing of a group of educationalistsable to devise, plan and implement change and devel-opment. This group is now contributing to the develop-ment of new directions in village family support whichare currently being piloted and, as discussed furtheron in this paper, are key personnel in the introductionof integration.

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EDUCATION IP'OR ALL

A statement of commitment

It is not surprising that a country which has madesuch an effort to improve access to primary educationshould be strongly committed to the concept of`education for all'. The Lao government is a signatoryto the Salamanca statement on 'Education for All'(1994), the Convention on Child Rights (1991) andits recently adopted decree on compulsory education(1996), together with the plan of action to enable thisto be achieved. This commitment includes disabledchildren. Currently, Laos is assessing the needsof small, multi-grade schools in isolated villages,considering the particular situation faced by girlsand the problem of providing suitable educationin the complex cultural and linguistic environmentwhich prevails.

The twin forces leading to the development of inte-gration have been the experiences gained throughthe primary school improvement programme andthe involvement in the UNESCO initiative, includingattendance at the regional seminar (1993, Harbin,China). Following this, a project board was set upby the MoE and the National Rehabilitation Centreto devise an exploratory, pilot project. They were ableto secure funding from UNESCO for an in-countryworkshop and to use regionally available expertisefrom SCF(UK), which also provided the necessaryfinancial resources for the programme. This was latersupplemented with additional funds from UNICEF.Outside expertise was necessary as their were no Laoprofessionals with training or experience in this field.Countries with an established special school systemmay not need to import expertise in this way.

The pilot project

The primary school chosen for the pilot project wasone in which the school improvement process waswell established. There was felt to be a committedstaff and good leadership in the school and there werealready three children with clear special educationalneeds on roll. In-service training based on theUNESCO 'Special needs in the classroom' pack wasprovided to deepen the understanding of new methodsand prepare the school and the local communityfor admission to the school of children with specialneeds. During the first academic year (1993/94),twelve children were enrolled, mostly in the lowergrades, and weekend in-service training continuedthroughout the year. The following year there were17 children, including those who had been in school

(and failing) and whose learning problems were at lastbeing recognised and acknowledged.

This pilot phase provided an important learning expe-rience and in the first half of 1995, the project boarddeliberated on what had been learnt and what the nextstep might be. It could be seen that:

the inclusion of children with special needs waspossible in Lao primary schools provided that theteaching and learning was active, interactive, andflexible and that teachers were supported throughin-service training and ongoing support systems;introducing integration could deepen and speedthe school improvement process by highlightingthe difficulties children might encounter in theclassroom and providing methodologies for helpingmany children when they faced temporary or longterm problems, thus reducing the failure andrepetition rates throughout the school;while the general introduction of improved teach-ing methodology was the basis for the integrationprogramme, teachers also needed to know whatkinds of difficulties children may face and to haveaccess to ways of overcoming these. They alsoneeded problem-solving strategies for when theywere faced with unfamiliar situations presentedby the diversity of the children;changes in school regulations regarding assessmentand progression were needed;it was intended that inclusion should become stan-dard practice for primary schools (thus achieving thegoal of education for all), but the level of trainingand support that the pilot school had received couldnot be made available to the other schools. Theprocess of change would need to be quick and cheap,and the training and leadership team would need tobe expanded;teachers had found it quite difficult to accomplishintegration successfully and it was realised that themajor difficulties could, and should, be eased forany new schools. It should be recognised that bothteachers and schools need time to develop skillsand that asking too much early on only createdanxiety and dependence on the training and supportteam. Looking at the pilot school it could be seenthat a number of factors had caused the mostdifficulties, most of which are related, not to theongoing situation, but to the previous period whenthere were no services. Demand grew so quicklythat children outside the schools' normal catchmentarea were being enrolled. The four main factorswhich caused problems were:

i) the recruitment of older children (10+) whoselong-term exclusion had resulted in low socialskills and subsequent behaviour problems;ii) the recruitment of some children with severe

learning difficulties;

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iii) over-recruitment, so that some classes con-tained more than two children with special needswhich distorted the teaching/learning environmentand placed too much of a burden on teachers;iv) using the old curriculum (the new curriculum

was being brought in one year at a time, ie. forgrade 1 in 1994, grade 2 in 1995, grade 3 in 1996etc.)

In considering these issues and formulating the nextstep, the project board felt that introducing earlyintervention for children with special needs couldbe advantageous.

EARLY 1[NTERVENTION

The rationale

There is clear evidence that early intervention can bevery beneficial for children with special needs. Whenearly intervention is available, children do not sufferthe additional problems caused by social isolation,and the lack of stimulation and training which arisesfrom distress, low aspirations and a low level ofunderstanding in many families. During the kinder-garten period, with its emphasis on and understandingof the all-round development of the child, specialattention can be paid to the child's needs. Families canget a more realistic picture of their child's potential and

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reach a better understanding of their role in helpingto realise that potential. Furthermore, there are no prob-lems with discrimination by other children at this age;the child will grow up with his or her peers and theycan continue together through the primary school withthe more able children supporting and helping theirfriends.

In Laos, a small, but effective, kindergarten systemwas available. It was felt that such kindergartens, withtheir understanding of child development, improvedmethodology, positive attitude to parents and strongemphasis on social development could provide, forat least some children, a strong start. In addition, itwould be possible to recruit to the team an additionallayer of trainers and support personnel who wouldbring with them the skills and understanding of childdevelopment which could help teachers, particularlyprimary school teachers, to assess children andplan learning programmes. Whilst it would never bepossible for all children to benefit from kindergarten,a significant number could, and the developmentof primary integration could be speeded by workingthrough the kindergarten system.

A national implementation strategy:the pilot

Expansion was planned within the Vientiane munici-pality (three kindergartens and five primary schools)and the southern province of Savannakhet (onekindergarten and one primary school) so that a possiblesystem could be tried out. It was largely based in

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Vientiane so that the Vientiane-based implementationteam could monitor the situation closely in the firstyear. On the other hand, a pilot outside Vientiane wasalso needed, so a modest start was made in Savannakhet.

It was decided that a sustainable and expandableprogramme would need to ensure that the continueddevelopment of the schools was in the hands of localadministrators and individual schools. This wouldkeep support from the central implementation team(now expanded to include administrators and technicalstaff from the MoE, teacher trainers and head teachersfrom both sectors and the rehabilitation centre staff)to the minimum. It was not financially possible toemploy visiting resource teachers or other forms ofsupport staff outside the general system, either for thepilot or an expanded programme. Continued supportfor this work had to come from experienced teachers,head teachers and administrative staff in local areas.Therefore, developing the process and habit of discus-sion, sharing and joint problem-solving was a keyfactor for success and it was important to develop thisfrom the start.

It was also felt that initial training should be kept asshort as possible so that it would not become over-theoretical. It was impossible to provide practicalexperience before starting, so training opportunitieswere split, with more training given after work had

started, thus enabling teachers to draw on their initialexperiences of the project. As it was felt that kinder-gartens had valuable insights into working withfamilies and in understanding child development, theunusual step of training teachers from both sectorstogether was taken.

The project board and implementation team carriedout the following workplan for the academic year1995/96 for the ten new schools, using Sapanthongschool as a resource.

Workplan

five day-long workshops, firstly for local adminis-trators and head teachers and then for deputy headteachers, grade 1 and 2 teachers and at least twoteachers per kindergarten, with the head teachersacting as group leadersrecruitment of a maximum of two age-appropriatechildren per class into lower grades and the target-ing of all other children in the school with a historyof failure;ongoing support including staff meetings anddiscussions, support from local administrators,assessment visits from Rehabilitation Centre staffand visits from members of the implementationteam;

Box 4

SOME OF THE CHILDREN

Sonthong has Down's syndrome and on admission to the kindergarten in October 1995, aged 5,he spent much of the day on the floor. He took no part in any activities and seemed to have little aware-ness of what was going on. He could not feed himself or go to the toilet alone. By June, he was fullyintegrated in the class and took part with his classmates in the demonstration of morning exercises forparents on 'children's' day'. This entailed a long series of quite complicated movements and thesinging of the national anthem in which he joined with enthusiasm. Of all the people there, perhapsonly his mother and his teachers were really aware of what he (and they) had accomplished.

Pousey was three when she came to school. Brought up by her grandmother, she had spent her daysindoors. With physical problems affecting her lower legs and right hand she crawled around theclassroom and was frightened of the other children. With advice from the rehabilitation centre, theteachers set to work. Within weeks she was feeding herself and one year on she has just started to walkand is using both hands, although not equally. She is very bright and joins in all activities. Her futureis assured.

Vilayvanh is nearly 4 years old and has learning problems. Frightened and isolated, he spent thefirst few weeks in kindergarten clinging first to a blanket and then a carrier bag full of other bags.Gradually he began to take part more and more in what was going on and now seems a full memberof the class. He still has his bags but is able to put them on one side for periods and can even jokeabout them with the teachers. This year he moves into the top kindergarten class so as to prepare himfor entry into an (integrated) primary school in one year.

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occasional extra training for any school showingdifficulty such as allowing a delegation of staffto spend some time with a stronger school;a mid-year seminar which included some parentsand other members of local communities, duringwhich each of the Vientiane schools hosted visitsfrom seminar participants;encouragement to develop ongoing relationshipsbetween schools;workshops for some grade 3,4 and 5 teachers andmore kindergarten teachers at the end of the schoolyear.

Results and evaluation

Results have been generally good. Seventy-fivechildren in all have been included and the only realproblems were where school improvement had notprogressed sufficiently or where pressure (and thevery real difficulty of refusing places) led to aprimary school taking on too much and overloadingsome classes which then were unable to completethe year's curriculum.

One pleasing result, unlooked for in this first year,has been the drop in the failure and repetition rate inmany primary schools. As one head teacher said:'1995 was the very last year of high repetition rates.We can now recognise difficulties long before theexam and put in extra help.' In her school, the gradeexamination failure rate had dropped by over half,and all but one of the 10 children with special needswere moving up a grade in September 1996.

Work in the kindergartens has gone very well, withall the recruited children showing significant improve-ment, including those described above. It takes littleimagination to consider what the situation for each ofthese children would have been, had education onlybeen offered to them at the age of seven.

Kindergarten staff immediately recognise the relation-ship between school improvement and integratededucation and see the new tasks as deepening theirgeneral teaching skills. They are better able to seeindividual difference and the need for the all-rounddevelopment of the child. They have also seen howmuch co-operative working relationships can con-tribute to the work of the school. This aspect of theprogramme is therefore very welcomed and seenas an additional spur to general school improvement.

Kindergarten teachers have also been very pleased thattheir special skills in working with families in socialand emotional development and creating interactiverelationships with children have been recognised, andthat primary school teachers have come to see how

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those same skills can enhance their work. Kindergartenteachers often have lower status than other teachers

'they only look after little children'. This is as true inLaos as it is elsewhere. Co-operation and joint trainingis leading to a reassessment of their skills and roles.When primary school teachers turn to them for ways ofimproving children's social skills, for ways of involvingfamilies, for methods of making teaching aids andfor their understanding of child development, theirself-esteem and confidence grows.

Families and communities have very much welcomedthe programme. Previously, when no services wereavailable, families were isolated and, feeling that therewas no way forward, were unable to help their children.With access to school and a personal relationship withthe teacher, attitudes have quickly changed and manyfamilies are working hard alongside their children.Seeing the changes in the children and their families,communities have become very supportive, andas these children have never been removed from thevillage or urban district into institutions, there is nofeeling that they should be 'somewhere else'.

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All teachers have made very full use of the mutualsupport which has been encouraged and indeed thiswould appear to have been one of the key componentsof the programme. This has been seen to be true else-where in school improvement work (e.g. in the UK)but where there is very little expertise to call on, wherethere are no diagnostic and assessment procedures foryoung children and where there are, as yet, very fewreference materials, teachers have to work together,learning how to observe, discuss, plan, and evaluateresults themselves. This can only be done through aco-operative team approach within and between schools.

It is also clear that the high level of co-operationbetween everyone else involved is vital. This includesco-operation at ministry and policy-making level,especially between health and education, betweenadministration staff across and within levels, betweenschools in different sectors and regions, between teachers,between schools and families and the community. Thisco-operation is based on an acknowledgment of therights of disabled children to have a full part in society.

Teachers acknowledge the additional work involved,but also understand the foundation they are laying downfor the children in guaranteeing their rights and theircontribution to society. Furthermore, the large and smallsuccesses that they have achieved are creating a moreconfident and enthusiastic workforce. As one personsaid: 'Sometimes we can't explain what has happenedbecause we are so thrilled at what we have done.'

The next steps

With word spreading, one current problem is theenormous demand for expansion. For example, in onedistrict with one integrated primary school, requestswere received from all the adjacent villages' primaryschools. It would be very easy to overwhelm theimplementation team, which would mean that schoolswould not receive the necessary support. One of thestrengths of the team is their day-to-day work in differ-ent branches of education, but work on this programmeis still new to team members and must be fitted intotheir other responsibilities. One way of addressing thisproblem is to expand the team gradually from thoseschools with experience of integration. Already somehead teachers are beginning to take on this additionalrole. Nevertheless, the greatest danger at present is

too swift an expansion before the personnel resourcesare available and before a proper evaluation of themethodology has been undertaken.

In this academic year (1996-97) a second group ofschools joined the project, including schools in boththe Vientiane province and the Khammoune provincein central Laos. Essentially the same programme hasbeen followed, with only small changes to the trainingprogramme. The experience in Savannakhet hadsuggested that it is easier to start in a group ofschools, so that each school has a close neighbour(i.e. the smallest group should be two kindergartensand two primary schools, rather than one primary andone kindergarten) and this plan was followed.

There are demands for additional formal training butthe implementation team and the project board feelreluctant to introduce this at this stage because oflimited financial and (more importantly) personnelresources. Instead they are seeking to increase theknowledge and expertise of the expanded implemen-tation team, which will then provide informal trainingat school and school group level. If, for example oneof the head teachers in Savanakhet were able to leada discussion of issues and help in the problem-solvingstrategies, would this not have more long-term benefitthan an additional formal workshop? However, thebalance between formal training and informal schooldevelopment needs to be carefully thought through.

The team also aims to produce the following:a newsletter to be used to spread experiences andgood practice between all those involved;a training manual, based on a combination of itemsfrom the UNESCO pack and other items which ourexperiences suggest are needed and straightforwardenough to be used locally;management guidelines;materials for teachers and parents.

It is also clear that some thought will have to be givento the problem of child assessment and how to provideaccess to information and help when schools are facedwith unknown situations. There will be a need for atleast some staff at a national level who have a muchhigher level of training than is currently available. Atpresent, some outside help can be drawn upon but thisexpertise will have to be available within the serviceat some point in time.

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CONCLUSION

The prognosis for children is better when help isavailable at an early age; it is also easier to give thathelp when they are young. Bringing in the kinder-garten sector makes sense. Perhaps it is also worthconsidering whether integration may not be just alittle easier when it is introduced at the very start ofservice provision, rather than when the 'mature wood'of a fully developed special school system makes`bending' in new directions more difficult.

The experience of the Lao Integrated EducationProject has shown that with careful planning andimplementation, and by using all the resourcesavailable, the twin goals of improving quality forall and providing for children with special needs cango hand in hand; each initiative in the process feedsinto the development, and in turn each benefits fromthe combined effort. Determination and co-operationare the keys to success.

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REFERENCE

Asian Development Bank (1993), Education andDevelopment in Asia and the Pacific, Vol. 1. LaosPDR. Manilla: ADB.

Emblen V. and Vonsay D. (1991), Pre-schoolEducation in the People's Democratic Republicof Laos, Primary Teaching Studies, Vol. 6, No 2.London: Polytechnic of North London Press

Holdsworth, J. C. and Kay, J. eds. (1995), TowardsInclusion SCF(UK)'s Experiences in IntegratedEducation, South East Asia and the Pacific RegionalOffice Documentation Series, Discussion Paper 1Bangkok: SCF (UK) South East Asia and PacificRegion.

Kay, J. (1994), Learning to See. SCF(UK) InternalReport.

Lao PDR, Ministry of Education (1990), Evaluationde l'etat actuel de l' education en RDP Lao Vientiane:Ministry of Education.

Lao PDR (1996), Policy on Compulsory Education(incomplete reference)

Lao PDR MoE General and Pre-school Department(1996), Child development and Assessment of Pre-school Children Vientiane: Ministry of Education.

Sacklokham, K. and Inthiraths S. (1993), SpecialNeeds in Lao PDR Country report for the UNESCORegional Seminar on the Policy, Planning andOrganisation of Education for Children and Youngpeople with Special Needs Vientiane: Ministry ofEducation.

UNESCO (1993), Teacher Education Resource Packon Special Needs in the Classroom, Paris: UNESCO

UNESCO (1994), The Salamanca Statement andFramework for Action on Special Needs in Education,Paris: UNESCO

UNICEF (1992), Children and Women in Lao PDRVientiane: UNICEF Lao PDR.

