South Africa: innovative approaches to including children with disabilities

The needs of children who are disabled continued to be addressed in several unique and practical ways in South Africa. Not only is there significant Government commitment to the education and inclusion of children with disabilities, but there are a growing number of examples of non-governmental organizations and media producers that are addressing problems faced by families, schools and communities. This article describes some of these innovative activities, materials and media:

TREE
Nearly everyone in South Africa knows TREE. It stands for Training and Resources in Early Education and has a history of serving the needs of young children during the years of apartheid until today. Their resource centers are based in one of the poorest areas, Kwazulu-Natal (KZN) Province, but their reach and impact extends across the entire country.

In addition to in-service training for people in the most remote and needy areas of KZN, they produce simple, low-cost educational toys and play materials. They also produce and distribute practical low-literacy materials that are designed to help those who care for children - including children who are disabled.

One such booklet is called "Activities for Children with Disabilities". The text is by Lee Hurrell and Illustrations by Jane Mqamelo. One of the first things I like is the first sentence: "Every aspect of the child needs to be planned for and developed: physical, intellectual, social, emotional". It is a simple statement, but it surprising how, even today in many parts of the world, often solely the physical aspects are given attention, how minimally the intellectual aspects receive attention and how frequently, the social and emotional aspects are dismissed.

The booklet continues with important messages to the caregiver, "the caregiver's own attitudes and expectations are important" to "Every child must be helped to develop a positive self image".

The booklet is useful for anyone working in the field of early childcare or early primary education. That is wonderful. It demystifies working with children with disabilities while also giving practical suggestions that are not overwhelming to someone who is already overworked and overwhelmed. For example, it tells the caregiver to: "help only when a child wants or needs it", and encourages the caregiver to: "ask yourself if your help to complete an activity will increase the child's learning, and is your help really needed?"

There is a section for various disability areas: mild developmental delay, severe learning disability, physical disability, hearing disability, sight disabilities, emotional difficulty - withdrawn and emotional difficulty - acting out. In each, it lists some of the signs for identification, simple key words to remember when working with a child who has a specific disability, examples of simple "tips" that work well.

The areas of emotional difficulty are often overlooked. I applaud TREE for including them. Especially in a province in a country where HIV/AIDS affects nearly every family - not to mention other potential causes of trauma, abuse and neglect - the number of children with these difficulties continues to grow. The information in these sections could be helpful to anyone caring for children.

In these sections, the practical suggestions range from the importance of listening to and observing the child closely, relaxing and soothing activities, fantasy play and storytelling - and the key words loving support and firm loving care , respectively for children who are withdrawn or acting out.

I have worked in many situations where caregivers and teachers are asked to include children who are disabled. They are often frightened and given no guidance - or too much information. This booklet is a model of what is not too much to overwhelm or frighten. It of course is not enough to meet all of the needs of the child. But I have so often seen that too much information is given, and then very little is internalized and used. Here, less is more.

ELRU
ELRU is the Early Learning Resource Unit based in Cape Town, South Africa. They are well-known and respected for their Anti-Bias Project , helping children in the country to learn about each other, live with and respect each other. They do wonderful work

One of the simplest and best books I have seen introducing a child who is disabled to other children is ELRU's "At School, What if...?" It is basically a storybook told in photos with very simple text. A young girl, Ncebakazi is starting school. We see in one of the photos that she used calipers. In the other photos - she is writing her name on her new books and lunchbox, getting her supplies ready, watching her mother sew the hem of her uniform. Later she asks "What if the teacher shouts all the time?" as she imagines a five-headed teacher in a cartoon! Then she asks "What if the children laugh at me?" and then she and her mom laugh as she imagines another cartoon where she and all the children laugh together "so much that our teeth shake right out of our mouths!" And one my favorites is when she worries about getting to the toilet in time because she can't walk or run fast enough. This time, Ncebakazi imagines that the perfect place would be a school where there are tons and tons of toilets everywhere!

Ncebakazi continues to talk about potential problems with stairs, spilling juice, not having anyone to play with, having difficulty learning, etc. Finally she goes to school and...she finds that all the things she was afraid of - turned out just fine. The teacher spoke with the other children about her disability, the school made simple adaptations so that there would be only one step to climb, she found new friends, learned new things - including that school can be fun!

This 2003 book was written, illustrated and designed by Reviva Schermbrucker and supported by the team at ELRU. The mix of photographs and cartoon illustrations is magical. The inclusion of worries that every child has about going to school combined with worries that a child who is disabled might have- is powerful. I have known about and loved ELRU's work since the early 1990s. This book continues their innovative legacy.

