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Inclusion for the excluded - a pipe dream or practical necessity?

Including children with learning difficulties in refugee camp schools on the Thai/Burma border

Sarah Wallis, 2002

The report that follows describes an Early Intervention programme piloted in a large, well-established refugee camp on the Thai/Burma border. The camp is home for one of the ethnic groups forced to flee from Burma as a result of military oppression. The programme, funded by Consortium (a US-based NGO) and Voluntary Service Overseas (partly funded by DFID in the UK) is in its infancy but seems to be an excellent model for inclusion practice. I visited the camp in February 2002.

During my visit I wanted to address the questions:

• What are the needs of disabled children and their teachers in the refugee camps?
• What is being done already to address these needs?
• What more can be done; can a model be developed for future practice?

Research methods used

• Formulation of interview questions for a small qualitative sample
• Visit to Mae La camp and additional interviews
• Analysis of findings
• Recommendations for Early Intervention as a model for inclusion in refugee situations

What I attempt to do in this short report is to summarise my findings which formed the basis of a Masters dissertation. A copy of the complete dissertation will be available in Autumn 2002.

The bulk of my research was to centre around eight families already identified by the NGO workers living in the largest refugee settlement near Mae Sot. Mae La camp is comprised mainly of Karen refugees. In the course of my investigation I needed to establish how the needs of these families had come to light, what their particular difficulties were and what was being done to address their needs. The western NGO worker was able to summarise the survey work undertaken by herself and her Karen-Thai colleague in the ten months previous to my visit. I will describe the process briefly here as it sets the scene for my own investigation.

• An initial survey indicated that there were 38 children who needed help in nursery classes and 24 who did not attend school, but may have had a home visitor. Homes with disabled children were usually known to community leaders and, at this stage, the teacher trainers had to rely on word of mouth and the individual translators' understanding of the information passed to them.
• A second survey revealed 118 children of kindergarten age with about three new cases identified each subsequent week. Given the camp population of approximately 40,000, two-thirds of whom were children, the survey figures probably only represent a fraction of the real population. However, this initial investigation gave the teacher trainers a starting point for their assessment of needs. It was apparent that teachers in already large nursery classes (averaging 40 pupils) needed considerable support if they were to be able to meet the needs of disabled children.
• The needs identified by parents, medical surveys, home visitors and teachers were described as: Cerebral Palsy, Down's Syndrome, speech difficulties, visual and co-ordination problems, behavioural problems, slow learning (repeating grades), seizures, attention and memory difficulties.
• Given the varied levels of training of nursery teachers (some had completed only middle school education themselves), the task of teaching children with this range of need was a huge one. The teacher trainers felt that the only realistic way forward was through training specialist support teachers. These would then be resources in the nursery classrooms or at home and assist in the transition into kindergarten.
• Job advertisements were posted in the camp. Community leaders were asked to suggest to serving teachers that they might apply for the training on offer. The teacher trainers devised a six-week training programme for the fifteen successful applicants. This was a huge challenge for teachers who previously had relied on their own memories of primary school education and /or had had a basic training in Early Years education. They were now being required to take on board new information about disabilities and special educational needs as well as ideas about child development and teaching methodology.
• Since the initial training in Autumn 2001 the teachers had met weekly to extend their skills and share ideas.

Research Findings

My own small-scale survey (eight case studies) was an attempt to understand the impact of the Early Intervention project and evaluate its effectiveness as a model for working with disabled children in refugee situations.

The average family size in the sample chosen was 4.4, though larger families were not uncommon in the camp. Seven families had been in refugee camps for more than five years and in at least three cases the parents had experienced their own childhood as refugees. Only two families had children who had attended nursery for more than two years, despite the age range of two to ten years of age. Their attendance was only really possible because of the focus on Early Intervention, the funding for support teachers and plans for further teachers in kindergarten.