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LEBANON

The Hadicat-as-Salam Programmefor Special EducationPart of the Tadamoun wa Tanmia Association(Solidarity and Development)

By RITA MUFARRIJ MERHEJClinical psychologist,Consultant in rehabilitation programmes for mentally disabled children

JAMAL CHOUAIBProgramme coordinator

and RIMA ZA'ZA'Training programme coordinator

ENTRODUCTI1ON

1. About the Association

The Tadamoun Wa Tanmia Association (Solidarityand Development) was founded in 1986. The humanbeing, regardless of race and belief, is its goal andresource. In practice, it follows the principles of theunity of a civil society and commitment to socialservice as a means for social change. It also believesin the development of practical, technical skillsthrough scientific resources.

The Hadicat As Salam Centre in Hlaliye Saida,is one example of the many activities undertaken bythe Association. It is concerned primarily with theintegration of children and teenagers with specialneeds with other members of society, and the devel-opment of a training programme for people workingin special educational and social fields. This reliesheavily on co-operation with, and the joint efforts of,other institutions, which also allows them to benefitfrom the Centre's work.

Since 1992, the Association has organised an educa-tional programme for special needs (SN) childrenaged two and above. The programme arose out of abelief in the importance of early intervention for chil-

dren with special needs and the absence of special careinstitutions for children under the age of seven. TheAssociation has also established a special care pro-gramme for SN teenagers (aged 14 years and above)which run professional training programmes.

The Hadicat As Salam Centre is one of the pioneercentres in Lebanon, gradually integrating SNchildren with other children through shared, carefullyco-ordinated activities.

2. The local environment

The Association is located in Saida, the third largestcity in Lebanon with around 300,000 inhabitants, themajority of whom are Lebanese. There are two majorPalestinian camps nearby : Ein-El-Helweh and Miye.More than 80,000 Palestinians live in the Ein-El-Helweh camp and there is a total Palestinian popula-tion of about 150,000 in the city as a whole, which isthe largest Palestinian community in Lebanon. Saidahas always been a city where different communitieslive side by side and is the most open city in Lebanon.

The socio-economic situation in Saida is similar tothat in other areas of Lebanon. The economy suffersfrom stagnation, as well as recession, increasingunemployment and growing inflation. This has led toa diminishing of the middle classes, who in the past

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acted as a security valve within the Lebanese system,and to a devaluation of the currency. In addition, thereare no social security networks. The Lebanese com-munity suffers a heavy burden in areas such as health,education, housing and food.

3. Educational provision

The city of Saida has 11 elementary and intermediatepublic (state-funded) schools which also providefor children at Kindergarten (KG) level who are agedbetween four and five. There are also 18 privateschools which take children who are over three yearsof age and 19 private nurseries, four asking for nominalfees, for children under three years of age. This earlystage (0-3 years) is not included within the publiceducation system.

It is important to note the lack of accurate nationalstatistics about the numbers of children, but it is clearthat there are too few schools in the city and a greatnumber of children to whom an education is denied.

Children with Special Needs (SN)

The official work during the war was focused onpartial financial support for a number of private socialinstitutions which care for SN children. Since the war,over the past three years or so, the level of care forthese children has increased at both private and publiclevel, owing especially to the work of the Ministryof Social Affairs. A National Committee has beenformed, comprising representatives of both the privateand public sector, and of those with special needs.

The `SN Identification Card' is one of the Committee'srecent achievements. It enables its holder to receive freesocial and health services. The National Committee hasa legal sub-committee which has produced a proposalcontaining 140 articles about the civil rights of peoplewith special needs. It has been transferred to theParliament, Chamber of Deputies for further study anddiscussion.

Prior to the war, five private institutions played amajor role in caring and providing special educationfor SN children of seven years and over in Saida.Currently, about 200 SN children attend the fiveinstitutions in Saida, but this provision is insufficientto meet demand, especially for those with more severeor complex needs, so parents have had to seek anappropriate placement for their child in the capital,Beirut.

There are few statistics about SN children in Lebanon,although in 1992, the Association tried to survey asample of inhabitants in Saida to identify the number

of children with SN under the age of five. This figurewas not established, since many parents find it hardto admit that their child has special needs and startedregistering their children a little too late after theinitiation of the programme.

Some of the difficulties facing families with anSN child are:

the absence of institutions, private or public,which provide for severe cases; as a result,the responsibility for care and support lies totallywith the parentsthe government gives partial financial supportto Lebanese citizens, (via the institutions), whichmeans that there are non-Lebanese children whoare completely unaided by the institutionsin most cases, private institutions lack the humanand material resources to provide special educationprogrammes for all the children in their care.

PROGRAMME DESEGNAND JIMPLEMENTATION

The Tadamun Wa Tanmia Association started itswork in the field of special education in 1989.During the initiation period, the work focused onco-ordinating joint activities for SN and non-SNchildren in summer clubs and camps. Between 1989and 1991, approximately 700 children between fourand 12 years old benefited from this programme.

In 1992, the evaluation of this initiative showed that ithad been a positive experience for the children, parentsand educators who had taken part. The Associationused what it had learned from this pioneering initiativeto help develop an educational programme forteenagers with SN and for children with SN, underthe age of seven. This was in addition to the existingnursery programme for non-SN children under three.This framework of programmes has allowed forthe development of a number of co-ordinated activitieswhich are discussed later in this paper.

1. Programme outline

The programme for children with special needs hastwo major strands :

a) The children's programmeb) The adolescent's programme.

The total budget for the programme is funded as fol-lows :

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30% International non-governmental organisations35% Lebanese Ministry of Social Affairs20% Beneficiaries (parents)15% Local Contributions.

Each of these programmes focuses on the individualneeds of each student at the Centre, taking into accounthis or her present level of cognitive development, typeof disability, chronological age, priority needs, andfuture environment needs. Each individualised 'formula'is then incorporated in the group programme, i.e. groupactivities which take into account needs common to aparticular group of students and aim to enhance socialand communication skills among the students withinthe group.

In the children's programme (Programme 1), there aretwo small groups of between five and six children ofbetween three and eight years old, each having a maineducator. The programme focuses on enabling themto achieve independence in daily living, through theenhancement of psycho-motor and adaptive communi-cation skills, and the development of basic cognitiveskills in the context of pre-academic training. Leisureactivities make up an important part of the programmeand include outdoor events, field trips and simpleadapted sports.

Programme 2 serves a group of 13 adolescent studentsaged between 12 and 18 years. They have oneeducator and one teacher-assistant. The programmeemphasises:

the basic academic skills which are necessaryfor future vocational trainingadvanced training for independent living withage-appropriate taskstraining in social and communication skillspre-vocational training aimed at preparing thestudents for the acquisition of a vocation whichwould ensure proper integration in the community.Several workshops have been planned to serve thisend, namely: cooking; agriculture; light carpentry;sewing and knitting, ceramics; and electrical work.

In addition to the above, there is an ongoingprogramme of leisure activities throughout the yearwhich comprises mainly sports activity, educationalexcursions and trips.

2. Objectives

The Hadicat-As-Salam Centre's general objective isto offer adequate educational opportunities and aproper social environment, as well as a rehabilitativeframework, to children and adolescents with specialneeds, in order to help them acquire the necessaryskills for integration in their community.

LEBANON

This objective can be broken down into several sub-objectives as follows:

to design and implement appropriate educationalplans to meet the needs of every child in the institu-tion, through the professional advice and carefulsupervision of specialists in the field of educationalpsychology and special educationto provide a stimulating environment ensuringthe development of each child's social skillsthrough the application of behaviour modificationtechniques and other educational strategies aimedat fostering socially-acceptable behaviourto offer students training facilities in pre-vocationalskills by providing a choice of sheltered work-shops, where each student is placed according tohis or her preferences and needs as perceived bythe staff in charge.

3. Mechanisms of early identificationof children with special needs

This aspect of the programme applies only to thechildren referred to us who are below five years ofage. The mechanism for early identification consistsof the following stages.

Stage 1

This is a preliminary interview with the child's parentsor principal carer(s). It is a lengthy interview carriedout by the Centre's social worker, in the presence ofone or two of the administrative decision-makers. Theinterview focuses on the prenatal, natal, neo-natal andearly childhood history of the child and tries to elicit asmuch information as possible from the respondent(s)concerning the medical history, as well as the presentbehavioural problems, of the child.

Stage 2

This is a screening and assessment session, duringwhich the school's psychologist administers a batteryof screening tests in order to draw up a diagnosticprofile and detect areas of weakness presented by thechild. These will then determine the basic curriculumareas for his or her educational programme. Thisinformation is later discussed in a private meetingwith the school administration in order to reacha decision on whether the child will be offered orrefused a place.

In case of refusal, the child will be referred to anotherspecialist institution.

If a child is admitted there are two more stages.

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Stage 3

This is a crucial probation and observation period.The parents are asked to bring in their child for aprobation period of one to two months, during whichobservation of the child enables staff to determine towhich group the child belongs, to identify the needsof the child and to establish the major elements of hisor her educational programme.

Stage 4

This stage comprises programme design and taskanalysis. Based on the observation recorded duringstage 3, the school psychologist and the educatorsdesign an individualised educational programme forthe child. The programme is carefully tailored to fit thepriority needs of the child and is set out in great detail,ensuring that it is comprehensible to the child's parents.It is important that they understand the objectives towhich the staff is working and the methods and materi-als used in the classroom. Involving parents in this wayalso helps to ensure continuity between the school andthe home in the whole educative process.

4. Monitoring mechanisms

To ensure that the entire educational and vocationalprogramme is running smoothly, a sound monitoringstrategy has been adopted, based on regularly-heldevaluation meetings between the administrationofficials and the educators in charge of the children.During these meetings, the objectives set for eachchild, as well as for the group as a whole, are discussedand revised as necessary. The methods used in theclassroom are also discussed, and suggestions areexchanged in the light of each child's development.Any problems encountered (a child's condition,difficulty in implementing a certain approach, materialneeds for the classroom, etc.) are carefully noted anda monthly meeting is held between the educators andthe psychologist where possible solutions, programmemodifications, and other educational and psychologicalissues are discussed. The psychologist also revisesall the individualised educational plans every month,focusing on the educational objectives and reviewingand evaluating the skills of each child.

5. Links with specialists / support services /referral services

The educational system adopted by the Centre isbased on a multi-disciplinary approach and specialistservices are provided for those requesting them. Theservices available are: physiotherapy, speech therapy,and psychiatric follow-up.

Few children registered at the Centre have severephysical disabilities, but many of them present mildforms of cerebral-palsy (spasticity, lack of motorcoordination, general imbalance, etc) and theserequire regular training and exercise, the aim beingto enable each child to obtain as much autonomy aspossible in his or her movements in the environment.Similarly, many children with mental disabilitiespresent mild to severe speech impairments whichaffect their ability to communicate. If neglected,these impairments are likely to affect the overalldevelopment of the child. This is why speech therapyand speech-reeducation should be an integral part ofany educational programme for children with mentaldisability.

Unfortunately, the Centre is unable to provide thesespecialised services owing to the lack of availableprofessionals in Saida who could work on a full-time,or even part-time, basis at the Centre. However,a sound referral system has been established at theCentre with stable links with a small number ofprofessionals in Beirut who are ready to provide theseservices in as systematic a way as possible in privateclinics or in other care institutions.

6. Partnerships with parentsand the community

If the potential of any educational and therapeuticendeavour is to be realised, then a solid link betweenthe home and the school must be established andcontinually reinforced. At Hadicat-As-Salam, parentsplay an important part in the educational process,and they do this in a number of ways.

a) They are given a copy of the individualisededucational plan which they can consult at anytime in order to work on the same objectivesas the school. In this way, they are involved inthe implementation of the plan.

b) Regular meetings with the parents allow for thediscussion of ideas and suggestions concerningthe educational programme, the child's needs,the child's progress and so on. Our experiencein these meetings reveals that parents have a greatdeal of enthusiasm and motivation to becomeinvolved in their child's education. They expresstheir ideas, opinions and criticisms openly andin such a way that the Centre learns a great dealabout how it can improve its educational andrehabilitation programme.

c) Interested parents are invited to attend trainingsessions alongside the educators, in order tobecome familiar with special techniques and

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methods for working with SN children and to helpthem implement these at home. In addition,all parents are requested to participate in activitieswith the group of children in which their child isplaced, and they are asked to prepare beforehand.

d) Regular monthly visits to the families are made byour social workers, the aim of which is to ensuresocial follow-ups for all children. These visitsare carefully structured and are discussed in staffmeetings to ensure that everyone has up-to-dateinformation.

e) A parent committee has been formed, the functionsof which are to: reinforce parental participation inthe vocational workshops; facilitate the communi-cation network between parents and the school;provide a means of representation for parents inadministrative meetings.

7. Staff training programmes

The staff in charge of the education of children andadolescents with special needs undergoes a yearlyfield-training programme at Hadicat-As-Salam

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consisting of conferences, lectures and workshopsin the following fields:

special educationspeech therapyessentials of occupational therapybehaviour modification techniquesclassroom managementdesign of individualised educational programmesbasic assessment and screening proceduresearly identification of disabilitiesprinciples of early interventiondevelopment evaluation.

Professionals in the fields of education, psychologyand social work are involved in the delivery of thistraining programme.

For the first few years, the executive board ofHadicat-As-Salam designed the training programme,but as a result of continuous intensive training, wehave reached a stage where members of staff candefine their priorities clearly and precisely. For thepast two years, technical and professional needs havebeen discussed by the educators, social workers andadministrative supervisors and these have then formedthe basis of the annual training programme.

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Our staff also participate in workshops and confer-ences outside the Centre and some staff are attendinga parallel two-year training programme offered bythe Department of Special Education in the Universityof Saint-Joseph in Beirut, which leads to a technicaldegree in special education. This programme empha-sises the theoretical aspect of special education andhas a clinical focus (etiology of disabilities, diagnosticmeasures, types of disabilities, understanding ofbehavioural and emotional disorders, etc.).

The continuous training includes administrators anddecision-makers as well as educators. They participatein conferences and sessions held at educational andadministrative levels both in Lebanon and abroad.Both constitute a real opportunity for us to share ourexperience with others and to learn from the experi-ence of others.

8. Outreach work

Since the ultimate objective at Hadicat-As-Salamis to ensure the integration of disabled people in thecommunity, all our efforts are geared towards therealisation of this goal.

Integration is pursued at the children's level;an annual plan of activities is prepared which aimsto integrate SN children with their non-SN peersin the nursery programme.

The programme includes:participation of the SN children with non-SNchildren in daily living activities and free activities(indoor and outdoor play)engagement of the SN children in some cognitiveactivities alongside the other nursery children(over two-and-a-half years), under the supervisionof the special educatorholding ceremonies and parties for both SN

-and other children, with the participation of theirfamiliesinviting SN and non-SN children from other insti-tutions to share in celebrations within the Centreinvolving a few SN children alongside non-SNchildren in a summer activities programme.

This plan of integration includes only the SN childrenwho have the potential to benefit, and activities areorganised to meet each child's developmental needs.To date, three children from the special education sec-tion have been placed in the mainstream kindergartenclasses following educational and social rehabilitation.

Wishing to build on and develop this work, in 1994we joined the 'Co-ordination Committee forIntegrating SN Children in Normal Schools'. It is a

non-governmental committee consisting of interestedindividuals. Its objectives are as follows:

Identifying SN children who are ready for beingintegrated, planning their individual programmesand follow-up, and training for the teachers incharge.Examining rules that support or hinder theintegration process and creating proper legislationto further that process.

Presently, this committee is concerned with undertak-ing relevant research and studies, and facilitatingthe exchange of experiences among institutions andindividuals.

PRO ILLEMSAND MAJOR 'ISSUES

1. Attitudes in the community

It is true that many positive changes have occurredover the past ten years in the way in which disabilityis dealt with in Lebanon. There are, however,many problems still facing the disabled person andseverely hindering his or her total integration intothe community.

One of the positive changes mentioned above is anincrease in awareness via the media (TV programmesand documentaries) and seminars and conferencesconducted by professionals. In a parallel way, newspecial care institutions have been founded in differentregions in Lebanon in an attempt to serve moredeprived areas. Moreover, academic programmesin special education have become part of universitycurricula which encourages an increasing number ofstudents to enrol in such programmes and get moreinvolved in the world of disability.

However, all this does not seem to be enough, for thereare still many misconceptions stigmatising disabledpeople in the cities as well as in the village. Disabledpeople are seen in general as pathetic, helpless people,and most of the time, as parasites living off societyand their parents. Stereotyped judgements prevail,condemning them to be dependent forever upon othersfor their material survival. The vast majority of thepublic is ignorant about the types and degrees ofdisability. For example, even now, mental disabilityis still confused with mental illness. The despisingand rejection of disabled people are at one end of thecontinuum, and charity and pity at the other end.There is no in-between position.

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It is more and more difficult for the notion of integra-tion to be accepted and applied in a society dominatedby these two extreme views of the disabledperson.

Parents of disabled children still feel marginalised,misunderstood and in many cases, wrongly judged.In some areas of Lebanon, superstitious beliefs stillprevail, and the incidence of disability in a familyis believed to be a result of the wrath of God overthat family.

As for the schooling and employment of disabledpeople, the Lebanese community does not yet seemto be ready to accept the idea, despite the fact thatserious attempts have been made in the last two yearsto promote the integration of disabled children inmainstream school settings. One of the main barriersto achieving this is the unwillingness of the communityto accept the idea of their 'normal' child being educatedalongside a disabled child. The employment of disabledpeople is similarly affected: non-disabled people find ithard to accept working alongside disabled colleagues.These are common attitudes, manifest in the rejection,humiliation and even abuse of disabled people.

