Unit 3: Family Empowerment

3.1 Encouraging family centred practices, parent self-efficacy belief and family involvement in child’s learning and parenting

3.2 Encouraging family acceptance of listening devices and ensuring its regular use

3.3 Supporting family in fostering and developing communication and language

3.4 Involving family in fostering and developing play, recreation and values

3.5 Encouraging family involvement in educational programme and participation in community based rehabilitation programme











3.1 Encouraging family centred practices, parent self-efficacy belief and family involvement in child’s learning and parenting


Family-centered practice is a way of working with families, both formally and informally, across service systems to enhance their capacity to care for and protect their children. It focuses on children's safety and needs within the context of their families and communities and builds on families' strengths to achieve optimal outcomes. Families are defined broadly to include birth, blended, kinship, and foster and adoptive families.

Family-Centered Practice Includes:

·      Learning about the family system and developing contextualized assessments and interventions that respect the family system and preferences (Hecimovic, Powell, & Christensen, 1999; Moes & Frea, 2000)

·      Careful attention to family priorities and concerns in planning interventions (e.g., Marshall & Mirenda, 2002)

·      Developing meaningful learning opportunities, providing information, teaching strategies, and offering feedback to families

·      Teaching families interaction skills to support and manage behavior and the development of communication and language

·      Recognizing that family and individual beliefs and values will vary based on culture, background, personal preferences, and individual variability

·      Recognizing that resource availability may vary over time and due to economic factors

·      Placing a high value on seeking and respecting family views

·      Individualizing services to the needs and desires of the family and involving families in decision-making

·      Recognizing the transactional nature of the disorder when evaluating family interactions and relationships;

·      Recognizing that family systems are dynamic rather than static, with family interactions and needs changing over time;

·      Engaging the family and using familiar items in various aspects of the evaluation and therapy sessions

Parenting stress refers to a series of processes that result in repugnant psychological and physical reactions to trying to fit in with the demands of parenting. It is a special kind of pressure that parents feel when they take on parental responsibilities. Parents of children with developmental disabilities (e.g., intellectual disability, autism, cerebral palsy, visual impairment, hearing impairment, ADHD) tend to experience higher parenting stress than others. Parenting stress can negatively affect children’s development, directly or indirectly. It is directly influenced by the behavioral factors in children. For parents experiencing high level parenting stress may impair their perceptions of the disability and their responses to children, thereby affecting their child’s skill development. For example, children with autism exhibit more behavioral problems than children without autism; parents of children with autism experienced a higher level of parenting stress. Moreover, parenting stress is also closely related with the severity of disability of children. Parents of children with disabilities experiencing high parenting stress may suffer psychological distress or other mental illness.

Parenting efficacy comes mostly from the concept of self-efficacy. Based on social cognition theory, parenting efficacy is an individual’s judgment and cognition of his or her ability to influence the child’s development and environment in parenting practices. Parenting efficacy has been considered a major determinant of parenting behavior and is strongly associated with child development outcomes and child psychological adjustment. Parents with higher parenting efficacy believe that they have good parenting ability, can complete parenting tasks, and have positive influence on children’s development. In particular, increased parenting efficacy can significantly improve the development of children with disability. Parenting efficacy has a close relationship with parenting stress, since they have the same empirical background, and parenting stress may alter parenting efficacy over time. Although the relationship between parenting stress and parenting efficacy has been established, the underlying mechanisms between parenting stress and parenting efficacy for parents of children with disabilities were still unclear.

There are four primary methods in which self-efficacy can be modified (Bandura 1989). These methods serve to either enhance or decrease perceived levels of parental self-efficacy (PSE).

The first and most important method is that of enactive mastery (personal) experience. This results from prior accomplishment in certain activities. Enhancing PSE levels is thus achieved by allowing parents to experience success in situations that they previously found challenging (Bandura 1977).

A second, likely method for improving personal self-efficacy is through the use of vicarious experiences. The individuals learn by observing challenging activities carried out by competent models, allowing them to re-evaluate their own mastery capabilities in relation to similar challenges they would encounter. It is especially useful when individuals see themselves as being similar to the observed model (Bandura 1997). Thus, having group discussions with other parents facing similar challenges, or watching videos or live parent models carrying out challenging tasks, are activities that may enhance PSE levels.

