Inclusion: theory and practice : Towards Inclusion - The Role of Information. Contents : Some Lessons from Cuba

The 2nd Ibero-American Special Education Congress

'Special Education Requirements and their Challenges for the 21st Century'

1 - 4 July 1997 - Havana, Cuba

Towards Inclusive Education: The Global Experience of Save The Children (UK)

Sue Stubbs . Disability Advisor . Save The Children (UK)

Executive Summary
In this paper, I present a personal overview of the experiences of an international non-governmental Child Rights Organisation - Save the Children (UK) - in relation to education and disabled children globally. I trace the development of philosophy and practice in relation to 'special needs' over the last few decades, alternating a discussion of key concepts with examples from Save the Children's programmes in different countries. This evolution in thinking and practice over time has resulted in some fundamental changes in policy and approach. Basically there has been a clear shift from a focus on the 'child as problem, requiring individual solutions'

towards a 'social model which identifies attitudinal, institutional and organisational barriers which can exclude children'.

Although in practice, different philosophies and approaches often operate simultaneously in order to respond to on-the-ground reality, I argue that it is extremely important that policy-makers and planners constantly examine and define the underlying philosophy and ultimate goals of any inclusive or integrated education programme. If not, then such programmes are in danger of perpetuating or even creating segregation and stigmatisation.

I also outline some of the key influencing factors on the move towards inclusive education, particularly in the economically poorer countries of the South. I argue that in recent years, many inclusive education programmes operating in these so-called 'less developed' countries are actually better and more successful models of inclusive education than are found in the industrialised countries of the North; there are many useful lessons from these programmes which need to be shared internationally.

I conclude with a brief summary of some of the lessons of experience of Save the Children, and also a personal vision for inclusion in the 21st century. Examples are given from work in the following countries; Morocco, Palestine, Thailand, China, Laos, Lesotho, Zanzibar, Kenya, Uganda and UK.

Introduction
Save the Children exists in order to promote and protect the rights of the child. The founder of Save the Children, Eglantine Jebb, gave special mention to the disabled child in her charter on the Rights of the Child written in 1919. Therefore working to promote the rights of the disabled child has been part of Save the Children's work over 76 years. In this paper, I will focus on the experiences of Save the Children in recent decades relating to the education of disabled children from countries in Asia, Africa, the Middle East and the UK. To begin with, these experiences to a large extent mirrored the development of policy and practice in the Western countries of Europe and the USA. However, in recent years, it has become apparent that our programmes in Asia, Africa and the Middle East are pioneering their own policy and practice and often demonstrate more inclusive and community-based approaches than can be found in the West. Therefore in this paper I will be sharing with you some of the lessons of experience from these countries which I feel could be helpful in informing policy and practice internationally. I will also outline a history of the concepts and philosophy behind special needs education, because this understanding has a direct impact on the policies and practice relating to the education of disabled children.

By 'disabled children' I am referring to all children who have some sort of physical, mental, sensory or behavioural difference which causes them to be excluded or discriminated against in mainstream society. This includes children with epilepsy, cerebral palsy, Down's Syndrome, visual, hearing and other impairments and also children who are not benefiting from mainstream systems, and are therefore 'dis-abled' by that system, policies, methods, and attitudes towards them.

Historical Perspective On 'Special Needs' Concept
In 1973, UNESCO defined special education as 'a enriched form of general education aimed at enhancing the quality of lives of those who labour under a variety of handicapping conditions' (UNESCO 1973).

The term 'enriched' was elaborated on to mean using specially trained personnel who would use special methods and technological equipment to offset handicap. So in this definition we can see that special education is special because of a) its target group, who have handicapping conditions and b) the use of special teachers. UNESCO further states that

'in the absence of such intervention, many handicapped are likely to suffer a degree of social incompetence and inadequacy and to live well below the level of their potential' (op cit).

In retrospect, it is not difficult to see problems with this definition; the target group is not clearly defined - which children do or do not have handicapping conditions? If a child uses a wheelchair and goes to school in an accessible building, then their condition is not handicapping. If a child with Downs Syndrome is attending their local primary school which uses a range of flexible child-focused methods to help all children, and is developing their potential, then we could also say that their condition was not handicapping. However if a child without any individual impairment is kept at home because the parents are too poor to send them to school, then that child has the handicapping condition of poverty.

This early definition also talks of special training enabling teachers to use special methods and equipment without which disabled children are likely to live below their potential. Experience has however shown that even with a vast amount of special teaching and equipment, the majority of disabled people in the UK for example, live below the poverty line, cannot get jobs, experience discrimination and cannot use public transport. They are living below the level of their potential because of the attitudes and barriers in society.

UNESCO has developed its policy on special education considerably since this 1973 definition, and is now a leading promoter of inclusive education, and of acknowledging that the term 'special needs' is a very wide-ranging term which can apply other groups of children not benefiting from existing educational systems.

Another implication of this earlier understanding of the special needs concept was that it gave rise to a whole profession of 'special educators', who worked in segregated settings, and had little to do with mainstream education. Most research and evaluations of special education focused on the impact on limited aspects of the child's functioning or learning, and rarely looked at the overall impact of the system and methods on the holistic development of the child, and how this type of education prepared them for the future.

