“Being disabled should not mean being disqualified
from having access to every aspect of life.” – Emma Thompson Chapter 1: Understanding Disabilities and Vulnerabilities 1.1 Definitions of Basic Terms (Impairment, Disability and Handicap)
1. Impairment: refers to any loss or
abnormality of physiological, psychological or anatomical structure or function It is an absence of or significant difference in person‗s body structure or function or mental functioning e.g., Loss of limbs or loss of vision 2. Disability: is a restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being (e.g- Difficulty walking or reading). 3. Handicap: refers to a disadvantage for an individual that limits or prevents the fulfillment of a role that is normal. It is a physical or attitudinal constraint that is imposed upon a person, regardless of whether that person has a disability. e.g., Lack of wheel chair/Ramp or eyeglasses) In short Impairment refers to the person‗s lose in body structure or function, or mental functioning; examples of impairments include loss of a limb, loss of vision or memory loss. Disability refers to activity limitation, such as difficulty seeing, hearing, walking, or problem solving. Handicap refers to Participation restrictions in normal daily activities, such as working, engaging in social and recreational activities, and obtaining health care and preventive services. The full inclusion of people with impairments in society can be inhibited by: 1. Attitudinal (societal barriers, such as stigma) 2. Physical barriers (environmental barriers, such as absence of stairs), and 3. Policy barriers (systemic barriers) If these problems/ barriers addressed, impairment may not lead to disability • We have to be very sensitive to words we use in regard to disability. Use ―a child with disability, not ―a disabled child 1.2. Causes of disability Disability can be caused by the following factors. Genetic Causes:- Abnormalities in genes and genetic inheritance can cause intellectual disability in children. In some countries, Down syndrome is the most common genetic condition. Sometimes, diseases, illnesses, and over-exposure to x-rays can cause a genetic disorder. Environmental Poverty and malnutrition in pregnant mothers can cause a deficiency The use of drugs, alcohol, tobacco, the exposure to certain toxic chemicals and illnesses, toxoplasmosis, cytomegalovirus, rubella and syphilis by a pregnant mother can cause intellectual disability to the child Unfortunate life events such as drowning, automobile accidents, falls and so on can result in disabilities. Unknown Causes:- The human body is a phenomenal thing. Scientists have still not figured out what and how some things in the body, cells, brain, and genes come about. Humans have still not found all the answers to all the defects in the human body Inaccessible environments:- Sometimes society makes it difficult for people with some impairment to function freely. Lack of education, support services, health opportunities for people with impairment can cause additional disability to people with disabilities and even people with no disability. 1.3. SOME TYPES OF DISABILITIES These are children who have at least one of the following conditions: 1. Visual impairment, 2. Hearing impairment 3. Learning disabilities 4. Speech and Language Impairments 5. Autism 6. Emotional & Behavioral disorder 7. Intellectual differences 8. Physical disability 9. Vulnerability 1. Visual Impairment The WHO definitions of Visual impairment is based on visual acuity scores. Visual acuity is the ability to see or distinguish small objects at a distance. Visual acuity is measured using Snellen chart, a clinical measure in which they test distance, usually 6 meters/20 feet/ is recorded as the numerator. • The term blind is used to describe children who rely predominantly on tactile methods in their learning ( e.g., Braille; Perkins). A person with low vision is one who has difficulty accomplishing visual tasks, but who can enhance his/her ability to accomplish these tasks with the use of visual aids and environmental modifications. People with low vision may have a visual impairment that affects only central vision—the area directly in front of the eyes—or peripheral vision—the area to either side of and slightly behind the eyes. 2. Hearing impairment It is the most prevalent sensory deficit in the human population (1 in 800 children born with a serious HI and more than 60 percent of people aged over 70 suffer from HI. Different definitions are used in different countries for different purpose. From legal perspective, HI is a generic term indicating a continuum of hearing loss from mild to profound. 2.1. Hard of hearing: refers to difficulty hearing but (usually with hearing aids) can use hearing as a primary modality of acquisition of language and in communication with others. 2.2. Deaf: refers those who have difficulty understanding speech, even with hearing aids but can communicate in sign language. From causative factors perspective, HI can be divided into two categories: Sensori-neural Hearing loss: may arise from genetic disorders, diseases and other events during pregnancy, from the act of birth itself. Conductive hearing loss: is the single commonest cause of hearing loss, where fluid invades the air space in the middle ear. The fluid prevents the efficient conduction of sound through the chain of bones in the middle ear. Hearing loss is measured using audiometer and expressed in terms of decibels (dB), the unit used to measure intensity of sound. The larger the number of decibels needed, the more severe the hearing loss. Children with a mild to moderate hearing loss are those for whom the oral/aural approach is usually recommended and is most successful. This involves training in listening with amplification so that the best use is made of residual hearing together with lip reading. The profoundly deaf however communicate through Sign language Degree of loss (dB) Level of hearing loss Description of the problem 25-40 dB Mild hearing loss has difficulty responding to conversational speech especially with background noise 40-70 dB Moderate loss -Has difficulty with all conversational speech. -Perception is better with amplification and use of visual clues like lip reading. 70-95 dB severe loss Difficulty with perceiving amplified speech without the aid of lip reading 95 dB & above Profound loss -Can respond to some amplified speech, but little information of sign language is a socially accepted mode of communication among the deaf, which has its own grammatical structure. 3. Learning Disability (LD) refers to a disorder in one or more of the basic psychological processes involved in understanding or in using language, spoken or written and mathematics. LD manifest itself in the imperfect ability to listen, think, speak, read, write, spell, or to do mathematical calculations. LD should not be confused with learning problems which are primarily the result of sensory, or motor disorder; of intellectual disability; of emotional disturbance; or of environmental, cultural or economic disadvantages There often appears to be a gap between the individual‗s potential and actual achievement. It is some times called ―hidden disability. A learning disability cannot be cured or fixed; It is a lifelong challenge. Types of Learning Disability 3.1. Auditory Processing Disorder (APD): Individuals with APD do not recognize subtle differences between sounds in words. 