What follows are descriptions of four of the families I interviewed:

Family Three had three siblings, the oldest child having a physical disability now diagnosed as cerebral palsy. The mother said that she had had malaria during her pregnancy, from the third to the eighth months and had been given medicine for this. The birth was difficult and the child was obviously affected, though the mother wasn't really aware of the difference between her child and others until she was about a year old. When she was six years old Handicap International provided a home visitor and a wheelchair was supplied. A support teacher now accompanied the child to nursery and there are plans to carry on some support into kindergarten. Her mother recognised the challenges ahead and described her daughter as ' blooming slowly like a flower'.

Family Four was a unit of four: mother, father, older son and daughter aged eight, described as having developmental delay following recurrent seizures between the ages of ten and fifteen months. The child had only begun to develop speech in the last year but was making some definite progress now. The mother, who was taught to Standard Eight herself (middle of High School) was able to work together with the support teacher on hygiene, colour and number recognition and behaviour reward systems. In this family the home language was Burmese rather than Karen and this posed an additional challenge as Karen is used in the schools. The parents were clear about the need to acquire basic skills and some vocational training. An opportunity for developing such skills might already exist in the form of the family's own business - a home shop, which sells basic necessities to other camp members.

In Family Five the child with a disability was two years old. At the birth the mother wasn't informed that the child had Down's Syndrome and it wasn't until at around the age of one year that the mother became convinced that her child was different from her older sister. A traditional doctor was consulted and she gave the child massage which helped the child to develop more control when sitting. Since a Handicap International home visitor and the support teacher had been involved the family received food supplements and, at the time of the interview, the child weighed eight kilogrammes. The mother hadn't received a formal education herself but the father was literate. The teacher trainers suggested that the mother try to attend the literacy classes available for women in the camp. The mother was very clear about her short and long-term aims for her daughter and encouraged independence as much as she could. She gave concrete examples of the ways she helped her daughter to help herself, by allowing her to feed herself and by encouraging social interaction with neighbours.

Family Eight faced the challenge of an autistic child; in this case the mother was also recently widowed and left to bring up four children. In this home the bamboo structure had to be barricaded to prevent the child with autism from flinging objects or himself out of the doorways and open sides. Calming himself in the hammock was a necessity throughout the day and the mother had developed a routine of allowing outdoor play after school hours when some of the older children in the neighbourhood could help to supervise him. The support teacher and mother hoped that they might be able to get the child to attend nursery school some time during the next term. They had both noticed significant improvements since the child began some home activities but were both aware that he would need constant supervision in the school setting. Further help for the mother in the form of support from the Extremely Vulnerable People Project (funded by the Catholic Office of Emergency Relief for Refugees - COERR) was discussed, as this family's source of additional income had disappeared with the death of the father.

There were several common threads to be drawn out of the interviews.

• Without exception the response from parents to the Early Intervention Project was positive. They all valued the time the support teachers were able to give and all felt that their child had made progress since the intervention. In five cases the parents referred to concrete examples of improvement.
• All the families recognised that the educational opportunities available to them in the camp were superior to those available in Karen State. Four of the parents indicated that there would be no schooling for children like theirs in Karen State.
• In almost all cases the question about how much help the parents were able to give the teachers was turned around to suggest how the teachers were helping the child. This was unsurprising as culturally the parents would be used to deferring to teachers and I had deliberately included the question to provoke discussion about partnership.
• On the other hand, five parents said that they worked with the support teachers to plan activities or were able to give them information about the child's needs or could help in practical ways (for example planning the playground or building equipment).
• Six out of eight parents mentioned the wish for independence on the part of the child as it grew up. A few parents gave examples of how they might work towards such self-care; others indicated that they were conscious of the need to look ahead to a time when they would not be able to care for their offspring themselves.

Parents' views about inclusion

• All expressed a wish that their child should attend the local school.
• Four parents talked about the need for social interaction and suggested that their child was well supported by local children and siblings.
• Two families suggested that having older siblings meant that the disabled child had a good model for development and that in these two households the disabled children were encouraged to be independent and/or asserted their independence in self-help skills.

