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This literature review gives an overview of human rights abuses, stigma and discrimination, and the process of exclusion of the PWDs from society. It will look into the effects of these experiences on the educational level of the PWDs. The current research aimed to explore these root causes and their impacts, as well as the challenges of educational development for the PWDs. The research will present meaningful aspects of general characteristics of the PWDs, will address the intersection between inclusive education concept and disability, and will also focus on the policy framework for education for the PWDs.
2.2 General Characteristics of People with Disabilities
In the developing world, Sen and Wolfensohn (2004) argued that 10-20% of the world population could be categorized as PWDs in some forms. However, when most people hear the word "disability," they immediately picture someone in a wheelchair. In fact, there are many types of disability: visual disabilities, intellectual disabilities, hearing disabilities, and physical disabilities. An internationally accepted definition of disability is as follows:
"Persons with disabilities include those who have long-term physical, mental, intellectual or sensory impairments which in interaction with various barriers may hinder their full and effective participation in society on an equal basis with others" (UN Convention, Article 1).
Moreover, the World Health Organization (WHO) defined disability as "any restriction or lack (resulting from any impairment) of ability to perform an activity in the manner or within the range considered normal for a human being" (WHO, 1980, p. 1). According to the JICA Planning and Evaluation, impairment was defined as "any loss or abnormality of psychological, physiological or anatomical structure or function" (JICA, 2002, p. 5). A person with impairment is usually defined as an individual who is limited or even prevented from being able to do his/her daily living. This consideration is made for all individuals regardless of age, sex, and social and cultural factors.
Although there is no legal definition of disability in Myanmar, it has been reported that the latest national household survey was based on the definition of the Convention on the Rights of Persons with Disabilities (CRPD). However, Dr. U Tha Moe, the Senior Medical Officer at a hospital for PWDs, defined the terms 'health', 'impairment', 'disability' and 'handicap' as follows:
Health - Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.
Impairment - Impairment is any loss or abnormality of psychological, physiological or anatomical structure or function.
Disability - A disability is any restriction or loss of ability to perform an activity in the manner or within the range considered normal for a human being as a result of impairment.
Handicap - A handicap is a disadvantage for a given individual, resulting from an impairment or disability, which limits or prevents the fulfillment of the role that is normal (depending upon age, sex, and social and cultural factors) for that individual. (JICA, 2002, p. 5)
Myanmar government cannot conduct regular surveys to generate a rough estimation of the number of disabled citizens. Therefore, the vast majority of CWDs do not have access to rehabilitative health care or support services, and many are unable to secure educational opportunities. Currently, the Department of Social Welfare (DSW) is making efforts to develop the country's plan of action for disabled persons by cooperation with UNDP and TLMI. Also, the National Disability Survey, 2008-2009, has been conducted with 108,000 households of 120 townships in Myanmar. According to the survey results, the main causes of disabilities can be broadly classified into three groups: congenital, injury and diseases. Figure 3 shows the percentage of the cause of disability. The most common causes of impairment mentioned by respondents were diseases (43.6%), followed by congenital (36.2%) and injury (20.2%). The main cause of the physical and visual disabilities is disease. Also, two-thirds of people with intellectual disabilities and more than half of people with hearing disabilities have congenital disabilities.
Figure 3; Main Causes of Disability
Sources: DSW and TLMI, 2009, First Myanmar National Disability Survey, p. 20.
Table (2.1) presents the distribution of the PWDs, by types of disability, as a percent of each state and division's population. Based on the distribution of disabilities, the highest percentage of the disability prevalence rate is found in Ayeyawaddy Division. Moreover, the prevalence rate of physical disability is more than any other type of disability in all states and division.
Table 2.1; Disability Prevalence Rate by Type of Disability and State/Division
Sources: DSW and TLMI, 2009, First Myanmar National Disability Survey, p. 22.
According to the National Disability Survey (2008-2009), there is a gap in the rate of disabilities with respect to the urban and rural area and age group. Regarding the areas, about two thirds of the PWDs are in the rural area. Considering the age group, the disability prevalence rate of old people is 19.33% (above 65 years of age) while the population of old people over 65 years of age contribute 5.58% of the total population in Myanmar (CSO, 2006).
Table 2.2: Disability Prevalence Rate
Sources: DSW and TLMI, 2009, First Myanmar National Disability Survey, p. 23.
