Children & Person with Special NeedsDr. Nik Nor Ronaidi bin Nik Mahdi
Definitions1. Child: A child means every human being below the age of eighteen years unless, under the law applicable to the child, majority is attained earlier. (United Nations Convention on the Rights of the Child, Article 1)2.Special needs: The Special or unique, out-of-the-ordinary concerns created by a persons medical, physical, mental, or developmental condition or disability. Additional services are usually needed to help a person in one or more of the following areas, among others, thinking, communication, movement, getting along with others, and taking care of self. (Center for the Improvement of Child Caring (CICC), USA)
3. Impairment:• reduced function of an organ or body part4. Disability:• reduced function and activity of a person7. Handicap:• the social, economic and cultural circumstances that place persons with impairment or disability at a disadvantage relative to their peers (International Classification of Impairments, Disabilities, and Handicaps, WHO)
Disease / injury The level of the organ or body part Impairment The level of the person Disability The level of interaction of persons with society or the environment Handicap (International Classification of Impairments, Disabilities, and Handicaps, WHO)
Causes of disability• Congenital or perinatal disturbances – Mental retardation – Somatic hereditary defects – Non – genetic disorders• Communicable diseases – Poliomyelitis – Trachoma – Leprosy• Non – communicable somatic diseases• Functional psychiatric disturbances
Causes of disability• Alcoholism and drug abuse• Trauma / injury – Traffic accidents – Occupational accidents – Home accidents – Violence• Malnutrition
Global• An estimated 10% of the world’s population (approximately 650 million people, of which 200 million are children) experience some form of disability.• The most common disabilities are associated with: – chronic conditions (cardiovascular and chronic respiratory diseases, cancer and diabetes) – injuries, (due to road traffic crashes, falls, landmines and violence) – mental illness – malnutrition – HIV/AIDS and other infectious diseases. (World Report on Disability and Rehabilitation )
• Disability is both a cause and a consequence of poverty.• About 80% of the worlds population of people with disabilities live in low-income countries and experience social and economic disadvantages and denial of rights.• Most of the developmental initiatives ignore the need of people with disabilities.• The UN convention on the rights of persons with disabilities emphasizesthe importance of mainstreaming disability issues for sustainable development. (World Report on Disability and Rehabilitation )
Primary prevention• This involves the prevention of the manifestation of the disability• It may be: – universal (i.e. prevention desirable for everyone) – restricted to a selected population (i.e prevention recommended for high-risk groups) – to an indicated population (i.e. prevention in individuals with an identified risk)
Primary prevention• Primary efforts are directed toward reducing the actual occurrence of disabilities• Employ measures that prevent the conception of a disabled individual or delay the disabling process
• Primary prevention efforts include: – genetic counselling • Genetic counselling is an essential part of primary prevention strategies. It is the process of providing information on genetic (recurrence) risk, the nature and consequence of genetic disorders and the means available for the prevention of transmission of defective genes – immunization programmes • general immunization during infancy have led to a remarkable decrease in several infectious diseases that used to be a major cause of disability (e.g: poliomyelitis, tuberculosis, meningitis and encephalitis) – improved prenatal, perinatal and postnatal care • This aspect of prevention concentrates on the management of maternal risk, factors at the time of delivery and support for the premature or compromised neonate – Improved nutrition – regulations and legislation • Certain health regulations and legislation, such as mandating immunization of infants, also play an important role in primary prevention. – environmental and technological interventions to prevent toxicities and injuries, and educational interventions (to reinforce a variety of disability prevention programmes)
Secondary prevention• Aim at reducing the duration or severity of disability• These activities provide early identification of the disabling condition followed by prompt treatment and intervention to minimize the development of disability.• These strategies can be applied either at the prenatal or neonatal level.• Neonatal screening is a well established preventive approach and includes both clinical and biochemical screening.
Tertiary prevention• Aims at limiting or reducing the effects of a disorder or disability that is already present.• It involves long-term care and management of a chronic condition – (e.g. rehabilitation or correction of the disability by surgical measures or by adopting strategies by which the disabled person can lead a normal or near normal life).
In Malaysia• Role of : – Ministry of Health – Ministry of Women, Family and Community Development • Department of Welfare – Ministry of Education – NGOs
Ministry of Health• Services: – Early assessment by multidisciplinary team, Occupational therapy, Physical rehabilitation / physiotherapy, Speech therapy, Hearing therapy / audiology, Follow-up treatment, Dietitian, and Psychotherapy.
