Journal of Childhood & Developmental Disorders

Keywords

Inclusive education; Early childhood development; Disability

Introduction

Children with disability have for long been treated with suspicion in many African communities. Some of them are usually treated either with reverence or contempt depending on the disability [1]. For example, children with albinism are revered because it is believed that their body parts have great magical powers, thus, concoctions made from albino body parts can make one rich [2]. Children with different forms of mental retardation are treated with contempt because it is believed that they are a curse to the family handed down by the gods for the family’s misdeeds [3]. To these people, such children must be mistreated or neglected because helping them will be interfering with justice that the gods have handed to such a family [1]. For fear of the justice from the gods, there are many reported cases where parents, especially men have abandoned their homes after fathering a child with disability [4]. Within the homes, these children suffer ridicule from family members; some are tortured or neglected by their parents or guardians resulting in malnutrition and death [1].

At school level, where we expect to find supportive teachers who are knowledgeable about special needs, the situation is not any better. They are never featured in any planning. For example, it is not uncommon to hear school heads comment about the school latrines being inaccessible to children with special needs because during pit latrine construction, the contractors ‘forgot that there are children with disability in the school’. Thus, for children with disability, going to the toilet becomes an ordeal that the child dreads, and the humiliation makes many children stay home after a brief period of going to school [5]. It is reported that those who persist in school have to crawl on the dirty latrine floor to use it because the pit latrines used in these schools have narrow doors and steps that are challenging for a physically disabled child to access with or without a wheelchair [5].

At community level, misconceptions and stigmas remain associated with such children, their homes and business that are run by persons with special needs. Even as children with special needs grow out of the family circles, their peers continue the stigmatization, often reinforced by overly superstitious adults who fuel the discrimination on a daily basis. The community members feel justified to ignore them to avoid the wrath of the gods [4]. Different government institutions that are supposed to help these children are no better. There are still cases where children with special needs are often seen as too young for the educational system, too damaged for the health system, too hidden for the protection system, and often perceived as someone else’s problem [6]. Thus, the whole process is packed with deep rooted negative attitudes and prejudices that fuels neglect, isolation, abuse and marginalization of persons with disability leading to increased discrimination [7].

As we move to start providing education for all children, we must all start working toward eliminating barriers that discriminate other children. This can be done by recognizing the fact that all children are equal and deserve the same treatment. Good treatment of children in early years guarantees better learning and development outcomes. As already noted, there is increasing recognition that the first few years of a child’s life are a particularly sensitive period in the process of development, laying a foundation in childhood and beyond for cognitive functioning; behavioral, social, physical health and self-regulatory capacities [8]. It is important to note that whereas participation by all children including those with disability in inclusive early childhood development programmes improves young children's capacity to develop and learn, not all children are accessing it [9]. The reasons for this are varied from lack of programmes, inaccessibility, ignorance about importance of early stimulation and negative attitude towards children with disability [4].

Definition and understanding of the term disability vary from place to place depending on the focus and intention of the one using it. One common definition of disability is that of the International Classification of Functioning, Disability and Health (ICF) which defines disability as a complex phenomenon, reflecting the interaction between features of a person’s body and features of the society in which he or she lives [10]. The 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 [11].

The National Constitution of Uganda [12] does not contain a definition of disability [3]. This omission leaves each user sector to construct own definition depending on its focus. For example, the Uganda Employment Act (2006) [13] defines disability as “any permanent physical inability or impairment; physical illness; psychiatric illness; intellectual or psychological disability or impairment; loss or abnormality of physiological, psychological or anatomical structural functions; reliance on guide dog, wheelchair or any other remedial means; or presence in the body of organisms capable of causing illness [14]. The National Social Security Fund Act, chapter 222 on the other hand defines disability in Article 22 a person who has a physical or mental disability that makes such person totally or partially incapacitated with the result that such person is “unable by reason of that disability to earn a reasonable livelihood”. Of late, UBOS has moved away from the original definition of disability that focused on “impairment” to a “difficulties in functioning” approach to disability [15]. Currently, disability in the UNHS 2009/10 is defined as permanent and substantial functional limitation of daily life activities caused by physical, mental or sensory impairment and environmental barriers resulting in limited participation [16].