A third mechanism to improve self-efficacy beliefs is the use of verbal and social persuasion, whereby others provide informed verbal feedback of an individual's capabilities pertaining to a certain task (Bandura 1997; Woods et al. 2011). Encouragement from others is believed to be useful in improving self-efficacy and skill, whereas discouragement has the opposite effect (Bandura 1986). Within parenting programmes, feedback or coaching from the interventionists may provide this source of modification.

The fourth way self-efficacy beliefs can be modified is through emotional and physiological arousal. Parents may experience stressful physiological responses that include increased stress, anxiety and/or fatigue, which make it harder to experience success (Bandura 1986). Therefore, reducing negative emotional arousal to subjective fears (through increased knowledge or skills, or access to necessary formal and informal support) would subsequently enhance performance and improve perceived self-efficacy (Bandura 1986). Figure 1 is a visual representation of common intervention activities and how they may influence self-efficacy beliefs. However, as programmes typically aim to decrease stress as an outcome for their intervention, based on the cumulative benefits of the other activities rather than the inclusion of a specific intervention activity (like mindfulness), this modifier is not included in Figure 1.

Families as Partners in Education of children with disability

Family members are the first and most influential educators of their children with disabilities. Home – school partnership is essential to ensure the educational improvement of the child. They have the right to choose the type of school and type of educational services for their child with disabilities. Parents can get involved in school activities in a variety of ways. A responsible parent should attend parent- teachers meeting regularly for discussions with the class teachers about the educational programme being implemented. Parents and other family members should take part in planning, developing and implementing Individualized Educational Programme (IEP) for their children. Families of children with disabilities can give useful suggestions for curriculum adaptations and teaching methods as they know the strength and functional limitations to their children. Family involvement can also come in the form of home-work supervision. Family members can encourage their child to practice the skills that they have learned from school. Families can thus assist their child to develop a more positive attitude towards the school, teachers and the learning system.

Advantages of Family involvement in Inclusion

Active family involvement has long been considered to be an important factor related to better outcomes in the education of young children with and without disabilities in inclusive programs. Some of the advantages of family involvement in inclusive education are:

·      When parents and other family members get involved in education, students achieve success regardless of their family backgrounds (eg. parents’ educational status, families’ socio-economic status, their religion/attitudinal background etc.)

·      Involvement in the educational process helps the parents to gain an understanding about the curriculum

·      By interacting with the parents teachers can collect more information about the child. Especially the associated problems and learning style of the child

·      Parental participation in education encourage children to develop a more positive view on learning

·      With active participation of the parents the school can develop an effective programme for the child

·      Parental involvement in their child’s education develops self confidence in children with disabilities. It will improve their self - esteem and they can use their abilities positively

·      Parent - teacher collaboration help to bridge the gap between the school and community environment.



3.2 Encouraging family acceptance of listening devices and ensuring its regular use


No matter which communication mode a family chooses, developing auditory skills can significantly improve chances for success. For families who choose listening and spoken language, the ability of a child to use audition is critical. Language is best learned by hearing it spoken around us, so consistent exposure to a clear, audible, speech signal is vitally important. Fulltime use of appropriate technology allows the auditory brain to develop and is critical to auditory language development—and language development is critical for literacy and development of social skills.

Having a child diagnosed with hearing loss or any other disability can be overwhelming for new parents. Because 95% of children with hearing loss have parents with normal hearing, most of those parents:

·      Have had no experience with hearing loss.

·      Do not know what to expect.

·      Do not understand what is involved with helping their child succeed.

Their primary language is spoken language, so even thinking about learning another language can be overwhelming. Parents frequently do not understand the value of hearing a loud, clear signal and the importance of full-time hearing aid use. In addition, while dealing with their grief about having a child with a disability and the work involved in learning about hearing loss, they are troubled by problems with managing technology and keeping hearing aids on the child’s head. They need to be sure that technology is working. If they do not observe responses to sound when the child is wearing hearing aids, it is difficult to believe that using hearing aids is necessary and valuable—making the work of keeping them on even more taxing.

The most important function which gets affected due to hearing loss is the natural language acquisition and speech. However language development is vital as it is the basis of communication. It is the most important factor in the all-round development of a child. It is the basis of most learning, not only in the formal aspects of education, but also in the development of character, emotional state and social relationship of the children. The questions are ‘who should develop language and how it should be taught to the children’.

