Access to education of children with disabilities: A contemporary perspective

A major impediment to understanding quality of care for children with disabilities (CWD) is the lack of a method for identifying this group in claims databases. We developed the CWD algorithm (CWDA), which uses International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes to identify CWD. We conducted a cross-sectional study that (1) ensured each of the 14,567 codes within the 2012 ICD-9-CM codebook was independently classified by 3 to 9 pediatricians based on the code's likelihood of indicating CWD and (2) triangulated the resulting CWDA against parent and physician assessment of children's disability status by using survey and chart abstraction, respectively. Eight fellowship-trained general pediatricians and 42 subspecialists from across the United States participated in the code classification. Parents of 128 children from a large, free-standing children's hospital participated in the parent survey; charts of 336 children from the same hospital were included in the abstraction study. CWDA contains 669 ICD-9-CM codes classified as having a ≥75% likelihood of indicating CWD. Examples include 318.2 Profound intellectual disabilities and 780.72 Functional quadriplegia. CWDA sensitivity was 0.75 (95% confidence interval 0.63-0.84) compared with parent report and 0.98 (0.95-0.99) compared with physician assessment; its specificity was 0.86 (0.72-0.95) and 0.50 (0.41-0.59), respectively. ICD-9-CM codes can be classified by their likelihood of indicating CWD. CWDA triangulates well with parent report and physician assessment of child disability status. CWDA is a new tool that can be used to assess care quality for CWD.

Special education is a form of instruction that is designed to meet the needs of children with disabilities so that they can learn the same skills and information as others. It not only enables them to utilize their right to education and to do their daily chores with ease; but also empower them to become more independent and self reliant. With the literacy rate being low in India, special education and skill training is the only way to make people economically independent and to enable them to earn either through self-employment or through wage employment. The children with disabilities (CWD) need this all the more, to supplement their differential talents so that they can prepare themselves for a happy, productive and useful life. Special education becomes all the more important for mentally ill persons as they are the most neglected section among differently abled too. The government in India has an attitude of neglect as far as special education needs of persons with mental disorders are concerned. This can be verified from the fact that though mental health disorders account for one sixth of all health disorders, yet India spends mere 0.83 per cent of its health budget on mental health. Hence, role of NGOs and charitable institutions becomes all the more important as far as special education opportunities for mentally ill persons are concerned. District Hoshiarpur lies in Doaba region of Punjab and it acclaims to have the highest literacy rate amongst all the districts of Punjab. However, as far as education for mentally ill persons was concerned, there was no government institute for the same. Hence, the present study has been conducted in Ashakiran, the only special school for Mentally Ill persons in District Hoshiarpur established by a charitable society. The present paper will critically analyze the facilities provided by the institute and will also recommend measures to improve the same.

Inclusionary ideals regarding the education of children with disabilities (CWD) are articulated in various international human rights treaties and instruments such as the United Nations Convention on the Rights (2006), the Salamanca Statement (1994), and the 2030 agenda of the UN's Sustainable Development Goals (SDGs). In the latter, the fourth goal explicitly focuses on the removal of barriers to education and supporting access to quality, equity, and inclusion for people with disabilities. Although data regarding access to education among CWD remains scarce, it is well known that rates of their participation in education remain low, particularly among those in LMICs. The research question of this descriptive review is what are the barriers to and facilitators of education for children with disabilities worldwide aged between 6 and 18 years old? A descriptive review of literature published in English between 2013 and 2021 was conducted following the Joanna Briggs Institute (JBI) guidelines for a scoping review using the following databases: EBSCO, SocINDEX with full text (EBSCO), and ERIC (EBSCO). The search resulted in 7,072 titles and abstracts, which were narrowed down to 1,335 papers for full text review. After data extraction, 54 papers were included in the analysis, with 34 being qualitative, 10 quantitative, and 10 mixed-methods studies. The findings on the facilitators and barriers to education for children with disabilities were analyzed using the International Classification of Function, Disability and Health (ICF) and Urie Bronfenbrenner's Ecological Framework (1979). Out of the eligible studies included in our research, 40 were conducted in developing countries, while 14 studies conducted on LMICs. Of the five environmental domains in the ICF, the most significant barriers were found to be that of attitudes and services, while technology and effective communication with school staff were found to play a crucial role in facilitating the education process. Applying Bronfenbrenner's framework, barriers occurred at the micro-system (school level), meso-system (parent and teacher communication), exo-system (services), and macro-system (education policy). Only 3 out of the 54 studies included the voices of CWD. Despite documented barriers, facilitators of education for CWD are underexplored, lacking research on their voices. Further investigation is needed.