Nevertheless, the overall picture is not as alarmingas it was ten years ago. For example, the LebaneseGovernment now has a Ministry for the Affairs of theDisabled and there is a clearly felt desire to changethe status of disabled people.

2. Limited resources

Like all non-governmental organisations workingwith disabled people, our organisation has a continu-ous need for resources both material and human

to enable it to improve its services.

A special budget is allocated every year for the pur-chase of new educational and recreational resources tohelp improve the quality of our teaching methods. Thisbudget is generally insufficient, owing to increasedprices in the Lebanese market. Financial contributionsfrom the families of our registered children do not coverthe total cost for a child participating in this programme,which is expensive because it includes various specialistservices (psychology, psychiatry, physiotherapy, etc).

It is worth mentioning that workshops sometimes pro-vide staff with an opportunity to produce educationalresources from scratch, but unfortunately this solvesonly a small part of the problem.

Part of our training programme is open to educatorsworking in other institutions, and the centre attachesgreat importance to the development of humanresources. It is always done for the benefit of as many

LEBANON

workers (in the field of early childhood education)as possible. This idea is not financially-driven(participants usually pay nominal fees); includingothers in our continuous annual training not onlydevelops the potential of the workers but alsoimproves the quality of work and services beingoffered by their institutions.

3. Availability of trained personnel

Perhaps the most significant problem facing all specialcare organisations in Lebanon is the non-availabilityof trained personnel to work with disabled people. Thegeneral lack of awareness in the community regardingthe status and the needs of disabled people is reflectedin the kinds of people who apply for work in specialcare institutions. They are usually people with no previ-ous experience and a limited educational backgroundwho want to join because there is nothing else they cando (!) and also because of the tendency to do charitywork. The professionals and experts who work in theseorganisations are there on a part-time basis as consul-tants on special service agreements because the majorityof such organisations cannot afford to pay salaries forfull-time professionals. However, more university pro-grammes are now available in Lebanon and universitystudents are starting to show some interest in the fieldof special education. It is hoped that these graduateswill join special care organisations and professionalisethe services the organisations can offer.

As for the personnel currently available, it is true thatthey lack the professional background, but as we havepreviously mentioned they are undergoing an annualon-the-job training programme. Furthermore, mostof them are completing their university studies, whichhelps ensure that they are continually developing theirexperiences in this field.

4. Identifying/reaching childrenwith special needs

The most crucial issues facing families and specialcare institutions in identifying cases and the problemsof children with special needs are listed below.

a) Owing to the absence of information and guidancesessions on basic health, parents are ignorant ofdevelopmental problems which might later affecttheir children's competencies and abilities. Inaddition, existing health, educational and socialframeworks contribute little to the recognition ofspecial needs at an early stage in a child's life.

b) There are relatively few specialist personnel inthe region who are able to recognise problems

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and diagnose them scientifically and objectively.As a result, parents usually go to a family doctorwho studies the child's health in general withoutrecognising the need for or attaching importanceto professional and educational intervention.

c) Scientific diagnosis is usually unaffordableand forms a major obstacle to early interventionin a child's health and educational needs.

d) There is a lack of either private or public agencieswhich can respond to the above-mentionedproblems. If such channels existed, they could:

raise parents' awareness of the child's problem.transfer the child to the proper diagnosticframework.direct the child to the appropriate specialeducation programmes.

CONCLUSION

Our experience of working with SN children has beenrich at many different levels, working with parents aswell as children.

The child:we have gradually noticed and recognised the impor-tance of early intervention and the early detectionof any problems. The pre-school programme hascontributed greatly to the initiation and developmentof specialised educational programmes.

Parents:we felt that most parents responded positively to ourprogrammes and developed a new perception regardingSN children and ways of working with them. Parents

have started accepting the fact that their children havespecial needs, and are beginning to devote more timeand effort to caring for them in order to create theopportunity for better development.

Integration:integration programmes have opened new horizonsfor some SN children to interact with the localcommunity in a number of different ways. In Saida,there has been a positive change in the attitudesof non-SN children and their parents; their increasedunderstanding and acceptance of SN children hascontributed to the success of the programme.

Training:it is important to recognise the role of the continuousprofessional training of workers. A training whichunifies concepts and methodology in field work, fostersa team-work approach among the workers and helpsovercome the need for professionals. However, theneed for trained professionals continues to be crucialin such programmes.

Sharing:it is important to exchange ideas and experienceat local, regional and international levels. Our experi-ence was enriched by opportunities to participate inconferences, study groups and visits within Lebanonand abroad and opened new horizons for us. Henceour reinforcement of the idea of exchanging researchand experience at different levels and in differentareas relating to early childhood education.

Our experience is modest and is just starting.However, it has contributed to the establishment ofnew concepts and practices. Our base is the belief inequality of rights for all children and equality ofopportunity. Our work has been only the beginning ofa long endeavour, to gain the necessary experience toenforce the basic rights of SN children and to developappropriate services which respond to their needs.

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9LEBANON

APPENDEX

Number of participants

Types of disability: developmental delay mild,mental disability Downs Syndrome cerebral palsy speechand hearing impairments communication disorders.

Year Number of children Ages Number of groups

92-93 6 2- 4 1

93-94 20 2- 4 35- 7

13-18

94-95 27 3- 5 3

6- 811-18

95-96 25 3- 8 212-18

96-97 30 3- 6 47- 9

12-19

N.B. Annually, around 25 children undergo the screening tests administered by the Centre's psychologiston a consultation basis. Usually, if they are not within the Special Education Programme'scriteria,they are referred to other specialist institutions.

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10MAURITIUS

Early Stimulation andIntervention in Special Needs Education:the APEIM Experience

By APEIM

INTRODUCTION

APEIM is the Association de Parents d'EnfantsInadaptes de l'Ile Maurice. It is a non-governmentalorganisation (NGO) which has been working for26 years on behalf of people with mental disabilities.

When APEIM was founded, there were no servicesfor these people and their families in Mauritius.Since then, 3,025 families have approached APEIMfor information, support, help and services; regularservices are currently provided to about 400 families.Children are referred to APEIM by doctors, hospitals,pre-school establishments, schools and even byneighbours and friends.

APEIM's activities include:

regular services:specialist schools,integrated classes,vocational training unit,early intervention programme,home visits,consultancy,counselling and therapy;

parent empowerment;information and training;fundraising.

Demographic information

The population of Mauritius is 1,094,430. Of these,13.4% live in the capital, 31.6% live in urbanareas and 55% in rural areas. The infant mortalityrate is 1.96%

Sixty seven per cent of the population is Indian(Hindus and Muslims), 31% are of mixed origin(mainly African and French), and 2% are Chinese.A range of languages is spoken at home; the majorityspeaks Creole (61.7%) or Bhojpuri (19.1%).

There is a falling birth rate and a stable death rate.There is 'full' employment, although two per centare out of work and this figure is increasing, andthere are 9000 temporary foreign workers.

The average number of children per family is three.There are often two or three generations of one familyliving under the same roof.

The rate of economic growth stood at 5.5% in 1995.The main economic sectors are: manufactured goodsfor export only (e.g. garments, jewellery, watches),sugar and tourism. The main asset in Mauritius is ourhuman resources, but the country needs:

more able and trainable workersimproved primary school teacher training(only 35% hold a diploma or certificate)improved secondary school enrolment (15%)improved pass rate for primary school examination,the CPE (48% repeated last year).

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SOCIAL ANDEDUCATIONAL ISSUES

Education

There is a highly competitive primary educationsystem, leading to a final ranking examination (CPE)which includes assessment in four academic subjects:French, English, mathematics and environmentalstudies, and in an oriental language, which is optional.

There is a multi-language policy for children overfive. Children are taught to read and write simultane-ously in English, French and an oriental languagewhich is chosen by the parents.

Class sizes are large, with a pupil-teacher ratioof 1:45.

Pre-school and child care

There are 1100 kindergartens, of which 960 are privateand 140 public.

Child care is organised in two phases: birth to threeyears and three to five years. There is no regulationof nurseries and creches. Private kindergartens canbe found all over the island but the type and level ofservice varies enormously.

A grant of Rs 200 (US$ 10) per month is provided forfour and five year-old pupils attending kindergartensregistered by the Ministry of Education. These registeredkindergartens are visited and advised by inspectors,and basic standards for kindergartens have now beenintroduced. There is a lack of trained staff, which inhibitsdevelopment. There are no figures on children withspecial needs; neither is there a policy. Indeed, there areno figures relating to disability in Mauritius at all.

Children with disabilities and their families

The attitude of the community to disability is positive,but not inclusive. There is still much ignorance, fear,misunderstanding and exclusion of disabled people.Families with disabled children, particularly thosehaving severe behavioural difficulties, autism orcerebral palsy, often experience isolation. There is alack of public information about disability, and raisingpublic awareness and understanding of people withdisabilities is an important issue.

An increasing number of mothers work and this canlead to new problems, such as stress, neglect and a

lack of time for stimulating their disabled children.However, there is a relatively large number of extendedfamilies where a grandmother is involved in the careof children with disabilities.

A high percentage of disabled children are left athome without access to education, and the systemrelies on families taking the initiative to seek adviceand services. Information for families needs to bebetter and more easily available.

The Ministry of Social Security gives a low levelof financial assistance to families. It providesRs 620 (US$ 30) a month for severely disabledchildren if the mother has to stay at home and if heryearly income is below Rs 42,000 (US$ 2100).(NB:check meaning, unclear). Once a disabled childhas reached 15, the government provides Rs 1,055(US$ 53) a month. The costs of transport are refundedfor children attending special schools.

All specialist services rely on NGOs: there are ninecatering for children up to the age of 10 and APEIMis the only one catering for children under 5 yearsof age. There is no systematic screening and earlydetection programme functioning at the national level.

The Ministry of Education does not have a policyfor inclusion and there is a lack of space in specialschools. However, it is possible to integrate childrenunder six years of age in kindergartens, except forthose with severe cerebral palsy, severe hyperactivityand behavioural difficulties. Integration is morecommon in the rural areas than in urban areas.

There is a lack of all types of professionals, includingteachers and doctors trained in the field of disability.Training is therefore a key issue for development.

PROGRAMME DESIGNAND IMPLEMENTATION

The Early Intervention Programme, launched in 1983,is part of APEIM's service provision, and caters forchildren from birth to six who have a mental ormultiple disability. To participate in the programme,children must be registered with APEIM.

The Early Intervention Programme is a mobile service,catering for parents and their children in their ownlocalities. The objectives of the project are to:

listen to and support parentsprovide them with guidance on stimulation andeducation for their children

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teach them how to use technical toolsprovide information through video, discussions,practical workshopslead sibling and handicraft workshopsprovide opportunities for extra-curricular familyactivities e.g. outingsdevelop means of inclusion in society and kinder-gartens.

This service caters for infants and children from birthto six years. Its purpose is to train families in low-costand simple intervention techniques to enable them tohelp in their child's development, whether their childhas a mental disability or multiple disabilities such asDowns syndrome, autism, birth anoxia, epilepsy,rubella syndrome and cerebral palsy. Information ontheir child's progress is provided regularly to parentsso that they can better stimulate their child, minimisedisability and develop positive parenting techniques.

Parents and children meet on a weekly or fortnightlybasis in APEIM centres or in parishes or socialwelfare centres in St Paul, Port Louis, Pamplemousses,St Julien and Plaine Magnien.

Appropriate goals and teaching sequences are set foreach child, and there are regular tests which assessprogress. Parents accompany their child, whichenables them to learn from and exchange experienceswith other parents. At the beginning of a session,parents watch the teacher working with their child.When they have grasped the content of the activity,they help in the group with their child and/or withother children. They are taught how to continue anddevelop the activities, mainly in the home environ-ment. Talks, parents' meetings and workshops forfamilies and siblings are organised at the end of eachterm, to allow them to share and to learn from eachother.

This programme has proved to be very beneficial forthe participating families. The progress of many chil-dren has been followed; some have been integrated intomainstream kindergartens and primary schools andsome have been placed with other APEIM services.

The Early Intervention Programme was launched withthe financial assistance of NFPU, a Norwegian associ-ation which financed the programme for 10 years.CBM (Christoffel Blindenmission) has been fundinghalf of the project costs for the past three years.United Way, a Mauritian association, helped tofinance the other half of the project for two years.A French association, Kilometres de Soleil, has madea donation which will enable us to run the early inter-vention programme this year.

IBEST COPY AVAILABLE

MAURITIUS

WORMINGTOWARDS I[NTEGRATI[ON

There is no specific mechanism for early identifica-tion in Mauritius, but APEIM's work is now quitewell known to hospitals, private doctors and thepublic. Children come to APEIM via many differentroutes doctors in hospitals, neighbours, friends,teachers and so on.

Between 1970 and 1980 kindergartens were isolatedand people were unaware of the importance of sendingtheir children to kindergarten. In 1980, a burgeoningof the number of kindergartens coincided with theexpansion of the EPZ and more women going out towork. The majority of kindergartens were not regulatedand did not share a common structure or educationalpurpose. Anybody could set up and run a kindergarten.Many have done so as a business enterprise and,in these cases, the interests of the children are oftennot a priority. Many kindergartens accepted childrenwith disabilities, often because of personal contactswith the family, for financial gain or other professionalreasons.

In those days integration was still a dream to berealised. After five to six years had passed, someparents in rural areas started sending their mentally-disabled children to their local pre-school (i.e. schoolbefore primary school). By accepting children witha mental disability, these schools in rural areas tooka first step towards integration. Children living invillages were more 'accepted', because at that time theteachers were running their own schools. There werefew schools and everybody knew their neighbours.APEIM started visiting the schools where children withmental disability were integrated, creating a positiverelationship with these mainstream kindergartens.

The next stage in the development was that thegovernment required all private schools to register,and inspectors started to visit the schools. Trainingfor teachers from private schools was introduced,and they included information about special schools.Teachers were taught that children with disabilitiesshould be placed in special schools and it thereforebecame quite difficult to achieve any level of integra-tion.

The frequent visits of inspectors to the schools rein-force this negative attitude, because they too are con-vinced that special schools are the solution. To helpput the case for integration, the APEIM team startedto visit pre-primary schools to explain the principlesof integration. As a result of APEIM's regular contactwith inspectors, they have been persuaded of the

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benefits of integration. APEIM has also worked withthe teachers, introducing the ABACUS assessment toenable them to detect children with a disability andrefer them earlier to APEIM, while keeping them inschool.

If a disabled child has been in a nursery, and if thereis a kindergarten attached and nearly all kinder-gartens do have attached nurseries then transfer ofthat child from nursery to kindergarten at the appro-priate age is usually automatic.

APEIM's objectives concerning integration are veryclearly explained to the pre-primary teachers. Themain objective is to guarantee disabled children theright to grow up, learn and live as able-bodied peopledo. Our past experience has shown that the childrenwho have benefited from integration develop betterand achieve more than those who stay at home.Parents feel more a part of the community and havefewer negative feelings. Life is easier for them andfor all their children.

All families look after their children at home (thereare no homes for disabled children in Mauritius).The majority of Mauritian parents overprotect theirchild if he or she has a disability. This close relation-ship means that separation from the child is difficult.Once the first step in separation has been achieved,the child can look forward to learning from and withothers outside the family.

In most of the cases concerning integration, onlychildren with a mental disability are accepted.It is more difficult for those with multiple disabilities,hyperactivity or autism. Sometimes such childrenare accepted if the mother stays with her child at theschool, especially during the first weeks. If the motheris at work, then she has to pay someone to accompanythe child. Most children with Down's syndrome arein nurseries and kindergartens.

Over the years, APEIM's intervention has becomehelpful when the parents are having difficulty infinding a kindergarten. As far as possible we let theparents do the maximum and we intervene only whenit is needed.

Training

Some schools ask us for help and request a specialprogramme which can be used in specific areasof a child's developmental programme. Site visitsto pre-primary schools often involve an explanationof APEIM's special techniques and the sharing ofinformation about our work.

APEIM team members meet with pre-primary schoolteachers, at their request, in schools where disabledchildren from our stimulation groups are integrated.These meetings generally take the form of an opendiscussion where teachers share the problems theyencounter when teaching children with disabilities.

Every.October APEIM runs courses for pre-primaryschool trainee teachers in collaboration with teachertraining organisations. The courses provide a basicknowledge of special education and integration anddevelop an awareness of the type of mental disabilitywhich the trainees may encounter in their schools.

Barriers to integration

The major problems we encounter when dealing withintegration are the attitudes of the public and the lackof staff training. There is still much work to doin changing people's attitudes. Teachers are initiallyresistant to and apprehensive about integration butonce they have received information and training,their attitudes change quite rapidly and they arewilling to try integration.

There is also much to be done to change the attitudesof other parents in the kindergartens. When they arenot 'prepared', they can easily ruin an integrationprogramme, so awareness-raising for the parents istherefore very important. We have to reassure themthat their own children will not begin to behavestrangely and that a disability is not contagious. Whennecessary, meetings are held to explain some of thesepoints and to try to pre-empt negative reactions.