Parents of a hearing impaired child may therefore interact and talk to him as naturally as they would do with hearing children. They should remember

If you decide on a hearing aid for your baby, the two main challenges are:

Ear moulds sit in the ear canal and transmit sound from the hearing aid into the ear canal. When ear moulds are loose, they cause the hearing aid to whistle which is uncomfortable for everybody. Babies' ear canals grow quickly and the ear moulds will need to be replaced frequently in the early months. This involves the audiologist taking an impression of the ear canal and sending this off to the ear mould manufacturers. The ear mould will take a couple of weeks to be made and can be posted to you which is usually more convenient. The ear mould comes with longer tubing than is necessary and you will need to carefully trim the tubing to the right length for your baby. Ask the audiologist to show you how to do this the first time. Rubbing some ear mould lubricant (available from Australian Hearing) around the mould may also stop the whistling. The lubricant creates a better seal and reduces the amount of feedback which causes the whistling.

The second challenge is keeping the hearing aid on as the baby grows. They tend to pull them out and this can be frustrating, particularly when you are not around to see where it has disappeared. Babies tend also to put the aids in their mouths. The hearing aids have small batteries and although the battery case door is tamper-proof, it is best to avoid the possibility of your baby accidentally swallowing a battery or an ear mould.

There are a couple of solutions here and the most popular one with mums appears to be using pilot caps on the baby for a time. They are made from soft fabric and fit snugly over the ears and tie under the chin. These make it more difficult for a young child to pull off the hearing aid. They can be purchased at a number of the early intervention services. The baby soon grows out of this phase and it is worth persisting if you have decided on using a hearing aid.

Check the hearing aids every day

It’s important to check your baby’s hearing aids daily. Your baby can’t tell or show you much about what they hear, so you can only know if the hearing aids are working by checking them. This is a routine you need to continue until your child is old enough to tell you if something is wrong with the aids.

Your audiologist will show you how to check the hearing aids. Most people need to be shown a few times before they feel confident. Your audiologist will be happy to review the procedure with you as often you like.

Hearing aid use in the first six months of life

The hearing aid may produce a whistling sound when your baby is lying down or leaning. This is called acoustic feedback and is a common problem for newborns. It happens because the ears are small and soft and your baby spends a lot of time with their ear pressed against a surface, such as when sleeping or feeding.

You can reduce feedback by using a lubricant. Your audiologist can recommend a lubricant suitable for hearing aids. Young babies may need new earmoulds every few weeks to reduce the feedback.

Try to use the hearing aids as much as you can, in ways that still allow you to enjoy spending time with your baby. It helps if you can make wearing the hearing aids part of your baby’s routine.

If you can only use the hearing aids for certain times of the day:

A bouncinette can be helpful. Your baby’s head and neck are supported and you can face your baby directly with a clear view of your face. If you use a bouncinette, a netting fabric cover is a good idea because the netting reduces the risk of whistling from the hearing aids.

Alternatively, you could sit upright on a chair or the floor with your baby lying in your lap. Place your baby’s head on your knees and legs on your chest. You can get good eye contact and it is a good position for playing ‘Peek-a-boo’ or ‘This little piggy went to market’!


Hearing aids are usually removed for sleeping, mainly for comfort. It will not harm your baby to wear the hearing aids while sleeping, although it might be a bit uncomfortable.

The bedding behind your baby’s head may cause the hearing aid to whistle. This may be annoying for you. Your baby may or may not hear the whistle, depending on the degree of hearing loss. In any case, the sounds heard will be affected by the feedback.


Feeding is a special time with your baby. Most babies are cuddled close while they feed so whistling from one or both hearing aids can be a problem.

Cuddling is important, both for you and your baby. You may be able to find a way to cuddle your baby that does not cause the aids to whistle. Otherwise, turn off one or both hearing aids at this time. If you can only leave one hearing aid turned on, this is still helpful.

Remember to turn the aids back on after feeding if your baby is still awake.

Bath time

The hearing aids should not get wet so you need to take them out when your baby has a bath.

When your baby is not wearing the hearing aids

At times, it’s impractical for your baby to wear hearing aids. Your baby may not want to wear them when tired, for example. There are a few ways you can help make it easier for your baby to hear.

