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COMMUNITY BASED REHABILITATION PROJECT ON IDENTIFICATION AND
AWARENESS OF FAMILIES IN EDUCATION SERVICES FOR VISUAL
IMPAIRMENT
Submitted by
T.RAMESHM.A, B.Ed
Reg.No.93613382032
Under the guidance of
PROJECT SUBMITTED FOR THE AWARD OF THE DEGREE OF
B.ED SPECIAL EDUCATION IN VISUAL IMPAIRMENT
Dr.B.R. AMBEDKAR OPEN UNIVERSITY HYDERABAD
1
DECLARATION
I declare that the project work entitled Community Based
Rehabilitation Project on Identification and awareness of
families in Educational Services for Visual Impairment in
ASWANI EYE HOSPITAL, NARASARAOPET, GUNTUR DISTRICT,
ANDHRA PRADESH the guidance of
__________________________________. It is an original work done by me
and submitted for the award of the B.Ed. Special Education-Visual
Impairment of Dr.B.R.Ambedkar Open University, Hyderabad.
Hyderabad,Dt: signature of the student
2
This is to Certified that Mr.T.RAMESH with
Reg.No.93613382032 is a bonafide student of B.ED (SE-DE) VISUAL
IMPAIRMENT, under Dr.B.R.AMBEDKAR OPEN UNIVERSITY,
HYDERABAD completed the project work on COMMUNITY BASED
REHABILITATION IN VISUAL IMPAIRMENT under my guidance and
supervision for the award of the degree of B.Ed. SE-DE – VI Course.
Station: HyderabadDate: SIGNATURE OF THE SUPERVISOR
ACKNOWLEDGEMENTS3
CERTIFICATE
I wish to express my deepest gratitude to my Research
Supervisor,
for his guidance, constant and untiring interest, support and
encouragement in the successful completion of the project work
within the time.
My heartfelt thanks to
for his guidance and valuable advice, suggestions and constant
encouragement throughout the project work.
My sincere thanks to Director, Dr.B.R.AMBEDKAR OPEN
UNIVERSITY, HYDERABAD, and DEVNAR FOUNDATION Management
for accepting me as a student to fulfill my ambition was made
possible.
I deem it my bounden duty to express my deep sense of
gratitude and indebtedness to Mrs.K.Sujatha Course coordinator
and Staff Members of Devnar Foundation for Blind, Begumpet,
Hyderabad for their valuable advice, suggestions and constant
encouragement throughout the project work.
Finally I wish to express my indebtedness to my family
members and all my friends who have helped me in the completion
of this project work.
HyderabadDate: T.RAMESH
4
INDEX
Sl. No.
DESCRIPTION Page No.
1. INTRODUCTION TO CBR 1
2. PROJECT WORK 16
3. CAPTER-I: INTRODUCTION 17
4. CAPTER-II: COMMUNITY PROFILE 20
5. CHAPTER-III: METHODOLOGY 27
6. CODE LIST 31
7. CASE STUDY 35
8. CHAPTER-IV: OUTCOME 66
9. CHAPTER-V: CONCLUSION 68
10. REFERENCES 70
11. APPENDIX 74
5
INTRODUCTION
Disparity between man and man is a grim reality of human society.
Human beings are often discriminated on the grounds of age, sex, wealth,
power, caste, creed, race and religion, physical and mental abilities. The
disabled are one such under privileged group whose rights are profoundly
violated since ages. A number of factors attribute to disability. Most of the
disability programmes suffer from the lack of disability data. The reasons
may be lack of uniform definition of disability, inadequate methodologies,
lack of trained human resource, lack of political will, and absence of priority
to the issue, inadequate technology, so on and so forth. Many attempts have
been made to provide a productive life to persons with disability since long in
different ways. This process of upliftment of persons with disability is
generally called rehabilitation. The stages of rehabilitation, empowerment
and community based rehabilitation approaches.
Community Based Rehabilitation is a strategy within community
development for rehabilitation, equalization of opportunities and social
inclusion of all persons with disability. It is a multi sect oral, dimensional and
disciplinary approach carried out with combined efforts of persons with
disability, their family members and community. It is the best option for us
owing to its advantages. They include wider coverage, cost effectiveness,
community participation and social integration which is the basic principles of
community based rehabilitation programme. In general terms, it is defined
as enabling people with disability to fulfill their potentials, with the help of
appropriate aids and equipments, education, training and retraining,
understanding and support from the family-community. The concept of CBR
6
was promoted by World Health Organization in late seventies, to increase the
coverage of rehabilitation services for disabled persons.