The above sector based definition of disability in Uganda is refuted by the National Union of Disabled Persons of Uganda (NUDIPU). To them, the definitions place the emphasis on the person with a disability rather than the social and environmental barriers which hinder full and effective participation of PwDs in everyday life, thus not in accordance with the UNCRPD’s definition of disability [3]. The fact that there is still no agreed definition of disability makes it challenging to provide inclusive education.

It is upon above realities about the meaning of disability and inclusive education that Vygotsky`s theory on dysontogenesis (TD) is considered. Vygotsky considered disability as a “social aberration” [17], in that “social aberration” springs from children’s changing social, environmental relations causing disturbances in social behavior [18]. Dysontogenesis creates a unique vision for future models of inclusion based on positive differentiation [19]. The theory gives preference to strengthening and empowerment of individual skills rather than the traditional stress on weaknesses or deviations [20]. According to Vygotsky`s theory on dysontogenesis, a positive approach implies a favourable societal view on children with disabilities, directing the focus point not on weaknesses and disorders, but on the strengthening and empowerment of individual skills [20].

The provision of effective education for all children is arguably, the biggest challenge facing school systems throughout the world [21]. It is important to remember that there is no one perspective on inclusion within a single country, or even within a school [22]. This reality has made the field of inclusive education even remain more confused as to what actions need to be taken in order to move policy and practice forward [23].

In order to cater for all children, must start looking at inclusive education as a basic human right and the foundation for a more just society [23]. In this education, inclusion is promoted as a ‘rights issue’ that demands changing the system to make it more accommodating of those who are ‘different’ [24]. If we are to follow the rights approach, then we have to let inclusive education focus more on barriers to learning, participation and resources to support learning and participation [25].

The notion of inclusive education is premised on the assumption that in a given school, all children, regardless of their strengths or weaknesses in any area, become part of the school community. However, coming from the background of segregation, integration and mainstreaming, most schools in Uganda still practice the concepts interchangeably to mean inclusive education. Graves and Tracy [26] noted that ‘in spite of the weight of educational research and ethical arguments, education systems have been slow to change.

At the international level, some countries are already applying reforms that support and welcome diversity amongst all children [27]. For example, in the UK, the implementation of the Education Act [28] shifted the purpose of assessment from diagnosis of ‘disability’ to the identification of Special Education Needs (SEN) [23]. The US has however, taken another approach. The legislative framework in the US has made it possible to have a mixed model of provision, where special schools still existed, but there is also scope for increasing provision in ordinary schools [29].

In the case of Africa, although the educational policies in many recognise inclusion as a desirable form of education for children with disability, its inclusion is not being satisfactorily implemented [30]. In some of the countries, inclusive education programs remain as ‘pilot projects’ [30] to serve children with ‘disabilities’ within general education settings [23]. Thus, the form of inclusion practiced in Africa is continuously resulting in isolation and frustration for children with disability as the necessary support and resources for meaningful inclusion are lacking [31].

The same beliefs remain a challenge for implementation of inclusive education even when many countries have ratified the Education for All declaration. Most children especially those with special needs still remain one of the groups being widely excluded from quality education [32]. The exclusion is attributed to the fact that disability remains one of the least visible yet most potent factors in educational marginalization [33].

In order for children with disability to benefit from quality education, deliberate policies need to be enacted to guarantee access to education in an inclusive setting. The use of a policy on an inclusive school setting offers the benefit of changing the current negative attitude towards those who are in some way different by educating all children together [34]. Currently, we have policies that support children with disability by we do not know why many of them are being developed. The ones that are also being implemented are not yet bringing the desired effect, thus necessitating a study on challenges being met in their implementation. It is upon this background that this study is being carried.

Objectives

This study was guided by the following objectives:

1. Establish prevalence of disability among children in ECD in Uganda

2. Identify educational placement for young children with disability in Uganda

3. Identifying policies that support children with disability in Early Childhood Education

4. Establish challenges of implementing inclusive education in ECD in Uganda

Methodology

A descriptive survey design was adopted for this study to enable collection qualitative information from different categories of respondents. The respondents included inclusive education and special teachers in Nakawa Municipality found in Kampala City Council Authority (KCCA) schools, policy makers in the special needs at the Ministry of Education, Science, Technology and Sports (MoESTS). The target population of the study included 20 early childhood development teachers and 20 primary school teachers, two teachers from each of the 10 schools selected for the study; 5 teachers, one from each of the five special school, 2 ECD teacher trainers and 2 MoESTS policy makers. The key informants were purposively selected for the study, while the teachers were randomly selected in their schools. A questionnaire and interview guide was used to collect data. The study was done in two phases: Phase one was primarily desk review to establish different policies and statistics relating to inclusive education. The documents were got from special needs department in the Ministry of Education, Faculty of Special needs at Kyambogo University and department of teacher education at Kyambogo University that houses ECD. Phase two was field work to collect information from primary sources to triangulate information got from the desk review. Content analysis was used to analyze descriptive data that was generated from the questionnaires and interview guide.

