Abstract

Parents' involvement in the rehabilitation process is very important. Parental views about the availability of related services and incentives are the significant indicators of their required particular needs. The aims of the present study were to evaluate the level of available related services and incentives in special education centers and to highlight their specific and suggestions for improvement of these services for students of four disabilities studying in these centers. A survey was conducted from 2019 to 2020 to collect data about demographic characteristics and information about related services and incentives provided to these special students from their parents and also their suggestions to improve these services. The sample consisted of 36 government special education centers at the Tehsil level, from which 479 questionnaires, filled by the parents of students, were received back. The results emphasized the low education and income of the parents, increasing incidence of disability in the families of special children, lack of available services and incentives in these centers, and acknowledged parental suggestions and recommendations. It was concluded from the survey that future planning of provisions of related services and incentives might be more helpful and effective if based on the requirements and preferences conveyed by parents of special students with four disabilities.

Key Words

Related Services, Incentives, Four Disabilities, Parental Perception

Introduction

Special Education includes specially designed teaching and training instructions to meet the individual needs of students with disabilities at no cost to the family including education, home assistance, medical screening and assessments. Special instructions include all needs of an individual related to learning that results from his disability and ensure him an equal access to education and quality life (Kalambouka et al., 2007).

Related services include support, transportation and developmental, remedial and all other services that are essential to help a child with a disability to get best outcomes from special education. These services may include early identification and assessment of disabilities, speech therapy, physiotherapy, psychological services, guidance and counseling, mobility training, financial assistance, medical services, curriculum adaptation or modification, recreational activities and vocational trainings etc. Parent counseling, training, school based health services, and social work services may also a part of related services (Kupper, 2017). Related services comprise, but are not restricted to the following:

i. Audiology services

ii. Speech therapy services

iii. Psychological services

iv. Physiotherapy services

v. Interpreting services

vi. Occupational therapy

vii. Early identification and assessment of disabilities in individuals

viii. Guidance and counseling services for parents

ix. Mobility and orientation services

x. Social work services

xi. Health services

xii. Diagnostic services




It is the responsibility of the professional staff to get all the evaluation information from the parents and related services staff to categorize those related services that a child with disability needs and also include them in the Individualize Educational Plan (IEP). The IEP also includes each service and gives its detail as when the service will start; how often the service will be provided and how long it will be provided to the special needs student. Every child with special needs requires related services listed above depending upon the nature and type of disability (Kirk, Gallagher & Coleman, 2014). In addition, this list of related services is not complete and may contain developmental and supportive services including assistive devices that are helpful for the child with special needs to benefit from specially designed instructions The IEP is a written plan for the provision of related services to meet the special educational needs of the students. The IEP team consist of related services personnel along with parents of the child with special needs. The team decides that what related services are required for the child to improve and benefit from special education (Fish, 2008). 

In Punjab, Special Education Department (SpED) is providing education to children with special needs through 294 special education institutions including Degree Colleges, Vocational Training Institutes, Schools for hearing impaired, visually impaired, physically handicapped students, Training Colleges and Special Education centres for four disabilities at Tehsil level. The enrolment in these institutions is 32345 (male 20,404 and female 11,941). The main purpose of these special education institutions is to provide quality education, rehabilitation through related services in special settings for special needs student to maximize their strengths and to enable them to become a productive member of society (Special Education Department, 2019). The international reports on disability highlighted that students with disabilities start their schooling late as compared to their normal peers. The retention and transition rate of students with disabilities is also lower. Calderbank (2009) reported that more than 57 million children of primary schools are out of school worldwide and up to a third of these children have disability According to UN report 98% children with disabilities of developing countries are out of school. In Punjab, the ratio of male students with disabilities is higher as compared with female students’ reflects that they are more likely to be out of school (Rose et al., (2018). 

In Punjab, there are separate institutions for students with special needs, which provide educational and related service. These institutions are as following:

i. Special Education centres for four disabilities

ii. Institutes for visual impairment 

iii. Institutes for hearing impairment 

iv. Institutes for mental disabilities 

v. Institutes for slow learners

vi. Institutes for physical disabilities 

vii. Degree college for hearing, visual and physically handicapped student

viii. Vocational training institutes.




At Tehsil level in Punjab, Special education centres were established in 2005 to provide educational and related services to the four disabilities i.e. hearing impairment, visual impairment, physically handicapped and mentally challenged in a single centre. Special education department provides related services and incentives to students with special needs, which contain free education, free transportation, psychological, speech therapy, physiotherapy, guidance and counseling, free Braille books, free uniforms, and monthly Rs.800 stipend for each child and assistive devices (Special Education, 2020).

