Early childhood intervention
1st National early childhood intervention conference
18 – 20 November 2006, Penang.
This Memorandum focuses on the critical role of Early Intervention for Children with Disabilities, Impairments, Developmental Delays or Special Needs in Malaysia (henceforth Children with Disabilities or Special Needs). It is based on the universal rights of all children; the affirmation of additional and specific rights of children with disabilities; the ideal of equal access and opportunities to education for all children; and the objective of attaining an appropriately inclusive, barrier-free, safe, secure and rights-based society for all Persons with Disabilities or Special Needs.
These values, principles and objectives are enshrined within the following international agreements which Malaysia has ratified or endorsed:-
- The UN Convention on the Rights of the Child (1989)
- The Salamanca Statement on Principles, Policy and Practice in Special Needs Education (1994)
- The UNESCAP Biwako Millennium Framework for Action (2003)
They are, also, an integral part of Malaysia’s national objectives as stated in Vision 2020:–
“that Malaysia will be a united nation with a confident society, infused by strong moral and ethical values, living in a society that is democratic, liberal and tolerant, caring, economically-just and equitable, progressive and prosperous, and in full possession of an economy that is competitive, dynamic, robust and resilient”.
B. THE IMPORTANCE OF EARLY CHILDHOOD INTERVENTION
Early Childhood Intervention is critical to optimizing the learning and development of Children with Disabilities or Special Needs.
- The early childhood years, from 0-8, are important for ALL children - they lay the foundation for all areas of development. Early experiences affect the way the brain develops, are critical in establishing learning patterns and in acquiring foundational skills;
- For Children with Disabilities or Special Needs, the early childhood years are of special importance – what they can achieve in their future development is determined by what happens in the critical early years after birth;
- Early intervention works best – it results in biggest improvements, bringing greatest benefits for the child;
- Early intervention is important for families – the early years are the best time for the family to build positive bonds with the child, to adapt to and learn how to support the child’s disability or special needs;
- Positive early childhood experiences lay secure foundations for both the child and the family to make successful transitions to pre-school and primary education;
- The longer the delay in providing intervention, the harder it is to effect the necessary improvements, and the higher the cost to the child and family, and to society as a whole.
In recognising the critical importance of Early Childhood Intervention for Children with Disabilities or Special Needs, we call for immediate and appropriate actions to be taken by all stake holders especially relevant ministries of the Government of Malaysia, non-governmental organizations, parents, professional bodies, the private sectors and other agencies towards the realization of the following objectives:-
1. EARLY DETECTION & PROMPT DIAGNOSIS
- Routine developmental surveillance, supplemented by routine developmental screening for specific conditions, for ALL children, from birth to 8 years, to be provided by the Ministry of Health, other relevant agencies and professionals;
- Multi-disciplinary assessment in government hospitals or health clinics for EVERY child upon identification of a disability or impairment, or at risk of developmental delay or special needs;
- Assessment should be conducted in a child-friendly environment, in close partnership with parents or carers, to facilitate identification of the child’s intervention needs so that these can be addressed at the earliest possible stage;
- Empower parents-to-be, parents and families, especially in the rural areas to play an effective role in prevention and early detection of disabilities through information and education on major causes of disabilities, genetic counselling, developmental milestones, nutrition, and other important aspects of early childhood development.
2. IMMEDIATE & APPROPRIATE INTERVENTION
- Immediate access to early intervention programmes – with clear points of entry, relevant therapies to meet specific needs, covering all major areas of development;
- High quality intervention services – delivered by trained and skilled personnel, committed to standards of evidence based best practice, working in a physically safe and emotionally conducive environment, to maximise the child’s progress and family’s participation;
- Regular and consistent services, with reviews and modifications – to meet the child’s and family’s changing needs, especially in planning for important transitions.
3. INTEGRATED, COORDINATED & CONVENIENTLY LOCATED SERVICES
- Early Childhood Intervention Units should be established by the Ministry of Health, Ministry of Education, Department of Social Welfare and/or Ministry of Rural Development in all hospitals, health clinics, local pre-schools (e.g. in those run by KEMAS and Ministry of Women, Family and Community Development), early childhood education or community service centres;
- Intervention services should be comprehensive and well-integrated, with major therapies co-located to provide convenient access when multi-disciplinary services are required;
- The Ministry of Health, Ministry of Education, Department of Social Welfare and NGOs should work closely to ensure that NO child is denied access to adequate, affordable, appropriate and well-coordinated services.