In reality, education level of the PWDs in Myanmar is not high enough due to the fact that most of the PWDs have not fully benefited from the educational policy. They face a lot of challenges to access the formal education system, especially for girls who have fewer educational opportunities. According to the UNESCO report, only 6% of women with disabilities have access to education and vocational training opportunities. Negative attitudes of community and associated labels of disability can cause discrimination and other forms of traditional and cultural oppression with regard to access to education. Besides, very few youth and women with disabilities in Myanmar have the vocational training opportunities. Also, most disabled students drop out of schools before finishing their primary education because of the social and environmental infrastructures.
From 1993 to 2002, the Central Law Scrutinizing Committee reviewed the disability laws in Myanmar but a special law for the PWDs is still being drafted now. The existing law ensures broader rights of persons with disabilities, including the rights to health, education, and employment opportunities. Myanmar Child Law, enacted in 1993, has a section to ensure education and protection for all children with disabilities. Section 18 of the Child Law states that disabled children can enjoy basic education (primary level) or vocational education in special schools run by the DSW or NGOs. In that law, all children with disabilities should have the right to enjoy special care and assistance provided by the government and should enjoy a full and decent life in the community. Also, the Disabled Person Employment Act 4 (3) was enacted in 1958 to provide vocational education and medical care to those who are physically disabled or mentally defective. In fact, these laws exist only on paper to support the PWDs, but their realization in practice still lags considerably behind.
2.3 Inclusive and Mainstreaming approaches of Inclusive Education
In the last decades, new terminology has surfaced pertaining to the education of children with special needs (Bergsma, 2000, p. 9). Frequently, the terms mainstreaming and inclusive are interchangeable. Yet, when they are used within the discussion of various education systems, there is a vital philosophical difference between the two terms.
The ideologies of mainstreaming assert that children with special needs are capable of meeting the existing standards of the regular classroom, with an assumption that these children must work their way into these classrooms until they are capable enough. Many mainstream classrooms adhere to the pull out approach where students with disabilities must leave the classroom in order to receive any additional support services or aids, such as a resource room. This approach indicates that the problem resides with the child with disabilities, rather than with the educational environment or classroom (Bergsma, 2000, p. 9).
Conversely, an inclusive approach maintains a philosophy of accommodating for children with disabilities within the regular classroom through participatory learning. (Booth, 1996, pp. 87-99) Also, the inclusiveÂ education model is based on the right of all learners to have a quality education that meets basic learning needs. The ultimate goal of inclusive quality education is to end all forms of discrimination and foster social cohesion. Moreover, the implementation progress of inclusive education for children with disabilities is an evolving issue within many developing countries.
2.4 Different Education Designs for CWDs
In the early years, the inclusive education (IE) was built with three basic priorities in mind, including education mainstreaming, producing inclusive settings, and teaching a variety of abilities to children with disabilities (CWDs). Under the inclusive setting, students with disabilities spend most or all of their time with non-disabled students. An extensive view of inclusion practices around the world is the best guide of the practices of inclusion model for the PWDs. Most inclusive educational integration processes for students with disabilities in developing countries use the following four different designs (a) the integrated education design, (b) the individualized education design, (c) the alternative education design, and (d) the special education design.
2.4.1 Integrated Education Design
The integrated education design is the practice of educating students with disabilities in regular classes during a specified time based on their skills and then combining this instruction with special education services (Sermsap Vorapanya, 2008, pp. 12-34). Every child with disabilities has the right to attend a regular school under the protection since 2001. Thus, the regular schools in other developed countries amend their general curricula to include special services such as resource rooms, sign language interpreting services, physical therapy and counseling sessions with social workers. In these schools, students with disabilities attend regular classes together with non-disabled students as well as access particular education classrooms or resource rooms. This design is made more useful for students with disabilities by addressing any needs of remediation in the regular class. It asserts that the inclusion of students with disabilities with their non-disabled peers fosters understanding and acceptance, and better prepares all abilities to function in the world beyond schools (Christian, 2007, pp. 4-9).
In addition, the integrated education design creates more academic effectiveness than special education practices. By comparing the full-time students in special schools with part-time and full-time positions in the regular class, the academic achievement of students with disabilities are more advanced for their long-term behavior when they attend regular classes. By including them in the regular education system, students with disabilities have more confidence and display qualities of increasing self-efficacy. Therefore, the inclusion practice allows students with disabilities to learn social skills through observation. They can gain a better understanding of the world around them and become a part of the "regular" community. This design spreads out the lines of communication between students with disabilities and their peers. Moreover, this design can also benefit non-disabled children. For non-disabled students, they can have more positive and accepting attitudes toward their disabled friends. Learning together in the same class can also reduce non-disabled students' fear of students with disabilities and promote a better understanding about disability issues.