3.2. Language Processing Disorder: It is a specific type of Auditory Processing Disorder (APD) While an APD affects the interpretation of all sounds coming into the brain, LPD relates only to the processing of language 3.3. Dyslexia: is a specific learning disability that affects reading and related language-based processing skills 3.4. Dysgraphia: is a specific learning disability that affects a person‗s handwriting ability and fine motor skills. 3.5. Dyscalculia: is a specific learning disability that affects a person‗s ability to understand numbers and learn math. Individuals with this type of LD may also have poor comprehension of math symbols, may struggle with memorizing and organizing numbers, have difficulty telling time, or have trouble with counting 3.6. Non-Verbal Learning Disabilities: Difficulty interpreting nonverbal cues like facial expressions or body language 3.7. Visual Perceptual/Visual Motor Deficit: is a disorder that affects the understanding of information that a person sees, or the ability to draw or copy 4.Speech and Language Impairments This Disability category can be divided into two groups: speech disorder and language disorder. A. Speech Disorder: There are three basic types of speech disorders: articulation disorders, fluency disorders, and voice disorders a. Articulation Disorders: include such problems as: Omission: (bo for boat) Substitutions: (wabbit for rabbit) Distortions: (shlip for sip) Addition b. Fluency Disorders: are difficulties with the rhythm and timing of speech characterized by hesitations, repetitions, or prolongations of sounds, words, or phrases. Stuttering: rapid-fire repetitions of consonant or vowel sound. Cluttering: excessively fast and jerky speech c. Voice disorders : are problems with the quality or use of one's voice resulting from disorders in the larynx characterized by abnormal production and/or absences of vocal quality, pitch, loudness, resonance, and/or duration. B. Language disorder: There are five basic areas of language disorders: a. Phonological disorders: abnormal organization of the phonological system, or a significant deficit in speech production or perception. b. Morphological disorders: difficulties with morphological inflections on nouns, verbs, and adjectives that signal different kinds of meanings. c. Semantic disorders poor vocabulary dev‗t, inappropriate use of word meanings, and/or inability to comprehend word meanings d. Syntactic deficit: difficulty in acquiring the rules that govern word order and others aspects of grammar (e.g., subject-verb agreement) e. Pragmatic difficulties: are characterized as problems in understanding and using language in different social contexts 5. Autism Autism refers to a developmental disability significantly affecting verbal and nonverbal communication and social interaction of a child. It is a pervasive developmental disorder characterized by lack of sociability, impaired communication and repetitive obsessive behavior such as politeness, turn- taking.
Linked to Profound Learning Disability (PLDs) are further impairments
in the production of speech. Among these are (i) personal pronouns reversal (ii) the misuse of such preposition and (iii) the prevalence, in speech, of echolalia formal repetition of other‘s utterances 6. Emotional and Behavioral Disorders A condition exhibiting one or more of the following characteristics over a long period of time and to a marked degree that adversely affects educational performance: An inability to learn that cannot be explained by intellectual, sensory, or health factors; An inability to build or maintain satisfactory interpersonal relationships with peers and teachers; Inappropriate types of behavior or feelings under normal circumstances; A general pervasive mood of unhappiness or depression; or A tendency to develop physical symptoms or fears associated with personal or school problems. Classification of behavioral and emotional disorders Different professionals have developed a classification system, which shows some promise for educational practice. These include: A. Conduct disorder: individuals may seek attention, are disruptive and act out. • The disorder is classified by type: overt (with violence or tantrums) versus covert (with lying, stealing, and/or drug use). B. Socialized aggression: individuals join subculture group of peers who are openly disrespectful to their peers, teachers, and parents. • Common are delinquency and dropping out of school. Early symptoms include stealing, running away from home, habitual lying, cruelty to animals, and fire setting. C. Attention problems- These individuals may have attention deficit, are easily destructible and have poor concentration. They are frequently impulsive and may not think the consequence of their actions. D. Anxiety/Withdrawn- These individuals are self-conscious, reserved, and unsure of themselves. They typically have low self- esteem and withdraw from immediate activities. They are also anxious and frequently depressed. E. Psychotic behavior: These individuals show more bizarre behavior. They may hallucinate, deal in a fantasy world and may even talk in gibberish. Causes of behavioral and emotional disorders Biological factors- genetic disorders, brain damage, and malnutrition, allergies, temperament and damage to the central nervous system. Family factors- include family interactions, child abuse, neglect, and poor disciplinary practices Cultural factors- include some traditional and cultural negative practices, for example watching violence and sexually oriented movies and TV programs. Environmental factors- include peer pressure, living in impoverished areas, and schooling practices that are unresponsive to individual needs Kauffman (1993) conclude that EBD fall into two broad classifications: Externalizing Behavior: also called under controlled disorder, include such problems disobedience, disruptiveness, fighting, tempers tantrums, irresponsibility, jealous, anger, attention seeking etc… Internalizing Behavior: also known as over controlled disorders, include such problems anxiety, immaturity, shyness, social withdrawal, feeling of inadequacy (inferiority), guilt, depression and worries a great deal 7. Intellectual disability is a disability characterized by significant limitations in both intellectual functioning and in adaptive behavior. Intellectual functioning: refers to general mental capacity, such as learning, reasoning, problem solving, and so on One way to measure intellectual functioning is an IQ test. An IQ test score of 75 an below indicates a limitation in intellectual functioning. Adaptive behavior: involves conceptual, social, and practical skills that are learned and performed by people in their everyday lives. Conceptual skills- language and literacy; money, time, and number concepts; and self- direction Social skills- interpersonal skills, social responsibility, self-esteem, social problem solving, and the ability to follow direction. Practical skills- activities of daily living, occupational skills, healthcare, travel, safety, use of money, use of the telephone. An individual who show a deficiency in one/more of these adaptive skills is taken as having Intellectual disability. The academic learning of intellectually disabled children and their adaptive skill at home, school, and community environments is as follows General Cognition: Their apparent slowness in learning may be related to the delayed rate of intellectual development Learning and Memory: The learning and memory capabilities of people