CBR means shift to rehabilitation intervention from intuition to the
homes of persons with disabilities in the process of intervention include
persons with disabilities their families an communities and planning,
implementation and evaluation thereby increasing coverage reducing costs
and achieving social integration.
A/c to CBR: Rehabilitation is
Community integration Equalization of Opportunity
Alma Atta declaration states essential health care is based on
Appropriate
Acceptable methods &
Technology made universally
Accessible to individual and families in the communities through their
participation at the cost that community can afford maintain self reliance.
7
Definitions of CBR:
“ Community based rehabilitation involves measures taken at the
community level to use and build on the resources of the community including
the impaired, disabled and the handicapped persons themselves, their
families and their community as a whole”
According to WHO:
“Community Based Rehabilitation is a strategy within community
development for rehabilitation, equalization of opportunities and social
inclusion of all persons with disability. CBR is implemented through the
combined efforts of disabled people themselves, their families and
communities, and the appropriate health, education, vocational and social
services”.
According to E Helander:
“CBR is a strategy for enhancing the quality of life of disabled people
by improving service delivery, by providing more equitable opportunity and by
promoting and protecting their human rights”.
A clear understanding of the three terms of this concept, namely
‘Community’, ‘Based’, and ‘Rehabilitation’, would be helpful here.
8
a) ‘COMMUNITY’:
The definition given by E. Helander is as follows, “A community
consists of people living together in some form of social organization and
cohesion. Its members share in varying degrees political, economic, social
and cultural characteristics, as well as interests and aspirations, including
health. Communities vary widely in size and socio economic profile, ranging
from clusters of isolated homesteads to more organized villages, towns and
city districts”.
It must be realized though that a desirable degree of homogeneity for
the implementation of the CBR project may not be found in every community.
There may be differences of culture and religion and it may take a lot of time
and effort before community responds and shows willingness and unity
towards the cause of the disabled. A community, beginning from a person’s
family members, includes the neighbours, friends, co-workers, local
administrative officers, local transport authorities, postman, school teacher,
village headman, local revenue officials, nearby shopkeepers, local
development agencies, and such other people who are in a position to guide
and help a disabled person and his / her family in the process of
rehabilitation. The support of the community is important because it
influences the life of an individual by assisting directly or indirectly the
progress, development, and welfare of the individual.
9
b) ‘BASED’:
The term ‘based’ means that the rehabilitation and integration of an
individual should take place in the community itself, and that it is the
responsibility of the family and the community. The community must realize
that the disabled too are entitled to equal rights, privileges and
responsibilities, and the family and the community must accept the
disadvantaged individuals totally and then also plan for their total
development and rehabilitation.
c) ‘REHABILITATION’:
The process of rehabilitation includes:
Medical intervention i.e. efforts for prevention of preventable
disability, cure if possible, and lessening of the disability as much
as possible;
Complete social integration;
Economic rehabilitation to the extent possible;
Provision of appropriate education for the children of school going
age;
Access to all the available concessions, privileges, and guidance
and counseling services;
The definition of Rehabilitation by ILO is as follows, “Rehabilitation
involves the combined and coordinated use of medical, social, educational
and vocational measures for training or retraining the individual to the
highest possible level of functional ability”.
10
The number of disabled population in India is quite large, and the
finance, and other resources – some times because of poor logistics – fall
short of the actual needs; and the needed manpower is yet to be trained
adequately. Hence, in the first place, very special and pointed efforts,
including the procurement/identification of essential resources and training
manpower needed for the purpose, would be required to begin the project,
work towards creating the necessary climate and availability of services. The
next phase would be to ensure access for the disabled to health and social
services, to education and work opportunities, and other necessities like
housing, transportation etc. When these are taken care of for all the disabled
population in the community to the extent possible, attention should also be
paid to their needs for cultural and social life including sports, recreational
activities, and so on.
Objectives of the CBR:
The main objectives of CBR programme are:
To make the home of the disabled person to become the rehabilitation
centre:
To make the community / village / slum to become the training site.
The specific objectives of CBR are:
To integrate the disable persons into family and community with
active participation.
11
To dissuade family members and community people form the deeply
rooted and prevailing attitude that disabled people are idle and
unproductive;
To create awareness in the community regarding specialist and
referral services when the need arises;
To find out educated young people in the community who are willing
to serve and undergo training as CBR workers;
Scope of CBR:
√ Prevention of disabilities
√ Identification of high risk mothers and infants
√ Easily identification of disabilities
√ Assessment of the needs of the family
√ Home based or neighbor hood programs
√ Play groups and integrated education
√ Advocacy groups and parent support groups
√ Equality and equalization of services
√ Solidarity and social integration
Principles of CBR:
Services are shifted from institutions to home of disabled persons
Shifted the services from professionals to minimally trained
community members
Delivery of optimum quality of services which we build on
traditional methods of rehabilitation
12
Community based rehabilitation develop on local area with better
network
Community participation can be used as amines to make programs
more effective and reduce cost. It is also an objective in itself if one believes
that people have to be involved in decision that affect their lives.
