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How pain management for children with cerebral palsy in South African schools complies with up-to-date knowledge
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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
Even we are important: Sexuality and the degenderisation of people with disabilities in the linguistic landscapes of two South African universities in the Western Cape province
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Background: This study focuses on the positioning of gender, sexual orientation and people with disabilities in the linguistic landscapes of two selected South African universities, which are located in the Western Cape province.
Objectives: This study aims to answer the question: How are power relations depicted through linguistic landscaping in the universities?
Methods: Given that there is minimal empirical data in this field, the researcher approached this question by exploring the way in which sexual orientation and people with disabilities are perceived, via the modal resources used in the categorisation of toilet users at the institutions. Specifically, toilet signage was observed as there were only a few other signage or forms of support (such as ramps and lifts – some of which may seem disability-unfriendly in terms of space) and acknowledgement in other places at the institutions for people with disabilities. Data (signs, images, texts, billboards and posters) were collected by means of photography. The interpretive paradigm was used to determine the choice of methodology: critical discourse analysis and multimodality. These were also used to thematically analyse the collected data.
Results: Findings revealed that sexuality, as well as subtle inequality, unfortunately remain unravelled areas in South Africa’s higher institutions of learning. In addition, the degenderisation of people with disabilities appears to be prevalent at the institutions, although this may not necessarily be reflective of practices at all higher education institutions in South Africa.
Conclusion: Nonetheless, the examined results are stimulating indicators of hegemonic and preferred practices in public places. They also depict the obtainable dissimilar scales and imbalances in society, which are not addressed may impede other authentic and ongoing measures of social integration and advancement.
African Journal of Disability, Vol 8, 2019
Gaps in access and school attainments among people with and without disabilities: a case from Nepal
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Aim: Many children with disabilities in low- and middle-income countries do not attend school and one-third are out of school. In order to ensure that education is for all including children with disabilities, research is needed on barriers to schooling to identify targets for intervention. The study will examine the determinants of school achievement among persons with and without disabilities as well as among each type of impairment.
Methods: The study will utilize data from a recent national, representative household survey on living conditions among persons with and without disabilities. The individual level data used in this article comprise 2123 persons with and 2000 persons without disabilities.
Results: The results show that an alarmingly high proportion of persons in Nepal have not accessed formal education, with access being significantly lower among persons with disabilities. While the results may be influenced by the assumed relationship between disability and poverty, results from analyzing the cross-sectional data cannot be conclusive on the influence of disability vs. poverty in determining differences in access and school attainments. Increased environmental barriers, higher age, rural location, and increased levels of disability were found to be associated with lower educational achievement. Pronounced differences in access to education were found between impairment types, with individuals with physical impairments achieving the highest level and individuals with multiple impairments, hearing and mental impairments achieving lowest.
Conclusions: It is necessary both to strengthen the entire educational sector and at the same time allocate resources that will ensure that all children are on board and that particular efforts are implemented to cater for those who are easily side-lined.
Social protection and disability in Zambia
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This report presents findings from a short study in Zambia to examine its social protection system and programmes and identifies the challenges faced by persons with disabilities in accessing them. The study was undertaken by a visit to Zambia between 31st October – 4th November 2016 during which a range of interviews and focus group discussions were undertaken. The study was supported by a review of the literature and some limited analysis of administrative data.
Topics presented in the report include:
- the broader context of Zambia particularly around issues of education, health and consumption dynamics
- the national population of persons with disabilities
- key challenges faced by persons with disabilities
- the legislative and policy framework on disability in Zambia
- the governance of social protection and support for persons with disabilities
- the disability classification system and an overview of the social protection system
- the evolution of the Social Cash Transfer and access to the scheme by persons with disabilities
Children with hearing impairment in Malawi, a cohort study
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The aim of this research was to assess the outcome of children with ear and hearing disorders 3 years after initial diagnosis, in terms of referral uptake, treatment received and satisfaction with this treatment. It also aimed to assess the social participation of the affected children, specifically, their ability to make friends and communicate needs, and their enrolment at school
752 children had been diagnosed in 2013 as having a hearing impairment and 307 (40.8%) children were traced for follow-up in 2016.
Bulletin of the World Health Organization, Volume 97, Number 10, October 2019, 645-728
http://dx.doi.org/10.2471/BLT.18.226241
Framing heuristics in inclusive education: The case of Uganda’s preservice teacher education programme
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Background: Recent education-related research has raised concerns about the persistent exclusion of vulnerable learners in Uganda. The Revised Primary Teacher Education Curriculum of 2013 marked an ambitious yet inconclusive attempt to advance the implementation of inclusive education but has encountered deeply entrenched sociocultural exclusionary practices among education experts.