with intellectual disabilities are significantly below average in comparison to peers without disabilities. Attention: Children with intellectual disabilities may have difficulty distinguishing and attending to relevant questions in both learning and social situations (Saunders, 2001). Adaptive Skills: A child with intellectual disabilities may have difficulty in both learning and applying skills for a number of reasons, including a higher level of distractibility, inattentiveness, failure to read social cues, and impulsive behavior Speech and Language: People with intellectual disabilities may have delayed speech, language comprehension and formulation difficulties. Motivation: People with intellectual disabilities are often described as lacking motivation, or outer-directed behavior. Academic Achievement: The cognitive difficulties of children with mild to moderate intellectual disabilities lead to persistent problems in academic achievement Physical characteristics: Children with intellectual disabilities with differing biological etiologies, may exhibit coexisting problems, such as physical, motor, orthopedic, visual and auditory impairments and health problems 8. Physical disability is a condition that interferes with the individual‗s ability to use his or her body. It includes orthopedic impairments, which refers to conditions of muscular or skeletal system and sometimes to physical disabling conditions of the nervous system. Classification and Characteristics: Based on the impact of physical disability on mobility and motor skills, it is divided into three: A. Mild physical disability:- Individuals have minor problems and walk without aids. B. Moderate physical disability:- individuals can walk with braces and crutches and may have difficulty with fine-motor skills and speech production. C. Severe physical disability:-individuals who are wheel-chair dependent and may need special help to achieve regular development. Physical disability can also be broadly classified in to two groups: The neurological system (the brain, spinal cord & nerve) related problems. Musculo-skeletal system (the muscles, bones and joints) are deficient due to various causes. I. Neurological system:-with a neurological condition like cerebral palsy or a traumatic brain injury, the brain either sends the wrong instructions or interprets feedback incorrectly. Epilepsy: is disorder that occurs when the brain cells are not working properly and is often called a seizure disorder Spinal bifida: damage to the spinal cord leads to paralysis and loss of sensation in the affected areas of the body . II. Musculoskeletal system:- It includes the muscles and their supporting framework and the skeleton.
A. Muscular dystrophy:- is an inherited condition accruing
mainly in males, in which the muscles weaken and deteriorate B. Arthritis:-is an inflammation of the joints. Symptoms include swollen and stiff joints, fever, and pain in the joints during acute periods C. Amputation:- a small number of children have missing limbs because of congenital abnormalities or injury or disease (malignant bone tumors in the limbs) D. Polio:- is viral disease that invade the brain and cause severe paralysis of the total body system. E. Club foot:- is a major orthopedic problem affecting about 9,000 infants each year. This term is used to describe various ankle or foot deformities, i.e F. Cleft lip and cleft palate:- are openings in the lip or roof of the mouth, respectively, that fail to close before birth, the cause is unknown. • Most cleft problems can be repaired through surgery. G. Health Impairments:-Any disease that interferes with learning can make students eligible for special services. These disease caused problems are as follow: 1. Heart disease 2. Diabetes: 3. Allergy 4. HIV/ AIDS 5. Corona Virus, etc. 9. Vulnerability An individual is said to be vulnerable when he/she is at risk of being harmed. In principle, everyone is vulnerable to some adverse event or circumstance, but some people are more vulnerable than others. Vulnerability can be generally defined as a complex phenomenon that refers to the following dimensions: Economic difficulties/poverty Social exclusion Lack of social support from social networks Stigmatization Health problems Being a victim of crime 1.9.1.CAUSES OF VULNERABILITY • Vulnerability may be causes by rapid population growth, poverty and hunger, poor health, low levels of education, gender inequality, fragile and hazardous location, lack of access to resources and services, including knowledge and technological means, disintegration of social patterns (social vulnerability). lack of access to information and knowledge, lack of public awareness, limited access to political power and representation (political vulnerability), (Aysan,1993). 1.9.2. WHO ARE MORE VULNERABLE? A. Women: particularly women in developing nations and those who are living in rural areas are vulnerable for many backward traditional practices. B. Children: Significant number of children are vulnerable and at risk for development C. Minorities: some people are vulnerable due to their minority background. Particularly, ethnic (cultural and linguistic minority), religious minority. D. Poverty: People are vulnerable for many undesirable phenomena due to poverty. E. Disabilities: People with disabilities very much vulnerable for many kind of risks. This includes abuses, poverty, illiteracy, health problems, psychological and social problems Age: Old people or very young children are vulnerable for all kinds evils 1.9.2. WHO ARE MORE VULNERABLE(CONT’D) G. Illiteracy and less education: People with high rates of illiteracy and lack quality educational opportunities are vulnerable for absence all kinds of developments H. Sickness: Uncured health problems for example people living with HIV/AIDS are much vulnerable for psychosocial problems, poverty and health I. Gifted and Talentedness: Gifted and talented children are vulnerable for socio emotional developments due to lack of psychological support CHAPTER-TWO THE CONCEPT OF INCLUSION
2.1. Definition of Inclusion
Inclusion is seen as a process of addressing and responding to the diversity of needs of all persons through increasing participation in learning, employment, services, cultures and communities, and reducing exclusion at all social contexts. Inclusive education refers to an ongoing process aimed at offering quality education/services for all while respecting diversity and the different needs and abilities, characteristics and learning expectations of the students and communities and eliminating all forms of discrimination (UNESCO, 2008). It involves changes and modifications in content, approaches, structures and strategies, with a common vision which covers all children of appropriate age range (UNESCO 2005). The fundamental principle of inclusion is that all persons should learn, work and live together wherever possible, regardless of any difficulties or differences they may have. Inclusive education extends beyond special needs arising from disabilities, and includes consideration of other sources of disadvantage and marginalization such as gender, poverty, language, ethnicity, and geographic isolation. UNESCO (2005) has provided four major inclusion principles: 1. Inclusion is a process. It has to be seen as a never- ending search to find better ways of responding to diversity. 2. Inclusion is concerned with the identification and removal of barriers that hinders the development of persons with disabilities. 