Flow of management for children with special needs (0-18 y.o) in MOH• Step 1 : Initial Assessment – Initial assessment is conducted by specialists to determine the child’s type of disability. Get an assessment from a doctor in a general clinic / child (paediatric) clinic / rehabilitation specialist.• Step 2 : Confirmation of Disability – Submit the ‘Children with Special Needs Registration and Placement’ Form – register with the Jabatan Kebajikan Masyarakat
• Step 3 : Detailed Assessment by a Multidisciplinary Team – for group assessment and treatment planning.• Step 4 : Treatment Planning• Step 5 : Treatment Begins• Step 6 : Follow-up Treatment and Re-assessment• Step 7: Proper placement in pre-school / special school / vocational school – Children who fulfill the entrance criteria can register with the State Education Department to enter the Special Education Programme of the Malaysia Ministry of Education. – Children who do not meet the entrance criteria for the Special Education Programme or who have severe disabilities will be referred to the Social Welfare Department for further action.
Social Welfare DepartmentDASAR ORANG KURANG UPAYA Dasar OKU menjadi asas kesaksamaan hak dan peluang kepada OKU bagi penyertaan penuh dalam masyarakat. Dasar ini turut mengutamakan nilai hak kemanusian seperti kemuliaan, kehormatan dan kebebasan bagi membolehkan mereka hidup berdikari.OBJEKTIF DASAR:4. Memberi pengiktirafan serta penerimaan prinsip bahawa OKU mempunyai hak dan peluang yang sama bagi penyertaan penuh dalam masyarakat;5. Memastikan OKU menikmati hak, peluang dan akses secara saksama di bawah undang-undang negara;6. Menghapuskan diskriminasi terhadap seseorang atas sebab ketidakupayaannya;7. Mendidik dan meningkatkan kesedaran masyarakat mengenai hak OKU.
Services provided for persons with disabilities:• Registration and Identity Card: – The purpose of registration is to collect data and statistics for the planning of services, rehabilitation programmes, prevention, training, education and early intervention. – The Identity Card For Persons With Disabilities (Kad Kenal Diri Orang Kurang Upaya) are issued to those who register themselves to make communication with the relevant authorities easier.
• Assistance with Orthotic/Assistive Devices (Bantuan Alat Tiruan/Otortik): – The purpose of this is to help persons with disabilities purchase orthotic/assistive devices such as wheelchairs, calipers, artificial limbs and other equipment they cannot afford.• Launching Grants (Geran Pelancaran): – To assist persons with disabilities who have the knowledge and skills but who do not have the financial capital or equipment for self-supporting / small business / agricultural projects. – Maximum Launching Grant - RM2,700
• Disabled Worker’s Allowance (Elaun Pekerja Cacat EPC): – This scheme is to encourage persons with disabilities to continue working and be self-supporting without depending on their family or others, and to obtain supplementary income for their basic necessities.• Sheltered Workshop (Bengkel Terlindung): – JKM works to obtain job opportunities for the disabled in the private/public sector, or placement in Sheltered Workshops such as Bengkel Daya Klang, Bengkel Daya Sg. Petani, or any of the 13 other workshops run by voluntary organizations.• Vocational Skills Training: – Courses offered include computers and secretarial, tailoring and fashion design, manufacturing of assistive devices, computer support, electrical wiring, electronics, baking, photography and driving.
• Entry into Rehabilitation Institutions (Taman Sinar Harapan): – Rehabilitation is given to persons with intellectual disabilities to acceptable levels based on individual capabilities and desires. – Shelter and care are also provided for persons with severe disabilities. – Activities include training daily living skills, pre-vocational education, informal academic classes, religious/moral lessons, sports/recreation and outdoor activities.• Community-Based Rehabilitation CBR (Pemulihan Dalam Komuniti PDK): – CBR is a community development strategy for persons with disabilities to obtain rehabilitation within their family and community whereby they are given the equal opportunity for rehabilitation and interaction with society. – Activities include gross motor skills, fine motor skills, language development, social development, self-care, pre- Reading/Writing/Math skills, creativity, sports and recreation.
Assistance and benefits provided for persons with disabilities• Education Assistance: – MOH’s Special Education Department provides special classes for children with disabilities.• Public Transport Assistance: – MAS gives up to 50% discounts on domestic airfares – KTM provides up to 50% off all classes of rail travel – TRANSNATIONAL busses gives up 50% discounts of ticket prices – PUTRA-LRT also provides discounts for the disabled• Housing Assistance: – Kuala Lumpur City Hall (DBKL) also provides the disabled with rental assistance for low-cost housing and DBKL flats.• Exemption from Medical Treatment Bills: – Persons with disabilities are exempted from paying for third-class wards, specialist bills and medication.