Part of the problem with these early concepts and definitions is that in their countries of origin, they can change fairly rapidly and they are often challenged and rejected, and replaced by new concepts and definitions which represent a range of perspectives. However, when these concepts are exported to other countries, there is often a significant time lag, an inaccurate transmission, a lack of debate, and an inappropriate cultural context (Stubbs, 1995). This heightens the need for conferences such as this which can stimulate cultural exchange of ideas, information and practices and promote open debate.

The Morocco Experience
Save the Children has been working in Morocco for nearly 40 years, focusing mostly on disability. Work began in response to an earthquake in 1960 and also mass consumption of contaminated cooking oil which left around 10,000 adults and children paralysed. Physical rehabilitation and education were priorities, and Save the Children set up orthopaedic workshops and an orphanage and boarding school for physically disabled children. The school was also opened to other physically disabled children, mainly disabled by polio. At the time in Morocco there were very few educational opportunities for physically disabled children because of transport difficulties and the attitudes of schools who would give disabled children lower priority for restricted places (Save the Children 1995).

In 1972 the school re-located to Khemisset and was supported by Save the Children for a further 21 years until its hand-over to the Moroccan Ministry of Social Affairs in 1993. The positive impact of the school included;

• providing some physically disabled children from poor families with an opportunity for the best education; many went on to university
• providing disabled children with quality rehabilitation facilities
• providing a close community and support system for physically disabled children
• providing residential primary schooling and assistance with transport to secondary school

The following are some of the drawbacks of such provision highlighted by Save the Children and also by x-pupils of the school;

• the school catered for around 120 physically disabled pupils and yet there are an estimated million disabled children in Morocco who receive nothing at all.
• when the children attended secondary school, they often experienced pity, ridicule, overprotection and isolation
• they were totally isolated from their families and communities and found reintegration difficult if not impossible
• the cost per child per year of this provision was around $1,200; and yet the vast majority of disabled children in Morocco received nothing
• the provision focused on the child and did not target the attitudes, policies and institutional barriers which prevent disabled children receiving education
• family responsibility towards their disabled child was ignored and families received no support to keep their child with them
• in the long term, this type of provision is totally unsustainable, does nothing for the majority of disabled children in Morocco, and does nothing to support families, and does nothing to remove the barriers in society which exclude disabled children.

Influences On The Development Of Inclusive Education
The Morocco experience illustrates how important lessons were learnt about the limitations of elitist residential special education through becoming aware of the different consequences of such provision, and by feedback from pupils themselves. I will now summarize some of the key factors which have influenced the growing support for the concept of Inclusive Education.

The Influence of 'Consumer' Groups
Disabled People's Organisations have become increasingly organised and vocal over the last decade, particularly since the International Year of Disabled Persons in 1981. The leadership in these organisations has largely consisted of people who have either acquired their disability in adult life, and so have had the benefits of education and often higher education before becoming disabled, or of those who have received the type of elitist special education discussed above, and have therefore received a lot of privilege which has helped them become educated and vocal. It is not surprising therefore, that as a whole the Disability Movement has been ambivalent about inclusive education. In the early stages of the movement, the focus was on the adult issues of employment, income-generation and equal participation in adult society. Disabled children's issues were largely left in the hands of non-disabled professionals. In recent years this has begun to change and more Disabled People's Organisations are stating their views on inclusive education, and joining forces with parents organisations. The main contribution of the Disability Movement overall has been to raise awareness of disability as a human rights issue, to campaign for all disabled people to have a right to participate equally in society and this naturally has strong implications for educational provision - they have rejected the purely medical and rehabilitation models which have historically been applied to disabled children.

In Lesotho, a small country surrounded by South Africa, Lesotho Federation of Organisations of Disabled People (LNFOD) was a strong and vocal advocate for the rights of disabled people, and set the scene for the development of the national Integrated Education Programme. During the piloting of the programme, LNFOD contributed to the curriculum development, and also to in-service training of teachers

Parents organisations have had a major impact in countries where there have been sufficient resources for parents to develop self-advocacy. In many countries, parents of disabled children are often caught in a cycle of poverty and isolation that leaves little time or energy for forming pressure groups. Increasingly parents are fighting for the right of their disabled child to attend their local mainstream school - in the UK this often results in a lengthy battle between parents and the local education authority or school, but many of these battles have been won, and therefore there are increasing examples of how inclusion can be successful in practice.

In an East London borough in the UK, the parent of a child with Downs syndrome who was the chairperson of the Education Committee, succeeded in her campaign to close all special schools in the borough, which she described as a 'form of apartheid' - this borough is now one of the most pioneering areas for inclusive education in the UK.