Results

Prevalence of disability among children in ecd in uganda

The forms of disability prevalent among children in ECD in the selected schools included: physical disability (33%), visual impairment (22.3%), Heard of hearing (12.3%), autism (10%), palsy (8.2%), speech (4.5%), down syndrome (4.2%), mental retardation (3.4%), and epilepsy (2.1%). The major causes of the disability identified included: disease (40.9%), accidents (20.1%), congenital (16.8%), witchcraft (10%), child neglect (7.2%) and poverty (5%).

Educational placement for young children with special needs in uganda

The best education placement for children with disability according to the participants included: Special schools (52.1%), home (27.9%), special units in mainstream schools (12.2%), inclusive schools (7.8%).

Inclusive education policies that support children with disability in early childhood education

From the desk review, the following policies that support inclusive education were established: Uganda has been praised as one of the champions in sub-Saharan Africa for advocating for the rights of persons with disabilities [35,36]. The first policy document is the Ugandan Constitution (1995) [12] which has a number of articles supporting inclusive education. Article 30 of the constitution provides that ‘all persons have a right to education’. Article 21(2) of the same constitution provides that ‘a person shall not be discriminated against on the ground of sex, race, colour, ethnic origin, tribe, birth, creed or religion, or social or economic standing, political opinion or disability’. Article 32 (1) provides that the State must take positive steps in favour of the groups disadvantaged on the basis of their sex, age, disability or for any other reason created by history, tradition or custom, so as to correct the imbalances against those groups.

To move further in providing for Persons with Disability, the Parliamentary Elections Statute of 1996 established five positions in parliament of which one of them must be a woman, and recognised the use of sign language for the deaf in parliament [12,37]. The 1997 Uganda Communication Act for the development of techniques and technologies to ensure communication services for PWDs was also enacted. Other frameworks includes the special allocation of university scholarships for persons with disabilities through affirmative action and the right to assets including land [38] and the National Council for Disability (NCD) Act 2002 enacted to promote the rights of persons with disabilities as delineated in existing international conventions, and legal instruments and the 1995 Constitution [37]. As one can see, these policies were created in different government departments, creating implementation conflicts and therefore needed to be harmonized.

As a way of harmonizing different policies in disability, the Government had to publish its National Policy on Disability in February 2006. This Act provided the needed legal basis for the implementation of the National Policy on Disability and a human rights-based framework for responding to the needs of persons with disabilities [16].

Specifically for children with disability, several policies have been developed to guarantee their protection and education. The first policy is the Persons with Disabilities Act (2006), which in Section 5 provides that Government shall promote the educational development of persons with disabilities through the establishment of special schools and units, where inclusive education is not possible [14].

There is also the Children Act, which in Sec. 9 specifies that it is the State’s duty to implement measures and policies in order to afford children with disabilities equal opportunity in education, subject to progressive realization [39]. The Act also provides for early assessment of disabilities amongst children to achieve early treatment, rehabilitation and education [39]. Similarly, Uganda has the Universal Primary Education (UPE) policy which provides for all children of school going age including those with disability to be enrolled in the primary school [40].

Another document is the draft inclusive education policy. This policy emphasises inclusion of children with special needs in ordinary primary schools [41]. However, the policy of inclusive education does not elaborate what inclusion means with regard to CWDs. No appropriate provisions have been made for CWDs to date [42].

Challenges of implementing inclusive education in ECD

The challenges of implementing inclusive education in ECD identified include: negative attitude towards children with disability (34.5%), lack of trained teachers (29.4%), lack of teaching materials like brailles (27.8%), high enrollment in classes (6.5%), unsupportive school environments (1.8%).

Discussion

Prevalence of disability among children in ecd in Uganda

This study established the main forms of disability prevalent among children in ECD in the selected schools as physical disability, while the least disability was epilepsy. This finding in line with that of NUDIPU (2013) [3] that had earlier established the common disabilities in Uganda as visual impairments; physical disabilities; hearing impairment; multiple disabilities; mental and psycho-socio disabilities; intellectual disabilities and albinism.

