Professional Documents
Culture Documents
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Table of Contents
Forward ........................................................................................................... 4
Introduction ................................................................................................... 5
Information about inclusion ...................................................................... 5
Disability ......................................................................................................... 6
Identification and Referral ......................................................................... 7
Inclusive language ....................................................................................... 9
Connecting with Families ........................................................................ 11
Talking to parents about concerns regarding their childs
development .............................................................................................. 11
Families and ECCD partnership ............................................................ 12
Talking to the parents of all children...................................................... 13
Talking with children about disability................................................... 13
Four stages of early communication .................................................... 13
Strategies ..................................................................................................... 15
Joint attention ............................................................................................ 15
Choice-making .......................................................................................... 16
Communicating for different reasons .................................................... 16
Model language ........................................................................................ 17
Encourage requesting through language ............................................. 19
Delivering instructions ............................................................................. 19
Signing ....................................................................................................... 20
Motor skill development ........................................................................... 21
Behaviour................................................................................................... 22
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Visual support for children with visual impairment ........................... 24
Communication support for children with a hearing impairment ... 24
Transition to school .................................................................................. 25
Schools that currently have SEN programs ....................................... 26
Online resources about disabilities ...................................................... 27
Acknowledgments of contributions for this booklet ........................ 28
Picture acknowledgments ....................................................................... 29
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Forward
Mr Sherab Phuntshok
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Introduction
The Guidelines for Early Childhood Care and Development
Centres states, All children, regardless of innate abilities or the
presence of disabilities are able to learn to be successful.ii It is
estimated that 21% of children in Bhutan between two to nine
years old have a disabilityiii. It is essential that ECCD centre
Facilitators have the support to know how best to include these
children and enable them to learn along with their peers. This
booklet has been created to offer suggestions on how to support
the inclusion of children with disabilities aged 36- 72 months into
ECCD Centres across Bhutan.
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Support
A strong foundation of system level supports ensures that the
efforts of individuals, programs and organisations are successful.
Providing avenues for working collaboratively among all
stakeholders (families, staff, therapists, etc.) to provide
specialised services is important to ensure that qualitystandards
are maintained.
Children learn to see their own capabilities and strengths and this
teaches our typically developing children to feel empathy and not
sympathy towards children with disabilities.
Disability
The term persons with disabilities is used to apply to all
persons with disabilities including those who have long-term
physical, mental, intellectual or sensory impairments which, in
interaction with various attitudinal and environmental barriers,
hinders their full and effective participation in society on an equal
basis with others.iv A disability may be present from birth, or
occur later in a person's lifetime.
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At an ECCD Centre, ECCD Facilitators might identify that a child
has delayed skills or differences in the following areas:
Physical (fine and / or gross motor)
Hearing
Vision
Communication
Speech when a child has difficulty pronouncing words
Language difficulty understanding words (receptive) and /or
difficulty using words (expressive)
Intellectual
Social & emotional development
Behaviour
Self care
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Children with a disability can be referred to Ability Bhutan
Society (ABS) - A Civil Society Organisation based Thimphu
that provides service to children with disabilities and their
families. ABS also advocates for and creates awareness
about disabilities in the community and society at large.
http://absbhutan.org 2340747 absbhutan@gmail.com
Disabled Persons Association Bhutan Disabled
persons organisation that advocates for the rights of people
with disabilities and can be contacted on www.dpab.org.bt
2339996 info@dpab.org.bt
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Inclusive language
People first language puts the person first, and the label second
each label is only a part of who that person is, it is not a
defining feature. Putting the person first does not mean that the
label is a negative thing that needs to be separate from the
person, but rather emphasises that it is only one part of that
person. Standards for Inclusive Education in Bhutanv
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Connecting with Families
Talking to parents about concerns regarding their childs
development
If ECCD Facilitators are aware that a child in the ECCD Centre is
delayed in their development or shows unusual behaviours, it is
important that this is discussed with the childs family.
Be aware that the parents might not have noticed any delays or
differences or might not be ready to talk about it. But it is the
ECCD Facilitators responsibility to discuss their concerns, even
though this is not an easy conversation. Families may have
different emotions about coming to terms with their childs delay
or disability, for example worry, fear, guilt, loneliness and shame.
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o the opportunity to participate in activities that support
their development, and
o preparation for starting school.
An ECCD Facilitator and parents discussing their child's progress and goals
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Talking to the parents of all children
To be an inclusive society, we need to make sure that everyone
is included in all aspects of the community, and that includes all
children attending ECCD centres. Talk with parents about how
they, their children and the Facilitators at the ECCD Centre, can
all assist in creating a learning place for all children and that
every child has a right to an education and to be included in their
community. ECCD Centres can be a place to develop social
acceptance and understanding and develop the foundation of
knowledge about the long-term nature of disability.