4. FAMILIES AS THE FOCAL POINT OF POSITIVE PARTNERSHIPS
- Recognize, support and empower parents, carers and families as positive partners in all aspects of screening, diagnosis, assessment and intervention;
- Special attention and provisions should be given to disadvantaged or vulnerable families, especially poor families or those living in rural areas;
- Parents, carers and families need respite care which should be recognized and provided for;
- Government should provide a disability allowance, increased tax relief benefits and subsidies, for parents/carers/siblings to meet costs incurred in the purchase of assistive devices and for intervention, rehabilitation, therapy services or programmes.
5. WELL TRAINED, HIGHLY SKILLED, INTENSELY MOTIVATED PROFESSIONALS
- Create more posts immediately for a full range of staff in the Ministries of Health, Education and Rural Development, as well as the Department of Social Welfare, so that early childhood intervention services can be provided to all children in need of them;
- All staff should be well trained, highly skilled and registered with their respective professional bodies to ensure the highest possible standards in the delivery of intervention services;
- Modules on early childhood, special education and disabilities should be a compulsory part of basic training and/or first degree courses for all relevant health and education professionals;
- Increase budget for in-service training of essential qualified personnel, to improve quality of early childhood intervention services;
- Salaries should commensurate with skills and training, with clear career paths for professional development to motivate staff and uphold and maintain the dignity and value of all Early Childhood Intervention professions;
- Recognize need for regular evaluation/monitoring, specialist professional advice and additional resources to enhance the quality of services.
6. MEET DIVERSE EDUCATIONAL NEEDS OF ALL CHILDREN
- All Children with Disabilities or Special Needs, of different categories and levels of need, should have the same right to basic formal education as their peers, in line with the principle of Education for All;
- Pre-school education should be provided by the Ministry of Education to ALL children, including and especially for Children with Disabilities or Special Needs, as an integral component of compulsory basic education for all children;
- Every child diagnosed with a disability or special need, should have an Individualised Education Plan (IEP), written by a qualified practitioner in discussion with the family, to meet the specific needs of the child. An IEP that details a child’s specific needs will enable parents to work closely with practitioners to choose and plan the best options for the child from the early intervention programme through pre-school to early formal education;
- All early childhood teachers, whether at pre-school or primary school level, should be trained to recognise and detect disabilities or special needs in young children, with regular in-service training to continuously upgrade skill levels;
- Mainstreaming should be considered the first option in accordance with the principles of Education for All which Malaysia endorses;
- Parents’ choice of type of educational facilities, language and culture in special education should be respected and provided for;
- Children with Disabilities or Special Needs should be granted the right to more resources than their peers to enable them to access essential basic formal education; including not only physical facilities, such as barrier free environments, provisions of wheelchairs and transport; modified curriculum and additional teaching materials; but also access to information (ICT) and support workers or teachers’ aides when needed;
- Children with Disabilities or Special Needs should have access to the necessary supporting specialist skills, such as Physiotherapy, Occupational Therapy, Speech Therapy, Educational Psychology, Audiology and Optometry as specified in their IEP, with careful planning, implementation and regular reviews;
- Teachers of Special Classes should have the appropriate training to meet the highest standards of their profession, so that they are able to cope with different levels of disabilities as well as the varied learning needs of Children with Disabilities and Special Needs.
7. A NATIONAL DATA BASE
The Department of Social Welfare in collaboration with Ministries of Health and Education should develop and maintain a National Data Base on Children with Disabilities or Special Needs, which will include detailed data on severity of disability and services required. This will encourage registration by parents, carers and families; provide reliable and accurate information for systematic analysis of the needs of the target population; and enable more effective policy formulation, budget allocations, and programme implementation.
8. BUDGET FOR THE NEEDS OF CHILDREN WITH DISABILITIES
In order to meet the above objectives, there should be special provisions to cater for Children with Disabilities or Special Needs in the annual budgets of all relevant government departments.
9. NATIONAL COUNCIL ON EARLY CHILDHOOD INTERVENTION
Finally, we call for the formation of a National Council on Early Childhood Intervention, to be placed under the Prime Minister’s Department. The National Council will act as a recognised forum for practitioners and parents to meet regularly with policy makers in the various Ministries to consider and discuss all matters relating to this important area of common concern.