Both Disabled Peoples Organisations and Parents Associations have highlighted important issues in relation to inclusive education;

• inclusion is not just about location; disabled children need to be receiving an appropriate and relevant education which allows them to develop their potential
• inclusion should not be seen as a cheap alternative; many resources tied up in segregated special provision need to be re-allocated to support mainstream provision.
• inclusion also needs to be adequately resourced.
• inclusion is not just about curriculum; the attitudes and ethos of the school is vital, and should actively combat discrimination and strive to promote an environment which welcomes disabled people
• disabled children need adult role models and need to develop pride in their identity as disabled people; this can be reinforced by encouraging disabled teachers, and ensuring all curriculum materials show positive images of disabled children and adults
• the voices and experiences of consumers; disabled children, disabled adults and parents need to be listened to in developing educational policy and practice; this task should not be left to non-disabled professionals.

Community-based Rehabilitation
Community-Based Rehabilitation (CBR) programmes have been spreading throughout the world since the early 1980s. A recent definition of CBR compiled jointly by UNESCO, WHO and ILO is;

CBR is a strategy within community development for the rehabilitation, equalisation of opportunities and social integration of people with disabilities.

CBR is implemented through the combined efforts of disabled people themselves, their families and communities, and the appropriate health, education, vocational and social services.'

CBR was initially pioneered by the World Health Organisation and was meant to be integrated into Primary Health Care programmes. This was a response to the scale of need (WHO estimated 10% of the population was disabled) and of the inadequacy and unsustainability of institution-based rehabilitation. From the start it had a health/medical bias, and focused on transferring basic physio and speech therapy techniques into the home and community. Because the philosophy was very much about supporting disabled children and adults within their own communities, and promoting their inclusion and participation in society, supporting attendance at local schools was a natural development once the child had improved their functioning through therapy. Also, there was usually no alternative provision (such as a special school) which was affordable or accessible. So integration happened as a result of both philosophy and pragmatics. However, there were many problems with this bottom-up, one-by-one approach, which will be discussed in more detail later.

Education for All and School Improvement
A third key influence on the move towards inclusion is undoubtedly the various international initiatives providing melting pots for the development of general educational policy and practice. The UN 'Education for All' conference in Jomtien in 1990 affirmed the principles of every child's right to education. The UNESCO World Conference on Special Needs Education in 1994 specifically examined how far 'special needs' is part of the Education for All movement. The resulting Salamanca Statement has since provided guidelines for policy development in several countries. This statement reaffirmed a commitment to Education for All, the unique characteristics of each child, the need to plan for diversity, the need for child-centred pedagogy and for the accommodation of children together in mainstream schools. (UNESCO 1994)

A major contribution of this conference was to highlight the range of difference which is present in today's societies, and to acknowledge that many groups and individuals are currently excluded from mainstream education, e.g. street children, children in conflict situations, working children, disabled children, children from ethnic minorities, children discriminated against (HIV status, leprosy), plus the large numbers of 'drop-outs' and 'repeaters'. This indicated a need to look at general educational reform, and to address issues of access and quality for all children.

Resources, Needs and Lessons of Experience
Another key influence on promoting inclusive education is maybe a more realistic assessment of the real world situation. Firstly an increasing global recognition that resources are limited, and need to be sustained. 'Solutions' to 'third world' poverty have been tried and failed and industrialised countries are experiencing recession. Secondly, numerous surveys have indicated that disability is widespread in all societies, and does not decrease with economic development, in fact prevalence increases due to better health care and increased longevity (Helender 1993). Widespread need and limited resources make integration seem not just a cheap option, but the only option, apart from any human rights considerations. Thirdly, after many decades of experimenting with large scale institutions and special provision, the lessons of experience were on the whole not positive in terms of quality of impact or sustainability.

Success of Inclusion
The final factor I will highlight which encourages the spread of inclusive policy and practice is the increasing evidence of successful inclusive education programmes. Although still very few and still far from an ideal of inclusion, what is interesting is the extent to which 'absolute' barriers seem to be overcome in practical situations where people persevere with vision and commitment. For example, in the UK, it was initially argued that children with Downs Syndrome could not participate in mainstream kindergartens; when they did, then the argument was that of course, they could not succeed in primary schools. When they did succeed in primary schools, the next argument was that they could not possibly succeed in mainstream secondary schools. In Lesotho (Stubbs 1995), inclusion was deemed impossible due to large class sizes and few resources, but schools with commitment and determination proved the opposite and demonstrated more success than schools with smaller class sizes and more resources.There is still insufficient evaluation and publicity relating to different models of inclusion, but even so, this has the potential to be one of the most powerful influences on the development of inclusion.

So to summarise, the following influences present strong arguments and lessons of experience to promote the move towards inclusive education;

• human rights and disability rights; the right to equal participation
• mobilising communities through CBR to push for education for their disabled children
• educational reform identifying many children who fail in current systems, and the need to improve both quality and access
• limited resources versus wide-spread need, and the failure of institutional/special models of provision
• finally, increasing evidence that inclusion can work, and that objections to inclusion can be overcome.