Concept of CBR:
Awareness and concern of the community
Initiatives from the community
Planning by the community
Resources of the community
Implementation by the community
Evaluation by the community
Modification by the community
Components of CBR:
1. Prevention of cause of disabilities
2. Provision of long term care facilities
3. Creating positive attitude towards people with disabilities
4. Provision of functional rehabilitation services
5. Empowerment, provision of education & training opportunities
6. Creation of micro & macro income – generation opportunities
7. Management / monitoring and evaluation of CBR projects
13
Community Awareness and Empowerment:
The essence of empowerment is that people with disabilities and their
families take responsibility for their development within the context of
general community development.
Empowerment of community to assume responsibility for ensuring
that all its members, including those with disabilities, achieve equal access to
all of the resources that are available to that community, and that they are
enabled to participate fully in the social, economic and political life of the
community.
Approaches for empowering may be social mobilization, political
participation, communication, Self Help Groups (SHGs) and Disabled People’s
Organisation (DPOs). People come together in groups to pursue common
interests. A DPO is a bigger than a SHG. It is more formally structured, with
office bearers and with systematic ways of conducting its work.
Providing information and choices about rehabilitation, education and
livelihood, and laying out choices and opening up opportunities for decision
making enhances the process of empowerment. For empowerment to
happen five approaches can be used –
1. Social mobilization
2. Political participation
3. Language & communication
4. Self Help Groups (SHGs)
5. Disabled People’s Organization (DPOs)
14
Community Participation in CBR:
a) To make projects / programmes more effective:
To facilitate a need-based plan, since they know the problems with
in the Community and can priorities needs.
To make them feel responsible for the project
They can identify people-who are capable and interested
They are better implementers.
b) To contribute towards costs of the programme:
Because the programme is with the Community and is for them
It is for the Community’s own development and benefits
It helps them to exercise their rights
It helps to get a better control over local resources politics etc.
Community participation can be used as a means to make
programmes more effective and reduce costs. It is also an objective in itself if
one believes that people have the right to be involved in decisions that affect
their lives.
CBR Vs Institution Based Rehabilitation (IBR)
CBR Vs Institution Based Rehabilitation (IBR)
15
IBR Merits:
It creates a new environment and promotes sol-clarity and
cohesiveness among disabled people
It is based on a high degree of professionalism and IS expected to
bring in quick and desirable results
There is general acceptances especially from able-bodied persons
because of institutional care for the disabled persons.
IBR Limitations:
It is mostly confirmed to towns and cities
It develops negative attitudes among disabled persons towards
returning to their homes. This leads to segregation of disabled
persons from the community
It needs a structured Organized and professional environment and
sound technology
It is cost effective and affordable to both the government and
individuals with limited resources
It is flexible, creative and innovative and aims a achieving
sustainable results since it is based on the principles of non-
institutional approach
It ensures effective Community participation and involvement
16
CBR Merits:
It tries to address the needs of all identified disabled persons in the
community through comprehensive set of interventions, such as medical
rehabilitation education rehabilitation, vocational rehabilitation, social
rehabilitation, economic rehabilitation, awareness and leadership building
etc.
It encourages innovative use of local resources, which can make
intervention more effective and more acceptable
It is a shift from everything for a few to something for everyone
It avoids segregation of disabled persons from the community and
promotes social integration
It attempts to change the negative attitudes of people in the
community and enables disabled people to fulfill their needs for an
active role in the society, and to live a life with dignity,
independence and self esteem
It is cost effective and affordable to both the government and
individuals with limited resources
It is flexible, creative and innovative and aims at achieving
sustainable results since it is based on the principles of non-
institutional approach
It ensures effective community participation and involvement
CBR Limitations:
17
There is no universal model of CBR which is applicable everywhere
Results are slow and time consuming
Low literacy levels and superstitions prevent acceptance of the
system
People with disabilities are not organized in villages people think
that they can achieve a permanent remedy for their disabilities
through treatment in institutions.
Some parents prefer to cash on the disability of their children
Steps in Implementation of CBR:
Identification of person requiring rehabilitation services
Assessment of disabilities and various needs for rehabilitation of
identified person
Provide the basic services through PHC, such as drugs, dressing
materials, protective footwear, counseling and training in self care
Introduce / escort the person to ‘Village Health & Sanitation
Committee’ along with his / her problems or issues
Refer him / her to secondary or tertiary care center for physical
rehabilitation services, like ulcer care, physiotherapy, surgical
treatment, treatment of eye complications, prostheses and so on.