Objectives: This study aimed to explicate education practitioners’ interpretations of Uganda’s flagship inclusive education programme in preservice primary teacher education.
Method: Drawing on the conceptual vocabulary of frame analysis and the qualitative analysis of individual and group interviews and classroom observations, the interpretations of inclusive education implementation in preservice primary teacher education in Uganda were examined. The participants included policy design experts, curriculum design experts and classroom practitioners.
Results: Three main findings emerged. Firstly, interpretations of inclusive education displayed a narrow framing heuristic of inclusive education as a perfunctory, daily practice rather than a pathway for reflective, inclusive pedagogical engagement. Secondly, the heuristic encouraged the treatment of inclusive pedagogy as a ‘label’ under a specific rubric referring to sensory impairments or disabilities – a historical device for sociocultural exclusion. Thirdly, inclusive education was a praxis but was misframed from its original intentions, causing tension and resentment among practitioners. These findings contribute to the debates on the sustainability of inclusive education beyond preservice teacher education.
Conclusion: Uganda’s flagship inclusive education programme in preservice primary teacher education was fraught with tensions, ambiguities and an overt, urgent need for change.
African Journal of Disability, Vol 8, 2019
Including parents in inclusive practice: Supporting students with disabilities in higher education
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Background: While a number of research studies have endeavoured to understand students with disabilities’ experience in higher education and have recommended ways to effectively support student success, the role of parental support has been neglected. Many studies have been hampered by a limited understanding of students with disabilities and have, in particular, underestimated students’ ‘access to economic, social and cultural forms of capital’ that caring parents provide.
Objectives: This article seeks to explore students with disabilities’ experiences of parental support in the South African higher education context. The research question guiding this article is: What forms of economic, social and cultural capital do parents and extended families provide to students with disabilities to enable them to succeed in higher education?
Method: In-depth semi-structured individual and focus group interviews were conducted with 17 students with disabilities at two universities of technology. The interview transcripts were thematically analysed with a view to understanding Pierre Bourdieu’s forms of capital that parents provided.
Results: The study found that while parents are not always able to provide material support, they offered rich and varied forms of social and cultural capital that enabled students with disabilities’ academic success.
Conclusion: Given that parental support plays an important role in the success of students with disabilities, and this role changes as these students become more independent, this study recommends the need for universities to also pay more attention to involving parents in the education of the former. It is hoped that putting in place appropriate forms of parental involvement can create a conducive environment for universities to provide inclusive education holistically.
African Journal of Disability, Vol 8, 2019
A university’s response to people with disabilities in Worcester, Western Cape
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Background: The call for institutions of higher education to foster interaction with communities and ensure training is responsive to the needs of communities is well documented. In 2011, Stellenbosch University collaborated with the Worcester community to identify the needs of people with disabilities within the community. How the university was engaging with these identified needs through student training still needed to be determined.
Objectives: This study describes the engagement process of reciprocity and responsivity in aligning needs identified by persons with disability to four undergraduate allied health student training programmes in Worcester, Western Cape.
Method: A single case study using the participatory action research appraisal methods explored how undergraduate student service learning was responding to 21 needs previously identified in 2011 alongside persons with disability allowing for comprehensive feedback and a collaborative and coordinated response.
Results: Students’ service learning activities addressed 14 of the 21 needs. Further collaborative dialogue resulted in re-grouping the needs into six themes accompanied by a planned collaborative response by both community and student learning to address all 21 needs previously identified.
Conclusion: Undergraduate students’ service learning in communities has the potential to meet community identified needs especially when participatory action research strategies are implemented. Reciprocity exists when university and community co-engage to construct, reflect and adjust responsive service learning. This has the potential to create a collaborative environment and process in which trust, accountability, inclusion and communication is possible between the university and the community.