On the other hand, there are some difficulties in this design because students with disabilities may require much more attention from the teacher than non-disabled students in a general class. The teachers' time and treatment may be taken away from the rest of the class. The effect of students with disabilities attending mainstream classes depends strongly on the available resources for assistance. In many cases, this problem can be mitigated by placing an adviser in the classroom to assist students with disabilities. However, this raises the costs associated with educating them. Also, other non-disabled students may be embarrassed by these other disability services in a regular class. Moreover, the parents of students with disabilities fear that the teachers do not have the sufficient skills to accommodate their students with disabilities in a general education classroom setting. This can lead to the regression of students with disabilities as well as general decreased classroom productivity. Regarding social issues, some students with disabilities in regular classes seem as socially rejected. Also, they become targets of bullying from their classmates. However, some students with disabilities feel more comfortable in that environment.
2.4.2 Individualized Education Design
The Individualized Education design is designed with a unique approach to help disabled children individually. In this design, the authorities organize a team that can assess the individual student's needs in the learning process. It can understand how the student better demonstrates their learning in the general education system, and how teachers and service providers improve the student learning more effectively. The key considerations of this design are (a) giving awareness of disabilities, (b) simultaneously considering the ability of the CWDs to access the general curriculum, and (c) ultimately choosing a location in the least restrictive environment for the disabled students. This design makes sure that students with disabilities can learn in an appropriate place. It gives an opportunity for them to participate as much as possible.
Before starting the individualized education, the school or the legal team must firstly determine the child's condition for individual education services. That team must include the student and the student's parents or guardians, a special education teacher, and at least one regular education teacher. To pass this step, the child's disability must have an adverse effect on the educational progress for eligibility. After that, the team needs to conduct a comprehensive evaluation of the child in all areas of suspected disability. Based on the results of the evaluation, the schools along with the parents meet to review the child's current level of performance. That review can determine the most important education services for that child. Lastly, the school convenes an appropriate educational plan for that child and implemented as soon as possible.
As the plan is implemented, the team needs to conduct regular meetings with one or both of the child's parents, one representative of the school administration committee who is qualified to monitor the individual education, and the child's teachers. In this education design, the role of parents is considered along with school staff because they have specific knowledge of their child's needs and the right to be involved in the educational development of their children. From the school's perspective, the significant effort ensures the parent's understandings of the activities of the team. The individual education plan is related to special services that the child needs in order to benefit from their education. These special services are necessary for considering the strengths of the child and the functional needs of that child. In some cases, a child's behavior hinders the child's education; the team must consider the use of positive behavioral interventions and support to address the behavior. The team must also consider the communication needs of the child. For example, if a child is visually impaired, the team needs to provide for instruction in Braille and the use of Braille materials. And if a child has hearing problems, the team must consider a way to provide the sign language interpretation for communicating with others. These specific educational services provide the children with disabilities to participate in general education.
2.4.3 Alternative Education Design
The alternative education can provide educational opportunities for children with disabilities who are not completing their basic education. The purpose of this design was to meet a variety of needs including preventing from dropping out of school for students with disabilities by providing other educational options as home-schooled. This is a unique approach to help disabled children individually at the least restrictive environment. In some cases, students with disabilities may have many challenges to attend school daily. Based on this difficulty, some educators try to fit it by formatting this design as alternative or home-schooled.
In this design, the teachers and service providers improve the student's learning in an appropriate place by determining the child's condition and reviewing the child's current level of performance. Home-schooling might particularly depend on the parents' education level. For students with mobility difficulties, the home-schooled approach can be cared and educated by fitting their needs accordingly. They have more advantages at home than at a school with insufficient resources. They can graduate faster than their counterparts who had been admitted to the formal schools.
The parents can provide the appropriate education needs for children with the intensive services of mental retardation. This design is typically served by specially trained teachers, and individualized instruction for students with disabilities. This practice has been criticized by the parents of children with disabilities because some of these children require instructional methods that differ dramatically from typical classroom methods. Parents of typically developing children can take critical levels of attention and thereby impair the basic education achievements of all students.
