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Archive for April 2013

This field trip was organized as per a request from the local NGO Naifaru Juvenile. The purpose of the trip was to conduct awareness sessions for parents and Pre School Teachers. Two facilitators from Care Society went to Naifaru to conduct the sessions from 11th to 13th April 2013.

The trip was funded by NGO Naifaru Juvenile.

The workshop started on the night of 11th April 2013, with an introductory ice breaker which was then followed by awareness sessions on UN Convention on the Rights of Persons with Disability and the Disability Act of Maldives.

On 12th April 2013 afternoon sessions were conducted on the terminologies used to refer to disability, the different kinds of disabilities and different ways that parents and teachers could possibly work with persons with disabilities. In the evening sessions, information was provided for the participants on the different services available in Maldives for PWDs. Also, a small evaluation was done in order to determine how much the participants gained from the sessions.

Teachers and parents recognized the need of having more awareness session, particularly for PWDs and their families. The teachers requested to conduct a special training program for them in order to equip themselves with necessary techniques to work with children with disabilities.

41 participants joined for this workshop .

Naifaru Juvenile is a very strong willed NGO wherein they do a lot for the local community to empower its youth, women, children and other groups. This is an ideal community where we can explore the possibility of implementing a Community Based Rehabilitation program.

The team from Care Society returned to Male’ on 13th April 2013.

Written by: Aishath Sufana

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Children with Autism communicate many of their needs through different behaviors.  Often the consequence of their action is getting “what they want”. Targeting the consequences and changing it would intern effect the behavior of the child. Consequence is what happens right after a behavior. It can be fulfilling a biological need, psychological need or materialistic need. Like we can control the triggering factors we can control the consequences of the actions,

Example: Aisha saw a beautiful toy on the shop while she was coming home with her mother. Aisha demanded her mother to buy the toy for her. When her mother said NO, she started crying and screaming. Then Aisha’s mother bought the toy for her and she stopped screaming and crying. The consequence of Aisha’s action is “getting the toy she wants”. Hence the chances are that Aisha’s screaming or crying behavior will increase in future. Because she is getting what she want by exhibiting a negative behavior.

Scenario modification: Aisha Sees a toy she likes (actecendent)=  Aishath Screems /Cry (behavior)  = Mother ignores (consequences)

In this Scenario Aisha is not getting what she wants hence chances are her behavior (screaming /crying) will decrease. However when we start to work with a child this change will take time to be evident enough to make a behavior change. In real life such behaviors would not occur over one incident. It might have taken several such incidences for a child to come to an understanding that they can get what they want by crying or screaming. Hence when we start a behavior modification program and focus on changing the behavior by modifying the consequences chances are that the child might exhibit several other negative behaviors before the behavior is changed as demonstrated below.

Aisha Sees a toy she likes (actecendent)=  Aishath Screems /Cry (behavior)  = Mother ignores (consequences)= Aisha Hits her mother= Mother ignores= Aisha show a temper tantrum= mother ignores and take her home= aisha cries at home= mother ignores

As we can observed aisha’s behaviors has not changed even when she did not get what she wanted. This is because it will take time for Aisha to understand what is happening. She would have to come to a realization that regardless of her negative behavior she is not going to get what she wants. And eventually she would reach there after several trials. As demonstrated below.

Aisha Sees a toy she likes (actecendent)=  Aishath Screems /Cry (behavior)  = Mother ignores (consequences)= Aisha Hits her mother= Mother ignores= Aisha show a temper tantrum= mother ignores and take her home= aisha cries at home= mother ignores= Aisha Stops crying=mother ignores= Aisha Attends to something else at home (acceptable behavior)= mother gives a hug

Hence, behavior modification is an achievable task with proper understanding of the Childs behavior and dealing with it consistently. Once it is decided to not give any reinforcement for a negative behavior then it is important to stick to that decision otherwise it would be a never ending challenge to deal with them. And because of this the child may face different challenges in functioning within the society.

Intervening behavioral problems at home: Working with children with Autism

One of the main features of children with autism is their lack of communication or speech delays. Due to this many of their needs, emotions and thoughts are not communicated well. Some children often find it hard to make others understand their wants. Hence such frustrations or difficulties are exhibited in the form of different behavioral problems. Addressing to behavioral problems is crucial in development of children with autism. This would enhance their participation, social functioning and learning. Though behavior modification and therapies are professional interventions parents can also play an important role in implementing such programs. There are many things parents can do at home. This article looks at one aspect of behavior modification.