In spite of all the difficulties, APEIM is still hopefulthat integration will succeed, although in primaryschools integration has so far proved problematic.As there is no policy on integration, it is difficult tomake progress and our attempts have seldom beensuccessful. First, the parents have to deal directly withthe person in charge of the school, who then contacts

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the inspector. The latter will inform the Ministry ofEducation about the case, and the Ministry.thenmakes a final decision concerning the integration ofthe child. Often, parents find this a slow and cumber-some process, so they become discouraged and giveup. As a result, many children who need to be inprimary school, especially those with a physicalproblem or mild learning difficulties, stay at home.When a child has been identified as having a disability,whether he or she is allowed to stay at school dependson two major points:

the personal view of the headteacherthe inspector's view of integration.

APEIM actually prefers to encourage the integrationof specialist classes in primary school. This seems tobe the best solution, given the number of barriers tointegration, which include the policy language, theteacher/pupil ratio and the highly competitive system.Some of our pupils are integrated for non-academicclasses when possible e.g. religion, art. Full inclu-sion could only be realised if important reforms wereimplemented.

Since January 1997, the government has given a grantto all children aged four to five who are attendingkindergartens. This has led to a new problem whichis threatening inclusion. Often, disabled children stayat kindergarten between the ages of three and eight.Because they do not fit the age criterion for a grant,some kindergartens which were formerly open tointegration now refuse to accept disabled children.This is a new struggle for APEIM, which has begunby meeting with the Minister of Education to discussthis important issue and to make him aware of the valueof inclusion in kindergartens and primary schools.

MAURITIUS

CONCLUSIONMany lessons have been learned during the yearssince 1983, including:

NGOs must always be accountable and reliable.Their image is very important when trying toreach and persuade the community, the publicand policy makers;adapt the programme to economic changeand the needs of the family;do not be aggressive or too demanding

take it one step at a time;first make contact with the people you alreadyknow;multiply intervention in local structures:go to schools and meet the headteachers andteachers as often as needed;use personal relationships/contacts, but stayprofessional;give free professional support to kindergartens andschools in order to reinforce good collaboration;accept requests from the public, such as pre-primaryteacher training, even if that is not your job try todo something;involve the parents, especially mothers, in thekindergartens when you integrate children withsevere disabilities or behavioural difficulties;reinforce the supportive links between parents whocan give others the courage to fight for inclusion;adapt knowledge received from foreign countriesto the needs and culture of your own country;accept that inclusion is long term work. Changesin attitudes are slow and we must remain steadyand persistent in our actions if the aim is to beachieved.

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Agueda's Experience:a social movement that made its historyin integrating socially disadvantaged childrenand groups into the community

By ROSINHA MADEIRA

IINTRODUCTIION

In this paper we intend to share our experience aseducators and social actors who, for 20 years,have been working for the integration of childrenand social groups who are discriminated against.

Following the Revolution in April 1975, a movementbegan which stood for the unconditional integrationof children who were denied social and educationalacceptance in the community. This integration wasseen as a legal expression of the recognition of equalrights for every person in the community.

The whole process of intervention has been under-taken by an open group of professionals andnon-professionals endeavouring to work toward thisprinciple and driven by the search for social changewhich is shared between parents, professionals andthe children themselves. This group set up the BelaVista, an integrated educational centre, which is,even today, a space which makes possible the devel-opment of new responses to the needs of children,

families and communities who have limited accessto social opportunity.

The Bela Vista started as a nursery school in which20% of vacancies were reserved for children withspecial needs and was, from early on, a spacein which the integration process was shared as muchby children with and without special needs as byparents and educators. Integration was viewedas a challenge, presenting the need to develop newattitudes and knowledge.

This was also the start of new services for childrenand the setting up of close relations between parents,other professionals and regional institutions, resultingin the creation of many other structures which supportchildren and local projects in the areas of health,education and informal community networks.

Agueda's experience, which is reflected in manyother institutions and local projects, needs to be toldas a process of communitarian intervention, inwhich the integration of children who have specialneeds and/or are at a 'high risk' in social terms, wasa key factor in social change and the community'sdevelopment.

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ACKGROUND ANDTIHIE MOVEMENT'S I;;EGINNIINGS

1. The Region of Agueda

Agueda is a Region with nearly 45,000 inhabitants,situated in the District of Aveiro, located on the cen-tral coastline of Portugal. It is part of a geographicalarea that has suffered many changes since 1950because of the speed at which industrialisation hastaken place.

The rural way of life was abandoned, but there wasno reorganisation of social structures to replace thetraditional, rural ways of solidarity. Over a shortperiod of time, many farmers left to work in industry.Since the 1970's, many of these new workers havebecome businessmen, contracting other families whocame looking for work.

This process led to an obvious material improvementfor a large number of families born in the area, butthere was a lack of housing and social integration forthe migrant population. Migrant families experiencedproblems in finding employment and housing, andsuffered financial hardship, finding it difficult toaccess social aid. This created increasing vulnerabilityand social dependence for these groups.

Thus there was a subordination of communitarianlife to industrial production. In such a community,children and old people are 'at risk' and in needof support, which is now provided in an impersonal,institutional way without a feeling of 'solidarity' andrespect for personal differences, both of which arenecessary for good family life. The children and oldpeople who had particular needs were discriminatedagainst because their 'differences' disturbed thenormal routine of this new way of life.

As we experienced and understood the possibilitiesfor and obstacles to the social participation of childrenwith special needs or those who were otherwise disad-vantaged, we began to see the integration of all peopleand groups as a human problem, a collective problemfor society and not just a technical problem.

The integration of children and young people withspecial needs was also seen as a means of accomplishinga more global social project, whose resolution shouldinvolve not only the children, families and specialists,but also the whole community of Agueda.

2. The beginning and dynamicsof the communitarian intervention

In 1975, an association for parents of 'deficient'children (children with special needs) from the cityof Oporto', came to Agueda to denounce the lack ofany educational structures and social aid for childrenand young people with special needs and theirfamilies. We recognised that the right to public andfree education embodied in the Constitution wasbeing denied to these children.

A small group of parents, professionals and non-professionals from Agueda visited several places inthe region to identify these children, young peopleand adults who were unknown to anyone except fortheir close family and neighbours. We found examplesof great loneliness, not only for children but also fortheir families. Many of them were born and grew upin their homes; they lived together and were cared forexclusively by their family. In a very few cases, thechildren and their parents received some help throughconsultations at rehabilitation centres, located indistant towns.

The recognition of the difficulties experienced bychildren with special needs and their families in theirdaily life created the right conditions for professionalsfrom several sectors, parents of different social groupsand other agents from the community to organisethemselves to develop local responses to the isolationof these children and families.

The creation of the Bela Vista nursery school wasan initial response which gradually sensitised otherpeople and groups to the need to end the passive mar-ginalisation of these children.

The press, the meetings between parents of childrenwith or without special needs, the new institution andabove all, the continuous investment in finding waysof responding to new challenges, provided a catalystfor change, resulting in new efforts by the communityto accept and respond to these children.

One of the unplanned effects of this action was thecreation of a special school. However, the school wasnot against the idea of integration and did not replacethe work at Bela Vista and other nursery schools inthe Region.

Two years later it was some of these teachers in theofficial school who accepted the challenge of integrat-ing children with serious difficulties in their classroom.They were stimulated by the evidence of nursery

This city is about 80 km from Agueda

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school educators and parents who had learned thehuman value and the social meaning of living together,as well as the value of shared learning betweenchildren with different characteristics, capacitiesand needs.

The care of those who are more dependent, the soli-darity based on respect for 'difference' and for thefreedom of each individual, have now been broughtback into people's consciousness, not in the form ofthe traditional values of a rural society in which chil-dren, adults and old people lived their daily lifetogether, but as an understanding of the need for acollective life in which everyone needs to learn howto live together.

The participation of children in introducing and pro-moting the idea of integration was as important as thatof adults. They too worked at improving sociability,communication and the quality of the human relationsin small groups, face to face.

3. The development of a new policy

In 1975, Agueda had only one crèche that belongedto a wool factory and four nursery schools: onebelonging to the state; two belonging to the church;and one privately owned. Two of the institutions wereresidential schools for orphan children or childrenfrom very poor backgrounds. There were 42 public(state) primary schools, one preparatory school, twoteleschools and one secondary school.

In these educational spaces, only two childrenwere integrated, one with spina bifida and one whowas partially deaf, although through contact with`basic groups' and schools we confirmed that therewere other children with learning and behaviouraldifficulties whose problems had arisen owing to theirfamily situation. According to the teachers, this didnot justify the need for any additional educationalsupport.

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INTEGRATION EN ACTION

1. Infrastructure

In this same period in Portugal, the education of chil-dren with moderate and severe learning difficulties wasoffered only by large institutions of special education,or by private schools located either in big town centresor in central areas of the inner part of the country.For children with mild learning difficulties therewere some special classes in Lisbon. Children withbehavioural problems were also hospitalised by ChildMental Health Centres in psychiatric hospitals inOporto, Coimbra and Lisbon. For children withphysical and sensory deficiencies there was only onecentre of physical rehabilitation and one receptioncentre for children with cerebral palsy, located almost300 km from Agueda. There were also big institutionsfor deaf and blind children.

All these institutions were financed by the Ministryof Social Welfare. The social educational integration inmainstream education was reserved only for childrenwith physical and sensory problems. In these cases thechildren received support from Ministry of Educationperipatetic teachers who had responsibility for oneor more districts of the country. Only 10% of childrenwith special educational needs were covered.

With the increased experience of integrating childrenwith learning difficulties in nursery and state schools inAgueda, came other positive responses to integrationfrom parents' associations. Between 1979 and 1981these contributed to a decrease in the number of newspecial schools. In this phase, Agueda's movement wasa point of reference for the political decision that ledto an expansion of the work of peripatetic special educa-tion teams in supporting the integration of children witha wide range of special needs in mainstream schools.An alternative had been created which guaranteed therights of children with learning difficulties to education,one which avoided their isolation from other childrenand adults in their community.

2. Formal support and resourcesfor integration

In 1981, Agueda's Special Education Team was oneof the first regional teams to be created to support theintegration of all children regardless of the type anddegree of their disability. This team gave status to thework of those at Bela Vista and to those who supportedthe integration of children with physical, sensory andlearning difficulties in mainstream education.

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There were already 153 children with learningdifficulties integrated in public schools. The childrenwith severe learning difficulties could also attendextra curricular activities at a centre which was runfrom Bela Vista and created as a complement toschool.

The teachers in this team, just like those from BelaVista and other nursery schools which were integratingchildren with special needs, did not have any specialistexperience of special needs. An informally-constitutedperipatetic group, comprising one educator, one socialassistant and one doctor, was established to workwith parents and educators from mainstream education,and with the special education team, in the analysisof the process of integration for children in their family,nursery school, school and other social contexts. Thecommon interest of these different teams and groupswas to find and invent opportunities for social partici-pation in each of these contexts. Such opportunitieshave to be compatible with a child's resources, bearingin mind their emotional, intellectual and social needs,as well as the expectations, conditions and needs oftheir family and community.

Individual educational programmes sought answersto a range of questions:

What are the problems that worry parents andeducators?What does the child need to learn to increasehis or her autonomy, self-esteem and participationin family life, school and peer groups?What resources are available?What resources is it possible to create?What can each person teach(where, how and when)?Which resources is it necessary to create in themedium term?

These programmes were registered in a book wherenew ideas and innovative approaches were alsorecorded.

Whenever possible, the child would be asked abouthis or her likes, interests and worries. Educators oftenasked the child's school friends or brothers and sisters,to discover his or her likes and dislikes and what he orshe could do in and for the school group.

The special education team is now made up of28 educators, specialising in different areas. They sup-port the integration of children and more dependentyoung people up to the end of primary education,thereby facilitating access for these young people topreparatory education (fifth and sixth school years),secondary education and higher education.

Some young people with severe learning difficultiesattend a Centre for Special Professional Training,between the ages of 14 and 16. At the centre, staffand professionals from the special education team,co-operate in the development of a curriculum basedon the principle of education in school and in othersocial-educational settings in its community.

EARLY INTERVENTIONTHE COMMUNI[TY

1. The early work

The same group that co-operated in the developmentof educational programmes for schools and nurseryschools, also worked with children under three yearsof age who were a source of concern to the communityand education and health professionals. This directcontact with the community was the first example ofthe early detection of young children who had possibleproblems.

As a result of this work, the educators and traineesfrom the nursery education course at Bela Vistadecided to visit and provide regular support to mothersof 19 children who were potentially 'at risk' or whoalready had development problems.

These visits involved listening and helping mothersto solve health and other problems related to theirchildren, and finding or building toys and gameswith recyclable and domestically available materials.They sometimes involved other mothers and otherchildren from the family, as well as neighbours. Fromthis starting point, we aimed to expand the networksof social support to mothers and to increase protectionfor children against being abandoned or neglectedowing to a lack of affection and their surroundings.

In 1982, the same educators from Bela Vista alsobegan to develop educational support for very youngchildren with development problems, expanding theintake in the reception year to more than 30 children.

2. Diagnostic and health care services

At the same time, the basic group invested in thecreation of nursing consultation, which was establishedin the hospital of the local parish at the request of thepaediatric hospital serving the entire central regionof the country. Many mothers came to these consulta-

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tions where problem situations and risks to the child'sdevelopment were identified. This provided a strongargument to the hospital administration and mobilisedpublic opinion to demand the creation of a publichealth service that could guarantee primary healthcare for both children and the wider community.

In 1981, Agueda's Health Centre was created. Itspriorities were birth control and mother and child health.The Health Centre has been an institutional partnerin most communitarian action to help solve childdevelopment and education problems. The Centre hasco-operated with the special education team, nurseryschools and district/regional medical services.

3. Multi-professional andcross-disciplinary support teams

The co-operation between the areas of health, educationand social support, which was informally facilitated bythe most dedicated professionals in the initial phase ofthe movement, was now being recognised officially asbeing of importance in developing services.

The development consultation and the multi-profes-sional teams, located in the head office of the Region,were created to have a complementary role in relationto existing services in several of the boroughs.They provided advice and support to parents andhealth and education professionals in each borough.

The development consultation team involved a paedi-atric doctor, an educator from the special educationteam and a psychologist from the Health Centre.The multi-professional team was officially createdin 1984 and gave continuity to the informal group'saction, which had supported school integration inits initial phase.

Both teams have a holistic and 'listening' approachto solving the problems of the parents and professionalswith whom they work. They place a great deal ofimportance on the enrichment and enlargement of thesocial networks which can provide both formal andinformal support to a child's family. The teams liaisedirectly with specialists working in the regionalservices. This ensures access to information and otherkinds of resources and guarantees co-operation overa child and its family's problems and needs.

These teams give priority to children and others whoare socially disadvantaged and they invest in projectswhich aim to make easier the local, borough-levelintegration of services provided by health and specialeducation teams and the social centres for child sup-port.

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4. Critical points of the intervention

While professionals were making integration, educa-tion and social support easier for children and familiesin their home, schools and activity centres, there wasalso an equal investment in creating new resources inthe community.

Logic implies that the establishing of the necessarystructures and resources to support the integrationof children with special needs would solve negativediscrimination against, and the exclusion of, 'different'children. But this did not happen:

In 1985,26 deaf children, nine children with severephysical disabilities and 120 children with moderateand severe learning difficulties, were attending thepublic (state) schools in Agueda. In the neighbouringregions, 36 other children with special needs werealso attending school in their community, with thesupport of their parents, teachers and peripateticteachers. All these children, their peers, parents andteachers were growing and learning to live together,and so helping to create a new philosophy and neweducational and social skills.

The teachers and parents shared their experiencesthrough the press, seminars and meetings with otherprofessionals, organised by Bela Vista. Theseexchanges were a key factor in maintaining thecommitment to search for solutions to new problemsarising at school. They were also an influential factorin political decision-making, generating supportfrom the Education Ministry which led to the creationof peripatetic teams and the placement of classroomsupport teachers to facilitate the integration ofchildren with learning difficulties.

However, there was still a big group of childrenwhose lives and development were strongly limitedby their parents' social status. The nature of theirparents' employment was used to assess their socialstatus.

These children were not successful at school and intheir social position; they were negatively discriminatedagainst by teachers and neighbours for not meetingexpectations in cognitive and social skills. The relation-ship that teachers and parents began to have with theservices for children with special needs made it seemas if the children's difficulties in adapting to thesocial rules in school and the demands of the formalcurriculum were the result of an intellectual inabilityand emotional disturbance.

It was confirmed, however, that outside school,these same children were able to undertake tasks and

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responsibilities as complex as looking after youngerbrothers and sisters, domestic jobs, work in the fieldsand sometimes work with community-based groups.

On learning that intervention from the special educa-tion team could be seen as confirming the community'snegative expectations of a child and his or her family,the team has been reluctant to answer schools' requestsfor educational support. The team has, however, createdan alternative response to these educational needswhich should not only be appropriate to the social con-text in which it operates, but also values the family'sknowledge and reinforces the need for them to assumesome responsibility.

5. Support for children at risk:community-based groups

In 1982, educators began to work with these childrenoutside school, within their daily social and familialcontext. An evaluation of their relationships and theroles they adopted outside school highlighted theirinterest in social interaction and the importance of theinformal networks of social support which help childrento solve their own problems. The work of specialeducation peripatetic teachers began to focus theseexperiences and resources, leading to a rapid creationof a considerable number of community-basedgroups.