Aim of the study is to assess “Elements contributing to limited participation of children with disabilities (CWDs) in school based sport extracurricular activities” using descriptive survey design. The study participants were purposely selected (n=36). Observation using check lists, semi structured questionnaires and structured interview was administered. And the data obtained was analyzed qualitatively and quantitatively. As the findings shows opportunities to participate in school based sport extracurricular activities are unequal among disabled and non-disabled children in schools which is in contrast with UN convention on the rights of persons with disabilities [12] which states to ensure that children with disabilities have equal access with other children to participation in play, recreation, leisure and sporting activities, including those activities in the school system. This limited CWDs to get the (Physical, Social and Psychological) benefits of participation in sport extracurricular activities. Lack of opportunities for participation, disability sport competitions at school level, poor facilities, poor school compound, poor student to student support and lack of awareness on including CWDs in sport activities are found as contributing elements. Recommendations: support professional development and mentorship opportunities for volunteer staffs, physical education teachers and create awareness on inclusive issues, all members of the sport extracurricular activities should be tasked with ensuring that CWDs feel welcome to participate, promote sports that embrace diversity and open them to all participants regardless of ability, pair CWDs with partners without disabilities on teams for competition and schools should prepare disability sport competitions as they prepare for non – disabled ones, by doing this, they can show the ability of disabled students.

This research study focused on an investigation into the factors contributing to the dropout of children with disabilities (CWD) in rural schools in Uganda with a case study of Ntungamo District. Questionnaires interviews were carried out by the research team. The data collected was compiled and analyzed. Findings indicated that majority of the respondents were in agreement that social and economic needs of children with disabilities is the major factor that contributes to the drop out of children with disabilities from rural schools. Other outcomes show that shortage of staff in schools contributes to drop out of children with disabilities, poor teachers attitudes towards the disabled children, poor government policies, hatred and discrimination against the disabled children, absence of morale by teacher's, lack of special equipment for teaching children with special needs was also averagely supported. The study recommends that the Government of Uganda and the responsible ministry put aspects of inclusion of all children into consideration, and also provide the necessary financial support as well as intensifying long life learning programs for special needs teachers with focus on primary education among other levels. Further comprehensive research ought to be of paramount importance in understanding challenges facing CWD.

This article explores the development of a sustainable training programme supporting the inclusion of children with disabilities in early childhood, education and care (ECEC) centres in Malawi. This programme is based on a review of literature of curriculum, pedagogy and teaching approaches in ECEC in sub-Saharan Africa, alongside a review of national policy documents. The training was designed to enable staff to value the inclusion of children with disabilities in ECEC centres, as well as suggesting practical ways to do so. We set out our response to the gap in training of ECEC staff through the development of a supplementary integrated training programme, which, whilst respectful of the curriculum, policy and practice of Malawi, challenged staff to consider ways of including children with disabilities (CWD) and their families. We suggest this is a pragmatic and sustainable model that could be applied to training in other ECEC settings across the region in sub-Saharan Africa. It concludes with guiding principles for training those working in ECEC with young children with disabilities in low-income countries.

Inclusive education is an education method in which children with disabilities (CWD) are educated with non-disabled peers in the same high school system right in the community where their families and children live. This is a progressive education model that comes from the view that every child has the right and opportunity to learn according to the needs and abilities of each child. In this educational environment, children with disabilities are equal with other children in all physical, cultural, and social aspects; Children with disabilities will be provided with all conditions to meet their needs and maximize the potential available to them. Therefore, children are fully developed in personality, participate and affirm their contribution to society. STEAM education with the orientation of integrating science - technology - engineering - art - math elements is considered as an effective solution suitable to the diverse learning characteristics of children with disabilities in an inclusive classroom. contribute to improving the quality of education for children with disabilities today.