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1. Discoverer - reacts to how they feel and to what is
happening around them, but has not yet developed the
ability to communicate with a specific purpose in mind.
2. Communicator - sends specific messages directly to a
person, without using words.
3. First Words User - uses single words (or signs or
pictures).
4. Combiner - combines words into sentences of two or
three words
1. Discoverer - children
usually love bubbles, so
it is an exciting activity
to encourage
excitement and
interaction between the
child and the person
blowing the bubbles.
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3. First Words User the child may request using one word
e.g. more, bubbles, pop.
Strategies
Use the Bhutan Early Learning and Development Standards
document to guide your planning for the children in your ECCD
Centre. In addition, the following strategies are suggestions that
could be used in an ECCD centre to support children with delays
or disabilities with their development. Be creative and consistent
to maximise the outcomes.
Joint attention
This is when two people are both focused on the same thing and
there is understanding between the two people they are both
interested in the same object or event. Joint attention is a
foundation skill for communication.
Sit at the same level as the child.
Encourage turn taking with joint attention activities.
Use activities like blowing bubbles which could encourage
visual tracking (following with your eyes) to focus on the same
item.
Use a torch in a dark room, to put a spotlight on different items
that you can look at items together and talk about them.
Encourage children to look at the activities they are doing by
verbally prompting them to do so. Give a visual prompt as
well. For example,if they are stacking blocks, pointing to the
blocks and say, look at what you are building.
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Use gross motor skill activities to support join attention e.g.
rolling and catching a ball or throwing and catching a ball
requires joint attention.
Choice-making
Some children are yet to develop the skill of making choices.
Decision making and communication can be supported by
offering choices.
Provide the child with
two or three different
activities to choose
from by showing them
two or three items.
Make sure the options
are named, so the child can hear the language related to the
different activities to build their language skills. For example:
Do you want the book or the car?
During lunch time, provide children with a choice of healthy
food options that they have to choose from.
If a child makes the choice without talking, make sure you
model the language. For example: You want the car. You
dont want the book.
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o request e.g. pointing to what they want, putting two
hands out to receive an item, or asking for what they
would like.
o gain attention e.g. tapping someones arm gently or
asking a person to look.
o label e.g. naming different items that they see.
o Comment e.g. talk about what interests them.
o gather more information e.g. learn to ask questions.
Model language
Children learn more about the world through listening. Talking
through each activity with them gives children the opportunity to
hear related language. This will help to expand their receptive
language skills (understanding) and offer the potential for
expressive language interaction (talking or signing).
Children develop their communication skills through imitation,
so give them opportunities to hear and see you communicate
and copy these skills.
If a child indicates (points, looks at, gestures or vocalises) that
they want an item, model the language that they could use in
this situation. For example: a child points to the car and the
Facilitator could say car. You want the car.
If a child uses one word to
communicate, you can use
that word and add another
related word or two to make
a phrase. For example: the
child says car, you can add
more language, such as red
car, drive the car, push
the car.
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Share books to encourage development in the childs
language skills. Children can learn new words and ideas
through the language and the images in books when a
Facilitator reads with a child. It is important to make story-time
an interactive experience, so that the child has more
opportunity to develop their language skills.
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Encourage requesting through language
Requesting is one of the early reasons to communicate. This
could be through spoken language or sign language.
Set up situations to encourage the child to make requests, for
example:
o place a desirable item out of reach but within sight (do
not do this after the child has indicated that they want
the item but prior to this interaction),
o have an item in a container that the child needs help to
open,
o leave out a puzzle piece so the child can ask for the
missing piece,
o use a toy that the child needs help with e.g. blowing
bubbles, winding up a toy.
Create an expectation that the child will use language
(spoken or sign) to communicate their requests. Waiting is
very important - it gives the child time to think about what they
want / need to say. Use an expectant look on your face, so
the child learns to take their turn in communicating.
At snack and lunch time,
encourage all children to
ask for help to open their
tiffins. This encourages all
children to ask for
assistance and also models
the language for children
with communication delays.
Delivering instructions
Be at the same level as the children when communicating
with them.
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Face the child when giving instructions so they can see the
expression on your face.
Encourage the child to look at the person that is
communicating with them.
Say the childs name before giving instructions to make sure
you have their attention.
Include gestures or signs with your instructions to make it
easier for them to understand.
Break instructions down into smaller steps, so the child does
not have to remember so much information at one time. For
example, instead of saying Go to the shelf and get the pencil
box and bring it to the table and draw a picture of your
favourite food, break it down to say: Go to the shelf and get
the pencil box. After that action is done, say: bring the pencil
box to the table. When the child brings that box to the table,
explain what they are to draw.
Signing
Key words signs can be useful for children with
communication impairments. For children who are deaf,
signing is essential. Facilitators can watch the Bhutanese
Sign Language videos developed by Wangsel Institute to
learn some key word signs
and use these with all the
children at the ECCD Centre.