Identifying the reason for the behavior

Identifying the reason behind a certain behavior can also be referred to as triggering factors or antecedents. When we understand these factors we are able to mold or change the outcome by changing the triggering factors.

Triggering factors can be biological such as thirst, hunger, and sleep deprivation, less energy or hyperactivity. It can be environmental such as temperature (too hot or cold), crowded environments, too loud and not enough play materials. It can be social/ interpersonal such as argument with family members, misunderstanding and lack of personal space.

Example: Aisha did not get her favorite roshi for breakfast instead she was given bread. Aisha started screaming so loud and the parent took her to her room till she stopped screaming. In this example the reason for screaming is because Aisha loves roshi and that is what she has for breakfast every morning. Since children with autism have difficulty in accepting such changes in routine, Aisha would not understand why she had to eat bread instead of roshi and neither can she communicate how she feels or what she wants. The only way Aisha knows how to deal with it is by screaming.

Now that we know Aisha finds it difficult to adjust to changes we can control the triggering factors. For one thing it is important to always keep roshi for breakfast to avoid the behavior of screaming during breakfast time. And a more practical approach might be to introduce different food along with roshi so Aisha might have variety of foods and eventually might start to like them too.

Hence, introduction of new concepts or changes to routine should be delivered slowly. Sudden changes might alarm them and it might be expressed through different behaviors.

It is important to note such observations and keep it for future references. The more you observe the child the more you will understand how you can help. It is not always easy to control the triggering factors.  However, it is one way of dealing with different behavioral problems and making sure such interventions are well planned with the help from professionals and the consistency in delivering is the key for success.

Written by Aishath Looba

Community Based Rehabilitation –  “Reducing the impact of disability for an individual, enabling him or her to achieve independence, social integration, a better quality of life and self – actualization.”

Care Society is a local non-government organization working with the aim to improve the lives of people with disabilities in Maldives. Disability services have grown since the founding of Care Society in 1998, with many services centralizing in the capital city, Male’. However the majority of the population lives in the outer atolls of Maldives where access to services and facilities are very limited.

 

Rehabilitation : Rehabilitation includes all measures aimed at reducing the impact of disability for an individual, enabling him or her to achieve independence, social integration, a better quality of life and self – actualization. Rehabilitation can no longer be seen as a product to be dispensed; rather rehabilitation should be offered as a process in which all participants are actively and closely involved.

 What is Community Based Rehabilitation (CBR)?

Community Based Rehabilitation (CBR) is a strategy within general community development which aims to deliver rehabilitation services in less developed countries. CBR programmes see the need to change attitudes and behavior and promote social inclusion, to make services accessible and remove barriers to equalization of opportunities.

Why CBR?

Institutional Rehabilitation provides excellent services to address the problems of individual persons with disabilities and is often available only for a small number at a very high cost. Institutional overheads and other major infra structural expenses make the process very expensive. Moreover, the endeavor in an institution is often out of context to the felt needs of the people with disabilities, and thus falls short of their expectations. The fact that this person comes from a particular background and cultural setting is often ignored. The institutional culture is imposed on the person with disabilities and they are often expected to function as advised by the “experts”. In an institutional rehabilitation programme, the community is not linked with the process. Hence, when the person with disabilities return home, it may become difficult for them to integrate into their community.

Many institutions follow community-oriented approaches. In this method of approach, the services are provided at the level of community through an outreach clinic or camp based approach. The program is guided by the institution and directed by the availability of the resources. The patients and community are only the beneficiaries. e.g. as and when appliances like wheelchair, tricycle, or calipers become available, they get distributed whether it is appropriate or not. However, these strategies are inadequate to respond to the needs and expectations of the disabled and their community. Whereas rehabilitation based in the community ensures community participation, uses locally available resources and learns from existing innovative approaches in the community.

 Community Based Rehabilitation is defined as a strategy within community development, for rehabilitation, equalization of opportunities and social integration of all people with disabilities.