In 1988, these groups brought together more than500 children in the regions. All the groups had founda meeting and working space (in abandoned houses,small rooms inside churches, private undergroundrooms, places used to keep decorations for religiousfeasts, etc.), and every group had its own name anda membership of more than 20 children.

Most of the children's parents, regardless of socialbackground, were involved in their group's activitiesand involved themselves in the improvement of theenvironment (repair work, recycling school material,needlework, etc.).

Each group has already established some means ofraising money to enable it to realise a range of projects.Fundraising activities include: selling sweets, paintingpots, and other handiwork made from naturally-occurring local materials or waste from industry/localcommerce. Recovering public spaces and cultivatingsmall kitchen gardens was simultaneously a significanteducational activity for the children and a means ofimproving the quality of their experiences.

In 1990, Bela Vista set up a project team in co-operationwith the Health Centre, the special education teamand the local authorities. The project team's role was

to work closely with the community-based groups.It was financed by two foundations.

In 1994, the work done with children, families andsocial agents in each community prompted socialcentres to open access for the groups and facilitatedthe creation of nine new local associations whichbegan to develop child support services. By 1995,the rate of coverage of child-care services was muchhigher than in most regions of the country. In 1995,the community-based groups were re-formed andbecame a social-educational project. At the same time,the target population for the services also changed.

The risk of negative discrimination which leads to theneed for additional care services is particularly greatfor young people who stay on at school and who, in afew exceptional cases, are secretly integrated into thelabour world, to help their families. There are alsoyoung mothers from 'at risk' social groups, who seekhelp from unofficial sources because they do not haveaccess to and/or cannot maintain a lasting link withthe social centres. There are children of incapableor inadequate parents who have health problems, orwho are in trouble with the law. Children of migrantfamilies and ethnic minorities (gypsies and Africans)are also in this group; they find it difficult to fulfilthe basic conditions of life housing, social aid anda secure job and are prevented from settling orreturning to their original home.

6. Training for and in intervention

A problem we have yet to solve is repeating/imple-menting the process we underwent in Agueda inother parishes. We have had experience of inductingprofessionals in our work through courses or whenother groups of professionals (and non-professionals)came to Agueda to find out how to implement similarinitiatives in their communities. We know that it ispossible to share knowledge that when applied locally,results in the development of new responses.

Therefore, between 1978 and 1985, Bela Vistapromoted annual seminars at which there was anexchange of experiences, through direct communication,photographic exhibitions and detailed documentation.The seminars were facilitated by people who shareda common knowledge and experience which helpedthose attending to deepen their knowledge and under-standing of the process. We also explored the limitsand opportunities of some of the solutions found forspecific problems and of continuing with intervention.

This has been the model of training and self-learningthat we have adopted, and work in small groups hasincluded the use of instruments to record significant

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events and to enable an analysis of the context withinwhich the processes have occurred and of thoseactivities undertaken.

These instruments embody the values and principlesof intervention which inform the work of Agueda'sgroup in intervention in the community. They facili-tate the gathering of factual and objective informationand also provide a sense of the reality in which ourintervention staff operate.

The perceptions, views and experiences of theintervention agents are seen as a valuable trainingresource. They enable us to begin analysing relevantproblems identified by the agents, allowing objectiveand impartial discussion of the issues by people whobring differing perspectives and knowledge.

The community-based groups and the approach,training and evaluation of the intervention process byAgueda's movement, ensures that it does not exhaustits creative potential. It is constantly addressing andthinking about the problem of social exclusion forchildren and disadvantaged social groups in our com-munity. They prevent the community from becomingcomplacent about the successes and make theexperience the people who have achieved something,despite the odds, the foundation, motivation andargument for the development of new knowledgeand approaches.

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SUMMARYAND CONCLUSION

In this paper we have outlined the story of thesocial movement which brought about the integrationof children with special needs in nursery schools,mainstream schools and other social-educationalstructures in the Agueda region. This has hadan impact on parents and on the authorities' politicaldecisions about education at a national level.

It is important that Agueda's community, now richin child support services, does not ignore the socialproblems inherent in its industrialised environment.This is an environment which provides an uncertainsupply of migrant groups and other minorities whofind neither lodging, welcoming attitudes or any otherfacilities to assist their integration in the community.These groups are increasingly at risk of exclusion.

We have also tried in this paper to show the interde-pendency of many actions and the link between thesocial and human context in which they were createdand their institutionalisation or embodiment in othersocial structures.

Today, a child who is born with special needs or intoa 'problem' family and/or an adverse social environ-ment in Agueda, does not have to go through aprocess which, not many years ago, led to negativediscrimination, progressive social isolation and theimpoverishment of his or her life and family situation.Now the child is recognised as (an integrated) partof the community. The child's parents and educatorsfrom the nursery and community schools are nolonger alone in working for the development of socialand educational solutions which protect and stimulatethe child's, and our, development.

As a group, we dream that one day we will fullyimplement this project. As we struggle for its accom-plishment we find ourselves writing the social realitywhich continues to sustain the search that leads usto other worlds that exclude, or better, overlookand leave in silence other actors and people of ourcommon history!

By 'telling our story' we want to encourage other com-munities to invest in their struggles against the socialunfairness which affects the lives of children andgroups whose 'differences' are not accepted. These arethe 'hostages' of an economic progress which followsan autonomous path but has contradictions which wehave to face, for the sake of a democratic project andthe well-being of all.

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Education for All:a Programme for the Inclusionof Children with Disabilities and otherSpecial Educational Needs into EarlyChildhood Development Programmes

By JUDY McKENZIE

AFRICA

I,) ACKGROUNDINFO NMATION

The Community and Child Development Centre(CCDC) is located in the Central Region of theProvince of the Eastern Cape in the Republicof South Africa. The province is currently copingwith the difficult task of reconstruction followingthe effects of the apartheid era. It is one of the poorestprovinces in the country, with high levels of illiteracyand inadequate health services. The total populationof the Eastern Cape is approximately 8.5 million,with a population density of 39 per square kilometre.Three quarters of children under 15, who form44% of the total population, live in rural areas (HealthSystems Trust and the Department of Health, 1996).

The province is divided into five or six regions;different government ministries divide the provincein different ways. The Central Region focuses onthe city of East London, where 43% of the populationis urbanised. This figure is considerably higher thanfor most of the other regions.

The major areas of development for the Eastern Capemirror national concerns. Within the health sector,there is a serious attempt to bring about universalaccess to primary health care through transformingsystems of health delivery. Within education, thearduous task of uniting fragmented systems is largelycomplete and the process for implementing the newcurriculum is advanced, with the phasing in startingin 1998.

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According to the Interim policy on Early ChildhoodDevelopment (1996) the situation which South Africahas inherited with respect to Early ChildhoodDevelopment (ECD), is the result of massive neglectof the needs of young children. Between nine andeleven per cent of all South African children undersix years old have had access to ECD and this hasbeen skewed in favour of urban white children, withrural black children being the most disadvantaged.The problem is not only with the level of provisionbut also with quality: 'Not only are very few infantsand children catered for, but even fewer receivean appropriate ECD experience and therefore havean abrupt introduction to formal learning.'(InterimPolicy, 1996)

Children with disabilities are even more disadvan-taged within the existing system. For families in ruralareas, access to early identification and interventionservices is limited. However, some areas benefitfrom community-based rehabilitation services(Schneider, 1996) and in some provinces, the welfaredepartment provides grants for families with childrenwith disabilities. For many rural families, the socialworker is the only source of help.

Once children with special educational needs(SEN) enter educational settings, they receive verylittle support from the psychological or remedialservices. Health and welfare services have the mostvisible profile in dealing with children with disabili-ties, and teachers often therefore have the perceptionthat disability is the responsibility of those servicesrather than of education (McKenzie and Mcleod,1995). Consequently, very few children with SEN areinvolved in ECD programmes. In a survey of learners

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at CCDC (McKenzie, 1996), it was found that aboutone per cent of children in ECD programmes hadobvious disabilities, whereas the prevalence ofdisability in the country as a whole is estimated asbeing in the region of 5.21%. (Schneider, 1996).

1. Policy and legislation regardingearly childhood care and education

Government policy for ECD provision targets childrenpresently outside the school system who are betweenfive and nine, and children who are at risk below fiveyears. Children over five will be provided for withinthe formal education sector in the Foundation Phaseof General Education and Training, once the imple-mentation of the Reception Year has occurred.For children under five, an integrated policy involvingEducation, Health, Welfare, Housing and other govern-ment departments, in collaboration with communitiesand non-governmental organisations (NGOs) will needto be developed.

The Interim Policy on ECD recognises the need toprovide services for children with disabilities andSEN and affirms the right of these children to becomelifelong learners who will be active participants insociety as a whole. However, there is as yet no indica-tion of how this will be achieved.

The policy will guide the implementation of a nationalECD pilot project which will initiate the start-up phaseof the National Reception Year programme. The pilotproject will explore the following areas:

developing interim accreditation and standardsfor practitionersbuilding provincial government and NGO capacitydeveloping interim policyestablishing sustainable subsidies for communitybased ECD services. (Philpott, 1997)

2. Policy and legislation regardingspecial educational needs

The White Paper on Education and Training (1995)recognised the neglect of educational provision forpupils with special educational needs and proposedthe appointment of a National Commission on SpecialNeeds in Education and Training (NCSNET), whichwas appointed in January 1997. Together with theNational Committee for Education Support Services(NCESS), it has a brief to make recommendations to theMinister of Education and Training (in October 1997)on all aspects of special needs in education and training.The Commission aims to consult widely, including withinterested members of the public.

The South African Schools Bill is equivocal onthe provision of SEN pending the outcome of thecommission. There is provision for learnerswith SEN in the mainstream sector, but there is noobligation for the mainstream schools to accommo-date such learners. Schools are cautioned to takeinto account the wishes of parents in the placementof children with disabilities and SEN. In addition,school principals cannot make decisions about admis-sions which conflict with the constitution by beingdiscriminatory in nature. Parent organisations,such as Down's Syndrome South Africa, feel that thisdoes not give parents enough leverage with reluctantprincipals, but await the outcome of the commissionfor direction in this regard.

3. Current situation of families of childrenwith special educational needs

For children with disabilities, there is a minimal sup-port structure. When disabilities are identified at birth,or by clinic nurses, the parents are given scant andoften inaccurate information on what they can expectfor their child. Rehabilitation services within the statehospitals are minimal. Physiotherapy and occupationaltherapy are available in all regions, but rehabilitation

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services are understaffed, lack equipment and urgentlyneed more resources. The Department of Educationprovides pre-school programmes at a few specialschools which are mostly residential. Very few of thespecial schools offer an outreach or home programmefacility to children who are unable to attend theschool. In the larger cities, such as Johannesburg orCape Town, there are sophisticated services availableto the more affluent families but, in the smaller towns,these services are not available to anyone.

In response to this situation, several NGOs andgovernment-subsidised agencies have stepped into thegap. REHAB, an organisation providing rehabilitationand welfare services to individuals with differentdisabilities, runs a day-care centre and a home-helpprogramme in East London, and reaches out to therural areas. Many parents in the community haveformed groups with the support of REHAB or theDisabled Children's Action Group (DiCAG).These groups provide day-care centres for children,and sometimes adults, with disabilities. The centresare run by mothers on a voluntary basis, and theDepartment of Welfare provides some funding forfood and equipment. Many of the children in thesecentres have severe intellectual and physical disabili-ties; thus the centres tend to focus on the care ofchildren, placing little or no emphasis on educationor training. The Community and Child DevelopmentCentre also assists in raising awareness amongteachers about including children with disabilitiesinto their programmes and supports parents in placingtheir children in regular ECD programmes.

Mainstream placements are seen as a poor second tospecialist schools. Some early intervention servicesare available but these are inadequate when childrenhave severe disabilities. Where children with disabili-ties are integrated, both parents and teachers struggleto find ways of working with them in the mainstreamsetting.

In the wider community, attitudes towards childrenand individuals with disabilities are not very positive.In one of the courses we offer at CCDC, the followingattitudes were reported by students from rural andperi-urban communities:

parents have difficulty in accepting a child witha disability. The mother is often blamed for thedisability and fathers deny responsibility for thechildthe child is not welcomed at school by eitherteachers or the other children and therefore feelsisolatedthe abilities of persons with disabilities are under-estimated and they cannot get jobswomen and children with disabilities are subjectto physical and sexual abuse; this is particularly

SOUTH AFRICA

true of children who are deaf or who have a mentaldisabilityconcerned individuals recognise the problemsin the community and tend to be over-protectiveor respond by 'making a school for these children':their attitude is one of pity.

PROGRAMME DESIGNAND

IMPLEMENTATION

The CCDC is a non-governmental organisationbased in East London. Our purpose is to assist in theprovision of education of the highest quality for allchildren. We aim to do this by providing training andsupport to ECD practitioners. Through this channelwe aim to contribute to the development of the com-munity as a whole. We believe in education withoutboundaries and therefore challenge the obstacles thatpresently exist, be they geographical, economic orattitudinal.

In 1993, CCDC recognised that in order to ensure thatthe needs of children with disabilities were being met,a specific focus on disability was needed. The aimwas: 'to spread an awareness of the needs of childrenwith disabilities and to promote their integration intosociety in general, especially through mainstreameducation'.

The following steps were taken to enable us to beginto implement this aim.

The staff committed themselves to examiningtheir own attitudes towards, and stereotypes of,people with disabilities. This in turn influencedthe curriculum so that discussion of attitudes wasincluded at all levels of training.Children with disabilities were admitted tothe demonstration school attached to the CCDC,with a great deal of success.Trainers attended workshops on disability issues.The building in which we worked was made moreaccessible to wheelchair users.(Muthayan, 1994)

The positive experience of CCDC in addressingdisability issues resulted in a growing commitmentwithin the organisation to children with SEN, andthe setting up of a project dedicated to promoting theinclusion of children with SEN into the mainstreamof ECD.

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A survey of learners enrolled at CCDC, which yieldedthe following results:

negative attitudes in the community resultin parents being reluctant to bring their childrenwith disabilities to the local ECD centre for fearof ridicule and rejectionlack of training on disability issues preventsECD practitioners who are willing to accommodateall children from doing sounder-resourcing of ECD centres, and thefact that most are not recognised or supportedby government, makes inclusion difficultsupport from experts who can provide specificskills is lacking. (McKenzie, 1996).

The programme for inclusion was developed onthe basis of these points. It has four componentswhich operate together to create a holistic approachto the inclusion of children with SEN. The fourcomponents are:

inclusion of children with special educational needsin the demonstration school attached to CCDCthe development of special educational needswithin trainingparticipation in policy development aroundECD and SEN at a national and provincial levelempowerment of parents of children with SEN.

I. Inclusion of children with SENinto the demonstration school

New Horizons pre-primary was set up by CCDC toserve as a model of a well-functioning ECD centrefor the community-based centres. It is locatedon CCDC premises in East London and is presentlysubsidised by CCDC, but plans are under way to giveparents more control and financial responsibility forthe centre. There are two teachers at the school(one of whom is Montessori trained) and a teacheraide. The special needs consultant at CCDC supportsthe school with recruitment of children, assessmentand adaptations to the curriculum for SEN.

Teachers and curriculum

The curriculum and teaching methods are Montessori-based, with the children playing a major role indesigning their own programme for the day. We havefound this helpful in an inclusive programme becausechildren can proceed at their own pace. Peer learningis encouraged as one of the key elements of our inclu-sive approach. The teachers at New Horizons havetaken on the challenges of inclusion in a positive way.They aim for maximum inclusion and seek technicaladvice, which the special needs consultant will accessfor them, when they cannot achieve this. They report

that they have learnt from having children withdisabilities in their programme and that they feel theyare making a valuable contribution by meeting theeducational needs of all children.

Teacher aides

The inclusion of a child with a severe physical dis-ability has necessitated the employment of a teacheraide who has responsibility for certain tasks with allthe children, under the guidance of the teacher. Shealso has a specific responsibility for the children withdisabilities. The aide has received specialist trainingin positioning and exercises for the children in hercare. It is also worth noting that she is a person whowent through special schooling herself and who hasfound her first job with us.

Specialised equipment

While it is true that inclusion of many childrenwith disabilities into the mainstream can be achievedat very little additional cost, some children requirespecialised equipment. We received a donation ofapproximately US$1200 for equipment and with thiswe were able to buy sufficient equipment to accom-modate learners with severe physical disabilities. Analternative would be to borrow the equipment fromthe rehabilitation services or to make equipment usinglow-cost techniques. The equipment facilitates a dis-abled child's independence and we feel very stronglythat it is an essential part of inclusion.

Pupil response

We have been impressed by the ease with which themore able children assist and support the others.Through observation we have noted that an assertivepersonality is a great asset for the child with severedisabilities in a mainstream setting, because it isultimately up to the child to control how much help heor she needs and what he or she can do independently.It is the task of those without disabilities to learn torespect these guidelines and to respond accordingly.For some children this can be difficult there arethose who persist in patronising the children with dis-abilities and others who ignore them, thus reflectingthe range of responses that can be expected from thewider community. We attempt to demonstrate moreappropriate interactions by relating to all the childrenin the same way.

Impact of the project

Since the programme started, six children withdisabilities have passed through the centre. This is avery small number and the impact can be no morethan minimal if we do not disseminate our experi-

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ences. We have to be able to show that inclusion canand does work, even on a small scale. Thus the schoolis open for observation by students and interestedmembers of the public. We have had media coverageof the school which has also raised questions aroundinclusion.