If your baby pulls the hearing aids off

At about six months of age, babies start gaining more control of their hands and begin to explore the world around them. Just as many babies find it interesting to pull off their shoes and socks, some babies love to pull off their hearing aids. Some babies also put them in their mouths.

Replace the hearing aid if your baby pulls it off. Try to stay calm. If your baby keeps pulling the aid off, or if replacing it develops into a struggle, put the hearing aid away for 15 minutes and try again later. This will help avoid a situation where your baby gets your attention by pulling the hearing aids off.

Helpful hints for keeping the hearing aids on your baby

Here are a few ideas for preventing your baby from pulling the hearing aids off.  

Keeping your baby safe

Check with your audiologist that your baby’s aids have (or can be fitted) with a tamper resistant battery compartment so your baby cannot accidentally swallow a battery. Make sure you use this feature while your baby is young.

Try to avoid your baby chewing on the earmould, in case it is accidentally swallowed.
Feel free to discuss any questions or concerns you have with our audiologists. They will be happy to help you.


For children to develop speech and language skills, they need to hear sounds, words and sentences over and over again. Therefore, for a child with a hearing impairment to develop speech and language skills, it is essential that the hearing aids are worn consistently.

The first few days and weeks of getting used to a hearing aid can be a difficult time for the whole family, or it can be a breeze! While some children take to hearing aids like ducks to water, accepting them immediately and wearing them all the time, for others it can take quite some time to establish regular and consistent use.

Your child’s age temperament and hearing level can all influence the reaction to hearing aids. It is also important to your child’s acceptance of the devices that they are comfortable and don’t feed back (whistle).

Your own reaction to hearing aids can also influence your child’s acceptance of the devices. Children are perceptive from a very young age and will respond to your facial expressions and body movements when handling or discussing the hearing aids. The thought of getting your child to accept hearing aids can be very daunting, particularly as you may feel uncertain about using the devices or of their benefit. This is especially true if your child initially shows little or no response to sound at early tests.

Luckily for most families, these fears are unfounded and the child accepts the aids without much fuss.

Please feel free to discuss any concerns at all regarding the hearing aids with your family audiologist. Many parents also find it helpful to discuss a variety of issues with other parents. Your audiologist will be happy to put you in touch with other families or with your nearest parent support group. Your child’s teachers/early intervention staff are also a mine of information about helping your child adjust to hearing aids.



3.3 Supporting family in fostering and developing communication and language


Children with hearing impairment often have some degree of speech and/or language delay. There are a number of different approaches to facilitate speech and language in these cases, and these depend on several factors:

How hearing impaired is the child?
What are the wishes of the parents?
What is child's first language (sign or spoken)?
Does the child have hearing aids or a cochlear implant?
What type of school the child attends (deaf or hearing)?

If the child is part of the deaf community and/or his parents are also deaf, it is possible that he may not follow an “oral / aural” route of language development and will use sign language. Sign language is a recognised language encompassing a wide vocabulary, grammatical structure and also involving facial expression. Individual countries have their own sign languages and often areas within a single country will have some regional differences (like having a local dialect or accent).

Other children with hearing aids or cochlear implants may follow an oral / aural route and have auditory training and learn speech sounds. There are different approaches to help with speech and language development. An effective habilitation and treatment for many cochlear implant wearers is Auditory-Verbal Therapy (AVT). This approach focuses on listening and sound awareness, as this is the most natural and efficient way that children learn speech. With AVT every possible opportunity to listen and learn is used through the day, using the child's environment as a learning tool.

Children with mild to moderate hearing loss and conventional hearing aid users may require more conventional speech therapy, but will still benefit from sound awareness and discrimination work. Although signing is not encouraged with AVT, some children with severe hearing loss and conventional hearing aids, may also use sign language alongside their speech work.

Speech Therapy for conventional hearing aid users

The success of speech therapy with conventional hearing aid users will depend on the extent of their hearing impairment, their motivation to communicate with speech, the dedication of the team around the child (including parents and care-givers), and whether they want to follow the signing or speaking (or both) route.

A lot of speech work will involve listening activities and getting the child to discriminate sounds. This may initially be just simple everyday sounds or words, accompanied by pictures.