Follow up of referral services is also an essential task.
Facilitating the accessibility to ‘socio-economic rehabilitation
services’ through social welfare department by a ‘CBR worker’. A
health supervisor, MPHW, ANM, AWW, ASHA, or even a volunteer
18
can play the role of CBR – workers. Joint efforts by ‘Village health
& sanitation committee’ will be often required.
Review meetings by all stake holders, to discuss the progress of
CBR project or individual’s problems will help in expediting the
rehabilitation.
District Nucleus steers the rehabilitation activities and provides
support to CBR workers in facilitating the accessibility to different
services
Coordination with social welfare department and working jointly
Education of people, behavioral change communication and all
effort to reduce stigma need to be carried out simultaneously and
jointly so that rehabilitation activities can be carried out smoothly.
19
PROJECT REPORT
20
CHAPTER – IINTRODUCTION
21
INTRODUCTION
To day many problems are exist in the rural villages. They influence
differently at different levels. These problems are interdependent and their
affect is deep rooted which hinders the progress of the whole community.
The main problems are illiteracy and lack of awareness, non availability of
proper information or guidelines, poverty and over population, lack of
rehabilitation services, lack of employment facilities, lack of social and
economic security, misconception and stigma. All these issued are not within
the limits of single person, or institution to deal with them. These can be
resolved only at community level.
NEED AND REASON FOR SELECTION OF CBR PROJECT
To work on my community based rehabilitation project. I have chosen
Endada village of Visakhapatnam district in Andhra Pradesh. In this village
near 60% people are under poverty line according to the 2001 censes. Most
of the people in the community are absolutely without any knowledge
regarding visual impairment. As there is no special school and special teacher
in this village, so I choose this village to aware them.
Endada village is being covered by “Sarva Shiksha Abhiyan” (SSA)
which mainly focuses on increasing educational levels of children with visual
impairment. Through the children are being provided with education in
regular schools, in order to orient the parents of visual impairment on
importance of inclusive education, the needs for this study is essential.
22
PROBLEMS ENCOUNTERED
During the survey I observe most of the people in the community are
not much aware of disabilities. Even though the community is near to the
city, the people who are living there are not much educated. Being illiterate
people are not interested and not cooperative. I found that most of the
people of this community are absolutely without any knowledge regarding
visual impairment.
TARGET GROUP
In the Endada village I found eleven numbers of different types of
disability people in the community. Among them two of Visual Impaired, two
of Hearing Impaired, four of Physical Handicapped and three of mentally
Retarded. So my target group is visual impairment people.
OBJECTIVES OF THE COMMUNITY
1. To conduct door to door survey of the selected community for
identifying persons with visual impairment
2. To create awareness among he community members regarding
different needs of children with disability.
3. To educate and create awareness about visual impairment in the
community
4. To provide an orientation to the parents of the identified cases on
the various rehabilitative aspects
23
5. To create awareness about the services and facilities available for
the visual impairment children
6. To create awareness about the special schools which are
rendering services for the visual impairment children
7. To create awareness about the institutes offering counseling or
treatment or services further visual impairment children
8. To identify visually challenged persons and to plan need based
programme for the identified persons
24
CHAPTER – IICOMMUNITY PROFILE
25
YELLAMANDA PANCHAYATH OFFICE
About Yellamanda
Yellamanda is a Village in Narasaraopeta Mandal in Guntur District of Andhra
Pradesh State, India. It belongs to Andhra region . It is located 47 KM towards
west from District head quarters Guntur. 246 KM from State capital
Hyderabad
Yellamanda is surrounded by Muppalla Mandal towards North , Nadendla
Mandal towards East , Rompicherla Mandal towards west , Santhamaguluru
Mandal towards South .
Narasaraopet , Chilakaluripet , Sattenapalle , Vinukonda are the nearby Cities
to Yellamanda.
This Place is in the border of the Guntur District and Prakasam District.
Prakasam District Santhamaguluru is South towards this place .
Demographics of Yellamanda
Telugu is the Local Language here.
HOW TO REACH Yellamanda
By Rail
Narasaraopet Rail Way Station , Munumaka Rail Way Station are the very
nearby railway stations to Yellamanda. Satulur Rail Way Station (near to
Narasaraopet) , Narasaraopet Rail Way Station (near to Narasaraopet) are 26
the Rail way stations reachable from near by towns. How ever Guntur Jn Rail
Way Station is major railway station 47 KM near to Yellamanda
By Road
Narasaraopet are the nearby by towns to Yellamanda having road
connectivity to Yellamanda
By Bus
Narsaraopet APSRTC Bus Station , Chilakaluripeta APSRTC Bus Station ,
Sattenapally APSRTC Bus Station are the nearby by Bus Stations to
Yellamanda .APSRTC runs Number of busses from major cities to here.
