Promoting the Rights of Children with Disabilities, UNICEF

A global resource for the promotion of CBR isprovided by WHO’s Programme on Disability andRehabilitation, which is discussed in box 6.3.Community-based rehabilitation is a general strategy,within which specific initiatives will respond to localsituations. In Guyana, for example, a CBR projectwas started in the coastal areas of the country byparents of children with disabilities. Subsequently,the decision was taken to extend the programmeto indigenous Amerindian communities in theinterior. As a first step towards establishing a CBRprogramme in the region of Rupunini, a meetingwas organized to which community leaders from thesurrounding villages were invited. When it emergedthat some of the villages had no schooling facilitieswhatsoever, it was decided that the CBR programmewould support the setting up of village schools aswell as training activities for teachers, village healthworkers and community volunteers.Within this structure, the communities themselvespromoted the issue of education for children withdisabilities. This example illustrates how taking adisability perspective from the initial stages of aproject and working within a community contexthelps to promote education for all. 93Other interesting CBR initiatives discussed in box6.4 illustrate how low-cost local solutions offer theadvantage of being both sustainable and sensitive tospecific situations.From institutions to communitiesMany of the initiatives that have been discussed,especially those relating to families and communities,are essential foundations for the successfulpromotion of alternatives to institutional care forchildren and adults with disabilities. These includethe introduction of measures that reduce thepressure for children to be admitted to institutionsin the first place, including the development ofchild-centred public services, accessible schoolsand the provision of local supports and services. 94These elements can be complemented by thedevelopment of support programmes for and byfamilies and the establishment of community-basedalternatives. These new community services can bedeveloped with the active involvement of parents andcommunity organizations.Immediate changes that might be introducedin existing institutions include restricting newadmissions where alternative support structures arealready established, improving the quality of servicesand protections against abuse, and regroupingchildren into smaller ’family style’ units, wheregirls and boys of a range of ages and abilities livein smaller groups with a ’house’ parent or parents.Sometimes such smaller family groups can be set upin the local community. 95Overreliance on institutional care for children inCentral and Eastern Europe and the former SovietUnion has in turn encouraged a number of newinitiatives for deinstitutionalization, with positiveresults. As an example, in the Saratov region ofthe Russian Federation, a Rehabilitation Centre forDisabled Children has been established with the aimof preventing institutionalization. The Centre sendsout mobile teams of professionals who providerehabilitation services to children with disabilitiesliving at home. As in the Portage programme, theyteach children skills to facilitate their inclusion intosociety. Family members, who are informed of theirlegal rights and entitlements as caregivers, are alsotrained to support children. The Centre has servedmany thousands of children and family members. 96(See box 6.5 for examples from Bulgaria.)An important lesson to be drawn from theseinitiatives is that deinstitutionalization programmesmust go hand in hand with relevant developments atthe community level. Structures must be changed,appropriate long-term support mechanisms need tobe put in place in the community, and understandingand acceptance of children with disabilities in widersociety must be promoted for deinstitutionalizationnot to give rise to its own set of difficulties. Forexample, sexual and physical abuse is a risk inthe community just as it is in institutions, and achild’s right to protection can be reinforced by theestablishment of an independent oversight system tomonitor protection issues.Towards inclusive schools and learningenvironmentsInclusive education involves ensuring that meaningfullearning opportunities are made available to allstudents within the regular educational environment.The ’World Conference on Special Needs Education:Access and Quality’ held in 1994 in Salamanca, Spainprovided decisive support for inclusive approaches toeducation. It unanimously adopted the Statement anda Framework for Action on Special Needs Educationproviding guidelines for action at the national level aswell as regional and international cooperation in thepromotion of inclusive education.Ideally, inclusive education means attending the ageappropriateclass of the child’s local school, with individuallytailored support. Inclusive education meansthat schools must change to accommodate a muchwider range of children. For example, the curriculumneeds to be differentiated to ensure access to a widerange of children – not just children with disabilities –and should reflect the needs and interests of childrenin the local community. Children are taught in smallgroups and are helped to support one another ratherthan to compete. Inclusive schools pay particularattention to developing appropriate methods of assessmentand avoid all unnecessary segregation ofchildren within the ordinary classroom. They also pay27 Promoting the Rights of Children with Disabilities Innocenti Digest No. 13