Another excellent book by ELRU is entitled "The Welcome Book: A guide to help teachers include children with disabilities in the classroom". It was written for ELRU by Laetitia Brummer. It has the feel of the classic Disabled Village Children by David Werner - with a very South African flavor. It is 147 pages, so this can be a little less user-friendly for some teachers, especially those in poor, rural areas who themselves have sometimes limited literacy skills. It does, however, use simple cartoon illustrations and symbols to help readers in many ways. The stories are always written as case studies with real people - some of them disabled, some not.

The book is divided into an introductory section, a chapter on child development and disability, one asking "Can inclusion work in my class?" a chapter on the fight against barriers and several appendices.

South Africa has come a long way and is a pioneer in many ways in its effort to assist and include children and adults who are disabled. The country's Bill of Rights as well as its new Constitution challenges unfair discrimination and ensures the right of basic education to all. There have been several commissions and papers written for the Department of Education and these have all led to recommendations and programs on the educations for all learners, beginning with Early Child Development.

Amidst all the facts and information, there is a gentleness and quiet confidence about the book. It speaks to the reader with reassurance about the possible intimidations caused by having a child with a disability enter one's class when you never met someone with a disability before - or you have never been trained to meet special needs. It addresses the needs of the teacher as well as those of the children - something one does not often see.

Since ELRU does a great deal of work in early childhood education, there is special emphasis on beginning at the beginning. It covers the need for community-based rehabilitation and services in a country where a majority of people live in rural communities. There are numerous examples of low-cost aids (though some teachers would probably want more detail as to how to make these) - including turning existing chairs upside down to make supports for children with cerebral palsy and other physical impairments.

The book was written in 1998 - and is very current with regard to most international standards. Having just worked in South Africa in 2003, I know that there continue to be changes and improvements. But this book is a goldmine for any teacher.

The Sunshine Centre
The Sunshine Centre is one of few organizations created to meet the early intervention needs of children who are "intellectually disabled or developmentally delayed". They have four Early Intervention Projects in the Johannesburg area of South Africa, including the township of Soweto. They offer training in working with the children as well as a Toy Library.

The majority of the people they serve are from poor, rural areas in the community. To meet the specific needs of these families, the Sunshine Centre developed specific materials for home-based intervention - the first of its kind in the country.

Maria Longley, the Director of the Sunshine Centre Association, states that this Home "Distance Programme" is in the process of being piloted and in addition to visits aimed at empowering families, they also network with Government and other NGOs, use the media to extend their reach, and are at present exploring additional ways to collaborate with community and national radio.

The Sunshine Centre's training is called the START Home Based Programme on early intervention. I was sent samples from their Parent's Guide, and Checklists to serve as indicators for the child's level of functioning in gross motor development, communication/receptive language, communication/expressive language, fine motor/cognitive skills and activities of daily living. There are audio tapes for distance education together with an accompanying manual with simple photographs and a description of activities to do with the young child. I was not able to review the entire manual or the audio tape - but the sample pages were simple, practical and seemed very user-friendly.

In a country were so many people live in rural areas and many in both rural and urban areas do not yet have services for infants and young children who are disabled - the Sunshine Centre is a ray of light that I hope will spread throughout the country.

SABC
SABC is the South African Broadcasting Corporation. Together with the Department of Education and the Institute for Health and Development there have been several initiatives that that have taken to include children and adults with disabilities in their programming. Some of the most popular are Takalani Sesame and Soul Buddyz/Soul City.

Takalani Sesame is a co-production with the U.S.-based Sesameworkshop. In addition to a number of implicit and explicit segments that talk about disability, a very important component is their outreach program, which includes supplemental materials and media for people in communities. It is designed to extend the use and impact of the television series. In posters and books for young children, children who are disabled are included.

In one booklet called "Let's move it!" the Muppet Moshe is pushing a healthy, happy boy in his wheelchair, along with other children and Muppets running, playing and " moving it". In a large poster that could be used in a preschool or community center, a community scene is depicted representing various colors, religions, professions, ages and disabilities. And in addition to children and adults who are disabled, one of the most popular new characters is Kami , a delightful Muppet who is HIV-positive. And in another booklet called "Look at me!" we see illustrations of children who can do many things to care for both themselves and others. Again, this includes children with both temporary as well as permanent disabilities. One of my favorites is of two boys doing pull-ups on the trunk of a tree. The only thing that might make this better would have been to include a young girl as well! All of these materials are multi-lingual (English, IsiZulu, Africans, Sesotho and IsiXhosa).

Soul Buddyz is a very popular series for older children often dealing with difficult or sensitive issues. It has an ensemble cast that in a drama format, helps viewers to learn about topics like racism, xenophobia, learning difficulties, drug abuse, HIV/AIDS, justice, etc. This TV series also has a community outreach component and numerous print resource materials for children, teachers and parents.

In one Guide for Parents, readers learn how to identify various learning difficulties, the correct terminology in several languages, and things that parents can do to help their children. It also includes messages of hope - that children with learning difficulties can do well, if they are nurtured, given the proper attention, not constantly compared to others, and included.

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