3. Inclusion is about the presence, participation and achievement of all persons. 4. Inclusion gives emphasis to those who may be at risk of marginalization, exclusion or underachievement. 2.2. Rationales for inclusion A. Educational Foundations Children do better academically, psychologically & socially in inclusive settings. A more efficient use of education resources. Decreases dropouts and repetitions Teachers competency( knowledge, skills, collaboration, satisfaction etc. B. Social Foundation Segregation teaches individuals to be fearful, ignorant and breeds prejudice. All individuals need an education that will help them develop relationships and prepare them for life in the wider community. Only inclusion has the potential to reduce fear and to build friendship, respect and understanding. C. Legal Foundations All individuals have the right to learn and live together. Human being shouldn‗t be devalued or discriminated against by being excluded or sent away because of their disability. There are no legitimate reasons to separate children from their education D. Economic Foundation Inclusive education has economic benefit both for individual and for society. Inclusive education is more cost-effective than the creation of special schools across the country. Children with disabilities go to local schools Reduce wastage of repetition and dropout Children with disabilities live with their family use community infrastructure E. Foundations for Building Inclusive Society Formation of mutual understanding and appreciation of diversity Building up empathy, tolerance and cooperation Promotion of sustainable development 2.3. Benefits of Inclusion A. Benefits for Students with Special Needs Education In inclusive settings people will develop: Appropriate models of behavior Improved friendships with the social environment Increased social initiations, interactions, relationships and networks Gain peer role models for academic, social and behavior skills Increased achievement of individualized educational program (IEP) goals Greater access to general curriculum Enhanced skill acquisition and generalization in their learning B. Benefits for persons without Special Needs Education Students without special educational needs (SEN) will: Have a variety of opportunities for interacting with their age peers who experience SEN in inclusive school settings. Serve as peer tutors during instructional activities Play the role of a special ‗buddy‗ during lunch, in the bus or playground. Gain knowledge of a good deal about tolerance, individual difference, and human exceptionality. Learn that students with SEN have many positive characteristics and abilities. C. Benefits for Teachers and Parents/Family I. Benefits for Teachers They have more opportunities to learn new ways to teach different kinds of students. They gain new knowledge, such as the different ways children learn and can be taught. They develop more positive attitudes and approaches towards different people with diverse needs. II. Benefits for Parents/Family Learn more about how their children are being educated in schools with their peers in an inclusive environment Become personally involved and feel a greater sense of accomplishment in helping their children to learn. Feel valued and consider themselves as equal partners in providing quality learning opportunities for children. Helps break down barriers and prejudice that prevail in the society towards persons with disability. Communities become more accepting of difference, and everyone benefits from a friendlier, open environment that values and appreciates differences in human beings. 2.4. Inclusive Environment An inclusive environment is one in which members feel respected by and connected to one another. It is an environment that welcomes all people, regardless of their disability and other vulnerabilities. An inclusive service environment is respectful, supportive, and equalizing. An inclusive environment has the following major characteristics: o it meets current accessibility standards to the greatest extent possible to all people with special needs o it ensures the respect and dignity of individuals with disabilities o provides accommodations willingly and proactively Though many countries seem committed to inclusion their rhetoric, and even in their legislation and policies, practices often fall short. The major barriers include: Problems related with societal values and beliefs- particularly the community and policy makers negative attitude towards students with disability and vulnerabilities. Economic factors- this is mainly related with poverty of family, community and society at large Lack of stakeholders taking responsibility in their cooperation Conservative traditions among the community members about inclusion Lack of knowledge and skills among teachers regarding inclusive education Rigid curricula, teaching method and examination systems that do not consider students with dives needs and ability differences. Fragile democratic institutions that could not promote inclusion Inadequate resources and inaccessibility of social and physical environments Globalization and free market policy that make students engage in fierce competition, individualism rather than cooperation Using inclusive models that may be imported from other countries. CHAPTER THREE CHAPTER THREE IDENTIFICATION AND DIFFERENTIATED SERVICES IFFERENTIATED SERVICES 3.1 Impact of Disability and Vulnerability on daily life 1. The Nature of the Disability: Disability can be acquired (as result of an accident, or acquired disease) or congenital (present at birth). If the disability is acquired, it is more likely to cause a negative reaction than a congenital disability. Congenital disabilities are disabilities that have always been present, thus requiring less of an adjustment than an acquired disability. 2. The Individual‗s Personality - the individual personality can be typically positive or negative, dependent or independent, goal-oriented or laissez-faire. Someone with a positive outlook is more likely to embrace a disability than someone with a negative outlook. 3. The Meaning of the Disability to the Individual: If the disabled is more likely to feel defined by his/her disability and thus it will have a negative impact. 4. The Individual‗s Current Life Circumstances – The individual‗s independence or dependence on others (parents). The economic status of the individual or the individual's caregivers, the individual's education level. 5. The Individual's Support System - The individual‗s support from family, a significant other, friends, or social groups. If so, he/she will have an easier time coping with a disability • 3.2 Economic Factors and Disability people with few economic assets are more likely to acquire pathologies that may be disabling Economic resources can limit the options and abilities of someone who requires personal assistance services or certain physical accommodations Economic factors also can affect disability by creating incentives to define oneself as disabled. 3.3 Political Factors and Disability If the political system is well enforced, it will profoundly improve the prospects of people with disabling conditions for achieving a much fuller participation in society 3.4 Psychological Factors of Disability One's psychological environment, including personal resources, personality traits, and cognition. These constructs affect both the expression of disability and an individual's ability to adapt to and react to it. 3.5 The Family and Disability The family can be either an enabling or a disabling factor for a person with a disabling condition. 