African Journal of Disability, Vol 8, 2019
Bridging the mobile disability gap in refugee settings
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This case study highlights refugees with disabilities’ access to mobile services and the benefits and challenges associated with using these services in three different humanitarian contexts. The analysis is based on a representative survey of refugees in three contexts: Bidi Bidi refugee settlement (Uganda), Kiziba refugee camp (Rwanda) and with urban refugees in Jordan. It also includes qualitative data drawn from two focus groups conducted with refugees with disabilities in Bidi Bidi and Kiziba. The survey used the Washington Group Questions (WGQs) to assess prevalence of disability amongst the refugee population
Summary Report. LEAVE NO CHILD BEHIND Invest in the early years
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A summary overview of the findings of a study led by LIGHT FOR THE WORLD with its partners, supported by the Early Childhood Program of the Open Society Foundations. The aim of the study was to uncover the trends in aid for inclusive Early Child Development (ECD) for 2017. It further identified strategic commitments to ECD, as reflected in policy documents up until 2019. The research examined donors’ spending and commitments in three key areas: early childhood development; inclusive early education and pre-primary; and disability-inclusive early childhood development investments in the sectors of health, nutrition, education and sanitation.
This study presents a baseline on donor investment in ECD services in low- and middle-income countries for the children who are traditionally left behind. It draws lessons from six bilateral donor countries – Belgium, Canada, France, Germany, the United Kingdom (UK) and the United States (US) – as well as the Global Partnership for Education (GPE), European Union (EU) Institutions, the United Nations Children’s Fund (UNICEF) and the World Bank. Donor advocacy briefs for each of these donors are provided.
The study focuses on donor contributions to scaling up ECD services in four African countries: Burkina Faso, Mozambique, Zambia and Zimbabwe
Introduction of Indian Sign Language in Inclusive Education
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Purpose: The predominant mode of human communication is speech, and whenever it is hindered, humans resort to the tactile-kinaesthetic mode. Use of sign language by persons with speech-hearing impairments is a classic example of such adaptation. The Demonstration School at the Regional Institute of Education in Mysuru, South India, undertook training of typically-developing students in Indian Sign Language (ISL), so as to facilitate communication and instruction of students with hearing impairment who are in mainstream learning environments.
Method: Training in ISL was imparted to140 typically-developing students in higher primary classes. Twenty-four 40-minute sessions were conducted over a month. After theoretical orientation in logical bases of manual communication, practical training commenced with elementary manual alphabets, progressed through essential daily-life vocabulary necessary to construct simple sentences and carry out general conversations, and culminated in signing the Indian National Anthem.
Results: Typically-developing students gained primary benefits such as improved awareness about non-verbal communication modes, mastery of basic skills in ISL, and positive attitudes towards sign languages.
Conclusion: The UNCRPD 2006 authorises sign language as the linguistic identity of the Deaf, and encourages the use of sign language in learning environments. Future research should add to the findings on secondary benefits in the form of scholastic and sociometric advantages derived by students with hearing impairments who receive instructions in sign language in mainstream learning environments.
Quality of Life of Persons with Disabilities in Southern Nations, Nationalities, and Peoples’ Region, Ethiopia
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Purpose: There is very little demographic or prevalence data regarding persons with disabilities in Ethiopia, let alone data on more in-depth factors such as access to services or quality of life. This study aimed to find out about the current quality of life of persons with disabilities in Southern Nations, Nationalities, and Peoples’ Region (SNNPR), Ethiopia.
Method: The WHO CBR Indicator Survey was used to measure quality of life, and the Washington Group Short Set was included to allow disaggregation of the data by different types of functional limitations. Interviews were conducted with 966 persons with disabilities in 10 towns in SNNPR. The majority of data collectors were persons with disabilities themselves.
Results: People with disabilities who were surveyed generally regarded their health as good (65.9%). Very few had significant levels of education (16.5% were completing higher education). Only 6.7% were working for wages and 45.2% were reportedly working on their own account. Hardly any of them (2.9%) stated that their money was sufficient for their needs. Only a small group (38%) felt valued in their community. Just over half of the respondents (56.6%) were members of a Disabled Persons’ Organisation (DPO) or any other self-representing group.
Conclusion: Persons with disabilities scored relatively or extremely low in all areas of life measured with the CBR Indicator Survey (health, education, livelihood, social and empowerment). The survey will be repeated after a few years in the same communities to measure changes over time, and persons without disabilities will be included in order to draw comparisons.
Implications: Public and private organisations in SNNPR need to become more accessible and inclusive of persons with disabilities so as to improve their quality of life.
Storying disability’s potential
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In this paper, we weave in and out of theory and narrative in order to consider the potential of disability and its relationship to knowledge construction. We consider theories to be stories that one can tell about the world. And these theories are enlivened by other stories that we tell about ourselves and the world around us. As disability researchers, we explore the ways in which disability becomes known in the world and we do so through our own tales and theoretical narratives of knowing disability. In telling stories, then, we break down artificial boundaries between theory and narrative. And in theorising our stories – and storying our theories – we seek to explore the potential of disability to unsettle and challenge exclusionary curriculum. This textual assemblage traverses diverse themes including diagnosis, school programming, welfare, transportation, social interaction and access.
