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This edition of the Disability inclusion helpdesk summarises the major announcements, events and reports published on 3rd December 2019, International Day of Persons with Disabilities.

This study measured and compared the prevalence of disability and developmental delay among children attending preschool centres in rural Malawi. A cross-sectional survey was conducted in 48 preschool centres in Thyolodistrict, Malawi. Data were collected from parents or guardians of 20 children per centre. Disability was ascertained using the Washington Group/UNICEF Child Functioning Module. Child development was measured using the language and social domains of the Malawi Development Assessment Tool. A total of 960 children were enrolled; 935 (97.4%) children were assessed for disability and 933 (97.2%) for developmental delay; 100 (10.7%) children were identified as having a disability

Child Care Health Dev. 2020;46:187–194.
https://doi.org/10.1111/cch.12741

Since the COVID-19 crisis has been particularly challenging for children with special needs, the Education Above All Innovation Development Directorate (IDD), in collaboration with experts in the field has developed the Activity Bank for Disabilities (ABD), an activity bank for children that require additional and specialized care, in order to support their continued development and learning.

The resources in the ABD have been developed for children with multiple needs. The domains and activities are meant to be chosen, customised and adapted by parents and caregivers depending on the learner needs and abilities. It is recommended that the activities are done under the constant supervision of the caregiver or parent.

Purpose:  The Rashtriya Bal Swasthya Karyakram (RBSK) is an ongoing screening and early intervention programme for children in India. Children with birth defects and developmental disabilities from rural and urban communities are referred for treatment and therapies to early intervention centres located in urban areas. This study primarily aimed at determining caregiver uptake and compliance to referral advice of the RBSK, with the larger goal of determining the utility of the community-based screening and district-based intervention service model for caregivers of children with disabilities.

Method: Three administrative blocks and one municipal corporation area of Pune district, in Maharashtra, were randomly selected. The sample consisted of 115 caregivers of children with disabilities. They were interviewed using a semi-structured questionnaire that investigated uptake of referral advice, treatment outcome, current health status of the child and reasons for noncompliance, three to nine months after the first referral by the RBSK team. 

Results: Sixty-four caregivers were aware of their child’s disability, but most children remained untreated. After screening and referral by the RBSK team, compliance was high for treatable conditions like congenital heart defects. Treatment was discontinued for 83% (24 out of 29) of children with developmental disabilities. Reasons for discontinuation included lengthy waiting time, distance to facility, difficulty in transporting the child, loss of wages, and denial of the child’s disability.

Conclusion and Implications: The results indicated that the RBSK programme provides treatment opportunities for children who are left undiagnosed and untreated in the community. Providing rehabilitation services at district centres is a barrier for service uptake. Alternative models such as early childhood development screening and integrating rehabilitation services at the primary healthcare level may be more feasible to provide services for children with disabilities in India.

Shy children can present challenges for teachers aiming at inclusive classrooms. Their educational attainments can be lower than their peers, they may have difficulties in adjustment to school and they can be at risk of meeting clinical criteria for social anxiety disorder. One recurrent finding is that they are often quiet across a range of school situations. The study reported here focused on teachers’ strategies to engage shy students in frequently occurring oral activities, such as group work, in elementary school classrooms. Data were gathered through post-observation stimulated-recall interviews with eight teachers who had experience of success with shy students and three focus groups with 11 similarly experienced teachers. The analysis examined teachers’ actions with these children to enhance their visible engagement in activities that require oral participation. The findings suggest that although teachers attended to the psychosocial aspects of student engagement, there was little emphasis on the pedagogic purposes of oral activities with these children. We conclude that more attention should be paid to the academic aspects of oral activities when aiming at inclusion for shy children.

Following a short summary of factors limiting access to education for children with disabilities, Humanity & Inclusion (HI) work in inclusive education is briefly reported. HI's aims, main areas of activities (families and communities, making services inclusive (education, social, etc.) and developing policies) and ongoing projects are outlined. Examples of innovative practices and testimonies (from Mozambique, Gaza, Mali, Nepal and Sierra Leone) are given. The importance of inclusive education and HI's approach are discussed.

The unprecedented impact of COVID-19 on education systems worldwide and the HI #school4all campaign are also highlighted.  

Main objectives

1 – To explore the knowledge and competencies of teachers in carrying out visual acuity testing.

2 – To investigate how visual acuity testing practices were applied.

3 – To determine teachers’ motivations and attitudes towards carrying out school-based visual acuity testing.

Summary

Although the school-based vision screening programme was well received and supported by the schools and health providers, limited time allocated for training and practice; limited supervision and the lack of refresher training; trainers insufficiently experienced in training non-health staff and teachers’ involved had many other responsibilities and could not allocate sufficient time to conduct the activity properly which undermined the effectiveness and efficiency of the programme.

Summaries on the findings from the following queries:

This query is a short summary of information gathered from interviews with implementers working on education for children with disabilities in Syria.

Background: Pain in children with cerebral palsy (CP) has its sources in musculoskeletal problems that can influence learning in a school setting. Best pain management is essential for these children, but school staff may not keep up to date with the latest developments and interventions. Therefore, staff’s perceptions of beneficial strategies may not comply with contemporary scientific knowledge about effective evidence-based interventions.

Objectives: This study investigated how pain management intervention for children with CP in South African schools complied with international scientific knowledge about evidence-based interventions. The intention was to provide support for an update of knowledge on both individual level (i.e. professionals) and system level (i.e. decision makers).

Method: Five focus groups were conducted with staff members at five schools for children with special educational needs in South Africa. Manifest and latent content analyses of professional statements identified interventions reported as beneficial and related them to higher and lower levels of intervention evidence as reported at the time of data collection.

Results: Most treatment strategies concerned motor functioning that fell within the framework of physiotherapists and occupational therapists. Access to orthopaedic expertise was limited, waiting times were long and medication for spasticity treatment was not offered.

Conclusion: A discrepancy between published evidence and clinical practice for pain management in children with CP in South African school settings was noted. Suggestions for improved early intervention to identify children’s hips at risk through surveillance programmes; and orthopaedic management are proposed to prevent deformities and unnecessary suffering in South African children with CP.

African Journal of Disability, Vol 8, 2019