Views of the support teachers and trainers

Generally the support teachers were very positive about the project and the training they had received. They were, however, quite shy and reticent and it would have been difficult to ask them to be in any way critical of the programme or to suggest improvements in the relatively short time I had to speak with them. Watching them in action with the parents and children I could see how committed they were to them and what good relationships they had formed with the families.

The Karen-Thai trainer felt that the project had been a significant challenge but had been successful so far because:

• it had allowed for much preparatory work in the camp community to allow for attitudes towards disability to surface and be discussed
• the request for help with children with disabilities had come directly from the teachers themselves and the camp committee had agreed in principle

When asked about future needs he suggested that:

• the parents would be empowered through more information about what could be achieved with their children.
• regular training for the teachers was a priority, particularly to develop Individual Education Plans

Later, in conversation with a trainer for the nursery teachers in the camp, I was able to establish what her impressions of the impact of the EI Project were. She felt that:

• the nursery teachers were very positive and they valued having another resource person in the classroom.
• the parents had wanted this kind of help for a long time and were enthusiastic about the integration possibilities.
• at the start of the training for nursery teachers, the camp committee had selected teachers who were considered to be ready to take on board new ideas. The trainers then discussed 'learning through play' and more general themes such as children's rights. These themes, she felt, were a good foundation for the integration work which followed.

Further interviews

To further my understanding of the EI Project as a possible model for other refugee situations I decided to seek the views of other NGO workers along the border. Two of these were directly involved with training teachers and I summarise their comments here. The first nursery trainer I interviewed worked with the organisation Women's Education for Advancement and Empowerment (WEAVE). She had been in post for almost two years. She had worked in four different camps, serving mainly Karenni refugees and had been fairly free to develop her role according to the needs of the teachers.

In summary she indicated that:

• the request for intervention by outside trainers had come from the Women's Group itself
• initially much of the training had concentrated on basic care, hygiene and support for mothers in the areas of health and nutrition
• the training had taken place for teachers in 21 schools and involved initial training and regular follow-up workshops. When the first wave of training began, the teachers attended a one-day session on special needs and subsequently issues surrounding disability or difference had been introduced as the situation demanded
• the camps were certainly no longer in a crisis situation but work on inclusion was not yet high on the agenda as the needs of teachers and parents were still at a basic level. However, the EI Project was due to spread to these camps and the trainer felt that the teachers would soon be ready to take it on board

At a different point on the border, I was able to meet with a representative from the Karen Teacher Working Group (KWTG), a relatively new organisation I had located during my searches on the Internet. This group of teacher trainers, established in 1997, operated out of a small office near the border but provided the training inside Karen State. While they were not wholly concerned with education in the camps, their training model seemed impressive and one which, in time, would include training for inclusion. On this basis I felt it important to include it in my findings.

In November 2001 the KTWG published a survey of the status of Karen schools in the four Northern districts. Twelve teacher trainers had visited the schools during June to August and found that the basic day-to-day needs of families in these districts were uppermost in people's minds. When sufficient food had been made available and basic health care needs addressed, then the teachers could focus on what their requirements as teachers might be. These needs could be summarised as teacher support, materials and teacher training (KTWG, 2001).

An important component of the KTWG's training was the manual they have produced to assist with teacher training (KTWG 1999). It included sections on Child Development and 'Individual Differences' which could be expanded to contain specific information about disabilities and teaching methods appropriate to inclusive schools.

Both trainers acknowledged a need to address the inclusion of children with disabilities in their training programmes and were attempting to interweave western and indigenous approaches to formal education. While the training for teachers in a formal way on the border is still in its relatively early stages, I observed an opportunity for models such as those demonstrated at Mae La camp to be repeated. To approach the inclusion of children with disabilities using an outmoded integrationist model would certainly be a lost opportunity, I felt.