Moving into formal education

A major issue is what happens to the children whenthey leave our programme. We have not yet success-fully 'mainstreamed' any of them. This could bebecause of the strength of the special school modelwithin our community, combined with the inadequacyof mainstream schools. We are caught in a dilemma:special school placements are often in the best interestsof the child, as the mainstream education sector isgenerally hostile towards children with disabilitiesbeing educated in mainstream schools. On the otherhand, long-term change within mainstream educationis probably only likely to occur through pressure,which will inevitably come from parents who arewilling to take on such a challenge, as has been thecase in the United Kingdom and the USA.

2. Special educational needswithin training

The people who come for training at CCDC are, in themain, local women who have identified the needfor child care in their communities and have decidedto learn more about how they can provide this service.Many of them are volunteers who receive little orno remuneration for the many dedicated hours theyput into this work.

`Weaving' inclusion into the curriculum

This aspect of the programme is staffed partly by thespecial needs consultant and partly by a community`educare' developer or trainer. CCDC believes thattraining for inclusion should not be seen as distinctfrom general training. Teaching children with disabili-ties or other special educational needs is not a specialskill, or an additional one, but an integral part ofwhat a teacher does in the classroom. By 'weaving'aspects of special educational needs into a curriculumwhich promotes a child-centred approach, we aimedto instill within our trainees a sense of responsibilitytowards children with disabilities and some basicskills in accommodating them within the mainstreamclassroom.

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The early identification of disability is included inour first level of training. Trainees are continuallyrequired to devise adaptations for children with physi-cal, mental or sensory disabilities to encourage theirfull participation.

In order to ensure that this occurs throughout training,we have held 'training the trainers' workshops ondisability issues. These workshops have revealed that,given the right attitudes, the aims can be achieved.Generally, trainers are committed to an inclusiveapproach and only need technical support.

Short course

We also offer a short course on the inclusion ofchildren with special educational needs into ECD,set up in response to a demand for training for studentsnot currently in training at CCDC. By the end of thecourse, the trainee should be able to:

understand the reasons for an inclusive approachand why this approach is being adopted nationallyand internationally (knowledge)develop positive attitudes in her/himself towarddisability and towards inclusion specifically(attitudes)include children with disabilities in the classroom(skills).

Our first course was held in May/June 1996 for29 students. Their response was very enthusiastic,as shown by their comments.

`Well planned. Information might help communityto accept disabled people and to accept their rights.'

`What was helpful to me was in overcoming the fearI had in inclusion of disabled kids in the communityas well as in the class. Inclusion to me was a dream.'

The course has a student manual and a manualfor the trainers. The course includes guidance on howto make equipment from natural or waste productswhich would be suitable for all children. We continueto run this course centrally and are now working ontaking this training out into rural communities.

As a follow-up to the courses, we have conductedcommunity visits. We have detected a greater willing-ness for teachers to accept children with disabilitiesbut a lack of skills to ensure that they are fully includedin all classroom activities. We now recognise thatteaching methods and curricular considerations mustform a larger part of our further training.

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3. Input into policy development

As was pointed out in the introductory section,South Africa is in the process of implementing majorchanges in its education system. We believe that weshould not wait for policies to be formulated butthat we must participate in policy formulation so thatSEN is an integral part of the overall process. Sinceinclusion is a relatively new concept in the country,this needs to be advocated in all possible fora.Our involvement in policy operates at a national,provincial and regional level.

The national level

We are involved in the South African Federal Councilon Disability Education Working Group which hashad a major input into the processes of setting upthe national commission. Several members of thisgroup have subsequently been appointed to the com-mission and we are therefore able to keep abreastof developments. We have also linked with UNESCOthrough this group. We had the privilege of assistingDPSA in organising a national workshop on inclusionwithin ECD in 1995 and this has formed the basis ofa network of interested people.

The provincial level

While there is much progressive thinking at thenational level, this is not always reflected provincially,where the executive powers for the provision ofeducation lie. We were therefore pleased to be ableto participate in the development of a provincial cur-riculum framework for ECD. A curriculum committeedeveloped a curriculum framework that places theinclusion of children with SEN squarely within itsscope. Recommendations as to how this can beachieved are included in the document which will bedistributed to every school in the province as the officialguidelines for ECD. Perhaps the most significant aspectof the curriculum is that it achieves this inclusiveapproach by adhering to national policies. An out-comes-based approach which fosters positive attitudesto diversity and which has a child-centred core encour-ages teachers to look at each child as an individual,rather than as a label, and therefore facilitates theprocess of inclusion.

The regional level

We have established a small education workinggroup with SAFCD affiliates in the region: Down'sSyndrome Association, Disabled People South Africa,

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Societies for the Blind, Mental Health and PhysicallyDisabled, with some input from the Society for theDeaf. This group came together to formulate a jointsubmission to the NCSNET and NCESS and toformulate a combined presentation for a departmentof education conference on inclusion. We anticipatethat this group will continue with the aims of providinga voice for parents of children with SEN, individualswith disabilities and NGOs and service providers,particularly in negotiations with the Department ofEducation. In addition, it will provide a body to advo-cate for children with SEN and to develop expertise inthis area throughout the region. We are in the processof inviting other organisations in the province to formsimilar groups and to work with us on issues of mutu-al concern.

4. Parent empowerment

Initially our strategy was to work with parents ofchildren attending the demonstration school, but thiswas not very successful. This necessitated singlingthem out from other parents, which we did not wantto do. We were also assuming that they had issues incommon with each other, which they might not haveperceived or agreed with. We found that parents havelittle time for additional participation that does notdirectly meet their needs.

In considering these issues, we have concluded thatour role at CCDC is to support parent information,support and advocacy groups which are achievingparent empowerment. We have taken an active rolein the development of a local Down's SyndromeAssociation and liaise with the Disabled Children'sAction Group which falls under Disabled PeopleSouth Africa and which is active in the rural areas.

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5. Other aspects of the project

Outreach

We have recently been invited by a rural district com-mittee to assist them with setting up a communitychild-care centre. We have taken this opportunity tointroduce a philosophy of inclusion which is relativelynew in such areas and has met with some resistance.We hope that through mutual respect and workingtogether we will be able to influence thinking in thisdistrict.

On an informal basis we act as an advice and advocacycentre to parents who are experiencing obstaclesto accessing education for their children with SEN.

We have offered training to visitors from Lesotho andwe are busy negotiating to work with a communityhealth worker training project in a nearby rural com-munity.

Funding

We have received some funding specifically forthe inclusion project but much of the work wedo is supported by the centre as a whole and doesnot require independent funding. For example, ourinvolvement in curriculum development is ongoingand forms part of the overall running of the CCDC.

Staff training

This is ongoing but problematic. We are not able toaccess any good training on the inclusion of childrenwith disabilities and curriculum development in SouthAfrica. Much of the existing training is based on amedical model of disability, which is inappropriatefor our needs. We hope to visit other countries whichare more advanced in this respect to learn from theirwork. Staff have, however, had the opportunity todevelop their general skills in working with childrenwithin the Montessori approach.

Networks and collaboration

Collaboration and networks are also crucial in ourwork, and our partnerships include:the two major hospitals which identify children withdisabilities; the Association for the Rehabilitation ofPersons with Disabilities (REHAB); Disabled PeopleSouth Africa (DPSA) ; and the Disabled Children'sAction Groups (DiCAG).

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IRO it;LEMSAND MAJOR 'ISSUES

1. Attitudes

In South Africa we were exposed to a racially-segregatededucational policy in the apartheid years. We are nowworking very hard to overcome this fragmentation andto build a unitary system. However, many people retainthe apartheid mind set when it comes to children withspecial educational needs, believing that it is necessaryto maintain a separate system of education for suchchildren. There is a sense that we do not valuethe potential of our learners with disabilities and otherspecial educational needs as much as we value thetypically developing child. In a recent conversationwith parents of children with Down's Syndrome,parents expressed their frustration with the low expec-tations placed on their children. There is a clear needfor demonstration schools or pilot projects which willmake the idea of inclusion a reality.

Children are not taught from an early age to respectindividuals with disabilities and teasing and abuse aregenerally more common than supportive behaviour.The disability rights movement, under the leadershipof Disabled People South Africa, has made someprogress but we still have a long way to go. We believethat the ECD sector also has a major contribution tomake in nurturing positive attitudes about individualdifferences in children.

2. The education system

Stress within the education system

For the majority of children in South Africa, educationtakes place within under-resourced classrooms,with a high pupil/teacher ratio and a rigid curriculum.Teachers are under pressure to get through the syllabusand to ensure that all pupils are able to performaccording to given standards. Since the adventof democracy in South Africa, education has beenthrough a period of transition, with the creationof a totally new system. This has put educators undera great deal of stress and pushed them to the limitsof their capacity for change. In addition, there isa mistaken belief that SEN affect a small numberof children and that educators must keep their visionfocused on the needs of the majority. These factorshave created a negative attitude towards inclusion.However, we have adopted the view put forwardby Villa and Thousand (1992), and others, that an

inclusive educational setting which meets the needsof children with SEN will be good for all children.

Out-of-school children

Children with multiple disabilities, severe mentalhandicap, mild mental handicap and homeless chil-dren are particularly severely affected by exclusionfrom the education system. The DiCAG centresonly scratch the surface of this problem and in ourview are a crisis response to the problem rather thana real solution. We hope that by including thesechildren within ECD programmes, the awareness oftheir needs and of their potential will be raised and theneed for education for ALL children highlighted.

A person with a disability is traditionally seen as theresponsibility of the Welfare Department. This isparticularly true in the rural areas, where grants foryoung children and adults with disabilities are highlysought after as a source of family income. Whileaccepting the need for these grants, it is unfortunatethat this helping mechanism has tended to create anattitude of dependency. Children who are excludedfrom mainstream or special schools (usually becauseof the severity of the disability) receive no supportfrom the Department of Education, but their familiesreceive a grant from the Department of Welfare.The Department of Welfare also subsidises day-carecentres which provide a valuable caring service butrarely offer an educational programme. It is ourfeeling that children of school age should have theireducational needs met by the Department ofEducation, rather than the Welfare services. Ourconstitution guarantees the right of all childrento an education and we are hoping to mobilise parentsand politicians to lobby, even to the point of takingthe Province to the Constitutional Court.

Inclusion versus special schools

There is a tendency for discussion of the provisionfor special educational needs to polarise around theissues of inclusion versus segregated education.We believe that this is an irrelevant issue, as neitherthe special schools nor the mainstream schools cancurrently lay claim to meeting the real needs ofchildren with SEN. We need to try to work out howto meet these needs, regardless of the setting in whichthe children are placed.

Within specialist schools there is often animositytoward the concept of inclusion, perhaps because itis threatening to professionals who are comfortablewith a certain way of operating. While it is clear thatthere will be a more inclusive approach in the future,there seems to be agreement that special schools arehere to stay.

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Many of the special schools accept children withfairly mild disabilities (for example, post-polio) andreject children with severe disabilities. We believethat this needs to change, so that special schoolsprovide support to children with disabilities in themainstream and take responsibility for educating thechildren with more severe disabilities in the specialschool setting.

3. Inadequate rehabilitationand health services

Many children with disabilities receive no form ofintervention until they enrol in a school or theECD programme. By this stage, parents' expectationsare low and many children have developed maladap-tive behaviour. It then becomes logical for schoolsto refuse these children admission on the groundsthat they are disruptive or show little potential forlearning. Early intervention services are vital, butthese need to be inclusive from the start. Parents needto understand that for their child to be included in theeducation system, they must first be fully includedwithin the family. Collaboration between healthand education is necessary to send the same messageto parents: that of integration within society.

4. Working froma non-governmental organisation

As an NGO, our impact is largely in the informaleducation sector. It is not always easy to impact ongovernment, which is obviously the major providerof education. We are fully aware that the developmentof inclusive ECD centres should be followed up byinclusive primary schools, but this is not happening.We have adopted a two-pronged approach to address-ing this issue. The one is to work on a policy level,from the top-down, and the other is to work withindividual schools in a bottom-up approach. The latteris difficult because schools are fairly closed systemswhich like to protect their autonomy. We hopeto work on this aspect by setting up a pilot projectwhich formalises the relationship between our centre,parents, schools and support services.

5. Limited resources

Our programme runs on a budget of approximatelyUS$20,000 per year. We have had to confineourselves to small interventions which we hope willhave a long-term impact. However, with growingexperience and confidence in our work and increaseddemands for our services, we envisage the need forexpansion of the project. We are experienced enough

SOUTH AFRICA

to offer training in inclusive education to ECDpractitioners from a wide range of settings, but wewould need to develop more staff to do this on alarge scale.

LESSONS LEARNED)AND CONCLUSIONS

1. Attitudes

First and foremost, inclusion is about attitudes.Inclusion begins with parents. Parents who acceptand love their child, and who are prepared to allowthe child to develop his or her own sense of worthand identity, will provide the necessary support forwhat is often a difficult and demanding process in themainstream sector. For inclusion to become a reality,we need to expect that children will achieve theirpotential. We have seen successful inclusionoccurring in poverty-stricken environments whereteachers have little formal training but understand thepotential within the child, and strive to release it.

2. The curriculum

We remain opposed to cosmetic inclusion Where thechild with SEN is placed in a mainstream classroomas a token gesture. Within a rigid curriculum,this is often the case. There must be room within thecurriculum for different ability levels and individualgoals. Villa and Thousand (1992) review some of thecurricular tools that enhance learning for all children,such as co-operative learning and peer tutoring.We hope that by moving toward an outcomes-basedapproach in education in South Africa, there willbe more room for curricular innovations which willbenefit not only learners with SEN, but all learners.

3. Support of the organisation

Probably our greatest strength at CCDC has been thesupport of the whole organisation for inclusion. Whilewe are identified as one particular centre project, thecentre as a whole is fully supportive of the approach.We are fortunate in that we do not have to fight tomake ourselves heard, but that inclusion is an attitudethat the entire organisation prides itself on.

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4. A holistic approach

The project described above has managed to have afar-reaching impact from small beginnings. We feelthat this is because we have adopted a holisticapproach. We do not feel it is enough just to trainteachers or to work on research and policy develop-ment. To have a real impact, all the componentsof the project need to work in a complementary way.

5. Parent participation

We have developed parental participation and involve-ment in deciding what they want for their child bypresenting them with the alternatives and helping themto work out what is best for them. In a transitionaleducation system which is not prepared for childrenwith SEN, parents need to be committed to the paththat they have taken and need intensive support fromother parents and professionals.

REFERENCES

Health Systems Trust and the Department of Health1996, Health Care in the Eastern Cape Implications

for Planning.

Department of Education 1996, Interim Policy forEarly Childhood Development.

McKenzie, J. and Mcleod, C. 1995, Special educa-tion: Rural neglect and policy guidelines. Matlhasedi,July 1995.

McKenzie, J., Report on Survey of Students at theCommunity and Child Development Centre(East London) into the Inclusion of Children withDisabilities into Early Childhood DevelopmentProgrammes. Unpublished report.

National Commission on Special Needs in Educationand Training and National Committee for EducationSupport Services 1997, Discussion Document:Proposed Vision, Principles and Strategies:Framework for the NCSNET and NCESS.

Philpott, S. 1997, Human Resource Developmentof Service Providers and Educators in the EarlyChildhood Development (ECD) Sector. Researchreport compiled for the National Commission onSpecial Needs in Education and Training and NationalCommittee for Education Support Services.

Schneider, M. 1996, Guidelines for DevelopingRehabilitation Services. The Centre For HealthPolicy, University of the Witwatersrand.

South Africa March 1995 Department of Education,White Paper on Education and Training. Cape Town,Government Printer.

Villa, R. and Thousand, J. 1992, Student Collaboration:An essential for curriculum delivery in the 21st century.In Stainback, S. and Stainback, W. (eds.). CurriculumConsiderations in Inclusive Classrooms: Facilitatinglearning for all children, Paul H. Brookes Publishing,Baltimore.

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Inclusion forPre-School Age Children:A Collaborative Services Model

By MARY BETH BRUDER, PH.D.,Division of Child and Family Studies,University of Connecticut Health Centre

1[NTRODUCTION

Recently, there has been a consensus on the need toredefine the relationship between early childhoodspecial education and early childhood programmes.This stems from a growing body of literature on theeducational benefits of including children with dis-abilities within programmes for children who do nothave disabilities. As a result, the major professionalorganisation for early intervention in the United States,the Division for Early Childhood of the Council forExceptional Children, has adopted a position papersupporting inclusion.