There is however, concern that the statistics body in Uganda is not capturing accurate data on disability. Uganda Bureau of Statistics (UBOS) has produced various estimates of prevalence rates of disability, which significantly contrast with each other. The 2002 Population and Housing Census estimated that 4% of the total population is considered to have a disability [43]. However, the 2005/06 Uganda National Household Survey (UNHS) has estimated that 7.1% of Uganda's total population has a disability, this being equivalent to approximately 2.1 million people [44]. In the same study carried out by UBOS [45], the prevalence rates of persons with disability were physical disability (41.9%), Visual (22.3%), deaf dumb (15.1%), speech (3.9%), mental retardation (3.6%), mental illness (3.6%), epileptic (2.5%), rheumatism (2.2%) and others (4.8%).

In 2006, the disability prevalence rate varied from 7% of the population or 3.2 million PwDs living in Uganda according to the UNHS 2005/06 to “20% for persons age five years and above” quoting the UDHS 2006. With the UNHS 2009/10 and UDHS 2011, the disability rate similarly varies between 16% and 19% respectively of the population aged above five years [46]. Just like for adults, data relating to children with special needs is scarce and to some extent what is presented is unreliable [43]. However, the research study conducted by the United Nations Children’s Fund (UNICEF) between November 2013 and February 2014, and also based on the estimates, the child disability prevalence is about 13% or 2.5 million people living with some form of disability in Uganda [7]. According to Katalemwe Cheshire home there are over 53,000 children with disabilities in the country [4]. This variance in the disability rate according to UNICEF is largely due to differences in the methodologies used and wording of the survey questions [46].

The main cause of the disabilities according to this study was disease, followed by accidents, while the least cause was poverty. This finding tallies with that of Combrinck [47] and NUDIPU [3] who found that in the developing world, communicable diseases; poor nutrition for example blindness caused by vitamin A deficiency; inadequate prenatal, childbirth and neonatal health care services; armed conflicts and their aftermath like unexploded landmines account for most of the cases of disabilities.

The enrolment rate of children with disability in schools is very low [7]. About 9% of the 2.5 million CwDs living in Uganda attended school over the 2009-11 periods [48] and only 6% of these children complete primary school and go to study in secondary schools [15]. This enrolment rate goes in direct contrast with the call for all children to be given access to school that has been for some time since the 1948 Universal Declaration of Human Rights proclaimed free and compulsory education to be a basic human right [41].

Educational placement for young children with disability in Uganda

Children with disability are catered for in different areas that match with their disability. Since there is no single approach that is recommended and no government or public ECD centre, different persons who have an interest in providing education service for children with disability in the early years are now left with the option of working with development partners to further their course. This move in effect ushers in a twin track approach to IE and SNE [15]. Others have gone ahead to make it a tripletrack approach to guide the way for ECD programs to take into account and meet the needs of children across abilities, sex, age and other cultural factors [6] as explained below.

Segregation is one of the approaches that is still widely practiced as one of the best means of supporting children with special needs in special schools. Parents and disability groups favour this approach partly out of concern about overcrowding and poor resourcing in mainstream schools [32]. Special schools are used to offer specialized support for children with specific conditions like autism, visual impairment or deaf. In special schools, the common services offered include: occupational therapy, speech and language therapy, special needs education and adapted physical education activities. Examples of such special schools include: Kyambogo University Early Childhood Learning and Assessment Centre (ECLAC), Teens and Tots Neuro development centre in Buziga, Komo Centre Entebbe, Ggaba special needs school, Tunaweza Children’s Centre in Kiwatule, Kampala, Kakunyu School in Masaka, Lwengo among others.

Another approach is integration which entails bringing children with disabilities into mainstream school by either having small units for the disabled children attached to the mainstream school or having special classes at specific times [41]. Like segregation, integration has also come under criticism for it requires ‘learners with special needs have to change or become ‘ready’ for accommodation in the mainstream’ [47]. This implies that instead of the school environment adjusting to the needs of the child, it is the child to adjust [41]. The approach ensures that children with disability are included in programs for all children while still receiving specialized services. In implementing these services, the features of early childhood education like special age and stage-specific needs are taken into account [6]. Thus, this approach is a half-way between segregated provision and full inclusion, although they are seen to be relying much on western value system, which are also being questioned in the West for their lack of effectiveness [49]. Examples of schools that offer integrated early childhood development education in Uganda include: Glory Be Nursery School Buwenda in Jinja and St. Kizito's Nursery School, Makondo.