Deaf children who learn language with sign acquire vocabulary at a similar rate to hearing, speaking children, but deaf children who are exposed to only oral language, will develop spoken language vocabulary more slowly. They also find it harder to develop grammatical skills.

Mother’s of deaf babies often mis-gauge their child’s language level, and pitch their level inappropriately, this makes the language environment less natural and can delay the development of the child’s language skills. It is also very important to give the child feedback and acknowledgement when they attempt any form of communication, otherwise they may become frustrated and start to give up communicating.

Auditory training

There is a hierarchy of treatment with auditory training, and if you are starting at the beginning with a child that has only recently been aided or implanted, the initial auditory work will just be getting the child to discriminate between sound and no sound. When the child can react to the difference between sound and no sound we work through a number of steps:

Examples of a Closed Set word list - shoe, pyjamas, gloves (this group of words has different initial sounds, different vowel sounds, and pyjamas has more syllables). A much harder closed set would be - hat, mat, mouse, house, rat (this group is more difficult as some initial and vowel sounds are the same, there is rhyme, and there are also words with close semantic links e.g. Mouse/rat).

An Open Set word list can have an endless list of choices and exposes the child to new words, these tasks are much more difficult.

Other speech discrimination tasks might require a child to listen to sets of words, but spot the differences between each set e.g. “are these 2 sets the same, or different?” 

Asking the child to discriminate words in phrases and words with background noise will also facilitate their listening development. Finally, to promote their word knowledge, we offer choices with questions (e.g. “Which one do you write with”), so their auditory comprehension is developed further.

What to be aware of when carrying out auditory training:

Lip reading

For some hearing impaired children, listening is not going to be their major source of receiving communication and they are going to rely on sign, gesture and lipreading. There is a difference between lipreading and speech-reading. Lip reading relies on lip movement and facial expression, whereas speech reading uses lips, facial expression, gesture and sound. Lip reading training involves becoming familiar with eye contact, facial expression, and lip shapes. Lip readers will then learn to match lips shapes to sounds, learn to identify words and common phrases, and as they become more proficient, short then long sentences.

Barrier games and story retell are good ways to teach both lip-readers and to develop auditory comprehension. Barrier games involve facing the hearing impaired listener, but have a barrier between you so they cannot see what is in front of you, or what you are writing or drawing. If you are testing auditory comprehension cover your lips so that the listener cannot get clues by lipreading. Try having a series of corresponding pictures in front of both of you. Name a picture, then see if the listener can listen, discriminate and understand what you have said, and name or point to their corresponding picture. You can do all sorts of games using the barrier such as map reading or picture drawing. Give the listener instructions to follow on a map and see if they end up at the same location. Draw a picture and describe it as you draw, and at the same time encourage the listener to draw the picture you are describing, then see if both pictures match at the end.



3.4 Involving family in fostering and developing play, recreation and values


When babies play, they are learning about themselves and the world around them. Play encourages social growth, language growth, problem solving, and imagination. In this section you will find exciting ways to encourage your baby to use play to explore the world.

From bubble blowing to blocks, from stuffed animals to stacking toys, babies love to learn through play. You can help your deaf baby encounter the language that children with normal hearing experience as they learn from their play. You will find ways to expand everyday activities into creative play, and ways to support your baby's first attempts at exploring fantasy and imagination.

Babies spend lots of awake time exploring the world through play. To adults, it might look like the baby is "just playing around." In fact, the baby is learning many new skills. For a baby, play is the best time for learning.

What is a baby learning while she mouths a toy or kicks her mobile over and over again? By the end of three months, a baby will make a little game of reaching and swatting at a mobile or hanging object. She discovers how to coordinate her hands and eyes to reach it. She learns that she can make the movement happen. These are big discoveries that stimulate her thinking skills. Let's look at some more examples...

Play is eating. Mothers and fathers use games such as "Open the garage, here comes the car," to make eating into play. While eating and playing, your baby learns that cars and airplanes have places to go, that cars go Beep! and airplanes go Zoom! When your baby is using amplification, those sounds are natural and important. The ideas that go with the sounds also are important. Babies will initiate play at eating time, too, although a baby's idea of play may be different than yours. Your baby may find the sight of the bowl of spaghetti hitting the ground very satisfying, and the sight of someone cleaning it up even more entertaining. Remember to be the tour guide and interpreter. You may not feel like using language such as "Uh-oh, fall," and "Mommy will clean it up" at such a time, but your baby is paying attention, so take advantage of the opportunity.