Inclusion has been cited as a quality indicator ofearly childhood intervention, and a number of recentservice delivery developments in early childhoodintervention are contributing to the continued expan-sion of inclusive programmes. These are as follows:

Families have become increasingly vocal abouttheir expectations for their children with disabili-ties.There has been an increasing demand for child-careservices for young children. More than 11 millionpre-school children attend early care or school pro-grammes.The Individuals with Disabilities Education Acthas emphasised the rights of eligible infants, tod-dlers and pre-school aged children to receive earlychildhood intervention services within 'naturalenvironments'.The Americans with Disabilities Act prohibitsdiscrimination against individuals with disabilities

by state and local governments and public accom-modations. All state and local government operatedservices for children, such as child-care centres,pre-schools, park, recreation and library servicescannot exclude from participation in, or deny thebenefits of, their services, programmes or activities,or otherwise discriminate against a child with dis-abilities. Moreover, the United States Departmentof Justice states: 'Integration of individuals withdisabilities into the mainstream of society is funda-mental to the purposes of the Americans withDisabilities Act'.In early 1993, the Administration for Children andFamilies within the Department of Health andHuman Services established rules which set perfor-mance standards for children with disabilities in theHead Start Programme (early childhood programmefor low income children and families).Young children aged three to five who are eligiblefor special education and related services have theright to receive these services in inclusive environ-ments. This was established in two memorandawhich were issued by the Office of Special Educationand Rehabilitation Services, of the United StatesDepartment of Education. Use of both private andpublic programmes (such as Head Start) fornon-special needs children and as special educationplacements for children with disabilities is onestrategy which has been identified to ensure that thesetting is not restrictive.

In addition to the expansion of inclusionary earlychildhood opportunities, the growing population ofchildren 'at-risk' for disability because of biologicalor environmental factors has called attention to theneed to increase the availability of quality early

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education programmes for all young children. Thesetwo service delivery trends, inclusion and a growingpopulation of at risk children, have provided anopportunity to design collaborative early care andeducation models which encompass all young chil-dren, regardless of a child's specific needs or label.

A C OLLA ORATTVEEARLY CETILDHOOD SERVI[CE

MODEL

The Collaborative Services Project is a five-year modeldemonstration project funded by the Early EducationProgramme for Young Children with Disabilities,U.S. Department of Education. The project representsa collaborative effort between the University ofConnecticut School of Medicine, Department ofPediatrics (UCONN), Hartford Public Schools,Hartford City Day Care and Hartford Head Start.These programmes serve approximately 1200 childrenwho have disabilities, are at risk for disability, or aretypically developing.

1. Project location

Hartford's population is 139,740 and it has the lowestper capita income in Connecticut, with 25% of resi-dents living below poverty levels. Seventy percentof Hartford's population is 'minority', about equallydivided between African Americans and Hispanics.Hartford's Hispanic population has experiencedremarkable growth, and 60% of children under fiveare Hispanic. The public school system is 93%`minority'; 43% African American and 45% Hispanic.Most Hispanics in Hartford (up to 90%) are PuertoRican.

Fifty-seven percent of all Hartford children live inlow-income single parent households; 18% requirespecial education services; 45% come from a homewhere a language other than English is spoken.

As Hartford's economy worsens, indicators of humanneed continue to rise. The number of Hartford resi-dents who are HIV-positive more than doubles eachyear and the number of babies born with special needsdue to maternal drug use escalates. Infant mortalityrates, the percentage of low-weight births, and thepercentage of births to teenage mothers are amongthe highest in the United States. The annual numberof births grew by 20% in the last decade.

The Hartford Public School system (HPS) enrols26,400 students. HPS enrols 4% of Connecticut'spublic school students, but has 40% of its bilingualpopulation and 16% of its special education students.Unfortunately, HPS is only serving a portion of thoseeligible for special education at the pre-school level.The most recent data suggest that only 1.6%(51 children) of 3 year olds and 3% (90 children)of 4 year olds were receiving services.

2. Project design

The purpose of the project is to develop, implementand evaluate a model of collaborative and inclusiveearly childhood services within an urban schooldistrict for young children with disabilities and theirfamilies. Three types of collaboration are emphasised:

Inter-agency collaborations, to assist in policydevelopment for both local and state-wideplanning.Service delivery collaborations focus on theadoption of recommended early childhoodintervention practices within the public (state)schools' pre-school special education programme,the Head Start programme, and the day-careprogrammes.Family collaborations focus on the adoption ofpolicies and practices to increase the involvementof families across early childhood programmes.

The ultimate goal should be the collaborative devel-opment of an individual education plan (IEP) carriedout under the direction of the family.

The main elements of the project are shown onFigure 1.

3. Component one:inter-agency collaboration

It is clear that few agencies have the resources to pro-vide a total continuum of services which encompassesall the issues that may impinge upon a young childwith disabilities and his or her family. Therefore,agencies, programmes and staff must be prepared toco-operate and collaborate for the benefit of families.For example, a child of Puerto Rican heritage whowas prenatally exposed to drugs requires the expertiseand services of bilingual early intervention staff,medical staff and community agency staff.

There is no magic formula for developing collabora-tive models, but a number of key ingredients havebeen identified; in particular, Melaville and Blank(1991) have identified five variables which shape aneffective inter-agency collaborative system.

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Figure 1: Project Component and Elements

The social and political climatefor change

A more favourable climate for collaboration occurswhen the targeted service delivery issue is a priorityfor each of the service agencies. However, not allparticipating agencies may agree about what needschanging. For example, they may not agree on thenecessity for service improvement. However, it seemsclear that the multiple needs of children and familieshave created the need to prioritise collaboration, andthis should facilitate the development of a favourableclimate in which change can occur.

The processes used for communicationand problem-solving

Inter-agency collaborations rely on the adoption of aprocess to establish goals and objectives, clarify roles,make decisions and resolve conflicts. The first stepis the adoption of a common vision by all involved inthe service delivery system. Difficulties in the estab-lishment of a vision across the relevant agencies andprogrammes stem from differing interpretations aboutthe adequacy of the existing system. Resolution canonly occur when specific processes are agreed uponand adopted by all participants to ensure open,continued communication, negotiation and conflictmanagement.

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The human dimension

The people involved in the creation, development andimplementation of the inter-agency service system area critical factor in the ultimate success of the collabo-rative model. An effective leader who can establish,and help sell, the vision to all participants is essential.He or she must also be able to translate the vision intothe reality of service delivery. The commitment of theother participants, at both policy-making and service-delivery levels, is also vital. All should have access tosupport and training as their roles change with thedevelopment and delivery of a collaborative servicedelivery system.

The policies which support or inhibitinter-agency collaboration

Each participating agency and programme enteringinto an inter-agency collaboration has a set of rulesand regulations which governs their mandate, targetpopulation, budgetary operations and servicestructure (including staffing patterns). Agenciesand programmes must be prepared to identify andshare these policies with each other so that barriersto interdependent functioning can be identified andremoved.

The availability of resources

In an age of shrinking resources, inter-agencycollaborations are often the only way to guarantee thedevelopment of an integrated service system. Earlychildhood intervention is one area in which resourcesmust be pooled to ensure the development and deliv-ery of services.

A collaborative climate must be maintained duringthe inter-agency process, and all agencies must feelfree to contribute issues and solutions which are thenjointly resolved. It is important to maintain a positiveatmosphere of communication and trust among theparticipants which is more easily achieved when thefocus of the collaboration is on the people involved,rather then the individual agency and programmerequirements. This focus should include both theconsumers of the services (families and children) aswell as the service providers. The collaborative visioncan be defined as 'relationship driven', as the partici-pants focus on improving the services or systemfor children as opposed to agencies and programmes.

4. Component two:service delivery collaborations

While programme development hinges on the effec-tiveness of inter-agency collaborations, the actualservice delivery must be implemented by individualservice providers. The personnel will have to adopt ateam model to ensure collaborative service deliveryand the success of the interventions will be dependenton the way the team functions. Teams must devotetime to identifying their goals and objectives. A trulyeffective team exists when members share responsi-bility for accomplishing common goals. An effectiveteam will:

have goals which are clearly understood, andcommunicated to all team membershave ownership of the goals and participate insetting themhave goals which are operationally defined andmeasurableshare individual or personal objectives with oneanother.

This project deploys a cross-disciplinary team, whichis one that functions around the needs of the family asopposed to the needs of discipline-specific serviceproviders. The members share roles and systematicallycross disciplinary boundaries in accordance with theassessment or service delivery needs of the family.This involves continuous give and take between allthe members of the team (especially the family)on a regular, planned basis. Assessment, intervention,and evaluation are carried out jointly by designatedmembers of the team.

As with effective inter-agency service delivery mod-els, collaboration is inherent in the cross-disciplinaryteam approach. A cross-disciplinary team is one inwhich the members perceive that they can obtain theirown goal if; and only if, the other team members alsoobtain their respective goals.

In order to facilitate service delivery collaborations,this component focusses on team process, recom-mended practices in inclusion, the development ofa social competence curriculum and the use of indi-vidual health care plans for eligible children.

5. Component three:family-centred collaborations

Parents of a young child with disabilities are rarelyprepared for the special challenges they will face.Most parents report an increase in the level of stressthey perceive as a result of the birth of a child, butthe parents of a young child with multiple or severedisabilities must deal with unanticipated pressures

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and responsibilities which can make the parentingrole appear to be overwhelming.

An expanded focus on family systems theory hasresulted in the recommendation that early interventionprogrammes move away from the narrow focus of thechild and encompass the broader and self-identifiedneeds of the enrolled parents. It has been suggested thatthe primary goal of early intervention should be tofacilitate the parents' awareness of, and adaptation to,the primary role of parenting a child with disabilities.A programme can then focus on helping the familyaddress the long-term needs of their child. The projecthas a particular focus on family support strategies.

A recent suggestion has been for early interventionprogrammes to recognise the ongoing stress thatparents of delayed and at-risk young children maybe experiencing by helping families adapt to stressthrough the recruitment of support networks.

It has been suggested that both formal and informalsupport strategies should be integral to any servicedelivery system for families with high-risk or disabledchildren. The support strategies should be both formal(e.g. assistance with insurance and financial needs;identification of respite services; training on medicalequipment) and informal (e.g. identifying existingcommunity resources; facilitating family involvementwithin the school). The overriding premise of suchsupport is that it must be individually matched to theneeds of the family, and the use of such strategiesshould be directed by the family. These principleshave been articulated as components of family-centredcare and these are listed below. Tamily-centred care'suggests that all services revolve around the familyas it is the family which will be the constant in thechild's life.

Principles offamily-centred care

a) Recognition that the family is the constantin the child's life while the service systems andpersonnel within those systems fluctuate.

b) Facilitation of parent and professional collabora-tion at all levels of health care.

c) Sharing of unbiased, complete information with theparents about their child's care on an ongoing basisand in an appropriate and supportive manner.

d) Implementation of policies and programmes thatare comprehensive and provide emotional andfinancial support to meet the needs of the family.

e) Recognition of family strengths and individualityand respect for different methods of coping.

0 Understanding and incorporating the developmen-tal needs of infants, children and adolescents andtheir families into health care systems.

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g) Encouragement and facilitation of parent-to-parentsupport.

h) Assurance that the design of health care deliverysystems is flexible, accessible and responsive tofamily needs.

PROJECT EMPLEMENTATEON

1. Project participants

The HPS serves approximately 120 children withdisabilities, aged three to six. There are 19 earlychildhood special education classroom teachers,assigned to 30 classes at 25 sites (separate morningand afternoon sessions). Seven additional peripateticteachers provide services to pre-school children withdisabilities placed in other programmes throughoutHartford. The HPS also has 11 speech, language andhearing pathologists who provide services to childrenidentified as having disabilities.

Hartford City Day Care serves a total of 274 childrenat eight centres in Hartford. There is a staff of52 teachers and assistant teachers working with chil-dren of up to kindergarten. age.

Head Start serves approximately 860 children at13 different sites throughout Hartford. Ninety teachersand assistant teachers provide services to pre-schoolchildren aged three to five. In accordance with man-dated federal guidelines, a minimum of 10% of theenrolment has been assessed as needing special edu-cation services through the HPS. Peripatetic teachersand assigned therapists provide related servicesto the children with disabilities who have individualeducation programmes at the Head Start sites.

2. The project in action

During the first three years of the programme, allteachers across the agencies participated in everyaspect of the project through training workshopsand focus groups. In addition, specific child-focussedactivities were implemented in different classroomsthroughout Hartford. Forty-three children with dis-abilities were placed in inclusionary early childhoodclassrooms, and 142 additional children with disabili-ties received technical assistance in order to remainin inclusionary placements.

During the first year of the project, the model devel-opment process was initiated in one school within the

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Table 1Evaluation strategies

Observations MeetingMinutes

Agendas Intervention Surveys InterviewsPlans

Interagencytransitionsfundinginservice training x

xx

Service Deliveryinclusive placementstransdisciplinary curriculumsocial competency curriculumintegrated health care records

x

xx

x

xx

x

x

Familyparent meetingsstaff attitudes and activities

x xx x

district. This school contained three early childhoodspecial education classrooms (total enrolment of23 children); a diagnostic play group for three-year-oldchildren with disabilities; and other early childhoodprogrammes which included two Head Start classes;one kindergarten 'readiness' class; four kindergartenclasses; and a daycare classroom. Staff from each ofthese programmes participated in training andreceived technical assistance.

The model expanded in the second year of the projectto include another school within the district. Thisschool contained three early childhood special educa-tion and two pre-kindergarten 'readiness' classes.During the third year of the project, the team-teachingmodel was replicated in a daycare class housed in athird elementary school. An early childhood specialeducation teacher and six pre-schoolers who haddisabilities were also assigned to the daycare class.During the current and fourth year of the project, akindergarten using a team-teaching approach is beingadded in Hartford, and two other school districts inConnecticut will participate in the project.

P OJECT EVALUATIONMETHODOLOGY

Given the high volume of activities proposed in thisproject, it was imperative that a systematic anddetailed plan of evaluation was developed. Such aplan allows for regular and frequent input from con-sumers and professionals regarding the direction ofthe project, in order to assure that the activities arefunctional to the field, socially relevant and scientifi-cally sound. As such, both formative and summativeevaluations are being conducted on both process andproduct outcomes.

The evaluation plan consists primarily of an objectiveor goal-based approach to evaluation. Multiple mea-sures of effects are used whenever possible to docu-ment outcomes. In addition, family and child mea-sures are used to document the effectiveness of imple-mentation and replication objectives, particularlywithin the service delivery component. Wheneverpossible, statistical analyses are used to documentproject outcomes across training audiences and con-sumers (families and children).

Case-study methodology is also being used to gatherqualitative information from families and children,and agencies are participating in the project.

Table 1 provides an overview of the sources of datathat were used to complete the case study.

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Table 2Training topics and workbook topics

Training Modules Workbook Topics

Developmentally Appropriate Practice Inclusion

Team Work Classroom Management

The Changing Role of the Assistant teacher in the Classroom Curriculum Adaptation

IEP Development and Implementation Glossary

Behaviour Management Routine Based IEP

Play and Play Intervention Social Competence

Attention Deficit Disorder With and Without Hyperactivity TransdisciplinaryTeaming in the Pre-schoolClassroom

Social Competence

PRELIMINARY RESULTS

1. Inter-agency collaborations

The focus of the inter-agency component is to identifycommon goals across the three agencies of HartfordPublic Schools (pre-school special education), HartfordDay Care and Hartford Head Start. Approximately25 three-hour meetings were held during the firstthree years of the project which were attended bythe directors of the three programmes. During thesemeetings both philosophical and logistical issueswere discussed.

The project's goal of inter-agency collaboration wasnot easy. The agencies had no experience of co-operating with each other, and they differed in theirperspectives on early education and their mission forchildren and families. All three agencies were pleasedabout receiving assistance from the project, but theywere not really clear on the collaborative emphasisof the project. To them, collaboration was an end goalin itself as opposed to a means to an end. Althoughthe interpersonal relationships between the programmedirectors were cordial and respectful, the organisationalrelationships and perceptions were more critical, asdocumented through interviews at the beginningof the project. The agencies had differing priorities andperceptions of good practice which meant that relationswere sometimes strained.

During the three years, the directors' meetings focussedon the direct implementation of project goals. Themeetings also provided the time for the individualprogramme directors to get to know each other. Afterthree years, the programme directors have built goodworking relationships, as evidenced by an inter-agency agreement between the public schools andHead Start, and the continuation of monthly meetingsas requested by them. These monthly meetings pro-vided the opportunity to discuss the individual modelelements within this component: training, transitions;and funding.

Training

There was a clear consensus that more training andmore support were needed by the teachers in theproject. During the first three years of the project,189 teachers (across agencies) participated in56 training sessions covering 28 topics. Detailedtraining syllabi were designed for 10 of the topicsand participants' workbooks completed for eighttopics.

The training occurred at convenient times for theparticipants, and included participatory strategiesand applications to classroom situations. Pre- andpost-questionnaires on training content suggestedsignificant gains in knowledge.

Comments about the training which were given duringinterviews with teachers were overwhelminglypositive. One teacher said: 'Before the training

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I hated inclusion. I felt it would be another strain onthe teachers. After the training, reading informationon inclusion, I felt that children with disabilitiesdeserve to be included in every learning process withthe typical (quote, unquote) child!'

The administrative team also valued the training asevidenced by a comment by the Head Start adminis-trator. 'I know we have some people in the pro-gramme who are capable of helping others better, butwe just need to form a sort of team and sort of steerthem through it [the process]. I'd like a training teambecause in each centre, I can see at least four peoplewho have already done workshops, who understandthe techniques, who could easily train or assist inhelping the new staff coming in'.

Transitions

All three agencies agreed that the transition processfor children with special needs was seriously flawed.There was also consensus that a smooth transitionprocess is important. The uncertainty of placementdecisions was one of the basic problems. As oneteacher stated: 'Even now [June] I can't even tellparents where their kids are going.'