The parents are responsible to fulfill the needs of their children regarding education and providing the environment to maximize their abilities and healthy growth and environment. But parents of children with disabilities have extra responsibilities to pool the resources for rehabilitation programs and specific devices required for their lacking areas of disabilities. The parents of special students need extra support to fulfill the needs of their disabled child (Emerson, 2003; Roberts & Lawton, 2001). The required support is not provided to the parents of students with special needs and it further, affect the motivational and involvement of parents to achieve their goals of rehabilitation. The support to approach the related services can be very helpful for the parents of students with special needs but the access to the services of screening and assessment of disabilities and related other professional is limited (Palsdottit ,2007). Parents are mainly responsible to provide and continue the rehabilitation program of their special child. As a result, it is necessary to assess and determine the needs of related services and incentives they required, otherwise it will affect and slower down the process of rehabilitation (Epstein, 2010). Parent’s efforts to support their children lead to frustration because they are unable to access the services and support they required for their special children (Harper, 2005). Therefore, the purpose of this study was to (a) assess the level of related services and incentives available to the special students studying in special education centres of Punjab (b) understand how parents explain to improve these services. Specifically, the subsequent research questions guided the focus of this study: 

The survey was planned to get the demographic data, to assess the parental perception about related services and incentives available to the students of four disabilities who are studying in these special education centres and to get the parental opinion recommendations to improve these services and incentives in special education centres of Punjab. Following research questions were formulated to investigate the phenomenon. 

1. What was the level of available related services and incentives provided to the special students of four disabilities studying in these centres?

2. Which of the related services and incentives demanded by parents for rehabilitation of special students of four disabilities studying in these centres? 

5. What are parent’s suggestions and recommendations regarding rehabilitation of special students of four disabilities studying in these centres? 

Methodology

The methodology adopted for the present study was as under: 




Research Design 

The present study was descriptive in nature.  The descriptive research investigates the questions “what is” and permits both the collection of quantitative and qualitative data. The survey consisted of following research design. 




Participants 

Thirty six special education centres established at Tehsil level, run by Directorate of Special Education, Punjab were selected dealing children with four disabilities i.e. hearing impairment, visual impairment, mental challenged and physically handicapped, were selected from all nine divisions of Punjab. In 2005 theses Special education centres were established at Tehsil level in all 36 Districts of Punjab. The Head Teachers serving in special education centre helped to get data from one special education centre of each Tehsil of 36 districts. In the second stage, 720 parents of special students of four disabilities (5 parents of each disability) studying in these special education centres from primary level to matric were randomly selected. The questionnaires were distributed by the Head Teachers for data collection from the parents and getting back these questionnaires to the researcher after completion. 




Instrument 

A questionnaire was developed for the parents of special students of four disabilities studying in special education centres of Punjab. Items were constructed section wise. The first section dealt with general information and characteristics of the parents and special students of four disabilities i.e. hearing impairment, visual impairment, mentally challenged and physical handicapped and two open ended questions were included about the prevalence of disability in the family and diagnosis of disability to get information about the available screening and diagnostic facilities. Second section consisting of 13 closed and Likert scale type items dealing mainly with available related services and incentives to estimate the level of available related services and incentives for special children. Last section comprised two open ended items about the problems faced by parents and recommendations to improve these related services and incentives in these special education centres. 

Reliability and Validity 

Questionnaire was pilot tested on 24 parents of special students of four disabilities studying in special education Institutions of Hearing impaired, visually impaired, mentally challenged and physically impaired students at District level in Attock, Rawalpindi and Chakwal. Content validity was assessed through parental opinion form that was enclosed with the questionnaire. On the basis of recommendation from parents the questionnaire was developed in Urdu. The reliability of the response form was checked through Cronbacks alpha that found to be at0.89.




Data Collection and Analysis

The response rate for this study was 67 % as out of 720, 479 filled questionnaires were back from the parents. Data were collected from the parents of special students of four disabilities including both girls and boys. The 63% were the parents of boys and 37% were the parents of girls. The frequency distribution of four disabilities was as under:

Figure 1

Frequency Distribution of four disabilities



Note. (H.I for hearing impaired, V.I for visual impaired, P.H for physically handicapped and M.C was mentally challenged).