The third approach is that of full inclusion, where children with disability learn effectively in mainstream schools where the whole system has been changed to meet all children’s needs. Although this approach is considered the most ideal, in Uganda, such schools are hard to come by. Most elite parents see these schools as creating a situation where children with special needs are simply inserted into existing programs without adequate preparation [6]. Also, most of them are located in remote rural areas, where they have been established with support from international agencies and NGOs. The notable NGOs supporting establishment of some of these inclusive ECD centres include: Save the Children, LABE, Child Fund, World Vision and Plan Uganda among others. Most of these centres are community based, often relying on volunteer parents and caregivers to provide some form of stimulation for the children. The agencies also work hard to ensure an essential link between the child, their peers and their teachers in the school setting [49]. With support from NGOs, basic play materials in form of local swings, balances or slides are constructed in the village open space to cater for all children in an inclusive setting. However, due to the openness of the play areas, all children including those who are well above the ECD age range access the materials. This in itself to a certain extent disadvantages those with disability. It has also been noted that caregivers in most of the centres are not trained in ECD or special needs education making provision of specialized services a challenge. Thus, the disability that is commonly recognized are those that is physical in nature, while those pertaining to cognition like autism are rarely discovered. Some example of full inclusion schools in Uganda include: St Kizito Bidati ECD centre, Nwoya supported by African Revival.

Besides the provision of institutionalized services, some agencies have come on board to initiate projects that support education of children with disability. One example is the introduction of the itinerant teacher programmes in partnership with local ministries of education [50]. These teachers work with regular teachers in schools that have children with disability. While in the schools, the itinerant teachers transcribe class work, tests, and examinations to and from Braille for both teachers and children and provide advice to class teachers on how to meet children's needs in the classroom [51]. The itinerant teachers also find children with disabilities who are not in school and work with their parents and the wider community to ensure that the children will be found a place in school or work with such families to help prepare the child for school [51]. The support has been found to bridge the teacher training gaps as observed in some schools where teachers fail to address the inclusion of students with special needs.

Inclusive education policies that support children with disability in early childhood education

It has been noted that the tradition of neglect and disregard of young children with disabilities, especially those in the ECD age bracket emerges partially from the fragmented and isolated nature of policies and programs [6]. Implementing an inclusive education system requires supportive policies that ensure appropriate service delivery. Whereas in Uganda the government has put in place policies to guide implementation of inclusive education, there are still conflicts in the policies. For example, while various attitudes towards the education of the disabled are enlightened, favorable and worthy of commendation, in reality, these laudable attitudes are hardly seen in the implementation of Special Education Policies [31]. Even as we support education for children with special needs, there is no specific data relating to how many children are in them [15].

Besides the attitudes, use of policies that rely on other policies that may not be in place can render them redundant. For example, the Persons with Disabilities Act (2006) in Section 5 provide that Government shall promote the educational development of persons with disabilities through the establishment of special schools and units, where inclusive education is not possible [14]. It is important to note that up to now, the inclusive education policy is still a draft. This means that officially, there is no inclusive education policy to operationalize the Persons with Disabilities Act (2006), thus creating an implementation gap. If we are to go by the Persons with Disability Act, we also meet an implementation challenges as the Uganda’s national policy on disability does not explicitly elaborate on how interventions relating to disability would be funded [52].

Use of two policies to address the same issues sometimes leads to confusion at the implementation stage. For example, the UPE policy being implemented by Ministry of Education encourages inclusive education in all schools. The same ministry has also authorized the establishment of 24 special schools and units without defining the boundaries of special needs education. This brings confusion between inclusive education and special needs education [15,32]. This confusion arises from the fact that while the CRPD expressly recognizes inclusive education for all learners without distinction on the basis of disability, the Act instead provides that in some situations there may be a ‘need’ to keep disabled children in segregated (special) schools [41]. The Uganda Human Rights Commission has recommended before that the PWD Act be amended to align its provisions with the CRPD but to date no tangible progress has been registered in this regard [42].

Another compounding factor is the policy on teacher pupil ratio. The current policy on teacher pupil ratio as being implemented by MoESTS is 1:49 [53]. This ratio is still high for ordinary children and worse for children with disability in huge class with more than fifty children as it reduces teacher–pupil contact and makes the selection of suitable teaching methods impossible [54].