Good practices on the implementation of the UNCRPD in Timor Leste (2015-2017)
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The 2015-2017 Advocating for Change Project (AfC), a project funded by the German Federal Ministry for Economic Cooperation and Development (BMZ), aimed at promoting and advocating for rights of people with disabilities through the push for the ratification of the UNCRPD at the national level, improving quality decentralization process at the local level and promoting quality livelihood action for people with disabilities through improved and inclusive vocational training center (CNEFP) in Tibar.
One particular activity in this project is the collection and dissemination of best practices with the "Making it Work" methodology. This methodology aims to document and promote already existing best practices that adhere to the principles of UNCRPD. Making it Work utilizes a multi stakeholder approach and encourages members of DPOs and other organizations to identify best practices and effective action in and surrounding their localities. These best practices are then collected with the ultimate goal to serve as examples of embodiment of the UNCRPD for replication by organizations or institutions elsewhere.
Integrating face washing into a school-based, handwashing behavior change program to prevent trachoma in Turkana, Kenya
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Trachoma is the leading infectious cause of blindness, and facial cleanliness has been associated with reduced odds of trachomatous inflammation and Chlamydia trachomatis infection. This study reports on the results of a program integrating face washing into a school-based handwashing promotion program in Turkana County, Kenya
American Journal of Tropical Medicine and Hygiene. 2019 Oct;101(4):767-773
doi: 10.4269/ajtmh.19-0205.
How do we ensure that children with disabilities are not bullied in school?
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Question & problem
Students with disabilities are bullied more often than their typically developing peers. Students in schools for children with disabilities may be victimized more often than students with disabilities in inclusive settings. Being bullied, which can take forms which are physical, verbal, indirect (relational, emotional, or social), and/or sexual, is associated with negative academic, social, and psychological outcomes for the victim. This evidence brief summarises what we know about how to prevent bullying of children with disabilities.
What works to improve educational outcomes of children with disabilities in school?
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Question & problem
For people with disabilities, a major determinant of social and economic outcomes in adulthood, is access to, and the adequacy of, education in childhood and adolescence. Yet, children with disabilities are less likely to be enrolled in, or complete, school. Further, there are substantial gaps in the evidence regarding what works to improve educational outcomes of children with disabilities in school. Educational outcomes, here include academic achievement, pass rates, and grade completion. Many studies measure child behaviour and proxy or distal outcomes in response to various interventions, but not actually how children with disabilities do in these domains. This is particularly the case in LMIC, where there is a dearth data about the effects of educational policies and practices on child educational outcomes.
How do we provide mental health support to children with psychosocial disabilities in school?
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Question & problem
It is estimated that approximately 10-20% of children, adolescents and young people (under the age of 18) worldwide have a disabling mental health condition. Approximately two-thirds of the global youth population goes to school for a significant proportion of the day. The idea of delivering mental health support in the setting has gained prominence as a way to increase the coverage and accessibility of mental health support for children. While there is a wealth of evidence around school mental health approaches in HIC, there is limited information with regards to their impact in low- and middle-income settings. This evidence brief explores what has worked for the delivery of school mental health initiatives in diverse settings, as well as evidence-based recommendations to strengthen them.
Assistive technology enables inclusion in higher education: The role of Higher and Further Education Disability Services Association
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Background: Using assistive technology is one way to foster inclusion of students in the post-school education and training (PSET) sector.
Objectives: Higher and Further Education Disability Services Association (HEDSA) enables the sharing of new knowledge about assistive technologies through its symposia, and making information available on its website. Additionally, it facilitates dialogue and collaboration amongst institutions in the PSET network using a listserv and newsletters, given that PSET institutions are spread countrywide.
Method: This is an article based on a presentation at the 5th African Network of Evidence-to-Action in Disability (AfriNEAD) conference in Ghana in 2017 that focused on the value of assistive technology for students pursuing studies in the PSET sector and the role played by HEDSA in South Africa.
Results: The positive gains and existing gaps in disability inclusion in the higher education sector in South Africa are highlighted, with reference to access to technology. All higher education institutions have internet access and can thereby make use of listservs to communicate information. MapAbility is a way that prospective students can gain a snapshot view of available resources at institutions of learning, using the internet.
Conclusion: An association such as HEDSA plays a critical role in the PSET sector to enhance disability inclusion using online tools to disseminate information.
African Journal of Disability, Vol 8, 2019
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