3.6 Needs of Persons with Disabilities and Vulnerabilities. All People with disabilities do not share the same experience even of the same impairment. Analyzing human beings, Maslow has identified five categories of needs, with different priority levels.They are order as follows : -survival (physiological), -safety, -social needs, -esteem needs, and -self-actualization (fulfillment). Maslow‘s model is also valid for persons with disabilities and vulnerabilities • Persons with disabilities and vulnerabilities have socio-emotional, psychological, physical and social environmental and economic needs in general. • The following list shows basic needs of persons with disabilities and vulnerabilities to ensure equality: Full access to the environment (towns, countryside & buildings) an accessible transport system technical aids and equipment accessible/adapted housing personal assistance and support inclusive education and training an adequate income equal opportunities for employment appropriate and accessible information advocacy (towards self-advocacy) counseling appropriate and accessible health care 3.6.1. Social Needs of Persons with Disabilities and Vulnerabilities Social protection plays a key role in realizing the rights of persons with disabilities and vulnerabilities of all ages: providing them with an adequate standard of living, a basic level of income security; thus reducing levels of poverty and vulnerability. 3.6.2. Gender and disability The importance of work and the daily activities required of living in the country are paramount in considering gender. Work, particularly paid work, is important for many of the female contributors. Being excluded from work because of others‗ protective or controlling views is particularly difficult for some women. 3.6.3. Identity and disability Identity marked by disability is complex and multilayered. Disability as part of an individual‗s identity is seen by some as a struggle. This is often two fold: internally to individuals and their sense of self and, too often, in the way they are perceived and constructed by those around them. 3.6.4. Belongingness and Disability Persons with disabilities and vulnerable groups have struggled to come to terms with a body and mind which seem unfamiliar to them. They have to make adjustments or accommodations both for themselves and in terms of their relationships with others. 3.7. The Health Care Needs of Persons with Disabilities and Vulnerabilities People with disabilities report seeking more health care than people without disabilities and have greater unmet needs. 3.7.1. Barriers to Health Care for Persons with Disabilities and Vulnerable Groups A. Prohibitive costs: Affordability of health services and transportation are two main reasons why people with disabilities do not receive needed health care in low- income countries. B. Limited availability of services: The lack of appropriate services for people with disabilities is a significant barrier to health care. C. Physical barriers: Uneven access to buildings (hospitals, health centers), inaccessible medical equipment, narrow doorways, internal steps, inadequate bathroom facilities, etc. D. Inadequate skills and knowledge of health workers 3.8. Addressing for Inclusive Barriers to Health Care a. Policy and legislation b. Financing c. Service delivery d. Human resources: Integrate disability inclusion education into undergraduate and continuing education for all health-care professionals. 3.9. Disability, vulnerability and the Environment The prevailing understanding about the cause of disability has undergone profound change worldwide. Previous models viewed pathology and disability interchangeably and that excluded consideration of the environment. They have been replaced by models in which disability is seen to result from the interaction between the characteristics of individuals with disabilities and the characteristics of their environment. Cultural norms affect the way that the physical and social environments of the individual are constituted. Disability is not inherent in an individual but is, rather, a relational concept a function of the interaction of the person with the social and physical environments. The physical and social environments comprise factors external to the individual, including family, institutions, community, geography, and the political climate. There are three types of attributes of the physical environment that need to be in place to support human performance: -Object availability -Accessibility -Availability of sensory stimulation (such as visual, tactile, or auditory cues, serves as a signal to promote responses). 3.10. Creating Welcoming (Inclusive) Environment External environmental modifications can take many forms: Assistive devices, alterations of a physical structure, object modification, and task modification. Rehabilitation must place emphasis on addressing the environmental needs of people with disabling conditions Examples of Environmental Modification 1. Mobility aids Hand Orthosis Prosthetic limb Wheelchair (manual and/or motorized) Canes Crutches Braces 2. Communication aids Voice-activated computer Closed or real-time captioning Computer-assisted note taker Print enlarger Books on tape Sign language or oral interpreters Braille writer Cochlear implant 3. Accessible structural elements Ramps, Elevators Wide doors Safety bars Enhanced lighting 4. Accessible features Built up handles Voice-activated computer Automobile hand controls 5. Job accommodations Simplification of task Flexible work hours Rest breaks Splitting job into parts 6. Differential use of personnel Personal care assistants Note takers Secretaries Editors Sign language interpreters 3.12. Impact of the Social and Psychological Environments on the Enabling-Disabling The social environment is conceptualized to include cultural, political, and economic factors. The psychological environment is the intrapersonal environment. Culture includes both material culture (things and the rules for producing them) and nonmaterial culture (norms or rules, values, symbols, language, ideational systems such as science or religion, and arts such as dance, crafts, and humor). 3.13. Disability Inclusive Intervention and Rehabilitation Services Including people with disabilities in everyday activities and encouraging them to have roles similar to peoples who do not have a disability is disability inclusion. 3.14. Strategies to Disability inclusive intervention and rehabilitation 1. Prevention Prevention of conditions associated with disability and vulnerability is a development issue. Attention to environmental factors – including nutrition, preventable diseases, safe water and sanitation, safety on roads and in workplaces – can greatly reduce the incidence of health conditions leading to disability. 1. Primary prevention – actions to avoid or remove the cause of a health problem in an individual or a population before it arises. It includes health promotion and specific protection (for example, HIV education). 