2.4.4 Special Education Design
This education design addresses the students' differences and needs by providing the systematic preparation of teaching curriculum, special equipment, and accessible settings. Special schools are designed to help students with disabilities achieve a higher learning level of personal self-sufficiency in school and community with typical classroom instruction. Students with disabilities are able to benefit from additional educational services at that school such as the different approaches to teaching, the use of technology, a specifically adapted teaching area, or a resource room. This means that students with disabilities can learn independently in special schools. Special education often reduces the social stigmas and improves academic achievement. Students with disabilities receive special education services through the special school services. For example, students with disabilities can receive additional assistance such as participating in a reading remediation program.
In Myanmar, special schools strongly support quality education for students with disabilities under the Schools Assistance Act, 2008. The Act of Special Educational Needs and Disability says that schools should make reasonable adjustments to ensure the same opportunities for people with disabilities. Special schools' education services start with social care and with the health service to help children with disabilities who are vulnerable to failure or impairment. Special schools use different approaches to provide appropriate education services for students with disabilities. In this approach, students with disabilities attend more intensive instructional sessions in a resource room or they receive other related services. Special schools provide the most appropriate setting. Today, some NGOs are working to provide opportunities for disabled children attending special schools. Special schools are also providing outreach services to support the teachers who work in mainstream schools. Therefore, this design can provide support for all children with disabilities by giving them access to the inclusive curricula. In addition, these special schools are able to purchase equipment for the disabled students who need different instructional strategies.
The accommodation of special schools can provide adequate improvement of teaching practices. According to the nature of the disabilities, the special schools focus on the schools' accommodations, response, and schedule. For example, a school may accommodate for students with visual impairments by providing large-print or Braille skill textbooks. And the materials help to reach the level of the curriculum such as the reading assignments by substituting the usual book for a shorter, easier one. Students with disabilities can receive both accommodations and modifications in independent schools.
In this context, these four different designs include many informants, parents, teachers, and social workers. It has been obviously demonstrated that inclusive education needs to improve assessment and training processes of appropriate curriculum development, teaching strategies, and individual educational goals.
The next section will analyze the issues related to educational development in Myanmar with a special emphasis on analyzing the inclusive education policy and its benefits of the PWDs.
2.5 Inclusive Education Policy framework
The inclusive education policy framework of Myanmar draws on the principles from the following international and regional instruments of EFA which advocate for the full realization of the rights of the PWDs.
2.5.1 International Instrument of UNESCO Salamanca Statement on Inclusive Education
The Salamanca Conference was formed in June 1994 by organizing with 92 governments and 25 international representatives. They came up with an agreed-upon Statement on the Education of All Disabled Children. In addition, that conference adopted the principle guidelines of the Framework of Action. In this framework, all educational policies should allow all disabled children to attend the formal schools together with non-disabled children regardless of their physical, intellectual, social, emotional, linguistic or other conditions. Also, the commitment of EFA recognized that all CWDs must have access to regular schools with inclusive education. That commitment went on to point out that it is the responsibility of governments to set the policy and budgetary priorities to improve education services for all CWDs. This responsibility includes the need for disabled people organizations, and community members to be involved in policy formulating and implementing processes as part of decision-making body.
Also, the Salamanca Statement reaffirms the obligation of "Education for All". The statement acknowledges the rights of people with disabilities to obtain an education within any regular education system (UNESCO, 1994). This coincides directly with the United Nations Convention on the Rights of the Child, which declares that all children have fundamental rights to an education, and to meet full participation within society (see Annex 2).
2.5.2 Regional Instruments on Inclusive Education
In the Asia Pacific region, education accessibility of children and youth with disabilities remains one of the most serious challenges of governments. The international progress of implementation for Action of Asian and Pacific Decade of Disabled Persons suggests that all nations in this region need to try to implement inclusive education policy for CWDs to access any form of education. But the lack of adequate education remains the key risk factor for both CWDs and non-disabled children in regards to poverty and social exclusion. For CWDs, the risk of poverty owing to the lack of education is even higher than that for non-disabled children.
After the World Conference on Special Needs Education in 1994, all governments in the Asia-Pacific region started the unique initiative of "Year of Education for People with Disabilities". From that initiative, Thailand, one of regional countries, found that the total number of students in primary schools increased a lot under the inclusive education policy framework of the Ministry of Education. However, only 11.33% of the school age population of disabled people was able to attend primary education (Sermsap Vorapanya, 2008, pp. 4-10). According to the UNICEF survey in Vietnam from 1998, the enrollment rate of primary education is 91%, and 61% of children aged 6 to 15 years completed their primary education but only 3-5% of CWDs attended school (UNICEF, 1998). In Cambodia, there were eight special schools for CWDs in 2001, but these eight schools provide services for just 500 children per year. These special school services can only cover a minority of the children with disabilities in Cambodia (Leuprecht, 2001, p 18).