• Exemption from Travel Document Bills: – exemptions from costs of preparing and processing travel documents (International passports)• Tax Relief and Exemptions: – Tax relief/exemptions are provided for parents who have children with disabilities below the age of 18 years. – Tax deductions are given for the purchase of special equipment for personal use or for the use of children/parents with disabilities. – Tax deductions are also given to employers of the disabled. – Additional tax exemptions are given to person and spouses with disabilities.
• Derivative Pension: – The government, through the Public Service Department’s Pensions Division, has approved a derivative pension for children/dependants of civil servants who have passed away.• Assistance with Prosthetic / Assistive Devices: – Exemption from import duties and sales tax for equipment designed specifically for use by persons with disabilities.• Job Opportunity Assistance: – The government’s commitment to provide job opportunities for the disabled includes the allocation of 1% of all public sector jobs. – The Department of Labour (Jabatan Tenaga Kerja) also provides registration services of job opportunities for the disabled.
• Assistance with Purchasing National Vehicles: – 10% off the sales tax of National cars / motorcycles.• Telekom Assistance: – exemption from monthly phone rental rates, free- of-charge 103 operator calls, and call waiting / call divert services.
Ministry of Education• Dengan adanya Dasar Pendidikan Wajib 2002, pendidikan peringkat sekolah rendah untuk semua kanak-kanak termasuk kanak- kanak berkeperluan khas adalah wajib di negara ini. Ibu bapa yang gagal mendaftar anak dalam umur persekolahan peringkat rendah boleh didakwa.
FALSAFAH PENDIDIKAN KHAS• Mempunyai matlamat yang sama dengan Falsafah Pendidikan Negara, menyediakan perkembangan optimum kanak-kanak dengan keperluan-keperluan pendidikan khas agar dapat berfungsi sebagai individu yang berkemahiran, berdikari, berhaluan, boleh merancang, mengurus kehidupan sendiri, boleh menyedari potensi sendiri dan boleh menyesuaikan diri dalam masyarakat.
Program Pendidikan Khas Kementerian Pelajaran Malaysia• Sekolah Khas: – Untuk murid kurang upaya dari segi • Deria (hearing and vision) • Kognitif• Program Pendidikan Khas Integrasi: – untuk murid-murid berkeperluan khas bermasalah pembelajaran, bermasalah pendengaran dan bermasalah penglihatan. – Program ini diwujudkan di sekolah harian biasa menggunakan pendekatan pengajaran pembelajaran secara pengasingan dan separa inklusif.
• Program Inklusif: – menempatkan murid berkeperluan khas belajar dalam kelas yang sama dengan murid biasa• Program Pendidikan Pemulihan: – kelas khas yang terdapat di semua sekolah aliran perdana (gagal 3M)
Peranan NGOs• Membantu agensi kerajaan menyediakan kemudahan seperti berikut: – Mengadakan Pusat Harian dan Pusat Latihan – PDK – Program intervensi awal – Aktiviti multidisiplin di komuniti – Bimbingan dan sokongan melalui laman web – Kaunselling – Pusat sumber dan rujukan
Associations and Support Groups in KelantanName : Persatuan Insan Istimewa Kelantan (INSANI)Address: No 33 Kampung Raja, Panyit, 18500 MachangName: Persatuan Membantu Orang-orang Cacat Pendengaran Negeri Kelantan (PEMANCAR)Address: c/o Jobstan Orl, Pusat Pengajian Sains Perubatan 16150, KelantanDescription: For persons with hearing imparimentName: Persatuan Orang Cacat Pendengaran Kelantan (POCPK) (Kelantan Association for Persons with Hearing Impairment)Address: PT 31 386-F Tingkat 1, Kedai Buluh Kubu, Jalan Pintu Pong 15300 Kota Bharu, Kelantan.Name: Persatuan Sindrom Down Negeri Kelantan (In Partnership with Persatuan Sindrom DownName: State Council for Rehabilitation Negeri KelantanAddress: Wisma Insaniah Tengku Anis, Jalan Bayam, 15200 KotaDescription: Its priciple objective is to make available various rehabilitation services to the handicapped in Kelantan, so that they are able to earn a living. Provides workshops for the resourceful rehabilitation at care centres for disabled children.
References– www.moh.gov.my– www.jkm.gov.my– www.moe.gov.my– http://www.disabilitymalaysia.com– Komitmen dan Peranan Guru dalam Pelaksanaan Pendekatan Pendidikan Inklusif di Malaysia. Supiah Saad, Jabatan Pendidikan Khas Kementerian Pelajaran Malaysia 2005.– Early recognition and intervention for prevention of disability and its complications, Mohsen A.F. El-Hazmi, Eastern Mediterranean Health Journal, Volume 3, Issue 1, 1997, Page 154-161.