2. Secondary prevention (early intervention) – actions to detect a health and disabling conditions at an early stage in an individual or a population, facilitating cure, or reducing or preventing spread, or reducing or preventing its long-term effects. (e.g., Supporting women with intellectual disability to access breast cancer screening) 3. Tertiary prevention (rehabilitation) – actions to reduce the impact of an already established disease by restoring function and reducing disease related complications. (e.g., Rehabilitation for children with musculoskeletal impairment). Implementing the Twin-track Approach Track 1: Mainstreaming disability as a cross-cutting issue within all key programs and services (education, health, relief and social services, etc) to ensure these programs and services are inclusive. This is done by: gathering information on the diverse needs of persons with disabilities during the assessment stage. Track 2: Supporting the specific needs of vulnerable groups with disabilities to ensure they have equal opportunities to participate in society. This is done by strengthening referral to both internal and external pathways and ensuring that sector programs to provide rehabilitation. Implement Disability Inclusive Project/ Program Concerned with realizing equity, quality services and protecting human rights, all sectorial strategies, program, projects and services must be disability- inclusive. The following tips will help to overcome the challenges as a key considerations for including persons with disabilities in all program and projects: A. Education and vocational training B. Health – vulnerable groups and persons with disabilities(PWD) have the same health-care needs as all other peoples C. Relief and social services – the two-way link between poverty and disability means that vulnerable group and peoples with disabilities and their families need D. Infrastructure and camp improvement, shelter, water and sanitation and environmental health – universal design concepts must be considered E. Livelihoods, employment and microfinance F. Protection – marginalized groups and people with disabilities may face risks & vulnerabilities to experiencing violence, exploitation, abuse, neglect and violation of rights & thus need protection G. Humanitarian and emergency response – the disproportionate effect of emergency and humanitarian situations on vulnerable groups and PWDs should be reflected in the design & implementation of the humanitarian projects. 3.15. Components of Rehabilitation Interventions Rehabilitation is a process designed to optimize function and improve the quality of life of those with disabilities. It involves multiple participants, and it can take on many forms: 1. Multiple Discipline Professionals: Rehabilitation intervention usually involve multiple disciplines and includes such professionals:: Physicians Occupational Therapists Physical Therapists Speech and Language Therapist Audiologists Rehabilitation Nurses Social Workers Rehabilitation Counselors Experts in Orthotics and Prosthetics, etc. 3.16. Persons with the Disability and their Family: The person with the disability and his or her family members are partners in this team process. 3.17. Community Based Rehabilitation It was originally designed for developing countries where disability estimates were very high and the countries were under severe economic constraints. It is defined as ―a strategy within general community development for rehabilitation, equalization of opportunities and social inclusion of all children and adults with disabilities‖(WHO, ILO, UNICEF & UNESCO, 2004). This definition advocates a broad approach for developing programs that involves the following elements: A. The participation of people with disabilities and their representatives at all stages of the development of the program B. The formulation and implementation of national policies to support the equal participation of people with disabilities C. The establishment of a system for program management D. The multi-sectoral collaboration of governmental and nongovernmental sectors to support communities as they assume responsibility for the inclusion of their members who experience disabilities. E. CBR focuses on strengthening the capacity of peoples with disabilities, and their families. F. CBR focuses on challenging negative views and barriers in society to enable equal rights and opportunities. 3.18. Major Objectives of Community Based Rehabilitation: to ensure that people with disabilities are empowered to maximize their physical and mental abilities, have access to regular services and opportunities and become active, contributing members of their communities and their societies CHAPTER 4: PROMOTING INCLUSIVE CULTURE 4.1. definition: an inclusive culture involves the full and successful integration of diverse people into a workplace or industry. They encompass both formal and informal policies and practices, and involve several core values: - Representation: The presence of people with disabilities across a range of employee roles and leadership positions Receptivity: Respect for differences in working styles and flexibility in tailoring positions to the strengths and abilities of employees and – Fairness: Equitable access to all resources, opportunities, networks and decision making processes 4.2. DIMENSIONS OF INCLUSIVE CULTURE There are three dimensions/ elements of an inclusive culture: 1. Universal Design 2. Recruitment, Training and Advancement Opportunities 3. Workplace Accommodations and Accessibility: Policy & Practice 1. Universal Design:-refers to the construction of structures, spaces, services, communications and resources that are organically accessible to a range of people with and without disabilities, without further need for modification or accommodation. This may include: Routinely providing manuals, materials and forms to all employees in a variety of digital formats that are as readily accessible to people who use adaptive computer technologies as to other employees. Building workspaces accessible to people who use wheelchairs or other assistive devices, as well as to all other employees. Providing employees with a variety of flexible schedule and work options. 4.2. DIMENSIONS OF INCLUSIVE CULTURE(CONT’D) 2. Recruitment, Training, & Advancement Opportunities A. Recruitment: Effective recruitment of people with disabilities involves two components: 1. Accessible outreach and hiring practices- outreach and hiring resources generally should be equally accessible to workers with and without disabilities 2. Targeted recruitment of workers with disabilities- targeted recruitment enables employers to reach and interview qualified people with disabilities. Training: Training plays a dual role in the creation of inclusive workplace culture. First, it involves the degree to which people with disabilities have equitable access to training sites, events, and materials. Second it relates to the training of middle management, and human resources staff, to work effectively with all people, including those with disabilities. 4.2. DIMENSIONS OF INCLUSIVE CULTURE(CONT’D) C. Advancement: Research demonstrates that in order to have equitable opportunities for promotion and professional development, like most employees, workers with disabilities typically require access to mentoring. 3. Workplace Accommodations and Accessibility: Policy & Practice Policy plays a critical role in generating meaningful inclusion of people with disabilities. In addition to recruitment, training and advancement, workplace policies need to carefully plan for the provision of reasonable accommodations. 4.3. Benefits of an inclusive organization These are some of the benefits of an Inclusive organization that needs to be considered: - Higher Job Satisfaction
Lower Turnover.