Community Based Rehabilitation is implemented through the combined efforts of the disabled people themselves, their families and communities along with medical and other experts as appropriate, incorporating health education, vocational and social services (ILO, UNESCO & WHO, 1994, Community Based Rehabilitation – For and with people with disabilities – a joint position paper). Accomplishing this involves creation of awareness in the community regarding disability, value of disability prevention, and rehabilitation methods. In order to base the rehabilitation in the community it is of prime importance to inspire the community and recruit volunteers for this task. This is not an easy process. An education and training model was found to be a compromise approach, which is likely to succeed, as will be explained subsequently. The volunteers need to be trained to identify and intervene appropriately to deliver rehabilitation services in the community.

History of CBR in Maldives

With the support from various donor agencies, Care Society has been able to conduct CBR program in various islands in Maldives and form CBR groups in those target islands. In the year 2007, CBR of Maldives has been partnered with South Asian CBR Network and in 2009 partnered with Asia Pacific CBR Network, which are international networks working towards networking of all CBR activities in the field of disability. CBR Network uses Community Based Rehabilitation as a strategy to approach the community and the government for the rehabilitation and inclusion of persons with disabilities in all developmental programmes and protection of their human rights particularly to promote UNCRPD (UN Convention on the Rights of Persons with Disabilities). In 2011, representative from Care Society was elected as one of the executive member of the Asia Pacific CBR Network.

Care Society has conducted trainings in some islands to implement the CBR programs. To conduct center based activities two centers have also been established. One center is in South Huvadhoo Atoll Thinadhoo (Heeds Learning Center) and the other in Addu Atoll Hithadhoo (Association for Disabilities Rehabilitation Care). Also, CBR workshops have been conducted in North Thiladhunmathi Maarandhoo and South Thiladhunmathi Hanimaadhoo. In these workshops, CBR volunteers have been trained to carry out CBR related activities within the islands. However, the efforts to retain these trained volunteers have been a challenge Care Society has been facing for the past years. The difficulties faced include, issues with financing, lack of support from stakeholders and the lack of a physical structure to conduct CBR programs.

Conclusion

With the support from the stakeholders, Care Society hopes to improve the quality of life of person with disability and the sustainability of the CBR activities in the islands. Care Society also welcomes new approaches to build a better inclusive communities.

A handbook on CBR has been launched on the 28th of March by the former president of the Maldives, Uz. Maumoon Abdul Gayoom.

Other government officials, NGos, parents and students of CDC, with staff, volunteers and participants from the Disability Management Training participated.

The function was held at Asaree Maalam, and in his speech the chief guest suggested the importance of having statistics about disabilities in the Maldives and also highlighted the importance of NGOs working together.

With the launch of this handbook Care Society hopes that the work in this area will be more established and the book serves as part of the contribution to the area of disability in the Maldives.

Below we have included the contents of the handbook for our reference.

Table of Contents (Community Based Rehabilitation Handbook)

Introduction of the Manual

What is Community Based Rehabilitation (CBR) Program?

·        CBR at Individual Level

·        CBR at Community Level

·        CBR at National Level

How to plan and execute a CBR Program

·        Formulating a CBR structure

·        System to run a CBR Program

·        Sustaining a CBR Program

-Strong Leadership

-Partnership

-Community Leadership

-Utilizing Community Resources

-Adapting to the local culture

-Building the Community Capacity

-Fund Raising

-Government Support

Stages of Implementing a CBR Program

·        Situation Assessment of the island to gather information

·        Potential Stakeholders to partner with the CBR Program at Island Level with their roles indentified

-Persons with Disabilities (PWDs) and the role of their families

-The role of Volunteers of a CBR Program

-NGO participation & their roles

-Participation of Disabled People’s Organizations (DPO) & their roles

-Participation & roles of Government Organizations

-Roles of CBR Managers & Workers

·        Services that can be provided through CBR

-Home Visiting

-Centre Based Activities

-Social Activities for Children & Persons with Disabilities

-Parent Support Groups

·        Vocation Skills Building Program for PWDs

·        Information on Disability

-What is Disability?

-Types of Disabilities seen in Maldives (signs, how to work with them)

-Skill Building through Play Activities

 

 

 



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  • Care Soceity: Yes, students can volunteer at Care Society. Please fill in the necessary forms. We will post them on the blog soon. Thank you
  • Care Soceity: I will share the volunteer form on the blog. Thank you for your initiation.
  • rooza: hi, I would like to voluntarily work with you. What should I do. and where could I find the forms.

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