This is an adult learning tool,
to allow adults to learn the
signs to then use them with
the children as a
communication mode. Get a
DVD copy of these signs
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from Wangsel Institute or the videos can be watched online:
https://www.youtube.com/channel/UCRk7aOjUDDIJWpXgrW
NYz8Q
Modify activities
Get creative to think how best to adapt and modify the activities
so all children can be included in the activities that are available
in the ECCD Centres. For example: if children are doing puzzles,
find puzzles that suit the different skill levels of the children in the
group; if the children are threading beads but it is a difficult
challenge for a child with delayed fine motor skills, use bigger
beads, with a wider stringer and holes.
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Provide children with the language to encourage success,
such as Im going to try my hardest or I can do this! rather
than I cant.
Provide additional opportunities to develop their gross and
fine motor skills through various activities.
Set up an obstacle course. Obstacle courses can help to
develop gross motor skills and body awareness. Design an
obstacle course that gets children to move in different ways
(crawl, walk, climb,
jump, etc.) and to
follow instructions
e.g. go under,
through, around,
over, etc. This is
also a great way to
teach prepositions
(e.g. under, through,
in).
Behaviour
Support children to develop their skills to wait their turn and to
share the resources. This can be done with Facilitators
guiding an activity with a small group, where turn-taking is the
focus and children are made aware that they will have a turn
but they must wait. For example, taking a turn to blow bubbles
or playing a matching card game.
Plan and control the environment. Limit access to activities
that are appealing but not appropriate at the time. For
example, do not leave toys in the sandpit when it is not time
to play in the sandpit. This should reduce the appeal of going
to the sandpit at inappropriate times.
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Reward appropriate behaviour through positive attention and
praising the child. Say what they are doing well, e.g. That is
good sitting, Well done keeping your hands to yourself.
When a child behaves inappropriately try not to give them
much attention. Children might be seeking attention through
inappropriate behaviours so this should receive little attention.
Provide the child with responsibilities to encourage their
interaction in activities. For example, ask them to collect the
book for story time and bring it to the group.
Try not to use negative language, e.g. words such as lazy or
naughty about a childs behaviour, as it is not helpful. You
can say no but then follow it with a simple explanation of the
behaviour that should be occurring e.g. if a child is touching
other children when they should not be, say remember we
keep our hands to ourselves or if a child is not sharing the
toys, say sharing with our friends is good.
Make sure other children do not try to tell others what to do.
Remind them that it is the Facilitators job to look after
everyone and the children need to look after themselves.
Develop Social Stories: Social Stories are used to teach a
specific communication or behaviour goal. Talk about the
desirable language or actions for particular situations. For
example, being gentle with friends, or how to greet people. It
is best to use photos of the child and the activities or
behaviours to make a simple social story. You can use simple
drawings too but they are more difficult for children to
understand that this story is about them than when photos are
used. For more information about social stories go to:
http://carolgraysocialstories.com/social-stories/what-is-it/
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It is okay to say no. Boundaries are important for all
children, including children with disabilities. We dont always
have to give a child what they ask for.For example, if a child
asks for tea when it is served to a guest, the Facilitator could
respond, No, sorry the tea is for our guests. You can have a
drink of water.
It is important that children receive consistent messages in
regards to boundaries and expectations.
Make a visual timetable for children to be able to see what
activities will happen that day. This helps them understand
what activities will happen.
Transition to school
ECCD centres provide an effective transition step for children to
move from home into the education system, rather than going
straight from home to formal education in class PP. For children
with disabilities or delays, ECCD centres can play an important
role in providing a supportive place to strengthen their skills and
develop an understanding of following routines that will support
them when they move to
formal schooling. In the childs
final year at their ECCD
centre, the family and ECCD
centre Facilitators should
discuss and plan for the next
step in the childs education.
This can include contacting
the principal of the local school
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or a school with a Special Education Needs (SEN) program and
discuss the childs enrolment for the following year. Also, take the
child to visit their future school. This can help them adjust to the
change ahead of a new learning environment. It also provides
the teachers an opportunity to start building a relationship with
the child and planning for how to support and include this student
in their classroom and school for the following year.
Autism https://www.autismspeaks.org
Epilepsy http://www.epilepsyaustralia.net/
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Acknowledgments of contributions for this booklet
Rachel Brindal, Early Intervention Advisor in the ECCD & SEN
Division, MoE, through the Australian Volunteers for International
Development (AVID) program, lead the development of this
resource.
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Picture acknowledgments
Thank you to the Wangsel Institute students for drawing the
images for this booklet and to Sushila Gurung for organising this.
The pictures were drawn by the following students:
p 25 Jigme Choden
i
Ministry of Education & UNICEF Bhutan. (2017). Early Childhood Care and
Development in Bhutan: A Case for Investment.
ii ECCD & SEN Division, MoE (2015) Guidelines for Early Childhood Care and
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