Another issue was raised by the Public School directorwho indicated that among the many transitions (birthto three into the system; pre-school into kindergarten;and between more or less restrictive environments) shefelt the most difficult transitions were between specialand mainstream education classes.

Almost all the comments about the transitionprocess were made by the Public School teachersand administration. Only one comment was made bysomeone from another agency: a representative fromthe Day Care services indicated that participationin the project made her more conscious that 'the chil-dren will be leaving' and of the need for transitionplanning.

As part of the project, a regional transition task forcewas developed to address all the transition points forchildren with disabilities. Twenty-six agencies partici-pated and the result was the adoption of a common setof guidelines for parents of children with disabilities,from birth to the age of eight. This occurred duringthe third year of the project, and it will be implementedduring the fourth year.

Funding

This area remained the most problematic and,as a result, very little was accomplished. During thefirst year of the project a private education agency,Education Alternatives Incorporated (EAI), was giventhe responsibility of running the HPS in an effortto reduce costs; EAI lasted three years but was thenvoted out of Hartford by the School Board inFebruary of the project's third year. EAI controlledbudget decisions, and did not include plans forchildren under the age of six in any planning. Thepublic schools' pre-school budget remained stableduring this time. Unfortunately, Head Start andDay Care services continued to lose funding as theHartford economy worsened. Funding is a veryimportant issue, and one which the agencies do notwant to share, as their focus remains on their ownsurvival.

2. Service delivery collaborations

`Frankly, it's hard to collaborate'. That was a com-ment made by one of the pre-school special educationteachers involved in the project, but it serves as asummary statement for the comments made by manyof the teachers providing services across the agencies.The barriers to collaboration were evident: the lack oftime to meet and plan joint efforts, the lack of infor-mation-sharing between agencies and the less thanpositive attitudes some participants showed towardsthe policies and practices of the other agencies.

Several of the teachers indicated that they felt collab-orative bonds had been established between theiragency and the project staff at UCONN, but that theydid not feel connected to the other agencies. 'I feellike we're all like kind of little separate entities thatare together but not really. I mean, it's like we're col-laborating with you, they're collaborating with you,but we're not collaborating together'. One of the otherrespondents identified collaboration as a goal of theproject but not a goal he shared; his goal was focussedmore on improving his classroom and agency. Thefour elements under this component each presentedseparate challenges.

Teaming

The concept of teams of professionals workingtogether co-operatively (if not in a full cross-discipli-nary model), however, was well supported. Several ofthe Public School teachers suggested that cooperationbetween professionals was required for good earlychildhood practice. 'Good early childhood practiceis a collaboration between the adults in the room,

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between adults in a building, such as your resourcepeople who you can call upon when you're stuck ona problem... the nurse's office... the speech people'.

The usual barriers of insufficient time and resourcesfor teams were also well documented in the discussions.In the Hartford system, there are few occupationaland physical therapists, and few speech and languagespecialists. To try to overcome these barriers, someteachers expressed a desire to set aside specificmeeting times so the group of professionals workingwith a child could get together to 'help with problems,being able to talk problems out.'

The difficulty of getting the level of support desiredwas echoed by the Public School administratorinvolved with special services. 'We are trying tofacilitate more collaboration between our staff... butI don't feel... I can give them the constant support ona regular basis because of the heavy schedule'.

During the three years it was found that the use of aconsistent planning time and process with the involvedindividuals could create a climate for collaborativeteaming. The most difficult issue concerned roles andresponsibilities, particularly those for the special educa-tion teacher. As the Day Care Senior Teacher indicated:`I think team teaching is very difficult and... {the}special education teacher and I haven't quite workedout what our relationship is.' The special educationteacher also expressed difficulties, 'I had a hard timemyself. Just, you know, trying to figure out what myrole is here in the centre.'

Recognising the importance of clear roles andresponsibilities, the project facilitated team meetingsin a number of collaborative sites. The focus of thesemeetings was role clarification and programmeplanning for the children with special needs. Of mostconcern was that such meetings were not a formal andmandatory part of the process. After the third yearof the project, Day Care and the Public Schoolsagreed to mandate weekly team meetings at all of theinclusive sites.

Inclusion

At the beginning of the project, most of the teachingstaff across the agencies did not have much experi-ence with inclusion. Head Start, by federal mandate,had a policy requiring that ten percent of the childrenit served-had to be children with special needs. Thus,several of the teachers at Head Start had had someexposure to children with special needs. However,as explained by both the teachers and administrationat Head Start, most of the children's special needswere speech and hearing related; fewer had motor orphysical disabilities.

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During the three years of the project, 43 childrenwith moderate to severe disabilities participated ininclusive classrooms facilitated by project staff. Anadditional 142 children who had IEPs were providedwith technical assistance by the project staff in orderto enhance their intervention and participation ininclusive settings. The participating teachers all feltthe benefits of this. As one teacher said: 'Inclusion isa great start for young children with special needs.They have the opportunity to interact with childrenwho have no disabilities. Inclusion helps the youngchild with his self esteem, which is very importantin a child's early years.' Another believed that:`Children with special needs should be included ina "regular" classroom whenever possible. It helpsthe children in the classroom be more accepting andunderstanding of children and people with disabilities.It also helps the disabled children feel acceptedand a part of a regular group. They can learn positivenormal behaviours from other children.'

One area of concern which surfaced in the teachers'comments was children who exhibit 'unmanageable'behaviour. Several of the teachers felt that such chil-dren were disruptive to the class. These problems werethe most common reason behind requests for technicalassistance. In addition, behaviour and classroom man-agement were the most commonly-requested trainingtopics. These attitudes differed considerably from thosetowards children with physical disabilities or learningdifficulties. Other than some apprehension about safetyand 'knowing what to do' there was overwhelmingagreement that these 'types' of children were clearly apositive addition to the classroom. Ironically, many ofthe children who exhibited poor behaviour were not thereferred children with identified special needs; ratherthey were children enrolled as 'typical' children.

Social competence

The incorporation of a social-competency-basedcurriculum into the pre-school programmes was a keycomponent of this project. While all three agenciesparticipated in training on social competence, HeadStart piloted a specific curriculum for the project.The Assessment of Peer Relations (Guralnick, 1992a)was implemented with 57 young children with specialneeds by six teachers. This will expand to all teachersduring years four and five of the project.

Some issues about the goals of pre-school and kinder-garten did emerge, particularly during discussion ofthe social competence curriculum with the teachers.One of the teachers, who was quite interested inthe presentation, discussed her feelings about theimportance of social competency for children and thechallenge of explaining its importance to parents whoare more interested in the development of cognitive

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and motor skills. The parents, she lamented, oftenthink the teachers are 'just playing and doing nothingand baby-sitting.' The social competency curriculumand the project in general were viewed as providingcredibility for the work that the pre schoolteachers do.

The challenge described above was to make parentsand other outsiders understand the importance ofsocial skills; amongst the project's participants therewas little controversy. However, there was somedisagreement expressed about the proper goals andmethods of kindergarten teaching and how much theydiffer from those of pre-school. The conflict was madeexplicit by one of the Public School teachers in a dis-cussion of how well the children who had experiencedpre-school special education did in kindergarten andfirst grade. 'In my mind, kindergarten is a continua-tion of pre-school. It is not little academia.Unfortunately not all kindergarten teachers agree withme that teaching children how to get along with eachother is more important than worksheets on ABCs.'

Integrated health plans

This area was felt to be very important by all projectparticipants, but a lack of team process between healthand education proved a barrier to the collaborationswhich were necessary to get the integrated health planscompleted. Head Start had a health emphasis, and feltits health care records were adequate. Unfortunately,the Head Start teachers did not have constant accessto them. The Public School teachers and Day Careteachers felt that this area was problematic for them.One teacher complained that: 'I guess the law changedand the nurse in our building is not allowed to shareas much as she used to share... I find it helpful whenI'm allowed into the records, but they are stored at theadministration building.'

Parent collaborations

`Parents, parents are a key.'

`A lot of support from parents and staff, 'cause I thinkwhen you have the support from both ways, you get alot done.'

`In order to work with any of the children or all of thechildren, you need support from the family. You needto have the family involved, you need to know what'sgoing on at home. Parents need to know what's goingon at school.'

These comments illustrate the feelings of teachersand others related to the programme about parentalinvolvement. They agreed that it is difficult to achievethe level of participation and support that is needed,primarily because it is difficult to get parents to come

into the schools. Several reasons were offered:safety in the urban neighbourhoods of the Cityof Hartford, many parents are afraid to travel to theschool;distance because placement in special educationis not neighbourhood based, many of the parentslive some distance from their child's school;schedules in many families, both parents workand are unable to visit the school during the normalworking day;stress for example, when a parent calls the schooland reports that their electricity has been cut off.

In addition to these logistical problems, psychologicaland interpersonal barriers to family participation wereidentified, including the feelings of intimidation feltby some parents. One teacher said: 'and they're stillvery intimidated and it may be a lack of experienceon their part with being in such a small room with somany kids at once. It may be that they're intimidatedby "school". Maybe they didn't make it throughschool'. The same teacher suggested that some teachersneed training to learn how to talk with parents with-out insulting them. Or making them feel like they'retwo inches tall. 'Cause I see that happening. And it'snot done deliberately, people aren't even aware of it.'

A representative from Day Care talked about thereticence of some of the parents in talking about theirchildren's special needs, especially when their needsare social rather than physical. 'A lot of the parentsdon't wanna let you in on the, those facts, either...You know the things that are physical... those aremuch easier to deal with because they are right there'.

A Head Start teacher raised a problem she finds withsome of the families. In the classroom, she tries to getchildren to do as much for themselves as they can butfinds that 'at home, they tend to do a lot of things forher [the child], as opposed to requiring that she dowhat she can for herself.' The teacher felt it would behelpful if the child's mother could observe other.children at school in wheelchairs to see what they arecapable of and what her child might be able to do aswell.

The interviewees offered several suggestions forincreasing family participation:

increase the sensitivity of staff to parental problemsand feelingsincrease the frequency of home visitsinvite parents to school functions and eventsentice parents into the school with mealsset up parental support groups based on commonal-ties of child's age and/or disability.

From the perspective of teachers and staff, the keyissue related to families was how to support and be

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supported by families at a level appropriate to thechildren's needs. They saw the prime problem asthe families' reluctance to come to the schools andparticipate. Several suggestions about what is per-ceived primarily as a logistical problem were offered.Although helpful, these comments offer only minimalinsights into the family component of the project,because the interview respondents did not includefamilies and many of the participants did not under-stand how the family component related to their ownconcerns.

CONCLUSION

Quality early childhood intervention requires thatmany agencies work together to develop joint activitiesfocussed on the development of collaborative servicemodels. A logical extension to this requirement forservices for young children with disabilities wouldbe the design of collaborative service models to encom-pass the early care and education needs of all youngchildren. As demonstrated in this project, the challengeis to identify the various agencies, professionals andpayment sources currently involved in the provisionof such services. The project's goal was to developa seamless system of service delivery which respondsflexibly to a family and child's needs, as opposedto delivering an inflexible programme with artificially-imposed limitations which reflect attitudinal, agencyand funding constraints.

There are many benefits to collaborative servicedelivery models; most importantly, a more efficientand effective use of service providers and fundingstreams across agencies, resulting in improved servicedelivery. These models also result in a reduction inservice duplication. Collaborative models enableparents and service providers efficiently to locate andmanage the necessary services required by the family.Lastly, collaborative models eliminate the need forformal transitions, as services are integrated, compre-hensive and longitudinal.

Unfortunately, the implementation of collaborativeservice models remains an elusive goal for manystates and localities. There are many reasons for this,ranging from philosophical to logistical. The mostchallenging of these are personnel issues, primarilythose involving attitude.

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Common barriers to collaboration

Competitiveness between agencies and providers:turf issueslack of information about other's functionspolitical issues.

Lack of organisational structure for coordination:differing philosophiesindependent goalshaphazard team processlack of a facilitatorlack of monitoring and evaluation processlack of planninglack of power and authority to make and implementdecisions.

Technical factors:resources staff, time, budgetlogistics distance, geography.

Personnel:parochial interestsresistance to changestaff attitudeslack of commitment to community needsquestionable administrative supportdiscipline-specific jargon and perspectives.

This model demonstration project is attemptingto address the development of collaborative servicestructures which support the needs of pre-school agechildren with disabilities within inclusive earlychildhood classrooms. The project is redefining earlychildhood service priorities to address all children andfamilies within a framework of recommended bestpractice. Progress has been made within the projectcomponents of inter-agency collaborations, servicedelivery collaborations and family collaborations. Twoquotes from project participants attest to the progressmade in changing attitudes about the placement andinclusion of children with disabilities within earlychildhood. A teacher from the Day Care programmestated: 'People literally are walking in the area of thedark ages because of their lack of knowledge in thearea of inclusion. Since I have been a participant of thisproject, I have a respect and admiration for those whoseek the big picture of the diversity of being humanbeings.... I truly believe that it takes a special personwith a heart open and receptive to the concept ofinclusion and now I believe I am one of those specialpeople. This project has opened up my understandingas well as my heart.'

A programme director also stated a belief aboutchanges that had occurred as a result of the project.`You [had] teachers who really were at a level thatthey didn't even want special needs children in their

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classroom. And now you have teaching staff whoactually approach us requesting that we have specialneeds children in their classroom, and not just chil-dren with speech delays.'

There are many more agency and family challengesto meet before all children are able to benefit fromcollaborative models of early childhood services.Hopefully, demonstration projects such as theCollaborative Services Model in Hartford,Connecticut, can facilitate the development andexpansion of collaborations for all children.

REFERENCES

Melaville, A. I., and Blank, M. J. (1991). What ittakes: Structuring inter-agency partnerships to con-nect children and families with comprehensive ser-vices. Washington, DC: Education and HumanServices Consortium.

Shelton, T., Jeppson, E., and Johnson, B. (1987).Family-centreed care for children with special healthcare needs (2nd ed.). Washington, DC: TheAssociation for the Care of Children's Health.

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ANNEX

Addresses of contributors

Name Address Fax

APEIM Association of Parents of Disabled Children39 St. Paul RoadPhoenix, Mauritius

(230) 696-7166

Bruder, Mary Beth (Ph.D.) Director of Child & Family StudiesThe University of Connecticut Health CenterDivision of Child and Family Studies263 Farmington Ave.Farmington, CT 06030USA

(1-860) 679-1368

Chouaib, Jamal PresidentAssociation Tadamoun Wa TanmiaCentre Hadicat-As-SalaamP.O. Box 605Saida, Lebanon

(961) 7 723438

Flavier, Fernande Valerie Inspectrice de l'Education Nationale43 bis, rue Achille-Viadieu31400 Toulouse, France

(33-5) 61.55.52.98

Germanos-Koutsounadis, Vivi,and Tsambouniaris, Meni

Ethnic Child Care,Family and Community Services Co-operative Ltd.Hut 13A, 142 Addison RoadMarrickville, NSW 2204Australia

(61-2) 9564 2772

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Name Address Fax

Holdsworth, Janet Integrated Education AdviserSave the Children Fund (UK)P.O. Box 1146Vientiane, Lao P .D .R.

(856-21) 216 285

Larraguibel, Erika National CoordinatorJunta Nacional de Jardines InfantilesDario Urzua 2109ProvidenciaSantiago de Chile

(56-2) 232.92.07

Madeira, Rosinha Centro de Educacao Integrada da Bela VistaLargo de S. Pedro3750 AguedaPortugal

(351) 34 623 261

McKenzie, Judy Special Needs ConsultantCommunity and Child Development Center47 Caxton Street, QuigneyEast London 5201South Africa

27.431.43408

O'Toole, Brianand Stout, Shoma

UCB-UCSF Joint Medical Programme (592-2) 62615Guyana Community Based Rehabilitation ProgrammeP.O. Box 10847GeorgetownGuyana

Rao, Indumathi CBR CoordinatorCBR Network291, 4th B MainJP Nagar 4th PhaseBangalore, 560078India

(91-80) 663 3706

Specialradgivning for smaborn Roskilde AmtKOgevej 80D-4000 RoskildeDenmark

(45) 46.32.04.83

Zoniou-Sideri, Athena Assistant Professor of Special EducationUniversity of AthensDepartment of Preschool Education33 Hippocrates 106 80Athens, Greece

(30) 1-360 5355

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We believe and proclaim that:1 every child has a fundamental right to educ and must be

given the opportunity to achieve and main an acceptablelevel of learning,

I every child has unique characteristics, interests, abilities andlearning needs,

1 education systems should be designed and educationalprogrammes implemented to take into account the wide diversityof these characteristics and needs,

1 those with special educational needs must have access to regularschools which should accommodate them within a childcentredpedagogy capable of meeting these needs,

I regular schools with this inclusive orientation are the mosteffective means of cocreating welcomingtand achieving educeffective educatio

bating discriminatory attitudes,unities, building an inclusive society

for all; moreover, they provide anthe majority of children and improve the

efficiency and ultimately the cost-effectiveness of the entireeducation system. FA,

The Salamanca Statement, Paragraph 2.

A compilation of case studieson early childhood education and children with special needs:

Australia, Chile, Denmark, France, Greece, Guyia, India,the Lao People's Democratic Republic, Lebanon, u

J.%

Mauritius, Portugal, South Africa, United States;

T1

(9/92)

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Educational Resources Information Center (ERIC)

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