Background. Eighty-five percent of children with disabilities (CWD) live in developing countries, and <5% receive rehabilitation services.Purpose. To describe perceptions of disability among mothers of CWD in Bangladesh, and to explore how these perceptions influence the care sought for their CWD.Methods. Descriptive qualitative research methods were employed. Eleven semi-structured interviews were conducted with mothers of CWD receiving services at a large pediatric rehabilitation facility in Bangladesh. Interviews were recorded and transcribed, and data were coded and analyzed to identify themes.Results. Three primary categories of themes emerged: (1) mothers' perceptions of disability; (2) perceptions of treatment; and (3) expectations for the future of their CWD. The findings suggest that the family members, healthcare providers, and the rehabilitation setting have a considerable influence on mothers' perceptions. Study participants had adopted a biomedical understanding of disability and treatment, but reported that family elders continued to believe strongly in traditional explanations creating conflict regarding appropriate treatment approaches. Participants suggested that education and peer support networks provided in the rehabilitation setting played (or could play) a critical role in addressing these conflicts.Conclusion. Understanding mothers' perceptions of disability and treatment, and the myriad of factors that influence those perceptions, provides valuable knowledge to assist in planning and delivery of family centered rehabilitation services for CWD. Rehabilitation has a central role to play in assisting mothers' understanding of the nature of their children's disabilities and how they can be managed. Ultimately, such an understanding may translate into improved social and educational opportunities for CWD.

Having a child with a disability does not happen to all families. Parents of children with disabilities have to go through an acceptance process without a specific blueprint as parents use different coping mechanisms and are influenced by several factors. This study aims to analyze parents' acceptance process and their aspirations for their child with CWD. Seven participants were selected through snowball sampling method and underwent semi-structured in-depth interviews for data collection while the instrument used was an interview sheet. Data analysis was conducted using the interpretive phenomenology (IPA) approach which resulted in high-level themes. The results showed that the process of parental acceptance includes different internal processes that are categorized into superordinate themes namely: discovering disability, facing reality, reconstructing a new normal, dealing with the situation, making peace, hoping for a better future, and advocating for an inclusive tomorrow. It can be concluded that parents of children with disabilities (CWD) face a unique and complex process of acceptance after learning of their child's disability. The implication of this study is the importance of interventions that focus on increasing social support and adequate health facilities for families with CWD.

Education is critical for expanding the life prospects of all children, including children with disabilities (CWDs). Inclusive, equitable, and empowering education systems can help build strong, inclusive, and equitable societies. This organic connection between education and society lies at the heart of creating change and achieving social justice. Inclusive education over the last decade has become a frequently used concept in international literature and has been accorded legitimacy through various international declarations. The concept of ‘inclusive education’ has become an international buzzword and has been adopted in the rhetoric of many countries across the globe. Inclusion is an effort to make sure that diverse learners, those with disabilities, and normal children get education together under a roof in the same compound and classroom, irrespective of their strengths and weaknesses. India is a diverse country that has traditionally valued differences. However, the country is also highly stratified socio-economically. Disability has been traditionally perceived as a serious handicap, a deviation from normality, resulting in discrimination and disadvantage. For decades, the education system has either disregarded or struggled with the idea of integrating children with disabilities into mainstream schools. Inclusion has, therefore, remained only a goal on paper. The Government of India has provided a comprehensive range of services for the education of children with disabilities over the past five decades. The policy on education in India has gradually placed a greater emphasis on children with special needs, and inclusive education in regular schools has become a primary policy goal.

The present study aimed to explore parents’ attitudes towards including children with disabilities (CWDs) in public kindergartens (KGs) in Jordan. A questionnaire was developed and distributed to 250 parents of CWDs and others without disabilities at the kindergarten stage. The results revealed that most respondents had neutral attitudes towards including CWD issues in public KG, and about 36.4% of parents held negative attitudes. The results of multiple regression analysis also indicated that the parent’s gender, age, having a CWD, and degree of disability, were considered statistically significant predictors of the parents’ attitudes towards including CWDs in public kindergartens. Implications of the findings and recommendations are provided.

Childcare centers (CCCs) can provide opportunities to implement physical activity (PA) via health promotion interventions to prevent obesity and associated chronic disease risk factors in young children. This study evaluated the impact of the Healthy Caregivers-Healthy Children (HC2) intervention on body mass index percentile (PBMI) and the PA environment in CCCs serving children with disabilities (CWD) over one school year. Ten CCCs were cluster-randomized to either (1) an intervention arm that received the HC2 curriculum adapted for CWD or (2) an attention control arm. Mixed-effect linear regression models analyzed the relationship between change in child PBMI and CCC childcare center PA environment by experimental condition and child disability status over one school year. Findings showed a significant decrease in PBMI among children in the HC2 centers (-6.74, p = 0.007) versus those in control centers (-1.35, p = 0.74) over one school year. Increased PA staff behaviors (mean change 3.66, p < 0.001) and PA policies (mean change 6.12, p < 0.001) were shown in intervention centers during the same period. Conversely, there was a significant increase in sedentary opportunities (mean change 4.45, p < 0.001) and a decrease in the portable play environment (mean change -3.16, p = 0.03) and fixed play environment (mean change -2.59, p = 0.04) in control centers. No significant differences were found in PBMI changes between CWD and children without disabilities (beta = 1.62, 95% CI [-7.52, 10.76], p = 0.73), suggesting the intervention's efficacy does not differ by disability status. These results underscore the importance of (1) including young CWD and (2) PA and the supporting environment in CCC health promotion and obesity prevention interventions.