Higher Productivity
Higher Employee Morale
Improved Creativity and Innovation
Improved Problem-Solving
Increased Organizational Flexibility.
4.4. Inclusive community
What is an inclusive community? An inclusive community:
Does everything that it can to respect all its citizens, gives them full access to resources, and promotes equal treatment and opportunity. Works to eliminate all forms of discrimination.
Engages all its citizens in decision-making processes that
affect their lives. Values diversity and
Responds quickly to racist and other discriminating
incidents. 4.4.1. Characteristics of an Inclusive Community Inclusive communities do have the following set of characteristics: Integrative and cooperative: inclusive communities bring people together and are places where people and organizations work together. Interactive: inclusive communities have accessible community spaces and open public places as well as groups and organizations that support social interaction and community activity, including celebrating community life. Invested: inclusive communities are places where both the public and private sectors commit resources for the social and economic health and well-being of the whole community. Diverse: inclusive communities welcome and incorporate diverse people and cultures into the structures, processes and functions of daily community life. Equitable: inclusive communities make sure that everyone has the means to live in decent conditions (i.e. income supports, employment, good housing) and the opportunity to develop one‘s capacities and to participate actively in community life. 4.4.1. Characteristics of an Inclusive Community(cont’d) Accessible and Sensitive: inclusive communities have an array of readily available and accessible supports and services for the social, health, and developmental needs of their populations and provide such supports in culturally sensitive and appropriate ways Participatory: inclusive communities encourage and support the involvement of all their members in the planning and decision-making that affects community conditions and development, including having an effective voice with senior levels of government Safe: inclusive communities ensure both individual and broad community safety and security so that no one feels at risk in their homes or moving around the neighborhood and city. 4.5. HOW INCLUSIVE CULTURE ESTABLISH? There are five stages in establishing inclusive culture: 1. Consider what you want to achieve and what the benefits will be. 2. Undertake an inclusion review of your workplace 3. Decide where work is needed and create an action plan 4. Communicate the plan with staff and put the plan into action. 5. Review, monitor and evaluate the plan’s impact and use what you find to plan future action 4.6. TEN CHARACTERISTICS OF AN INCLUSIVE ORGANIZATION It accepts diversity and inclusion as a way of life It evaluates individual and group performance on the basis of observable and measurable behaviors and competencies. It operates under transparent policies and procedures.
It is consistent in its interactions with everyone
It creates and maintains a learning culture.
It has a comprehensive and easily accessible system of
conflict resolution at all levels It recognizes that it is part of the community that it serves.
It lives its mission and core values.
It values earned privilege over unearned privilege.
It accepts and embraces change.
4.7. INCLUSIVE VALUES Appreciating diversity, equality and equity, cooperativeness, participation, community, and sustainability are examples of inclusive values that are fundamental for successful inclusive education. Indigenous inclusive values and practices Indigenous ways of knowing were often discounted and discredited as non- scientific because they were rooted in the story of the people, their language, culture, art, mythology and spirituality. It was important to recognize the right of indigenous peoples to land, resources and sacred sites. Incorporating Indigenous ways of learning into educational practices has potential to benefit both Indigenous and non- Indigenous learners. 4.8. Inclusive Practices Inclusive practice is an approach to teaching that recognizes the diversity of students, enabling all students to access course content, fully participate in learning activities and demonstrate their knowledge and strengths at assessment Inclusive practice is about the attitudes, approaches, strategies, and talents to ensure that people are not excluded or isolated. It means supporting diversity by accepting welcoming people‘s differences, promoting equality by equal opportunities for all. Inclusive practices in education are based on six principles: 1. Diversity enriches and strengthens all communities; 2. all learners„ different learning styles and achievements are equally valued, respected and celebrated by society; 3. all learners are enabled to fulfill their potential by taking into account individual requirements and needs; 4. support is guaranteed and fully resourced across the whole learning experience; 5. all learners need friendship and support from people of their own age; and 6. all children and young people are educated together as equals in their local communities. Inclusive teaching strategies: refer to any number of teaching approaches that address the needs of students with a variety of backgrounds, learning modalities, and abilities. These strategies contribute to an overall inclusive learning environment in which students feel equally valued. Benefits of Inclusive practices: The benefits of inclusive practices are numerous for both students with and without disabilities. include: Friendships; increased social initiations, relationships and networks; peer role models for academic, social and behavior skills; increased achievement of Individual Educational Plan goals; greater access to general curriculum; enhanced skill acquisition and generalization; increased inclusion in future environments; greater opportunities for interactions; higher expectations; increased school staff collaboration; increased parent participation; and families are more integrated into community. CHAPTER 5 INCLUSION FOR PEACE, DEMOCRACY AND DEVELOPMENT 5.1. definition of Inclusive education Inclusive education is at the heart of any strategy for peace- building, democracy and development. It is through inclusive educational that values, skills and knowledge which form the basis of respect for human rights and democratic principles can be developed. It is through Inclusive education that the rejection of violence, and a spirit of tolerance, understanding and mutual appreciation among individuals, groups and nations can be enhanced. 