The framing in the Education Act also leaves room for children with special needs in the area of ECD not catered for. For example, according to the Uganda Education Act of 2008, “pre-primary education is to be run by private agencies and the financing of this education is the responsibility of parents and guardians” [55]. This means that provision of inclusive ECD service is at the digression of the private person, usually for profit as the first motivating factor. Children with disability who need to enroll in these centres must meet the financial admission criteria and adhere to the set standards. This approach in itself creates exclusion in that families that cannot afford fees demanded by such institutions keep their children away from them even when they need the services desperately.

Another critical area is seen in the presentation of pre-primary education. According to the Education Act (2008), pre-primary is the first level of education in Uganda. However, pre-primary education is optional, as there is no government ECD centre, kindergarten or pre-school to provide inclusive education to all children [56]. The Ministry of Education, Science, Technology and Sports (MoESTS) has no specific or ongoing project targeting children with disability in ECD [15]. This omission is in direct conflict with the policy to provide quality education for all children as a right enshrined in the constitution [57].

Uganda, like any other state is a party to UN treaties and is obliged to submit initial and periodic reports to treaty bodies. It is however reported that the Uganda is yet to submit its initial report on ICESCR, 25 years after its ratification, while for the CRC, government last reported in 2004, and the initial report for CRPD was due in 2010 but was never submitted [58]. The delay in submission may be attributed to the progress of implementation as some of the policies that Uganda needs to operationalize inclusive education for children with disability are still in draft form. For example, the inclusive education policy and special needs education policy have been drafts for the last five years. It becomes challenging to use draft policies for any meaningful intervention which can be reported in international forums.

Areas of challenge that need to be addressed to promote inclusive education in early childhood development

The biggest challenge that children with disability face is the aspect relating to stigmatization of persons with disabilities stem from communities [59]. The stigmatization arises from both cultural biases towards such children, which is compounded by lack of knowledge about a particular disability. This lack of knowledge by parents about disability sometimes result into generalizations or misdiagnosis where in some cases the disabilities reported are not actually disabilities, but instead ailments that require seeking medical attention [41]. In the case where confirmatory tests are never done, such children remain wrongly categorized as having special needs for a long time attending the wrong intervention.

Besides the stigmatization, most schools lack basic infrastructure to adequately cater for children with disability. Such inadequacies range from poor physical structures, inaccessible walkways, toilets, corridors, lack of special educational equipment like Braille machines and hearing aids [7,41].

It has also been noted that although the Uganda Education Act specified ECD as the first level of education (MoES, 2008), there is no public or government supported day care or kindergarten in Uganda. The government is yet to make pronouncement on her plan to support kindergarten, although it recognized it as very critical levers for accelerating the attainment of Education For All (EFA) Goals and the Millennium Development Goals (MDGs) [60]. Early childhood education is still optional in that it is at the digression of a parent to either keep the child at home or take to access an ECD service. There is no law in place that requires parents to compulsory take their children to ECD where children’s special needs can be identified early. This in itself provides the clue to less knowledgeable parents that ECD is actually not important that is why government is paying less attention to it.

In the areas where there is government support for inclusive education in the lower primary section, budgetary allocation for inclusive education remains disturbingly low. Usually a paltry 0.12% of the entire education budget is availed for special needs education [61]. This low budget according to some observers not only hardly support the unique demands of special needs but also is contrary to the Persons with Disability Act (2006) which suggests that 10% of the entire education budget be dedicated to special needs [61].

In Uganda, provision of Early Childhood Development services is in the hands of parents and private service providers [62]. This service is usually at a fee for profit since the provider considers it as a business. As we all know, children with special needs require slightly more care than ordinary children. The additional care given to such children increases the unit cost levied on parents to maintain children with special needs. As a result, most schools that take up children with special needs charge extremely high fees which become unaffordable to majority of the poor who badly need the service. The cost also makes children with special needs to be irregular in school and fall further behind in school as compared to their counterparts.

