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This report presents a summary of the main issues and conclusions from a CBR and persons with intellectual disabilities workshop. The workshop’s four sessions included "a session on health care needs led by Alaa Sebeh; a session on inclusive education led by Katharina Pfortner; a session on livelihoods and economic independence led by Philipa Bragman; and lastly, a session on social participation and empowerment led by Kathy Al Ju’beh." At the end of the workshop the participants agreed to establish an electronic group/network on CBR and intellectual disabilities. All presentations can be accessed from the website in pdf format
"CBR and Persons with Intellectual Disabilities"
Agra, India
24-25 November 2012

Purpose: The Kudumbashree mission, an initiative of the Government of Kerala state in India, has collaborated with Local Self Governments to set up ‘Buds’, a special school system for individuals with intellectual disability. The objectives of this study were to evaluate the structure and functioning of ‘Buds’ schools, to identify the healthcare needs of the students, and to conceptualise a framework for healthcare provision.

Method: A cross-sectional survey was conducted among 202 children at 11 registered ‘Buds’ schools in Kerala. A multidisciplinary team consisting of a psychiatrist, public health personnel and a social worker from the Medical Colleges of Kerala, visited the institutions. Data collection consisted of abstraction from medical records, interviews with parents, and clinical assessment and prescription of intervention by the specialists concerned. A pre-tested semi- structured questionnaire was used for every child. Using both quantitative and qualitative techniques, the public health personnel in the team evaluated the structure and functioning of the schools.

Results: The most commonly associated condition was epilepsy, seen in 11.9% of the children, while 28.2% had behavioural problems. The medicines needed were mainly anti-epileptics and drugs for behavioural problems. Interventions for self help and social skill training were also among the important requirements. The infrastructure and other facilities were poor in many schools, with the average student to teacher ratio at 14:1. While these institutions were well utilised, functioning was good only in 27.2% of the schools. Healthcare services and visits by healthcare personnel were far from adequate. This study proposes a framework in which the Medical Colleges and Health Services can function together to deliver healthcare services to children at these schools, with linkages from the District Mental Health Programme (DMHP).

Conclusion and Recommendation: Evidence that these schools are well utilised indicates a need to propagate this initiative in other areas of the state, country and other countries. However, improvements in infrastructure, human resources and other logistics are required. Besides, the healthcare needs of these children have to be addressed. A comprehensive healthcare programme through the existing system, using a multidisciplinary approach, needs to be developed.

Support through care and protection within a medical framework, rather than through the idea of independence within the least restrictive environment, continues to guide service provision for intellectually disabled people in the sexuality area. Past practices have included use of involuntary sterilisation. This article outlines the outcome of a search for information undertaken because of concerns that use of sterilisation-related procedures may remain embedded in contemporary approaches to sexuality support management. Verified instances of hysterectomy carried out between 1991 and 2001 were uncovered. Documents tabled at a Parliamentary Select Committee in 2003 expressing concerns about use in relation to young disabled girls were also found. Requests for sterilisation-related procedures exemplify how the right of all vulnerable citizens to full bodily integrity is currently adjudicated in New Zealand. It is suggested that further research is needed to pinpoint and address the underlying social customs through which requests for such procedures are negotiated and resolved.

When attempting to understand the construct of intellectual disability in different contexts, speaking to family members in addition to the individual with the disability may provide new insight about understandings of and responses to intellectual disability in society and may help to identify the forms of support that are available or needed to ensure the quality of life of people with disabilities. This article outlines and discusses interviews that were conducted in Dar es Salaam, Tanzania, with family members of children and adults with intellectual disabilities. These interviews explore how families came to understand that their child had an intellectual disability; the availability of family support; and family hopes and dreams for the future, and were a part of a wider exploratory study that gathered insight from individuals with disabilities, families, and other providers of support to explore understandings and perceptions of disability in Dar es Salaam. Understanding family experiences will help researchers, policy makers, non-governmental organisations, and others to identify family strengths and family support needs which can ultimately improve family quality of life and the quality of life of the member with a disability.

Purpose: The present study aimed to find the level of functional social skills of adults with intellectual disability, and attempted to analyse these skills with respect to gender, level of disability, type of school attended and number of years of schooling.

Method: Descriptive method of research was employed for the study. The study sample consisted of 100 adults with intellectual disability, randomly selected from various special schools which provide vocational training in Kottayam district of Kerala state, in South India. Data on social skills of these individuals were collected through a standardised Functional Social Skills Assessment Scale developed by the authors. The data were analysed through arithmetic mean, standard deviation, independent t-test and one-way analysis of variance.

Results: The results indicated that only 48% of the adults with intellectual disability in the study sample possessed functional social skills.

"This Issue Paper describes the challenges faced by Council of Europe member states in dealing with the issue. These include the flaws of current guardianship systems and procedures, the automatic loss of human rights of those placed under guardianship regimes and the pressing need to develop support alternatives giving persons with disabilities equal opportunities to shape their life paths. The paper outlines the applicable international human rights framework, including the relevant case-law from the European Court of Human Rights. It concludes with examples of good practice to show the way forward"
Commissioner DH/Issue Paper (2012)2

"Focusing on the southern parts of the country, this report examines the experiences of persons with mental disabilities in Ghana in the three main environments in which they receive care: the broader community, the country’s three public psychiatric hospitals, and residential prayer camps...Human Rights Watch found that persons with mental disabilities in Ghana often experience a range of human rights abuses in the prayer camps and hospitals that Human Rights Watch researchers visited. These patients are ostensibly sent to these institutions by their family members, police, or their communities for help. Abuses are taking place despite the fact that Ghana has ratified a number of international human rights treaties, including the Convention on the Rights of Persons with Disabilities (CRPD), which was ratified in July 2012. These abuses include denial of food and medicine, inadequate shelter, involuntary medical treatment, and physical abuse amounting to cruel, inhuman, and degrading treatment"
The report is available in pdf, easy to read and html formats