In the Asia Pacific region, the most common form of education model for children with disabilities is the special education design. These special schools are rarely located in rural areas. Some schools cannot obtain government support. Also, the statistical data on CWDs in educational attendance and attainment is limited and they are seldom specifically represented in the national education system.
In 2002, many governments in the region reported increased access to regular schools for children and youth with disabilities in terms of the rate of enrollment in primary education (Yutaka, 2003, p. 23). Improving the quality of education is relevant in both formal and special schools for CWDs which are appropriate to achieve the Inclusive approach in their communities. It is difficult to assess the quality of education for all CWDs in many countries in the region.
2.5.3 National Instruments on Inclusive Education Policy
Based on the Salamanca Statement, Myanmar is now aiming for the achievement of EFA with respect to making access to basic education compulsory for all school-aged children in formal schools. Implementation of the EFA-NAP is being stepped up with the aim of creating opportunities for disabled students, as well as offering quality education for all school-aged children. This progress also provides opportunities for children facing learning difficulties to have access to compulsory primary education.
Inclusive education is a program that creates the formal education opportunities for CWDs together with non-disabled children in order to achieve Myanmar's EFA goals. To achieve that goal, Myanmar organized an EFA forum in May 2002 and adopted six national goals for EFA as the EFA-NAP (2003-2015). The EFA-NAP has been drawn up within the framework of the 30-Year Long-Term Education Development Plan and is attempting to reach the global goals of EFA, the education-related goals of the Millennium Declaration, and the World Fit for Children. Also, EFA-NAP intends to achieve the second goal of the Global Education Forum held in Dakar, Senegal, 2000, that is:
"Ensuring that by 2015, all children, particularly girls, children in difficult circumstances and those belonging to nationalities, have access to complete free and compulsory primary education of good quality" (UNESCO, 2000, part VI, p. 36).
The Myanmar EFA plan is now guiding progress towards the compulsory basic education of good quality for all school-age children by 2015.With regard to increasing access to primary education, CWDs are a priority target. The MOE is now implementing seven main activities toward this goal, namely providing free textbooks and stationery, developing a sufficient number of trained teachers, creating flexible teaching and learning programmes, and other facilities (Ministry of Education, 2008, p. 9).
Also, the Department of Myanmar Education Research Bureau (DMERB) has produced sample lessons in audio and video formats for deaf students and Braille equipment for blind students. Now, over two hundred CWDs are now attending in formal schools (Ministry of Education, 2008, p. 9). They are getting special care and attention from the teachers and also the assistance from their peers. The teachers are trained to be able to use sign language to teach their disabled pupils. In addition, Myanmar government tries to achieve educational inclusion by furnishing special arrangements for disabled students when they must sit for their final examinations. These arrangements include giving extra time or providing an assistant during the exams. And the government has opened the IE Centre in Yangon and other cities in order to achieve attainment of EFA goals with respect to access to primary education.
In this way, Myanmar has demonstrated its commitment of EFA through the support of the right to education for every child. Also, MOE is trying to make special arrangements for CWDs to continue their education with special care and attention. Yet, many disabled children still do not receive an education. Thus, the Inclusive Education program in Myanmar is still trying to accommodate for all children with no discrimination.
2.6 Myanmar Social Welfare Services
The Department of Social Welfare (DSW) under the Ministry of Social Welfare, Relief and Resettlement is carrying out welfare services for prevention, protection and rehabilitation of disabilities. Their programs focus on children, youth, women, disabled people and the elderly. Myanmar has also promulgated important laws such as the Disabled Persons Employment Act and the Child Law. These laws are directly concerned with the DSW and their welfare services for the PWDs. Under the DSW, there are eight training schools and six nursery schools for children and youth with disabilities. In these schools, medical staff members such as nurses and doctors are appointed for taking responsibilities for all students. The disabled children are referred from the hospital to the special school after taking medical treatment. There has also been some experimentation by the DSW with the inclusive model in Myanmar society. It should be noted that the contribution of social services has many times been made in collaboration with NGOs.
In this study, the researcher argues that all CWDs need to be protected by law in order to get the basic education opportunities with the most effective model. The education available for CWDs must have a link to national education systems so that they can continue further studies and they can live independently.