The idea of charging high fees to care for children with special needs gives the illusion that if a parent struggled to get the fees, the child will benefit from supportive inclusive services. Sometimes the opposite is true. Some of these schools can be overcrowded and use only generalized facilities that hardly take cognizance of children with special needs. In the schools, you will come across teachers who have limited knowledge about specific special needs. Such teachers are only able to recognize the special needs that are physical in nature because their limiting nature is obvious for even the untrained to see. Autistic children, those with behavior disorder, ADD, or dyslexia may never even be identified through their stay in the ECD centre. Wrong diagnosis of children is common in some of the schools since some of the schools are never in touch with any specialized professionals like speech therapists that are handy for referrals.

Another disturbing factor that keeps making inclusive education in the area of early childhood elusive is the persistent negative attitude that most parents and communities in general have towards children with special needs. Even in a situation where a school is able to offer inclusive education to all children in an inclusive setting, stigmatization makes such goals unattainable. There have been cases where some parents withdraw their children from particular schools because such parents saw a child with special needs in company of their children in the school. The belief that some conditions like epilepsy, Down syndrome or autism is transferable from one child to another through contact is very strong in many communities in Uganda. Since schools do not want parents to take away their children, they have to expel those with special needs so as to maintain their customers. In a situation where such children remained at school and got an attack, as in the case of epileptic attacks, both teachers and children will flee from them for fear of the disability being transmitted to them. If the child recovered, no other ordinary child will be encouraged to sit near such a child, leading to isolation and final drop out of school, thus frustrating the idea of inclusive education.

As a result of the persistent stigmatization of children with special needs even by the persons who are supposed to protect them, most of these children are taken to special schools. Although special schools are discouraged in Uganda in preference for inclusive schools, more special schools are being opened to handle children with specific special needs. For example, we now have schools for children with autism, schools for those with speech challenges or schools for the blind. Thus, the concept of inclusive education in Uganda is construed to mean a school that accepts children who are lame, have low vision, or spina bifida studying with normal children in the same class.

Conclusion

In conclusion, despite the uncertainty seen in the way inclusive education is being implemented in ECD in Uganda, there is hope that there is some progress towards full inclusion. Our firm ground is in the legislative basis for providing inclusive education for learners with special needs that is embedded in the National Constitution [12] which provides for the right to education, provision of affirmative action in favour of marginalized groups on the basis of gender, age, disability or any other reason [61]. The constitution is to be further strengthened by inclusive education policy that is yet to be approved. The draft policy is seen to be in line with Uganda’s commitment to observe and respect human rights especially for marginalized groups in this country [41] and provide guidance on access to physical environment in schools, the curriculum, assessment and information [7]. It is also expected that the policy will ensure that where possible, learners with special needs study in an inclusive environment to enable them benefit from an interactive school atmosphere by providing guidelines for provision of specialized instructional materials, equipment and supportive services and training of inclusive education personnel [61]. Those with profound disability need to be supported in places that can provide specialized support to help them benefit from education.

The area of curriculum management is also an area of focus in the policy. It is being proposed that for better curriculum management, the teacher to pupil ratio should be 1: 10, instead of the current 1:55. Adhering strictly to this teacher to pupil ratio is crucial to make available staff who can work together as a team incorporating services of a physiotherapist, occupational therapists and speech therapists; for effective teaching in such schools [62].

Finally, inclusive in Uganda is benefiting from the good will of both public and private practitioners who want to see it thrive and meet the ultimate goal of supporting children with special needs adequately. The will is shown by structures being institutionalized, the policies in place and those in the offing, the materials being developed and encouragement being given to children with special needs to enroll and stay in school. These gestures make observers believe that inclusive education is moving further along the desired straight path to reality. It should be noted however, that the above actions alone cannot take inclusive education any further than where it is now. Failure by government to allocate significant resources to the sector, optional nature of critical early childhood development programme, absence of public ECD to provide inclusive education to the rural poor who form the majority of those who deserve it take the gains backwards. The idea of waiting for development partners to keep supporting ECD and inclusive education devaluates critical national programmes to the level of intervention projects is disturbing. The interventions only help specific parts of the programme to move forward when donor funds are available only to drop later further at the end of the project creating an impression of circular movement along a straight path.

Recommendations

Attitudinal change

Change in attitudes takes some time, but can be easily accelerated if role models are used. Persons with disability who are successful in life need to be brought to particular communities where a specific disability is prevalent. The person can be able to share his/her experiences that can help to make parents value their children who have a similar disability. The same role model can also help dispel the fear of superstition that may be associated with such disability for acceptability.