Definitions: Special, Integrated And Inclusive Education
At this point it will be useful to clarify the terms used in this paper. There are many different definitions and understandings of all these terms. The following definitions are derived from the experience of Save the Children and from the international literature, but they are not reflecting any type of consensus; all these terms are highly debatable and ill-defined in a range of cultures and contexts. I make no apology for defining these terms somewhat simplistically, and making a caricature of them; this is in order to stress the way in which they have influenced practice on the ground, rather than to highlight academic subtleties.

Special Education - this term is based on the assumption that there are children who have ''special educational needs (SENs). 'The term 'special' is used to refer to children who have some physical or behavioural difference from a locally and culturally perceived norm. A 'special educational need' is a loose term which is defined in relation to arbitrary concepts of what is normal and acceptable. The term SEN was originally devised to prevent labeling of individual children, and instead to draw attention to particular needs in an educational environment, which any child could have for any amount of time. Unfortunately it soon came to be used as a fixed characteristic of the child; 'special needs child'. A second assumption of this definition is that these children form a distinct group. This is also a false assumption because this group includes children with physical, mental and sensory impairments who are all very different. The third assumption in this definition is that these special children therefore need special teachers, special resources, special methodologies, and often special environments. The problem with this definition is that it is based on false or unsubstantiated assumptions. These assumptions are false because;

• children are all different, there are many types of difference
• so-called 'special methods' are often no more than good child-focused teaching practice, which would benefit all children
• all children experience difficulty in learning, and need their learning supported
• children learn through interaction and example of their peers, and yet children who have most difficulty in learning socially-appropriate behaviour are often kept together and are excluded from the mainstream environment, thus reinforcing inappropriate behaviour

Integrated Education -This term is most commonly used to describe; the process of bringing children with disabilities into a mainstream school (also called mainstreaming, particularly in USA). Often the underlying philosophy is similar to that of special education. The problem is located in the child, and the child must change or must be ready to fit into the existing system. The majority of resources, methods, approaches are used to prepare and support the individual child, not to focus on the system. The term is also used to refer mainly to the location of the disabled child, and 'integration' is sometimes used when a disabled child is in a classroom even if they are not benefiting and are being discriminated against. If the child drops out, repeats many years, or is excluded, then this is perceived to be the child's fault; 'they could not follow the curriculum', 'they could not walk to the school', 'they could not cope with the other children's comments'. The term integration is also used to refer to the system of having small units within a mainstream school, but often it is just segregation in closer proximity.

On the other hand, many times an approach which begins as integration (apart from the small unit model), acts as a catalyst for inclusion, and gradually more and more resources and focus is placed on adapting the system and changing the attitudes and behaviours of teachers and other children. With rigid systems, integration is often the only entry point to starting the process of inclusion.

Inclusive Education - I personally understand Inclusive Education as a strategy contributing towards the ultimate goal of promoting an inclusive society; one which enables all children/adults, whatever their gender, age, ability, disability, ethnicity, to participate in and contribute to that society. Difference is respected and valued. Discrimination is actively combated in policies, institutions and behaviours. Inclusive education is more than schooling, it incorporates a range of strategies within a community or society to ensure that all children have equal access to education which will equip them for life as part of that community, and which will help develop their potential. For a child with severe physical and mental disability, this may mean education within the home and family focused on developing self-help skills and on receiving a range of support from the community for the long-term care of the child. For a child who is deaf this may mean access to deaf adults and the development of local sign language, and education of the community, with the aim of preparing deaf children to participate fully in society. For the majority of children with mild and moderate impairments, it may mean participating fully in mainstream schooling, which would reflect the needs of children with child-focused methodology and a flexible curriculum. In developing Inclusive Education, the majority or resources and focus is on the system as a whole, not on individual children. This could include; training of teachers, awareness-raising, curriculum development, parent involvement, production of resource materials with positive images, promoting recruitment of teachers which reflect the difference in the community. The focus is on identifying and removing barriers which exclude children.

From Special, To Integrated, To Inclusive; Examples From Save The Children's Experience
I will now share examples of different models supported by Save the Children, and the lessons learnt from these experiences. Lessons learnt from segregated special education (the Morocco Experience) have been discussed earlier.

Small Units
A model which is often called 'integration' is that of the small unit or special class for disabled children existing within a mainstream school.

This model was piloted by Save the Children in Thailand, as a response to the needs of parents whose children were on a waiting list for a day care centre at the Rajanukal hospital for children with mental disabilities. The special class for children with mental disabilities was set up in a primary school in Bangkok in 1989 and aimed to gradually integrated the children into more of the schools activities. This would begin with lunch and play time, moving on to sports, music and art, and then gradually more academic lessons. A specially trained teacher would supervise the class. (Holdsworth and Kay 1996). This project extended to a second school and achieved some success in integrating the children.

