Access to Appropriate Programs...Croatia_3_0
My name is Darija. I'm Director of Mali dom-Zagreb from Croatia and I will talk today about access to appropriate programs for children with multiple disabilities and visual impairment, and for deafblind children in Croatia. Croatia has a population of about 4.3 million people, and the prevalence of children with disabilities up to 14 years would be around 40% of all population of disabilities, and with multiple disabilities that would make around 13,540 children. For multiple disabilities and visual impairment, for the number of those children, we do not have exact data, but the estimated number according to the percentage that is usually used, is about 2,400 children.
As well as for MDVI children, for deafblindness, unfortunately, we do not have exact data, and also the estimated number we can use and that would be a little bit about 200 children. In Croatia, we can say that we do have timely detection of children in delay or at risk and who are with disabilities, but unfortunately, we do not have appropriate referral and that comes for a variety of reasons. One of the reason is not enough coordination between the systems, health care and social welfare systems, and nonexistence of referral protocols, and not enough of legal framework. So all that leads to the referral that is not appropriate.
For support for children with MDVI in Croatia, we do have early intervention programs. We do have school programs, for the last few years or maybe 10 years, special and mainstream schools did open their doors for the children who have additional disabilities and visual impairment. So today, there are some who are included in mainstream and special schools.
Beside school programs, we do have daycare centers who provide education and habilitational programs. And unfortunately, we do still have children in institutions that provide rehabilitation or medical programs. Luckily, their number is decreasing and there's not many children left in those institutions, mainly they're adults. So within a few years, I hope there will be none in those institutions. And then we're left with Mahli dom-Zagreb. We are the only ones who provide specialist services for MDVI children. We developed a curriculum that is aimed to provide education for MDVI and deaf-blind children.
That was MDVI, and now about deafblindness a bit. In Croatia, it was only in 2003 where our legal system recognized deafblindness as a unique disability, but still there are a lot of problems regarding classification of deafblind people, identification, and other problems that are connected to those. So when we come to talk about education and the habilitation of the deafblind children, we also talk about schools, special and mainstream, both of them, and they are also included in those schools. But then we talk about children who are deafblind and have no, or have only mild additional disabilitities. When we talk about children who have a little bit more or severe additional disabilities besides deafblindness, then we are also the only one, Mali dom-Zagreb, who provide services and programs for those children.
And then the third one that is important in Croatia who deal with the deafblindness is definitely NGO Dodir. They did, and they do, a lot of advocacy for deafblind people and, lately, they're focused mostly on adults and we do provide support for the children who are deafblind.
Now we come, as I have mentioned before, Mali dom-Zagreb is the first one and we developed a curriculum for educational programs for MDVI children. We do have full programs for departments. First one is intertransdisciplinary assessment and counseling. Second one, we deal with early intervention programs and we provide them. And third one is education habitational program on a daily basis, and then we serve as a resource center for all those programs.
We started as NGO working-- starting to work with MDVI children 18 years ago. Then two years after that, we did make contact with Perkins School for the Blind and our first teacher went in 1997 to the ELP program. And starting from that day until today, Perkins was a constant support in developing appropriate programs for our children. Also in those days, when we did function as an NGO, we wouldn't make it without the help from CBM Germany.
Since we developed our program to a significant level and the number of children we have served or advised, in 2001, our Ministry of Social Welfare officially recognized our specialist program as the program for MDVI children. At that point, we had to transform to a public institution because it's within our law at that time, and we became a public institution that was founded by the local government of City of Zagreb. From that first day up till today, we have provided services for more than 1,320 children with multiple impairments, and visual impairment, and help for members of their families, so they've all been supported through our program.
Our first department, or the first program we do provide in our organization is assessment as a first step. Whereas we do a variety of assessment depending on the child's needs. So we do functional motor assessment, educational rehabilitation assessment, functional vision assessment, general movement/developmental assessment from birth to three months of age, speech and communication assessment, sensory integration assessment, occupational therapy assessment, and of course, psychological assessment.
We try to shift from inter to transdisciplinary assessment. Our professionals work in teams, and teams could be consisted of two or three of them, and sometimes we do the observation throughout multiple sessions throughout the week. And professionals who make the team are special education teachers, physiotherapists, speech therapists, occupational therapists, psychologists, and sensory integration therapists. Our assessment is overall and, of course, it's the first step and basis for creating optimal individual educational plan.
After the assessment, if the child is to stay within our program, then they go into early intervention program. We provide for children who are at risk or children with delay and have showed impairment. That's rehabilitation program from birth to the age of three. And mainly, or basically, we do it through the home visit and family support program. But some of the services we provide is center based and those programs cannot be done throughout the home visits. And those are experience groups, swimming, parents support group, and other services that could benefit the child and the family from those services. But the key person is definitely the early interventionist who conducts home visits.
