Dr. Pranali Somkumar, DR. (MRS.) G. Shashikala, DR. Radhika Marwah, DR. Vandana Giri.

Background

We are gradually moving towards mainstreaming children with developmental disabilities which aims to provide integrated context and setting where uniqueness of the child is valued . For about twenty years mainstreaming has been the philosophy of our center. But we were not satisfied with the interaction of our center with schools. So we plunged onto the opportunity given to us to work as developmental educators in a mainstream school to see whether we can make any difference in addressing the effectiveness of this service.

Objectives

to evaluate the role of developmental intervention centers in mainstreaming and to see the effectiveness of developmental therapists (occupational therapists) as participants in resource room service.

Design

Multi perspective qualitative approach.

Method

1. Orientation program for teachers so that they are equipped with few skills to address the needs of the children with developmental disabilities. It was a general misconception that these children can not be trained and that they cannot learn. The orientation covered – Nature, needs, potentials, deficits, attitudes, misconceptions teachers have, role of the school authorities and regular school teachers and method for successful integration.
2. To facilitate participation, social integration and non-academic talents, children were made to participate in various school activities which included conducting the school assembly, participating in fancy dress competition and sports events in annual sports meet of the school, performing on a patriotic song on Republic day and making greeting cards on the occasion of Diwali. School authorities, teachers as well as parents of normal children were surprised to see them performing. Everybody appreciated them very much and could not believe that these children can do so many things if trained.
3. Each child was assessed and target areas were identified which incorporated-
   • Cognitive enrichment
   • Creative language and communication
   • General behavior
   • Work behavior
   • Learning environment
   • Environmental factors (home, parents, school, teachers, helpers, peers)

   All the target areas were used to formulate individualized educational program for each child. Emphasis was placed on functional curriculum. The skills listed in functional curriculum were activities that are utility based and developmentally appropriate. The core curriculum included the activities in motor skills, self help skills, social skills, shopping skills, occupational skill, leisure & recreational skills and language skills. The language chosen as a medium of instructions was the language for communication hence preferably regional language or national language.

4. Facilitating teacher- child interaction: Initially mothers used to sit along with their children in the class room and there was hardly any interaction between the child with special need and the teacher. Children were completely dependent on their mothers for practically everything & they would not get any opportunity to become more independent. Importance of self direction and self responsibility were highlighted to both the teachers as well as parents so that children learn to work independently.
5. Since all the children with developmental disabilities could not be mainstreamed admission criteria was suggested to the school authorities for children with developmental disabilities. The criteria included-
   1. Readiness for school
      • No separation anxiety
      • Physical independence (Not applicable for children with Cerebral palsy)
      • Acceptable attention span & concentration.
      • Self feeding/ require minimum assistance
      • Toilet trained.
   2. Have borderline intelligence
   3. Have minimal verbal communication. Physical prompting for non – verbal autistic children.
   4. Following simple instructions & be compliant (also in a group situation).
   5. The child should be on proper medication as and when necessary.

Observation

• Though it was little difficult to make parents understand concepts of integration but to our surprise we found that teachers were very co-operative and welcomed all our ideas and later on started referring children having learning problem from normal classes.
• Few of the children were very difficult to manage. They were very hyper- kinetic, were not even toilet trained, were non-verbal, their comprehension level was very poor and therefore were difficult to manage in a mainstream school.
• Once children with disabilities start going to school they discontinue development based early intervention services.
• Mainstreaming is seen as an end by itself by parents of children with special needs and there seems a communication gap between patients and professionals in this regard.

Conclusion

Developmental therapists with functional approach can effectively work in mainstreaming. For mainstreaming to succeed there should be an ongoing fruitful interaction between parents, teachers, school authorities and early intervention centers. Mainstreaming should be viewed as one of the steps towards life span approach of disabilities rather than an end by itself.

References

1. Bottos M, Feliciangeli A, Gericke C, Sciuto L, Vianello A (2201) Functional status of adults with cerebral palsy and implications for treatments of children. Developmental Medicine And Child Neurology 43: 516-28.
2. Pandit (2002) Mainstreaming children with special education needs. Childhood Disability Update 2: 13-17
3. Singh R (2003) Me too! Putting the pieces together – early childhood care and education in India. Childhood Disability Update 3: 16 -23.
4. Butler C(1996)Mainstreaming experience in the united states :Is it the appropriate educational placement for every disabled child? Developmental Medicine And Child Neurology 38:861-866
5. Llewellyn A (2000) Perceptions of mainstreaming a systems approach. Developmental Medicine And Child Neurology 42:106-115