Analysis of Findings

Early Intervention as an imported Western model

Although the concept of Early Intervention originated in the West, a careful interweaving of Western and Asian approaches to education had ensured success at the beginning of the project. In summary:

• The initial survey of needs and subsequent home visits provided opportunities for the trainers to gain valuable information about the child and the strategies already employed by the parents. The visits were fairly informal and unthreatening, which was a key to their success, particularly as the parents had in most cases been, as one NGO worker put it, "over surveyed".
• All the parents were positive about the Early Intervention programme.
• Despite their natural deference, the parents were building good relationships with support teachers.
• Parent workshops were providing opportunities for parents to share ideas and skills.
• A recent development, the introduction of Individual Education Plans (IEPs), was a particularly Western method and one which had yet to be fully implemented. It was much too early to evaluate its effectiveness as a tool for assessing progress and planning future provision. All of the professionals involved had doubts about the intricate detail which seemed to be necessary in written form and the teacher trainers expressed a wish that a simpler method might emerge from the trial of the IEP format used.

Implications for teacher-training programmes

• The EI project has clearly raised questions for the trainers involved in mainstream education programmes. The signs seem positive however; for example both the Western and Asian nursery teacher trainers expressed the belief that mainstream teachers would soon be ready to take on board the concept of inclusion and the methodologies required to make it happen.
• As the children involved in the EI project grow up the mainstream teachers in kindergarten, primary and secondary schools will need to be equipped to meet their needs and to work with support teachers.

Recommendations

There are two major strands to the recommendations that emerge naturally from my investigation; namely the empowerment of parents and the training of further teachers. Finally I consider how such a model of provision might be applicable in other refugee situations.

Two recommendations for the Thai/Burma border situation

It is in the area of empowering parents that the EI project could, I suggest, usefully invest more time and resources.

• The monthly meeting is an important forum for the sharing of ideas but is in its early stages and the parents lack confidence in their own ability to present ideas or voice opinions.
• A long-term aim ought to be for a parent group to assume the status of a representative and advisory body. Whether they remain in a refugee camp or return to Karen State, it is the parents who will need to demand future provision for their children.
• A more formal training programme for 'parent advisors' (incorporating some of the information available to the support teachers and skills training in presenting ideas such as the outdoor play scheme to the camp committees) and some training in basic counselling /listening techniques might be appropriate.

Secondly, the expansion of the teacher training programme must be a priority. As the children identified by the EI project grow up the challenges facing their class teachers grow with them.

• Support teachers will need to be recruited from the pool of existing teachers at primary and secondary level.
• The training available to mainstream teachers should incorporate an introduction to disability and learning difficulties.
• The education committee in the camp needs to be clear about its policy on inclusion.

All of these recommendations involve a large investment of time and require some training expertise. They would only be successful if, as in the case of the EI project, the parents and teachers and camp administrators were fully committed to including all children in the camp's schools.

Is this model for inclusion applicable in other refugee situations?

The camp I have described was a well-established, well-supported community with developed social and administrative structures. In this situation development work can successfully take place and is clearly appropriate. However, in a country like Afghanistan where the needs of the people are manifestly more immediate and basic, education is not a priority (Coleridge, 1998). In refugee situations such as these the need is for food and shelter and for diplomacy to allow for integration or repatriation. Projects such as the EI one could not be introduced in such a crisis situation.

On the other hand, there are several refugee situations in the world where people are in long term, fairly well organised camps and where education provision is, at least, possible. In these situations a similar model of inclusion could be embraced and parents and teachers might benefit from studying the examples of Early Intervention on the Burmese/Thai border.

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Reference:
Title: Inclusion for the Excluded. A pipe dream or practical necessity? Including children with learning di
Author: Wallis, S
Date: 2002
Link: http://www.eenet.org.uk/resources/docs/burma_refugee.php

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