A systematic review of academic performance of Children with Disabilities (CWDs) in inclusive education schools in Low and Middle-Income Countries (LMICs)

BackgroundThe burden of disability is more severe among children in low income countries. Moreover, the number of children with disabilities (CWDs) in sub-Saharan Africa is predicted to increase with reduction in child mortality. Although the issue on CWDs is important in sub-Saharan Africa, there are few researches on risk factors of disabilities. The purpose of this study was to evaluate the risk factors of neurological impairment (NI) among children in western Kenya.MethodsThe present study was conducted in Mbita district (which has high HIV infectious prevalence), Kenya from April 2009 to December 2010. The study consisted of two phases. In phase 1, the Ten Question Questionnaire (TQQ) was administered to all 6362 caregivers of children aged 6–9 years. In phase two, all 413 children with TQQ positive and a similar number of controls (n=420) which were randomly selected from children with TQQ negative were examined for physical and cognitive status. In addition, a structured questionnaire was also conducted to their caregivers.ResultsThe prevalence was estimated to be 29/1000. Among the types of impairments, cognitive impairment was the most common (24/1000), followed by physical impairment (5/1000). In multivariate analysis, having more than five children [adjusted odds ratio (AOR): 2.85; 95%IC: 1.25 – 6.49; p=0.013], maternal age older than 35 years old [AOR: 2.31; 95%IC: 1.05 – 5.07; p=0.036] were significant factors associated with NI. In addition, monthly income under 3000 ksh [AOR: 2.79; 95%IC: 1.28 – 6.08; p=0.010] and no maternal tetanus shot during antenatal care [AOR: 5.17; 95%IC: 1.56 – 17.14; p=0.007] were also significantly related with having moderate/severe neurological impairment.ConclusionIt was indicated that increasing coverage of antenatal care including maternal tetanus shot and education of how to take care of neonatal children to prevent neurological impairment are important.

Background: Early rehabilitation interventions can significantly mitigate the effects of disabilities in children as they grow older. However, families of children with disabilities (CWDs) in resource-deprived settings face limited opportunities to access rehabilitation services for their children resulting in largely unmet rehabilitation needs.Aim: This study assessed knowledge of families of CWDs on rehabilitation services and accessibility to services for their children.Setting: The study was carried out in the selected districts in the Upper West Region, Ghana.Methods: Families that knew about rehabilitation services and acknowledged their child’s need for one were the subjects of this cross-sectional, quantitative study, using a researcher-administered questionnaire. STATA software was utilised for analysis.Results: Over half of the participants, 113 (54.85%), attempted to access rehabilitation services for their children, but only 31 (27.18%) were successful. The barriers to access included financial problems (n = 197 [95.63%]), shyness (n = 167 [81.07%]), transportation issues (n = 155 [75.24%]), community discouragement (n = 145 [70.39%]) and the attitudes of healthcare providers (n = 145 [70.39%]). Among those who accessed rehabilitation services, over half reported dissatisfaction with travel distance and associated costs (n = 18 [58.06%]), as well as travel time and wait time for services (n = 15 [48.39%]). Participants with no formal education (adjusted odds ratio [AOR] = 0.22; 95% confidence interval [CI]: 0.07, 0.59) and those who agreed that negative attitudes from health personnel were a barrier to access (AOR = 0.08, 95% CI: 0.00–1.01) were less likely to access rehabilitation services for their children.Conclusion: The low access to rehabilitation services suggests that many CWDs may miss relevant rehabilitation services that could improve their health outcomes and functioning. Policy interventions are required to facilitate families’ access to rehabilitation services for their children.Contribution: This study contributes to the literature on rehabilitation care in Ghana and provides a foundation for further research in rehabilitation care in the Upper West Region, as it is the first of its kind conducted in the region.