The idea of inclusion is still challenging to implement, bearing in mind the cultural bias and superstition about different forms of disability coming from the community. Human rights activists and informed teachers in the area of inclusive education need to take one step at a time to bring acceptability of children with disability in mainstream society. What we only need to know is that inclusion often requires a shift in people’s attitudes and values, which comes over a period of time.

Provision of integrated services by different stakeholders need to be embraced so as to provide entry points for the community to be involved in care and understanding of children with disability. Different resource persons in other fields related to child wellbeing can work with teachers to raise awareness about different forms of disability in children and dispel the negative cultural beliefs associated with them.

Strategies to improve policy

If the dream of providing Education for All children irrespective of their ability is to be met, Ministry of Education needs to make ECD compulsory for all children before enrolling to primary or elementary school at the age of 6 years. The present state where children stay at home without any form of early childhood stimulation in an organized centre should be discouraged.

More mainstream schools need to be supported to take on children with disability so that to avoid perpetual isolation. This is because children raised in purely special schools continuously keep being isolated such even when they leave school, making it hard for them to fit in a community that isolated them.

Another way of supporting children with disability that needs to be inbuilt in different policies is timely collection, processing and usage of data on disability. If local authorities are empowered by policy to periodically collect such data, it will help in providing updated information on disability which will support planning.

As already noted, some policies have been put in place in Uganda to support provisions for children with disability. However, these policies have not put in place an inbuilt mechanism for funding ECD in an inclusive setting. If we are to provide the right start for all children in the early years, this must be catered for first in order to start the process of building inclusive communities where all children learn together in a supportive environment.

Policy makers need to consult all stakeholders so as to clarify what inclusive education and disability entail. The current definition of disability that focuses on the children and not the environment should be realigned to meet international inclusive standards so as to be supported by the persons they are meant to protect.

School environment

Activities conducted in the class and in the school compound should take into consideration the diversity of learners. Inclusive school activities should take care of gender, cultural identity and language which break negative stereotypes not only in textbooks but also in teacher’s attitudes and expectations (UNESCO, 2009) [64].

Within the classroom, teachers must learn to start implementing a flexible curriculum that is responsive to diverse needs and not overloaded with academic content. It is important for teachers and parents to understand that not all children are destined to be academicians in order to succeed in life. The more teachers and parents understand the sole aim of education as helping children develop appropriate skills for their independent living, the more the schools will become inclusive for all learners.

School heads must be encouraged to provide environments that accommodate all children and provide education as a right. A rights-based education helps children realize their rights and to understand that school is not only academically effective but also inclusive, healthy and protective of all children, genderresponsive, and encourages the participation of the learners themselves, their families and their communities (UNESCO, 2009) [64].

While inclusive education is being advocated in all public schools, little effort is being made to implement an inclusive curriculum in early childhood development centres. A deliberate effort must be made by Ministry of Education to adequately prepared ECD teachers to embrace inclusive teaching approaches so as to cater for education needs of all children under their care.

Strategies to improve teacher training

Training of teachers in the area of special needs should be stepped up to cover the knowledge gap that exists in most inclusive schools. This training should be reoriented and aligned to inclusive education approaches in order to give teachers the pedagogical capacities necessary to make diversity work in the classroom and in line with reformed curricula [64]. Teacher training should also include the necessary skills needed to appropriately identify children with other forms of disability in consultation with other experts. It is from this collaborative effort that appropriate referrals can be made to help support children as early as possible when the disability is still manageable [65].

The training of teachers who work with children with disability should tackle the approach used in the education system that looks the child as the problem and not the education system. It is time for all teachers to start preparing schools to receive and retain all children irrespective of their abilities as opposed to children preparing to come to school. If this is done, it will help shift the burden from the already disadvantaged child to the education system.

More training programmes need to be introduced to educate different professionals, especially teacher trainers who are in most cases left out of different training opportunities because it is assumed they already know. This group has the potential to make more direct effect in that they are the ones responsible for training all the teachers who come out every year to go and work with children with disability.

Due to the constant superstitious talk and discrimination that even teachers who work with children with disability face on a daily basis, there is need to introduce rewarding incentives for them. These incentives can be in form of a little allowance like that given to scientists or teachers in hard to reach areas to compensate them and keep them in their work stations.

Strategies for family intervention

Community development officers need to be supported to implement programmes that will change the negative mindset that is still strong in communities those special needs is a curse. They should be helped to appreciate that special needs is not transferable from one child to another and that like any other person, such children deserve protection and education like the normal children.

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