As with the Morocco experience, this project provided some important lessons of experience for Save the Children. Despite the limited success for some individual children, the following drawbacks emerged;

• because of the existence of a 'special teacher' within the school, when mainstream class teachers experienced any problems, they sent their children back into this class.
• even children who were previously in the mainstream class were sometimes sent to the special class if they demonstrated some difficulty in learning or behaviour
• initially the project had a supportive head teacher who included these children on the school roll; when the headteacher changed, these children were excluded from the school roll
• the existence of a special class and special teacher reinforced the idea that mainstream teachers did not have the responsibility or skills to teach these 'special' children
• the success or otherwise of integration into certain classes depended on the goodwill and skills of the individual teacher, and was not necessarily supported by a whole school policy
• the mainstream methodology and curriculum continued to be teacher-focused and very rigid, and not responding to the individual needs of children; if there were problems this was seen as the child's fault and not the teacher's.
• even though the unit was located in a mainstream school, it still used a level of resources which was not replicable; specialist teachers and separate space for a small number of children, when mainstream classes were overcrowded.

In other countries where Save the Children works (e.g. Kenya and Uganda), this model has been found to have other disadvantages;

• specially trained teachers see themselves as different from other teachers, and often want to set up their own special school rather than work in a mainstream setting
• there can be bad feeling between the special and the non-special teachers because the former have smaller classes and more resources, whereas mainstream teachers are struggling with large numbers and few resources
• where the model is replicated and resources are scarce, often the small unit just becomes at best a 'baby-sitting' environment where disabled children pass the time, at worst it can become a 'dumping ground' for troublesome children who then suffer from neglect and even abuse by under-trained and under-supported staff.
• even when small unit teachers have been trained, they often lack practical experience and can become isolated and stressed when they get no support to deal with the on-going challenges of teaching groups of disabled children.
• these teachers are under pressure to demonstrate their 'special' skills, yet often find that these are of little use in helping them address some of the key problems experienced by disabled children; the negative attitudes of others, the need for support for their parents and families, their long-term prospects for employment and participation in society, their social behaviour and integration.
• the children in the units are often placed there just because they are 'disabled' rather than because of their learning needs. It is not uncommon to find units with a mixture of children with mental disability, hearing, visual impairment and even physical disability who have nothing in common with each other in terms of their learning needs
• children learn very effectively through imitating those around them, to place children with mental or behavioural disability together in a group often reinforces inappropriate social behaviour, which could easily be modified if they were able to imitate other children modeling more appropriate behaviour.
• by removing these children from their families on a daily basis, the families gain no support and training in how to manage and help their children to learn. In the long term this is dis-empowering for the parents, and ultimately when the child leaves the school and probably ends up at home, the parents are unable to cope
• some parents have been known to take these children to such a unit and then not return to collect them; a last resort after many years of lack of support and guilt.

The key lesson of the 'small unit' model is that it is fundamentally based on the same philosophy as segregated special education; the disabled child is different from the non-disabled child and needs special methods, teachers and resources. The child, not the system is seen as the problem. Therefore this can ironically increase segregation rather than promote integration.

Full Integration
Another model which Save the Children has learnt much from is the 'full integration' model. This is where disabled children are incorporated into mainstream classes with varying degrees of support. This model often has its origins in a Community-based Rehabilitation programme. This approach has happened in Save the Children-supported CBR programmes in many African and Asian countries. (Stubbs 1994a, examples from Zanzibar and Kenya)

Often what happens is that the CBR workers or volunteers have been trained in basically a therapy approach to disability, they will know some basic physiotherapy and speech therapy techniques to help improve children's functioning and to prevent the impairment becoming worse. As CBR programmes developed and tried to respond to the needs of families and communities, the role of CBR workers and volunteers broadened to focus much more on community-awareness-raising, family support, promoting the development of self-help groups, and also trying to ensure that the basic therapy approaches were integrated as much as possible into the daily household routines, because mothers rarely had time or energy to spend specifically on therapy. Education was constantly highlighted as a key priority by parents of disabled children, and so CBR workers found themselves liaising with schools to try to gain access for the disabled children in the CBR programme. This involved the following activities;

• helping to address the mobility problems of the child, eg enabling the child to walk with calipers or crutches, obtaining some type of 'transport' ranging from being given a lift on a bicycle, to being taken by other children in a wheelbarrow, to using a wheelchair, tricycle or public transport
• raising awareness amongst teachers to persuade them to accept the disabled child
• offering support to teachers in managing the child
• raising awareness and gaining support amongst other children through Child-to-Child activities
• promoting home-school links to support the integration, e.g. encouraging siblings to help with homework, encouraging the school to welcome and talk to parents
• demonstrating the benefits of social integration; e.g. a child who would previously be wandering round the village badly dressed and being ridiculed, would often become transformed once they had the 'status' of attending school, and would take pride in being 'like the others', even if they were not very academically able.
• encouraging peer tutoring and simple techniques in the classroom; sitting the child at the front or next to a child who could help them.

With physically disabled children, once they were able to gain access to school then attitudes would change quickly as teachers, pupils and parents soon realised that they could learn. With the mentally disabled children, the social benefits were often seen as a justification for integration, but because children were often identified when they were older, the full benefits of integrating a child when they are younger were not very visible. This model obviously had a direct beneficial impact on the individual child and often on the attitudes of the community.

A key factor which promotes the success of this model is that research has shown that prior to any extra integration of 'disabled' children, most schools already accommodate a large percentage of children who have some type of impairment which affects their learning in the mainstream situation.

