By Dr Amar Singh HSS
The recent report of children caged in a residential home for children with disabilities in Batu Gajah has prompted the National Early Childhood Intervention Council (NECIC) to revise and reissue these guidelines first written and circulated in 2002 by Network (a sister organisation of the NECIC). By right the Welfare Department is responsible to supervise such homes and prevent such an atrocity from occurring.
The NECIC is a registered coalition of parents, therapists and professionals from a large variety of NGOs and aims to promote early childhood intervention and services for children with disabilities. The NECIC is concerned that many residential homes for children with disabilities are poorly managed, have potentially serious hazards and are not conducive for the development and well-being of these children. According to Article 23:1 of the Convention on the Rights of the child, ‘a mentally or physically disabled child should enjoy a full and decent life, in conditions which ensure dignity, promote self-reliance, and facilitate the child’s active participation in the community’.
The NECIC strongly recommends the implementation of the following guidelines for these residential homes based on the Convention on the Rights of the Child.
Safety at the residential homes
1. All residential homes for children with disabilities should be registered with State Welfare Departments. The State Welfare Departments should conduct frequent checks on the running of these centers.
2. Care at the residential home should be provided in a safe environment, which minimises the risk of illness and injury and which promotes physical and emotional health. The premises should convey a feeling of warmth, have good lighting, ventilation and space, be accessible for people with disability.
3. It should comply with state health and safety requirements, with regular checks from Welfare, Health and Fire departments.
4. Staff at these residential homes should not have a communicable disease and food handlers should be subjected to state health laws.
5. Staff at these residential homes should not have a criminal record or a history of abusing children. To avoid the potential for sexual abuse, these children should not be left in the sole care of any adolescent or adult.
Quality of care givers
1. Care givers should work a maximum of 8 hours a day. This is to minimise staff fatigue and potential abuse of children who are difficult to manage.
2. Care givers should be specifically trained in child development and disability management in order to meet the needs of these special children.
3. Children should be placed in small groups according to their abilities with sufficient numbers of consistent, interactive care givers who have long-term relationships with the children in their care.
4. The minimum care giver to child ratio should be 1 adult staff to 5 children with disability.
1. Before being admitted to the residential home all children with disabilities (residents) should be required to have a complete documented health evaluation signed within the last 6 months by a licensed health care professional, preferably a paediatrician.
2. Parents or guardians should be required to provide the residential home with a health history, which includes the child’s previous illness, immunisation record, prior surgery, injuries, known allergies, present state of health, current medical problems and medication.
3. The residential home should keep a record of all emergency contacts (phone numbers & addresses) for all children.
4. Care givers at the residential home should have a plan to handle medical emergencies, be trained to give first aid (this should include management of fits, choking, basic life support, etc).
5. Care givers at the residential home should be responsible for the safe storage and administration of medications to these children.
6. The residential home should be responsible to ensure that the children receive periodic health checks and specific medical follow-up.
Rehabilitation & Education
1. Every child at the residential home should have a written individual education and rehabilitation program, which is reviewed yearly. This should include the physical, emotional, social and intellectual areas of development with the aim of achieving the greatest degree of self-reliance and social integration possible.
2. If the residential home is unable to provide for the child’s educational needs, children at the pre-school age should be enrolled in an early intervention center and children who are of school age should be enrolled in a suitable educational system/setting.
These guidelines would apply whether children or adults with disabilities are cared for.
Dignity must be given to very person, disabled or able.
Dr Amar-Singh HSS is the President of National Early Childhood Intervention Council.
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