The National Council will review and monitor progress towards the target of a comprehensive and integrated continuum of child and family services, spanning government, non-government and private providers, in line with the beliefs and principles stated above, that can meet the needs of ALL Children with Disabilities or Special Needs, from 0 to 8 years of age.
In conclusion, it is our hope that Malaysia can, through determined efforts and positive partnerships between policy makers, practitioners and parents, achieve the targets set out in the Biwako Millenium Framework for Action where by 2010, at least 75 per cent of children and youth with disabilities will be able to complete a full course of primary schooling and by 2012, all infants and young children (0-4 years) will have access to and receive community based early intervention services.
When ALL families caring for a Child with a Disability or Special Needs are able to access flexible and responsive specialist intervention services, enabling the children to achieve their full physical, intellectual, social and emotional potential, we will have reached an important milestone in our journey towards becoming a fully developed and truly caring nation.
- The United Nations Convention on the Rights of the Child (1989), of which Malaysia is a signatory, in recognizing that the child, by reason of his physical and mental immaturity, needs special safeguards and care, specifies the fundamental rights essential for fully preparing the child to live an independent and responsible life in society.
Among them are the right to:-
- Access to and enjoyment of the highest attainable standard of health and facilities for the treatment of illness and rehabilitation of health;
- A standard of living adequate for the child's physical, mental, spiritual, moral and social development;
- Education directed to the development of the child's personality, talents, mental and physical abilities to his or her fullest potential;
- Rest and leisure, play and recreational activities appropriate to the age of the child
The Convention highlights the importance of special and additional provisions for children with disabilities, to ensure their full enjoyment of all human rights and fundamental freedoms on an equal basis with other children; and, in order that they, too, will, as adults, enjoy a full and decent life, in conditions which ensure dignity, promote self-reliance and facilitate their effective participation in the community.
Of particular importance are the right to : -
- Special care and assistance appropriate to the child's condition and special needs;
- Effective access to education, training, health care services, rehabilitation services, preparation for employment and recreation opportunities in a manner conducive to the child's achieving the fullest possible social integration and individual development, including his or her cultural and spiritual development.
- The Salamanca Statement on Principles, Policy and Practice in Special Needs Education (1994), which Malaysia endorses, proclaims that:-
- every child has a fundamental right to education, and must be given the opportunity to achieve and maintain an acceptable level of learning;
- every child has unique characteristics, interests, abilities and learning needs;
- education systems should be designed and educational programs implemented to take into account the wide diversity of these characteristics and needs;
- those with special educational needs must have access to regular schools which should accommodate them within a child centred pedagogy capable of meeting these needs.
The fundamental commitment of all countries is to Education for All and the guiding principle should be that ordinary schools will accommodate all children, regardless of their physical, intellectual, social, emotional, linguistic or other conditions.
In particular the Framework requires that all educational policies should specify that disabled children attend the neighbourhood school 'that would be attended if the child did not have a disability.'
In line with these principles, Governments are urged to:
- give the highest policy and budgetary priority to improve their education systems to include all children regardless of individual differences or difficulties;
- adopt as a matter of law or policy the principle of inclusive education, enrolling all children in regular schools, unless there are compelling reasons for doing otherwise;
- develop demonstration projects and encourage exchanges with countries having experience with inclusive schools;
- encourage and facilitate the participation of parents, communities and organization of persons with disabilities in the planning and decision making processes concerning provision for special educational needs;
- invest greater effort in early identification and intervention strategies, as well as in vocational aspects of inclusive education.
- The UNESCAP Biwako Millennium Framework for Action (2003), which Malaysia endorses, identifes early intervention and education as one of seven priority areas for action as it is only through the full enjoyment of this right, without discrimination, and on the basis of equal opportunity, that children with disabilities may develop their personality, talents and creativity, as well as their mental and physical abilities to their fullest potential.
The Biwako Millennium Framework identifies three main targets for early intervention and education:-
- By 2010, at least 75 per cent of children and youth with disabilities will be able to complete a full course of primary schooling;
- By 2012, all infants and young children (0-4 years) will have access to and receive community based early intervention services;
- By 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary education.