For example, in the feasibility study carried out in Lesotho over a six month period, it was established that 17% of existing primary school population were experiencing learning difficulties in that situation. Many of these children would be 'repeaters' (staying down and repeating a year, often many times) and drop outs.

This means that when a CBR worker offers support to a teacher in this situation, often the teacher is relieved to be getting some support and advice which will help her/him with a large number of children already in the class, who are failing. However, the lessons of experience indicate several limitations to this model of integration linked to CBR;

• success depends on the ad hoc response of the individual class teacher and school
• scale of impact is limited because children are integrated one by one often requiring substantial support and follow-up from a CBR worker
• the lack of early childhood care and education provision in most situations means that the optimum time for developing the potential of some children with mental or sensory impairments is missed.
• also in most CBR programmes, it takes many years before community awareness means that parents will ask for support in the first few years of a child's life; many referred children in initial stages of a CBR project will be older than children in the first year of primary education.
• CBR workers rarely have a background in education and have limited knowledge and training in supporting teachers
• even with a background in education, CBR workers and teachers will often know little about 'inclusive methodology' which is still under-developed, under-publicised, and there are few or no relevant resource materials to draw on (Annex 1 on EENET)
• not all disabled children can benefit from this approach, as it ultimately depends on the how much the child is able to adapt to the existing system and how they can access the school
• finally, the key issue is again that the underlying philosophy has not significantly changed; the emphasis is on preparing and changing the child to fit into the existing system which is rigid, teacher rather than child-focused and often not particularly useful or relevant to most children, not just disabled children.

In the experience of Save the Children, although CBR is essential in the full support of Inclusive Education, as a strategy it can help integration but cannot promote an inclusive system; this has to be achieved through a comprehensive educational strategy in its own right. The CBR approach does however, offer more sustainable success than the small unit or segregated model. Once a school has accepted disabled children, and also started to more effectively respond to those already sitting in the class, then;

• teachers often feel substantial sense of pride and 'reward' when a disabled child succeeds in learning or develops more socially acceptable behaviour
• teachers take responsibility for all children partly because they have no alternative
• other children, given encouragement, naturally love to make friends with and offer mutual support to each other.
• many non-Western societies prioritise a sense of social responsibility above individual development, and so teachers and parents of non-disabled children will often support the spirit of collaboration and mutual support which is developed amongst the children
• the existence of a CBR programme provides the necessary back-up to families in terms of helping improve the functioning of disabled children, and of offering overall support to parents which is needed to reinforce the benefits of integration
• the CBR programmes increasingly focus on awareness-raising at all levels of the community, this is made more effective by the visible model of children succeeding at school, and in turn increases support for the policy and practice of integration.
• in educational systems where resources are scarce, this approach does not require specialist or extra resources and is therefore seen as the only viable option by many communities or education authorities.
• parents can become more motivated to support their child's education

Towards Inclusive Education
The final model based on Save the Children's experience which I will discuss I am calling 'Towards Inclusion'. All of the experiences discussed above indicate the limitations of what is called the 'individual model' of disability. In brief, this is when the problem is located within the disabled person, and therefore all the interventions and approaches are focusing on changing the disabled person to make them fit into a so-called 'normal' system. The inclusive model however, is based on the 'social model' of disability which emphasises that people with impairments are dis-abled by barriers which exclude them from participation. Save the Children has experiences which arise from several of the influences promoting inclusion which I discussed earlier. These examples show how some of these barriers are removed, but we are still a long way from developing a fully inclusive, non-discriminatory model of educational provision which values and supports all children. Hence 'towards inclusion' - we have not yet arrived.

Anhui, China
Anhui is a poor province in China with a population of 56 million people. The Anhui Provincial Education Commission (APEC) was influenced by China's legislation promoting Education for All, and felt that integration might be a way forward. Save the Children was keen to promote the equal rights of disabled children and worked in partnership with APEC to take forward a pilot programme of integrating children with mild mental disability into kindergartens. From the start in 1988, this project focused on changing the existing kindergarten system. The dominant model was of children sitting in rows, being directed by the teachers, lengthy lessons requiring children to sit still, and success or failure being perceived as the child's responsibility. The system was impressive in that it enabled large numbers of young children to access education - many kindergartens had over a thousand children and teachers were extremely committed and hard-working.

The pilot programme encouraged the following changes;

• active learning by children
• small group work
• learning through play
• closer cooperation with families
• whole school approach and teachers supporting each other
• support from administrators and the community through the establishment of local committees
• regular teacher training
• two children with learning disability were gradually integrated into each class

The results were impressive;

• acknowledgment that this improved education for all children
• APEC's acknowledgment that this was not just a 'cheap option' but a 'better option' than segregation
• scaling-up of the pilot project to reach every district within Anhui province
• children moving on to primary schools and continuing to succeed

The whole kindergarten system is being transformed, and this will eventually enable more children with different types of disability to be included. The aim is also to take these lessons into the primary school sector.