5.2. Inclusion for Peace Peace is defined as creating mutual understanding, positive relationship between individuals and groups. These groups may include culturally, linguistically, economically and biologically heterogeneous groups. • Peace make the mind quiet and calm prevents anxieties, worries, stress and fears, and awakens inner strength and confidence, develop freedom, happiness, love, joy, justice and gratitude Inclusive education is a foundation for inclusiveness in all aspects of life. It creates equality and equity among divers population. Diversity refers to in terms of language, religion, socioeconomic status, culture and psychology. It is important to realize inclusive education to create a society that is peaceful, democratize and developed. Hence inclusive education is crucial for: Fostering education that promotes the values, attitudes and behavior inherent in a culture of peace, including conflict prevention and resolution, dialogue, consensusbuilding and active non-violence; Promoting sustainable economic and social development by targeting the eradication of poverty and social inequalities; Promoting respect for the Universal Declaration of Human Rights at all levels; Promoting gender equality in economic, social and political decision-making; Fostering democratic participation and citizenship and supporting processes that promote and sustain democracy; Advancing understanding, respect for cultural diversity, and human solidarity by promoting a dialogue among societies; Supporting participatory communication and the free flow and sharing of information and knowledge in the promotion of a culture of peace; Promoting international peace and security through action such as the promotion of general and complete disarmament Sources of Conflict Spiritual sources of conflict Result of original ancestor‘s separation from God and negative influence from evil spiritual forces Individual sources of conflict Disunity within the individual and confusion of values Family sources of conflict Family dysfunctions affect succeeding generations. National/international sources of conflict National policies affect future generations and can lead to conflict within or between nations. How to Resolve Conflict 1.Agree on a mutually acceptable time and place to discuss the conflict 2.State the problem as you see it and list your concerns 3.Let the other person have his/her say 4.Listen and ask questions 5.Stick to one conflict at a time — to the issue at hand 6. Seek common ground 7. Seek for win-win approaches. Sustaining Peace :Building of peace requires taking the following steps: Fostering inclusion, ensuring access to justice, strengthening the social fabric and delivering good governance Reaffirm a commitment to human rights, the foundation for human dignity and just societies. Foster social resilience by strengthening inclusion and addressing inequality Think local and act global: recommit to multilateralism as a safeguard for the most vulnerable National implementation alone will not suffice to achieve the SDGs: Protect and support civil society in fostering sustainable peace Inclusion for Democracy Democracy is a great philosophy of inclusion that born and grown in inclusive schools. It means the rule of the people, by the people, for the people; and where ―people is to mean all human being, regardless of the diversities. Democratic schools are an educational ideal in which democracy is both a goal and a method of instruction. It brings democratic values to education and can include self-determination within a community of equals, as well as such values as justice, respect and trust of diversities. Schools are the ideal place to promote democracy. One of the most important tasks of schools should be helping students to realize the values of democracy. . The democratic values include is to enhance protected right, independent quality life for all, freedom, pursuit of happiness, justice, the common good, truth, respect and tolerance for diversity and partisanship. Democracy is one of the principles of inclusiveness in the process of building inclusive society that begun in schools. Inclusive education is based on the following democratic principles: Diversity enriches and strengthens all communities; all persons with disabilities are different in their needs, potentials, learning and working styles; their achievements according to their potentials should be equally valued, respected and celebrated by society; and all learners should be enabled to fulfill their potential by taking into account individual requirements and needs. Inclusion for Development Development is a positive growth or change in economical, social and political aspects of a country. Any kind of development should be inclusive. Some scholars define inclusive development as a process that occurs when social and material benefits are equitably distributed across divides in society. Inclusive development also has an ―integral focus on the achievement of equity and the rights of citizenship (Hickey, 2013). Inclusive development consists of ensuring that all marginalized and excluded groups are stakeholders in development processes regardless of their gender, ethnicity, age, religion, disability or poverty. If there is no inclusiveness in all walks of life, development cannot be sustainable. Inclusive and sustainable development is crucial to reduce poverty in all its dimensions so that all members of the society are benefitted. The goals of inclusiveness is to prevent social exclusion and creating more social inclusion that aim at including all members of society in the growth process. Social inclusion is an integral part of inclusive development Social inclusion enhances capabilities, broadens social ties of respect and recognition, and at the collective level, enhances social bonds, cohesion, integration and solidarity) among human race(UNDP, 2015). Respecting divers needs, culture, values, demands and ideas These include race, ethnicity, age, ability, language, nationality, socioeconomic status, gender, religion, or sexual orientation. Acceptance and respect, accommodation of beliefs, and ethnic, cultural differences, gender equality, physical and mental disabilities, generation gaps, and language and communication. Diversity may happen in the Workplace Ethnicity (language and cultural differences) Age and Generation differences Gender and Gender Identity Religious and Spiritual Beliefs Disability and Ability Socioeconomic Status and Background Valuing Diversity: Recognizes differences between people and acknowledges that these differences are a valued asset. Multicultural education is an important component of valuing diversity. It respects diversity while teaching all children and youth to become effective and participating members of a democracy. Marginalized group of people People may be marginalized on the basis of the social, gender, cultural, ethnic, economic, social order, beliefs and other factors. Marginal groups can always be identified by members of dominant society, and will face irrevocable discrimination. Marginalized groups exist nearly everywhere. They are people who, for whatever reason, are denied involvement in mainstream economic, political, cultural and social activities. Creating friendly environments for marginalized people 1. Tolerate for the differences opinions and attitudes 2. Seek out marginalized voices and perspectives and provide support 3. Confront your own racist thought and try to be inclusive of all the differences 4. Use your privilege to support marginalized people‘s movements 5. Give your time and money, if possible for the success of inclusive development 6. Be proactive about inclusion in your daily life 7. Avoid segregation 8. Do the work that help to promote inclusiveness “I can’t change the direction of the wind, but I can adjust my sails to always reach my destination.” –Jimmy Dean