We do start from creating individually family support plan. And part of that plan is first the individual education plan for the child. So basically, our early intervention program is family focused and family centered. Then the third part of our program is daily program, educational and habitational program, where we have children with severe disabilities and we run our programs through everyday activities.
Our curriculum is activity and theme-based curriculum and we do it after assessment, observation, and consulting with parents. We make IEPs, individual educational plans, created for every and each child. Classrooms groups are made of six to eight children and in each group, of course, all activities are made in accordance with goals that are set up for every child. We provide a variety of activities, of course, educational, daily living, domestic activities, and we make sure that we do not drop social and leisure activities as well.
Communication is an basis and integral part of our curriculum. We do use multimodal communication approach and it's embedded in all activities and used across all curriculum areas. First, what we have to do with the child is, of course, assess it's communication level. And according to the child's communication level, we must find and match the communication system we can use for that child. So that is the first step and that's the basis for everything else that we do with that child.
Apart from those educational and other services, we also do have some specific habilitation services. And this is therapy dog. We do use and we do work with therapy dogs in different settings and different activities, so this is like a very good thing and very beneficial for our children. Then we have swimming, snoezelen, assistive technologies, sensory integration, visual stimulation, and we do have also low vision clinic.
We try to make some other activities to fulfill goals that are set for each child in their individual plan. And we try to be creative and, therefore, we also use many activities that are creative so we also use music therapy, movement and dance therapy, and art therapy, to reach certain goals that we've set.
From the first day, we have tried to raise awareness, public awareness, of children with MDVI and we also tried to raise awareness of the importance that they should be included in the community, in things that are happening out in community, so we do have community outings. Every year we do make some projects that are public. We do make workshops with children from regular schools. We go visit them, they come visit, we do some things together.
We have made public actions, performances in the streets, in the squares, but we also do some art projects and exhibitions in museums. And then we also do have workshops, joint workshops, with school children or with other participants.
Of course, the big issue is family support. We do try, in all our programs, to act as partners with parents. They are included in developing of individual education plans and setting goals for their children and also in achieving those goals. So they do also have their homework, and they have to work with us and we have to work with them because that's what we can do for their children and what they can do for their children as well.
But aside from being partners with the professionals, we also do have support for them, not only for parents, but also for family. So we do have individual and group support in different settings and in different activities. We do have family gatherings and activities with siblings as well.
And the final part of our program that we offer is that we grew gradually into a resource center and networking center because over the years, we have been oriented together to gain new knowledge and to share information and knowledge between professionals within our organization, but also out of our organization. And since we developed and, as I have already said, we are developed and using the curriculum and educational program that is aimed and made especially for MDVI and deaf-blind children, therefore, we provide support for others who have just begun to make those programs, and who have maybe one, or two, or few students, in their programs who have additional disabilities. And, therefore, we provide support for them, for the schools and for other service providers where those children might be and use their programs.
We do organize seminars, in-service trainings, exchange visits on a national level. More than 20 service providers came to us for some kind of support and more organized only one time support. And on a regional level, we also do that through Perkins International support. So we did seminars and in-service trainings and exchange visits in Bulgaria, Bosnia, Czech Republic, Romania, Armenia, Greece, and Serbia.
Apart from that, since we are always aiming to be more professional and to hire a professional level in order to provide more and better services for our children, we do cooperate on various projects, not only practical ones, but we also are starting to do some projects, research projects, and we've done lots of different kind of projects in order to provide better conditions for children with MDVI and deaf-blind children. Those projects we have worked with universities, hospitals, schools, NGOs like UNICEF, et cetera.
In Croatia, we do have a lot of work still to do to strengthen programs that are offered and that exist for children with them MDVI. Weaknesses of our system are, well, a few, but there are just two that I would like to stress out and that is poor inter-agency coordination between health, social, welfare, and educational systems. Unfortunately, because of that and because of not enough of legal framework where we can put it, a lot of things are left out, and a lot of children have been left out throughout the years and did not have access to appropriate programs because of that poor coordination.
Fortunately, there are people and professionals who, on their personal level, have been enthusiastic and have been planning and creating a network of professionals from different fields. It is now spreading and that's how we overcome that weakness. And the second weakness, which is also a strong one, is lack of, nearly completely lacking of transitional planning, especially when we talk about when leaving school age, and that is 21. When children come to that age, there is very little or not at all transitional planning.
But there are some positive changes, especially in the last few years. Public awareness has been raised to a significant level. Networking, which I've mentioned before, between professionals and organizations from different fields has been spread, although it's starting, and it still is, based on a very interpersonal contact and the professionals personal will to network. This network nowadays is quite strong and it covers a great deal of the population.
Legal framework is getting better. And we have to mention master plan of deinstitutionalization. So I also did say that, within a few years, there should be no children in institutions left. And beside that, all big institutions had to transform to a service provider in the local community.
Children in the last 10 years have more access to appropriate education and, of course, you can see a big shift, although not good enough, but a big shift from medical approach that was typical in our region towards ecological approach. That would be all. Thank you.