Lesotho, Southern Africa
Lesotho is a small mountainous kingdom in the middle of South Africa with a population of around 2 million. The influences on promoting inclusive education were

a) the lobbying by disabled people, parents and other rights groups such as Save the Children within the Southern Africa region, to highlight the rights of disabled children,

b) the international influence of the Education for All conference (Jomtien 1990) and

c) high drop-out and repeater rates in Lesotho schools, many of whom were children with learning disabilities.

The project began with a six-month feasibility study which identified 17% of existing children in primary schools had some sort of impairment affecting their learning. Teachers felt unable to meet the needs of these children already in their classes. Therefore the project began by addressing a need within schools, rather than adding anything extra. Ten pilot schools were chosen and the main strategies were as follows;

• awareness-raising at all levels; education administrators, teachers, the community
• involvement of parents and formation of a Parents Association of parents of disabled children
• initial three week training for all teachers from the pilot schools
• follow-up training and school support
• production of curriculum materials for teacher training giving basic information about disabled children
• minimal input of resources to promote sustainability.

A research project was carried out on two of the pilot schools, one which was deemed to be successful, and another which was deemed unsuccessful by the integration team. The results can be summarised as follows;

Key lessons from the 'successful' pilot school;

• large class sizes (sometimes over 100:1) and few resources were not an absolute barrier to integration
• participation at all levels had been encouraged from the start
• there was strong leadership and district level support
• parents were involved and supported
• teachers felt the programme helped them address an existing problem and reduced repeater and drop-out rates
• the strong sense of community responsibility fostered an ethos of mutual support
• teachers felt their jobs were more rewarding, even though they often worked harder to help individual children

Key lessons from the 'unsuccessful' school were;

• the school lacked support and lacked positive leadership
• the school was keen to preserve its reputation for academic success and therefore not keen to include 'slow learners'
• the school was owned by a Church which did not offer support
• the school had a hostel for disabled children which had been imposed on them by a missionary priest, and they felt no ownership of this hostel
• there was a strong body of teachers who had taught at the school for several decades, and new teachers with new ideas were outnumbered
• initial negative attitudes meant that they dropped out of training courses and so did not acquire relevant skills, therefore failure became ingrained.

In the example of the 'successful' school, children with all types of impairment were being included and even with large class sizes the teachers used several strategies;

• peer support; sitting them next to pupils who could help
• seating; sitting children near the front of the class
• adapting the curriculum
• group work
• encouraging sibling support at home
• promoting positive attitudes.

There is a long way to go in terms of improving the quality of education in Lesotho, but this applies to all children not just disabled children. The most important factor is that the disabled children are included and are benefiting from social integration and are offered an opportunity to learn. The approach is inclusive because it aims to change the system as follows;

• a curriculum component will be incorporated into the mainstream initial teacher training
• in-service training is targeted at whole schools not just certain teachers
• there are no special teachers, classrooms or curricula
• specialist support will be available at district level, not in individual schools (e.g. braille support)
• teachers are encouraged to see that they are responsible for all children, and that all children need support with learning.

Palestine, Middle East
Palestine in the Middle East has a population of around 2.4. million. The newly formed government states that every child has the right to education and that disabled children should be integrated. Traditionally, these children have been excluded either by staying at home, or in special provision. The project in Palestine is to promote inclusion through a Child-to-Child programme. This has grown from an initial CBR programme which succeeded in integrating individual children into mainstream schools. A recent evaluation of this programme emphasised the need to move from integration towards inclusion by more focus on attitude change. This small project aims to use the well established methodology of Child-to-Child approach in order to make the school a more inclusive environment. Child-to-Child promotes active learning and streses that children themselves are capable of analysing and solving their own problems, and promoting community development. This project will facilitate children themselves, both disabled and non-disabled to devise strategies for promoting a school environment where difference is welcomed and all children are treated equally. The focus will be on changing attitudes, behaviours and the environment. This project is in process and so has not yet been evaluated, but is an example of a pioneering strategy to promote inclusion. (Hawwash M and Maas L, 1996)

Laos, South East Asia
Laos has a population of 4.5. million people consisting of a wide range of ethnic groups. After the 1975 revolution, the Lao People's Democratic Republic was faced with a formidable task of reconstruction after 50 years of colonisation and 30 years of civil war and extensive bombing. Massive improvements were made in expanding access to schools, but quality was still an issue of concern and this resulted in the School Improvement programme, to which Save the Children gave assistance. (see Holdsworth and Thepphavongsa 1996, and Save the Children 1996 for more details on this programme)

The Laos Integrated Education project grew out of this national programme focusing on up-grading teacher effectiveness in primary schools. The focus was on pre-service training and classroom methodologies. What emerged from research in classrooms was that very little attention was being given to children's individual learning needs. This gave rise to a debate on children's learning needs and strategies which could help them. Therefore the IE programme grew logically from the school improvement programme. The strategies were as follows;

• study tours for key officials to see integrated education in practice in other countries
• training based on the UNESCO Resource Pack (called Special Needs in the Classroom) for Laos education staff.
• the establishment of a replicable pilot primary school.