Pincodes near Yellamanda
522601 ( Narasaraopet ) , 522611 ( Kavuru ) , 522603 ( Ravipadu (Guntur) )
27
MAPS
i) Social conditions:
In this village based on religion Hindu, Muslim and Christians are the
main categories; most of them belong to Hindus. Based on caste wise
majority of the people belong to Backward Communities, little percentage of
people belongs to Scheduled Caste and Scheduled Tribes.
28
ii) Economic conditions:
In this village near 60% people are under poverty line according to the
2012 censes. They are depending on cultivation, fishing and daily wages.
Remaining people are employees, business people.
iii) Cultural conditions:
The villagers are following old traditions. They follow all religious
festivals, and village festivals. Even though today they believe god and ghost
are leads their lives. Curse, superstitions and misconceptions are ruins the
village peoples.
iv) Environmental conditions:
The village have very pleasant environment. The village locates
besides the beach view. The total village covers with trees and coconut
groves.
29
CHAPTER – IIIMETHODOLOGY
30
METHODOLOGY
Methodology focusing on transfer of knowledge and skills to persons
with disabilities, their families, and communities with the purpose to reduce
the impact of disability for a person, enabling him / her to achieve
independence, social inclusion, a better quality of life and self-actualization.
Extension of these programmes through earlier rehabilitation methods to all
rural areas is difficult which requires huge amount of human resources, funds
and materials. In such a case, the community based rehabilitation
methodology provides an effective alternative for providing essential services
and extension of rehabilitation services to the rural, semi urban and other
remote areas. In many countries the local NGOs practiced community based
rehabilitation methodology and organizing persons with disability into
disabled person’s organizations to support a productive life for people with
disability. When compared to Institutional Based Rehabilitation the
community based rehabilitation approach permits coverage of large number
of people, is cost effective, favours the community participation and PWDs
social inclusion. At the end, it becomes a collective effort for achieving the
common goal of facilitating a productive life for these unprivileged sections of
the society.
Door to door survey was conducted during the study in the selected
community for identifying persons with visual impairment. The people in the
community have extended good cooperation. The identified cases were
directed to district head quarter for detailed assessment and treatment in the
community. The ensuring project has two components
31
a) Base line Survey
b) Holistic Intervention
Base line Survey:
To achieve the objectives of the project a base line survey is
planned
The survey includes identification of persons with disabilities
particularly with visual impairment
The survey includes parental awareness about the disabilities
specifically on visual impairment
Screening of suspected cases by using schedule
The survey also examines perception regarding facilities available
and also their views regarding rehabilitation
Holistic Intervention
On the basis of the report, Holistic Intervention is planned in terms, of
sensitization of families, awareness creation regarding rehabilitation services
and special schools and government institutions, NGOs working for the
disabled in general and specific to visual impairment. Creation of awareness
regarding government concessions in bus, train and also regarding vocational
employment ensured.
32
CONTINNUM OF EDUCATIONAL SERVICES
A continuum of educational services ranging from the totally
integrated setting of the regular classroom to the totally segregated settings
of the residential programme has been established to implement the least
restrictive environment. A student with disability would be placed in the
placement alternatives based on the needs, skills, abilities and motivation.
According to Blackhunt and Berdine (1981) the ten levels of educational
provisions as follows.
10. Hospital / Institute
9. Home bound Instruction
8. Remedial School
7. Special Day School
6. Full time Special School
5. Special class with part time in regular school
4. Regular classroom placement with resource room assistance
3. Regular class placement with itinerant specialist assistance
2. Regular class placement with consulting teacher assistance
1. Regular class placement with free or no support service
33
1. Regular class placement with free or no support service
The lease restrictive environment in placement of a child with special
need in a regular classroom with few or no supportive services.
2. Regular class placement with consulting teacher assistance
During the entire day the child will be in the regular classroom without
receiving any special services. The regular class teacher will receive
consultative services from a special educator or other support personnel
depending on the nature and severity of the needs.
3. Regular class placement with itinerant specialist assistance
At itinerant teacher travels from school to school to provide direct
services to students. The regular education programme is delivered in the
regular class rooms and student receives weekly supportive services from the
itinerant teachers. Depending on the school arrangement, the teachers may
deliver services within the regular class room or in the place provided for
them.