Data related to personal information, characteristics of parents were scattered, and contained rich diversity. The data illustrated that most of the parents of special students were poor, not highly qualified, and majority belonged to lower level of socio economic status with lower level occupation in government sector or private job and small level business as explained below:




 

Table 1. Respondent and Child Characteristics

Variable	Frequency	Percent
Questionnaire Respondent
Mother	315	65.6
Father	164	34.4
Education
Master	43	8.9
Bachelor	66	13.8
Intermediate	78	16.3
Matric	125	26.2
Under Matric	167	34.8
Employment Status
Govt. Job	62	12.8
Skilled/ Labour	162	33.8
Business	58	12.1
Private Job	93	19.4
Overseas	48	10.2
No response	56	11.7
Monthly Income
Up to 10,000	26	5.4
Up to 15,000	54	11.3
Up to 20,000	78	16.3
Up to 25,000	94	19.6
Up to 30,000	105	21.9
Up to 35,000	42	8.7
Up to 40,000	25	5.2
Up to 50,000	20	4.3
No response	35	7.3
Child’s Disability
Hearing Impairment	138	28.8
Visual Impairment	122	25.5
Mentally Challenged	101	21.1
Physically Handicapped	118	24.6
Child’s Gender
Boy	302	63
Girl	177	37
Incidence of Disability in the Family
No Disability	185	38.6%
Father	45	9.4
Mother	33	6.9
Brother	74	15.4
Sister	63	13.2
Any Other	79	16.5
When Disability was Diagnosed
At Birth	67	13.9
At One Month	52	10.9
At 6 Months	47	9.8
At 1 Year	43	8.9
At 18 Months	37	7.7
At 2 Years	21	4.5
No response	212	44.3

 




Table 1 indicates characteristics of the parents and special children of four disabilities in the study. In this sample, the characteristics of special students of four disabilities from class one to matric estimated the attributes of all children receiving special education related services and incentives in the Punjab. It also explains the poor parental socio economic status and their educational level. It further gives details that more financial assistance is required from the government to support these special students of four disabilities for rehabilitation. Furthermore, the data revealed that the incidence of disability in the family was more common in the siblings (Brothers 74%, Sister 63%) of special students as compared to their parents. The data showed the parents did not report the time of diagnosis of disability (44.3%). This indicates the insufficient availability for screening and diagnosis services for disabilities. Parents were requested to report the related services and incentives they received during the last year.

The concerned parental opinion about the extent of available related services and incentives provided to special students of four disabilities studying in special education centres, the following bar graphs are plotted with y-axis having the percentages of their view ranging from very less support to very much available support. All the related services and incentives provided to special students of four disabilities studying in special education centers are shown on x-axis. Blue bar represents the cumulative percentage of much support; green bar represents the combined percentages of less support level and the red bar representing the percentage of average level of support is in the middle.

Figure 2

Availability of IEP Services to special Students of four Disabilities

Figure 2 shows the level of IEP support services available to students of four disabilities (Hearing impairment, visual impairment, physically handicapped and mentally challenged). More parents of all four disabilities reported less available IEP services provided to the special students.

Figure 3

Medical assessment and diagnosis Services

This figure illustrates the availability of medical assessment and diagnostic services. Parents of students with four disabilities reported that they have very less support regarding medical assessment and diagnostic services.

Figure 4

Assistive Aids and Devices

Figure 4 depicts that students with hearing impairment disability have very less support from government to provide hearing aids while students with visual impairment have more support from government regarding assistive aids and devices for reading and writing Braille. The parents of physically handicap and mentally challenged students reported that average support from government is provided to their special children.

Figure 5

Guidance and Counseling Services

Figure 5 explains the guidance and counseling services provided to the students of four disabilities in special education centres. The parents of all four disabilities reported that much support in guidance and counseling is provided to them in special education centres.

Figure 6

Free Pick & Drop Facility

The figure demonstrates the pick and drop facility available to the students of four disabilities. The parents reported that students have average support for pick and drop facility from the special education centres. 

Figure 7

Speech therapy

The above figure demonstrates that speech therapy services are required more to hearing impaired and mentally challenged students. 

Figure 8

Physiotherapy

The above figure explains that parents of special students reported that special education centres provide very less sport regarding physiotherapy to the students. 

Figure 9

Provision of Textbooks and Braille books

This figure shows the provision of textbooks and Braille books to the students of four disabilities. The parents reported that that they have average support from in provision of text and Braille books from the special education centres.

Figure 10

Provision of Uniform

The above figure shows that parents of four disabilities reported that special education centres provide much support to the students in providing uniform for both summer and winter season.

