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This content is taken from the London School of Hygiene & Tropical Medicine, International Centre for Evidence in Disability & Fundação Oswaldo Cruz (Fiocruz)'s online course, Integrated Healthcare for Children with Developmental Disabilities. Join the course to learn more.

Skip to 0 minutes and 11 seconds TOM SHAKESPEARE: Education is a fundamental right for all children, including children with developmental disabilities. This right is recognised by the United Nations Convention on the Rights of the Child and the Convention on the Rights of Persons with Disabilities. But despite immense global progress in education standards and enrolment, children with developmental disabilities are still being left behind. This is particularly true in low- and middle-income countries, where children with disabilities are 10 times less likely to attend school than their non-disabled peers. Those that do attend school still face significant barriers and challenges. And early dropout rates are high. Without good quality education, children with developmental disabilities are deprived of their right to learn and reach their potential.

Skip to 1 minute and 8 seconds And later, to benefit from employment and participation. Indeed, the exclusion of children with disabilities from schools reinforces the separation between disabled and non-disabled children, strengthening misconceptions, misunderstanding, and societal stigma. And without education, there is a good chance that those with disabilities living in poverty will remain in poverty. So how are children with developmental disabilities excluded from schools? Well many of the barriers to education are not dissimilar to the barriers to healthcare access. Schools and other learning environments may be physically inaccessible with inappropriate entrances, hallways, toilets, and classroom furniture. Information and teaching materials may not be appropriate for children with hearing, visual, or intellectual impairments.

Skip to 2 minutes and 8 seconds Teachers and staff may not have the necessary skills, confidence, or training to support a child with additional needs. There may be stigma and discrimination from teachers, other children, and members of the community who feel that children with developmental disabilities are not suited to an education. Or who tease or bully them. As with healthcare, there may also be financial constraints, especially when considering the highest rates of poverty among families of children with a disability. Parents may simply choose not to invest in their disabled child’s education. It’s important to recognise that these barriers to education will be different across different countries, cultures, and contexts. But what we need to understand is these barriers do exist.

Skip to 3 minutes and 0 seconds And the consequence is to exclude children with developmental disabilities. So how do we overcome these barriers? In different countries across the world, different approaches are used to improve the access to education for children with developmental disabilities. Traditionally, children with developmental disabilities have been educated in special schools and special classes, segregating them from non-disabled peers. These special schools are often urban-based, in short supply, and of variable quality. And they may also help to perpetuate the social exclusion of people with disabilities. Because of these concerns, there has been a move in recent decades towards inclusive schools, whereby children with developmental disabilities are supported to attend mainstream schools.

Skip to 3 minutes and 55 seconds Inclusive schools that educate all children together will need to develop the teaching skills and resources to respond to a diverse group of children. For instance, teachers will need to be able to teach children with different abilities, speaking different languages, and from different backgrounds. And in doing so, they can produce better outcomes for all children, not just those with disabilities. The inclusion of children with developmental disabilities in mainstream schools may also help to reduce stigmatising attitudes in society. And help to build a more accommodating tolerant society. To realise inclusive education is not an easy process, as mainstream schools must provide physical accessibility, appropriate information resources, and train teachers.

Skip to 4 minutes and 51 seconds The movement towards inclusive education requires a twin-track approach, in which we provide both specialised schools for children with developmental disabilities, as we work towards inclusive mainstream schooling so that children are not left behind. Although education is a fundamental right for children with developmental disabilities, you may wonder why education is relevant to health and indeed, healthcare professionals. We don’t want to medicalise education! Healthcare professionals do, however, play a very important role in supporting inclusive education. First, they can advise teachers and schools on how to adapt furniture and other school equipment to suit the needs of children with developmental disabilities. This is particularly important for children who require ongoing medical or rehabilitation support, even while they’re at school.

Skip to 5 minutes and 51 seconds Healthcare professionals may also be asked to consult on the equipment. And train teachers and staff in care and support procedures. Similarly, healthcare professionals can work with teachers, parents, and children to make decisions about how to maintain a child’s health at school. And discuss possible reasonable adjustments. This may involve developing an individual healthcare plan. And this plan may include medication procedures for a child with cerebral palsy. Or behaviour management for a child with autism. As we will discuss later in the week, this will involve healthcare professionals collaborating with schools in their setting to promote inclusive education and health. This is a two-way street.

Skip to 6 minutes and 40 seconds And connecting with teachers will give health professionals an opportunity to learn more about a child under their care.

Access to education

In this step, Professor Tom Shakespeare (LSHTM and Lead Educator) considers the right of children with developmental disabilities to education.

Professor Shakespeare will start by describing the barriers to education faced by many children with developmental disabilities, before discussing the move towards inclusive education. To end, Professor Shakespeare will consider the role healthcare professionals have to play in helping children with developmental disabilities access education.

In this presentation we have briefly discussed inclusive education, but we should recognise that many children with developmental disabilities will benefit from specialised support, which is often provided at a special school. Ideally, parents and children should have the choice of which school best suits them, but unfortunately this isn’t always the case. This brings us back to the idea of needing a twin-track approach.

  • What do you think of the twin-track approach and the provision of both inclusive education and special schools?
  • In your setting do healthcare professionals collaborate with teachers and schools to support the health needs of children with developmental disabilities?
  • How could this collaboration be encouraged in the future?

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This video is from the free online course:

Integrated Healthcare for Children with Developmental Disabilities

London School of Hygiene & Tropical Medicine