The work in the primary education sector highlighted the potential benefits of extending this approach to the kindergarten sector. Prior to the changes, the methodology in kindergartens was teacher and subject focused; teachers did most of the talking, teaching aids and toys were not available, children had little participation or choice. After the changes, the child became the centre of the curriculum and methodology, the philosophy of 'learning though play' was implemented, and children's participation and choice was encouraged. Both parents and teachers are happy with the obvious improvements in children's learning and behaviour. This new environment prepared the ground for the more systematic inclusion of children with disabilities (e.g. Down's Syndrome, cerebral palsy). The skills of kindergarten teachers were not only up-graded, but they gained increasing status and recognition; primary school teachers began to look to them for training on how to involve families, developing social skills etc. There is currently a high demand for expansion of the programme, but this still needs to proceed slowly, to avoid cosmetic changes and to properly evaluate methodology. With a lack of material and technical resources to draw on, a key factor contributing towards success has been the high degree of cooperation and mutual support between teachers and schools, and between all levels involved; ministry, administrators, community, schools, parents, teachers and children. (op cit)

In the above examples, programmes we can see a fundamentally different underlying philosophy; the problem is located in the system and in society; structures, policies, methodologies, attitudes. In practice of course, there is often a mix of philosophies operating simultaneously, and where rigid systems already exist (which is everywhere to some extent) then the approach takes time to change from integration to inclusion. The issues of language and culture are also central, and often in Save the Children programmes, the terms 'special education', 'integrated education' and 'inclusive education' are used differently or inter-changeably - this is because these terms have different meanings in different contexts, and it is not always useful to keep changing terminology to follow fashion, unless it can really help increase understanding. It is important however, to be clear about the underlying philosophy and aims of a programme, whatever language is used.

The following is a summary of some key lessons from Save the Children's inclusive education programmes;

Prior to Implementation

• a comprehensive situation analysis should be carried out before initiating a programme, covering government legislation, organisational structures and roles and responsibilities, current attitudes and behaviours, assessment of openness or resistance to change, existence of local resources
• identify and build on local resources and initiatives
• if possible start with the youngest age groups, eg kindergarten sector
• choose a pilot school which is not untypical and can provide a replicable model
• start small and build on success.

Implementation of Inclusive Education

• training should occur in small doses, should be on-going not one-off, and should preferably be based on site
• awareness-raising needs to happen from the start and at all levels, and ownership and participation encouraged
• success does not depend on a large budget, rather the careful and planned use of resources over time
• good leadership and a whole-school approach is needed
• specialist support should be located at district and national levels, not within schools
• the programme needs the support of experienced educational personnel
• the pace of development should be slow and enable participants to feel comfortable with the changes
• support systems for families, teachers and schools are needed
• the programme should aim to benefit all children, not just disabled children. School improvement is a necessary, not an optional component
• capacity building of key people is essential
• ownership should be shared between the school, family and community.

Inclusion In The 21st Century
In the above discussion and examples, I have shown how policy and practice have developed within Save the Children Fund from the perspective of its global experience in promoting the Rights of the Child. Alongside the development of policy and practice which influence each other over time, has been the gradual development of a vision of an inclusive society which is the logical outcome of adherence to key principles of the equal value and dignity of all people. This vision is not yet realised anywhere in the world, and no doubt will continue to evolve. Where there is a clear commitment and vision however, the above examples illustrate how small steps can be taken in this direction, and that so-called 'barriers' can be overcome and demolished. Once children and young people are supported and encouraged to accept and value each other in an inclusive education system, there is more chance that they will grow up to create an inclusive society, which is ultimately sustainable and beneficial to all.

This is a personal list of some features which may characterise an inclusive education system in the 21st century;

• a comprehensive educational system which goes beyond schooling, and which targets all members of the community, whatever their age, gender, ability, ethnicity, disability or HIV status
• community-wide awareness, understanding and acceptance of disability and disabled people, and of people of different appearance, behaviour, beliefs, culture etc
• attitudes, behaviours, policies and practices which celebrate diversity within society
• accessible environments and transport benefiting not just disabled people but people with young children and elderly people
• curriculum materials and resources in accessible formats and displaying positive images of children with all types of difference
• a teaching force trained to respond to individual child needs, and able to manage diversity in the classroom
• sign language and other mother-tongues accepted and recognised; bi-lingual educational provision
• family support and involvement in education, and education system support and acknowledgment of family situations.
• diversity reflected in composition of educational personnel, e.g. disabled teachers, teachers from ethnic minorities
• specialist resource teachers being located at district and national levels, not within individual schools
• inclusive early childhood education focusing on maximising the potential of all children, prioritised and well-resourced
• life-long and flexible opportunities for education
• diversity and difference recognized and celebrated in a variety of ways, including cultural and arts.

This paper has aimed to share a broad-based experience in order to challenge thinking and to stimulate debate. Any inaccuracies or mis-representations of Save the Children programmes are the fault of the author. Comments and feedback are welcome.

References and Bibliography

Inclusion: theory and practice : Towards Inclusion - The Role of Information. Contents : Some Lessons from Cuba

22/08/1997