Figure 11

Provision of Stipend

The above figure illustrates that parents of four disabilities reported that special education centres provide much support to the students in providing stipend of Rs.800/ month to the student on regular basis.

Figure 12

Provisions of Recreational Trips

The above figure demonstrates that parents of four disabilities reported that special education centres provide much support to the students in providing recreational trips on regular basis. 

Figure 13

Provisions of Sports Facilities

This figure shows that special education centres provide much support in providing sports facilities and opportunities to the students of four disabilities.

Figure 14

Provisions of Vocational Training



The above figure shows that parents of four disabilities reported that special education centres provide less support to the students of four disabilities in providing vocational training.

The precise opinions of parents of four disabilities and problems they faced in delivery of related services and incentives are as follows:

• The Individualized education plan for special students is not planned by teachers. 

• Medical assessment and diagnosis services are not provided to the students studying in these centres. 

• Assistive devices like hearing aids are not provided to hearing impaired students. 

• Guidance and counseling facilities are provided to special students and their parents. 

• Speech therapy services are not sufficient on the basis of their needs. 

• No physiotherapy service is available in special education centres.

• Parents are satisfied with the provision of uniform, stipends of Rs.800 per month, recreational and sports facilities. 

• Parents reported inadequate facilities of provision of text and Braille books. 

• Vocational training facilities are inadequate for special students.

The parental recommendations and demands where immediate attention from the government is required are as following:

• Individualized educational plan must be followed in special education centres.

• Financial support and provision of early screening and diagnosis facilities. 

• Provision of Assistive devices, hearing aids and accessories 

• Provision of text and Braille books. 

• Teachers are not regular and trained. 

• Appointment of a physiotherapist, speech therapist and audiologists in special education centres. 

• Free monthly medical checkup and provision of free medicines in all hospitals. 

• Provisions of mental, visual, auditory and physical assessment facilities.

• Enhancement of transportation for free pick and drop facilities to all special students.

• Vocational training facilities in all centres leading to job placement in future. 

• The amount of stipend is insufficient and does not fulfill the needs.

Discussion

The purpose of this study was to evaluate parents' understanding with their child's special education services. Results of the study showed that the majority of male children had disabilities in all Tehsils. The male special children were 63% and female special children were 37%. The findings are in line with National Census (1998) and (Doyal & Das-Bhaumik, 2018) that showed high prevalence of disability in boys than girls. Naeimeh, Pedram, Nasrinet et. al. (2009) observed in their study that early screening and diagnosis are essential for the special children and their parents. Early diagnosis of disability in special children would allow early treatment, which can help the special child to progress in his weak area. Physiotherapy, occupational and speech therapy help the children with special needs to attain their developmental milestones with minimum delay (Majnemer 1998; Skotko et al. 2009).

The incidence of disabilities in families was increasing is in line with results of Barnett (2002) and Noor and Arif (2017) who observed rapid increase in the incidence of disability in the families of hearing impaired. The percentages of disabled parents (9.4% fathers and 6.9% mothers in the current study are close to the estimate of Mitchell & Karchmer (2004). The result also indicated that majority of parent’s of special students were poor of financial status, not educationally well qualified and belonging to skilled / labour or private jobs are consistent with (UNESCO, 2000; Singal, 2009;Hameed , 2006; UNICEF, 2017 & Manzoor et al., 2018 ). Other finding of the study about unavailability of textbooks, Braille books, insufficient assistive devices for special students of four disabilities are near to the findings of Center for Evaluation and Education Policy CEEPA (2015) and of Tassawar and Khurshid (2019) that without proper services, resources and assistive devices, it is very difficult to support and educate  special students of four disabilities in special education centres.

Conclusion

The study revealed that special students of four disabilities were not being taught according to Individualized Educational Programme (I.E.P). Basic related services of speech and physiotherapy, transport facility, text and Braille books and assistive devices were not available. The majority of the parents reported that they were unable to purchase assistive devices for their children, as they are very expensive. Vocational training was not provided to students as no vocational teachers were appointed in these special education centres. Most of the parents pointed out the lack of skill oriented curriculum and vocational training facilities. The majority of parents demanded to upgrade these centres and provision of modern and latest assistive devices on the basis of disabilities and financial support from the government. The parents also demanded to provide screen and medical facilities for early diagnosis and intervention. Parents recommended changing the curriculum of special students focusing more on practical and vocational skills. Parental demands and needs are fundamental for effective future planning of special students in their rehabilitation process.

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