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Title: Development and evaluation of a community-based rehabilitation programme for pre-school disabled children in Guyana
Author: O'Toole, Brian John
Awarding Body: Institute of Education, University of London
Current Institution: UCL Institute of Education (IOE)
Date of Award: 1989
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There are millions of disabled persons in the world. An Institutionally-Based model of rehabilitation alone cannot meet the challenge. The World Health Organisation (WHO) have offered Community-Based Rehabilitation(CBR) as an alternative approach. CBR advocates a simplified form of rehabilitation , mobilising resources that exist within the community. This project examines the relevance and effectiveness of a CBR project implemented in two rural areas of Guyana over a two year period. The programme is facilitated by a Local Supervisor (LS) who works in the child's home alongside a family member. Two groups of LSs were recruited, one comprised 26 volunteers from the community and the other constituted 25 nursery teachers. Disabled children were identified by surveys and by referrals by parents and professionals. A Multiple-Baseline Design was adopted to assess the child's progress. The children were assessed fortnightly on the Portage Checklist and pre, post and at a 6 month follow-up on the Griffiths Test of Mental Development. The quantitative gains were balanced with a qualitative analysis of questionnaire and interview data. The majority of parents participated actively in the programme, however for others the role was too demanding.An analysis of Portage scores revealed a gain of .67 items per month per subtest under baseline conditions, 1.95 items under treatment conditions and 1.02 items under control! follow-up conditions.The Griffiths results were significant at post-test and 6 month follow-up test (p= .01 for both groups of children.) The mothers observed changes in themselves feeling more relaxed and confident, and less depressed. The changes were however more characteristic of the 'volunteer' mothers than the 'nursery' mothers. 4/26 volunteers and 12/25 nursery teachers were not involved in the programme. Progress was seen in the physically and mentally handicapped children, others with severe speech and hearing problems may need more intensive help than that offered by this approach. A local committee created a resource unit for the disabled children of their area. The cost of the programme, excluding the cost of referral services, was £27 per child, per year. The thesis analyses; key features of introducing an innovation; ways in which the WHO approach was modified; limitations of the CBR model, and suggestions for further study.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Sociology Sociology Human services