4. Regular classroom placement with resource room assistance
Like the itinerant teacher, the resource room teacher often provides
services to the students with disabilities. Only the difference is, the itinerant
teacher travels from one school to other, while the resource room teacher has
a classroom within the school. The resource teacher usually serves the
students who can be mainstreamed for the majority of the school day.
34
5. Special class with part time in regular school
Here the students’ main placement will be in a class setting within the
same building or regular school. The academic programme for these children
will be supervised by a special educator.
6. Full time Special School
In this facility the children are in special class but their normal peer
will be exclusively in a social, rather than instructional settings. They share
common experience on the school bus, lunch, recess and school functions.
This is also appropriate for children with visualy impaired.
7. Special Day School
The commonly found model in India is special day school. Students in
this placement attend a special school. All the instructional and therapeutic
will be looked after in special school only. Children with visually impaired
with varied range of severity levels attend the schools.
8. Residential School
Residential programmes are designed to sever disabilities. Children
who do not have families or for those who do not have special schools nearby
their homes students in special day schools return home at the end of the
school day, but students in residential schools live at the school day, but
students in residential schools live at the school for 24 hours, and visit their
home during holidays.
35
9. Home bound instruction
Some students who are recovering form surgery or illness or who
cannot be taught in schools owing to the severity of the condition may
require home bound instructions. A teacher visits the home and delivers the
instructional programme. The training will be given to the parents in the
home situation. This is suitable for those children also who do not have
special educational facilities in their locality.
10. Hospital for institution
This is a facility where persons with disabilities are segregated and
looked after for throughout their lives. In India such a facility does not exit.
A good decision making in educational placement should try placing a
child starting from level 1 and going towards 10. The objectives of education
should be to have process and procedures to aiming at moving the child to
level 1.
A child with visually impaired usually benefits best from special class
in regular school settings, which allows from optimum integration without
compromising on the quality of education.
Positive attitudes among community members can be created by
involving them in the process design and implementation, and by transferring
knowledge about disability issues to community members. The provision of
functional rehabilitation services includes.
36
Eye care services
Hearing services
Physiotherapy
Occupational therapy
Orientation and mobility training
Speech therapy
Psychological counseling
Orthotics and prosthetics
People with disabilities must have equal access to educational opportunities
and to training that will enable them to make the best use of the
opportunities that occur in their lives. In communities where professional
services are not accessible or available, community workers should be trained
to provide basic levels of services in the following areas:
Early childhood intervention and referral, especially to medical
rehabilitation services
Education in regular services
Non-formal education where regular schooling is not available
Special education in regular or special schools
Sign language training
Braille training
Training in daily living skills
37
CODE SHEET
38
CODE SHEET
Sl. No. Variables Code number
V1 Serial Number 01, 02, 03, 04, ……… 80.
V2 Sex Male = M; Female = F
V3 Age 01 to 05 years = 1; 06 to 15 Y = 2; 16 to 25 Y = 3;
26 to 50 Y = 4; above 51 Y = 5
V4 Marital status Married = 1; Unmarried – 2
V5 Religion Hindu = 1; Muslim = 2 ; Christian = 3
V6 Caste OC = 1; BC = 2; SC = 3; ST = 4
V7 Economic
Status (per
month)
Rs. Below 5000 = 1; 5001 to 10000 = 2; 100001 to
20000 = 3; Above 20000 = 4
V8 Family type Nuclear family = 1; Joint family = 2
V9 Consanguinity Congenital = 1; Non congenital = 2
V10 Education Illiterate = 0; 1 to 5th class = 1; 6th to 10th = 2; Inter
= 3; Graduate and above = 4
V11 Occupation Cultivation = 1; Labour = 2; Employee = 3;
Business = 4
V12 Disability Visual Impaired = VI; Hearing Impaired = HI;
Mental Retardation = MR
39
IDENTIFICATION OF DISABILITY- CODE SHEET
V1 V2 V3 V4 V5 V6 V7 V8 V9 V10 V11 V12123456789
10111213141516171819202122232425262728293031323334353637383940
40
V1 V2 V3 V4 V5 V6 V7 V8 V9 V10 V11 V1241424344454647484950515253545556575859606162636465666768697071727374757677787980
41
CHILD & TEACHER PHOTO
42
43
CERTIFICATE
This is to certify that Mr. / Mrs.T.RAMESH with Reg.No. 93613382032 is a
bonafide student of Dr.B.R.AMBEDKAR OPEN UNIVERSITY, Hyderabad has
collected necessary information about _____________________ for the
purpose Case Study COMMUNITY BASED REHABILITATION IN VISUAL
IMPAIRMENT.
Date: SIGNATURE OF THE PARENT /GUARDIAN
44
Format of Case Study / History ( A Sampled)
Name : …………………………………… Date: ………………..
