Inclusive ECCD: - Consultative Group on Early Childhood Care and ...

■ There is an increasing gap in terms of the
number of people who can be served by
‘specialists’ and the number of people who
need to be served.
It is estimated that approximately 10% of the
child population can be classified as having special
needs. In countries where there is extreme poverty,
war, and violence, this is likely to increase to sixty
percent or more. One way to assess the extent to
which the country is meeting the needs of this population
is to look at what percentage of special needs
children are being served by the school system. In
1986/87 UNESCO conducted a survey of 58 countries
in relation to provision for people with special
needs. It was found that 34 countries have fewer than
one per cent of pupils enrolled in special education
programmes; ten of the countries had special education
provision available for less that one-tenth of one
percent of pupils. (Anscow 1994, 2–3) Evidence
from the survey led to the conclusion that, “Given
the size of the demand and the limited resources
available, the education and training needs of the
majority of disabled persons cannot be met by special
schools and centres.” (UNESCO 1988b, 15)
Thus even ten years ago the need for specialised services
far outstripped the demand.
Today the situation is even more severe. With
screenings that identify more people with special
needs, the increase in the numbers of children who
have physical disabilities and needs for psychological
support as a result of war, the increasing number
of children with special needs as a result of a polluted
environment, and the increasing number of children
raised in poverty as a result of global economics, the
percentage of the population that could be classified
as having special needs is increasing exponentially.
(UNESCO 1997)
■ There is a recognition that the resources
required to provide specialised services
leave many unserved.
The costs of introducing specialised services in
the Majority World that are equivalent to (i.e., meet
the standards of) what is offered in resource-rich
countries are high. When countries are struggling
just to meet people’s minimum needs for health and
education, it is hard to justify the allocation of extensive
resources to the creation of specialised services.
As O’Toole notes:
In our blinkered desire to imitate the services offered by the
West we have lost sight of the true magnitude of the problem.....However,
to the 98% of families who are presently
receiving no assistance the argument concerning ‘standards’
has no relevance. For them the question becomes, quite simply,
will any significant service reach them during their lifetime.
(O’Toole 1991, 11)
■ There is a recognition that the holistic
nature of a child’s development requires a
holistic approach.
Specialisation leads to compartmentalisation of
the child, and to the belief that discrete actions can
be applied to meet the needs of categories of children.
People in the Majority World should not have
to make the same mistakes that have been made in
resource-rich countries where experience has shown
that the ‘multiple-professional’ model for working
with children with special needs is not the best model.
To illustrate the complexity of the multi-specialist
model, and what it leads to in terms of services for
the child, Bruder (1997b) lists all the specialists that
might be involved with a young child. These may include
audiologist, early childhood special educators,
early childhood educator, nutritionist, nurse, occupational
therapist, physician, psychologist, physical
therapist, speech-language pathologist, and a vision
specialist. As Bruder notes,
Each discipline has its own training sequence...and licensing
and/or certification requirements, most of which do not require
specialisation to work with young children (and their families)….
Different disciplines tend to use different treatment
modalities (e.g., occupational therapists may focus on sensori-integration
techniques, and physical therapists may
focus on functional movements using a neuro-developmental
approach). (Bruder 1997b, 1)
This specialisation has led to a partitioning of
children, and to treatment that focuses on trying to
ameliorate the problem, rather than addressing the
multiple needs and abilities of the child.
By looking at the assumptions underlying the multiple
professional model it is possible to see its limits.
These are outlined by Bruder (1997b, 2) and include:
■ The model assumes that a professional from a
specific discipline is the most appropriate person
to provide the intervention within a given
developmental area.
Yet, given the nature of children’s development,
there would be overlap between what is provided
through, for example, oral/motor interventions, and
those that are provided through social-cognitive interventions.
■ The model is based on the assumption that the
child will progress in only the developmental
area in which the discipline-specific intervention
occurs.
Most children who receive early intervention services
demonstrate delays across many areas of development.
It is very difficult to design interventions for
these children because of the necessity and intensity
of discipline-specific interventions. The choice of interventions
becomes arbitrary and the effectiveness
of a single disciplinary intervention cannot be evaluated
in isolation of other interventions. In resource-
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