Age / D.O.B. : ……………………………. Sex: M/F/MC/FC
Address: Permanent: Temporary:………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………
Religion: ……………………. Aid User: Yes/No, If so, Model: ……………
Nature & type of disability: …………… Degree of Disability: …………..
Father’s / Guardian’s Name Mother’s Name
Age: ……………………… Age: ……………………..
Education: …………………… Education: ……………………..
Occupation: ………………… Occupation: ……………………..
Income: ……………………… Income: ……………………..
Religion: ……………………… Income: ……………………..
Education: …………………… Mother tongue: ……………………..
Occupation: …………………… Income: ……………………..
Earlier investigation / treatment : ……………………………….
Child’s Educational History:
Attends school: Regular / Special, Studies in Class …………...Age of Admission: ………………… Medium of Instruction : ……..
Mode of Communication: ……………. Failure, if any, Indicate level: …………45
Parental History:
Problems during pregnancy, if any: Viral infection / Drug taken / Physical and emotional Trauma / Rh incompatibility / Any other : Nil
Perinatal History:
Delivery at : Home / Hospital, Full time / Premature / Post matureBirth cry : Normal / Delayed / FeebleBirth weight : ……………………… Blueness: Yes / NoPostnatal History : (Indicate the age of onset and duration of illness)Family History:a. Nuclear family / Joint Family : b) Consanguinity : Yes / Noc. Viral infection / Drug slacken /Respiratory infection/Head Injury/Any other ……………………………..b. History of family deafness / other handicaps ………………………………………………………………………………………………………………………………..
Social and behavioral history :
Gross motor activity: …………………………………………Fine motor activity: …………………………………………Social interaction: ………………………………………..Receptive language: …………………………………………Expressive language: …………………………………………Reading : ………………………………………………………….Writing : ………………………………………………………….Numbers: …………………………………………………………Time : …………………………………………………………Money : ……………………………………………………….Domestic activity: …………………………………………………. Recreation / leisure time activity: ……………………………………….Additional information for child / adult if any:……………………………………………………………………………………………..
(You may add more information if relevant to your case-study and the general report)
Name of interviewer:Date: Signature
46
Preliminary Information:
Name of the Case :
Sex :
Age :
Date of Birth :
Father name :
Age :
Education :
Occupation :
Religion :
Mother Tongue :
Income :
Mother Name :
Age :
Education :
Occupation :
Family History:
47
Mr.B.Srinivas family is nuclear family. He has two children’s. the
elder child Santhosh is studying 8th class. Santhosh is normal child. Giri is
younger one is a mild visually impaired who is under study. It is a
consanguinity marriage.
Case History:
Pre-natal: Smt.Devi has no any problems during pregnancy like viral infection,
physical and emotional trauma.
Peri-natal: It was full time and normal delivery in the home. Birth cry was
delayed (they can’t remember then the situation) and they don’t know birth
weight.
Post – natal: There are no any significant factors in post-natal period.
Development:
Giri was no physical development up to 5 years of age attainment.
After 5 years he gradually developed. He has good weight and height. His
speech is also good and hearing also good. He has very good remembering
power. Some time he was very active and some times he was very dull.
Education:
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Giri parents are not willing to send the normal school. But Giri wants
to go to school. He was very much interest to play with other students. Giri’s
parents never sent to school regularly. The school teachers were also
neglecting the child. Though he was attain 11 years of age he was studying
third class only.
There is no special school in the village. Due to illiteracy of the family
and cause of the visual impairment, his parents won’t send the school, even
though neighbor house also they are not willing to send. Giri’s uncle takes
care about his education and development.
Causes of Visual Impairment:
Parent’s marriage is consanguinity and the delivery at home in
traditional system, and genetic factors may be leading the visual impairment
for this case.
Goal Selection & implementation:
I discussed with his parents and according to their condition I have
given instructions to the parents and his uncle how to develop academic skills.
Giri has very much interest to go to school. So I select a goal to develop his
listening and speaking skill. Due to illiteracy of the parents I gave suggestions
to the Giri and his uncle how to develop listening and speaking skills.
Follow-up Programme:
49
I gave instruction to his parents and uncle how to teach and how to
behave with the child in critical conditions. I also told to his friends and
neighbors how to behave with Giri and ask them to help him to achieve the
goal.
Future Planning:
I have given some suggestions to improve better life and awareness of
educational services, government concessions and benefits in bus, train
reservation in governmental institutes like education, employment, self-
employment and loan facilities for the disabled persons. I aware them about
special schools and where the schools are available.
Outcome:
The community based rehabilitation survey helps the parents of
visually challenged child and aware them about all facilities provided by the
government. It changes the attitudes of parents of visually challenged. Not
only parents of visually challenged and rest of the community also got aware
towards the disabilities.
Particularly, in this case I suggested to the giri’s parents the facility of
home bound instruction as well as special day school services are very use full
for improve education and enhance better life.
50
CHAPTER – IV OUTCOME
51
OUTCOME
The community learned many things about Mental Retardation i.e.
causes of mental retardation, misconceptions of mental retardation,
intervention programmes, special education, special school and government
support towards the mental retardation. Community was ready to change
their attitudes towards mental retardation. They are also ready to teach their
children. They knew about facilities provided by the government of India.
EXPERIENCE
In my project work I got very good experience from this community.
People are very cooperative and helpful. They were very enthusiastic to know
about the awareness programmes and intervention programmes. Local
administrative like Panchayati President, School Head Master, and Teachers
are also involved in the awareness programme.
FOLLOW UP WORK
In orientation programme I told to the community about mental
retardation, causes and the facilities provided by Government of India and
also Rehabilitation Council of India. Programmes about the teaching learning
of students according to their level, age and need were given. In awareness
programme I educated the community how to behave with mentally retarded
children. Also I assured them to help in such cases.
52
CHAPTER – VCONCLUSION
53
CONCLUSIONS
The overall goal of this project has been to assist in identifying the
opportunities and constraints which community rehabilitation faces with
respect to community participation. The critical lessons can be summarized
as follows: Community diversity reminds us of the disparate interests of
communities and that expectations of participation can overburden specific
segments of the community. Examination of the process of eliciting
community needs highlights several other problems around the
determination of the meaning of disability and what counts as needs. We
also know that disability may not be a community priority, and what is in the
best interests of individual disabled persons may not be in the best interests
of the community as a whole. Finally, critical examination of community
mobilization strategies reveals that projects grounded in local participation
can still be rejected.
Suspicion of community based projects in a time of shrinking global
economies and diminishing resources for health should not come as a
surprise. If community participation is to escape this dilemma, it seems
imperative that those who are interested in developing a community
approach take note of others’ experiences. Critical analysis is clearly the
starting point for understanding the history and lessons of community
participation.
We have shown that community diversity, needs identification and
mobilization strategies have represented considerable challenges to the
development of community based rehabilitation. Those interested in
54
community participation should take note of these experiences and adapt
their plans accordingly. We assert that knowing the communities in which we
live and work is crucial to this task.
Community is a term with powerful positive characteristics, but also
with the potential to divert attention from significant problems in society. Its
idealist basis is easily co-opted without regard for its true characteristics and
values. We need to be aware of this danger and critically examine claims to
community for the legitimate signs of ‘communitas’ and ‘biocenosis’ –
common concern, integration, and interdependency. The challenge of
community based rehabilitation is in finding ways of integrating persons with
disabilities in such communities.
In the community based rehabilitation awareness program my main
principle is to identify the disabilities to assess the disability and to suggest
instruments and appliances as per the need and further suggest suitable
education rehabilitation and for their overall development.
In awareness programme I educate them towards the educational
services, government concessions and benefits in busses and trains and
reservations in governmental institutions like education, employment, loan
facilities for their enrichment.
The community learned many things about visual impairment i.e.
causes of visual impairment, misconceptions of visual impairment,
intervention programmes, special education, special school and government
support towards the visual impairment. Community was ready to change
their attitudes towards visual impairment. They are also ready to teach their
children.55
REFERENCES
56
REFERENCES
World Health Organization Disability prevention and rehabilitation. (Report
of the WHO Expert Committee on Disability Prevention and Rehabilitation,
Technical Report Series No. 668). Geneva: 1981.
Midgeley. J, Hall A, Hardiman M, et. al. Community Participation, Social
Development and the State. London, Great Britain: Methuen, 1986.
Rifkin, SB. Lesson from community participation in health programs, Health
Policy & Planning 1986; 1 (3); 240-249.
Stone L. Cultural influences in community participation in health, Social
Science and Medicine 1992; 35 (4); 409-17.
Boyce W. Structural Dimensions of the Community Participation Process: The
Health Promotion Contribution Program. Unpublished PhD Thesis, University
of Toronto, Toronto, Canada, 1997.
Lysack C. Community participation and community-based rehabilitation: An
Indonesian case study. Occupational Therapy International 1995; 2 (3) : 149-
165.
Dr. Jayanthi Narayan, (Ed.2002): A practical Mannual on special Education
Practical and Teaching Practice in Mental Retardation, B.Ed Special Education
Self-Instructional Material MPBOU, Bhopal.
Statistical data of Guntur District, DSO, Yellamanda.
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