Play is communicating. Every parent-child interaction, from "Peek-a-boo" to "Pat-a-Cake," from knee bouncing to lullabies, comes from a love of communication games, face to face, enjoying one another. If your child is signing, play these baby games anyway, and learn the signs that signal what will happen: "Want to play bounce?" "Let's play pat-a-cake." Early lipreading, mouth movements, rhythm and facial expression are learned during communication play. If your infant or toddler is learning spoken language, these games let you call her attention to meaningful sounds. This is a first step in learning to listen. For example, you pull the blanket over your face, wait a moment and then start calling, "Bailey....Bailey....Peek a Boo!" As this game becomes familiar your baby will be alert when she hears her name. A little later she will pull the blanket when she hears the familiar pattern of "peek-a-boo." Her reward for listening is your smiling face and chances to keep playing the game. A finger-play song like pat-a-cake has a special pattern or rhythm that your baby will start to recognise after you play the game many times. After you have played the game many times, try asking your baby, "Want to play pat-a-cake?" Wait a moment and see if the baby responds by showing excitement or moving her arms. Babies begin to show they understand around 10 to 12 months of age.

Play is bath-time. First your baby loves to just splash. Then come the floating toys, and finally the cups and sieves and bottles for filling up and pouring out. Water goes in and out. Cups are full and then empty. Your baby pours, and the water splashes. What a lot of concepts you have to label when water is the toy. "You are wet. Cup's empty. The water is all gone. Fill it up. Pour." Even though your baby will not wear his hearing aids or cochlear implant in the tub, keep talking. You are close by at bath time, and it is a special time for babies and parents. If your baby is signing, she will enjoy watching your animated expressions, gestures and signs as you talk about the feel of the water, the splashes, and the rubber ducky, and what fun you are having.

Play is hugging. Loving contact between you and your baby is just as important as loving words. The vibration of your body when you sing or speak supports your baby's understanding of sound, either by complementing what she hears from her hearing aids or implant or by feeling your voice. The safety in your arms lets your baby claim you, look around at other people and things, and know that you will be there. Babies love to be touched. Many experts suggest that massages can be a satisfying way for mums, dads and babies to get to know one another in the first three months of life. Beyond the soothing skin-to-skin contact, touch is a relaxing and nonverbal way for you to socialise with your baby. It can be calming for you both. Anne Krueger of Parenting Magazine points out that young babies use touch along with other senses to learn about their surroundings. Deaf mothers and fathers of deaf children often use touch to connect and communicate with their infants.

Play is riding. Bouncing on a knee, riding piggy back on shoulders, travelling safely strapped into a wagon, a stroller, a shopping trolley or a car seat lets your baby see whole new parts of the world. Moving from place to place is the beginning of "Where?" and "Let's go to the...?" and "Go again!" Think of all the places that you can name. If you are encouraging your baby to listen with new hearing aids, try using riding games. Here are some examples:

Long ago mothers used the following rhyme during bouncing games:

Gonna trot trot trot to Boston (bounces)
Gonna trot trot trot to Lynn (bounces)
Watch out little girl/boy (moves baby side to side)
Cause you might fall INNNNNN. (gently moves baby down over knees and brings her back up)

Babies love the changing motor actions that go with this rhyme. They will anticipate getting to "fall back" and they listen for the exaggerated pitch change in "INNNNNN." You can hesitate a moment before the final line and final action to help your baby listen and anticipate what is next.

Horse back rides can be adapted to encourage listening. You can be in position for a bouncy ride and wait expectantly for a moment. Then tell your baby, "Let's go!" Make fun sounds like a horse or say "whee." When the action stops, stop the sound. Your baby will begin to notice that sound starts and stops. She will notice that the fun begins when we hear the sound.

Many movement games can be accompanied by sound or music to give your baby lots of chances to listen during play.

Play is watching and helping. Mum is washing dishes. Dad is folding laundry. Big sister is putting away groceries. The distance between watching an interesting activity and wanting to help isn't very big. Pretty soon, the baby who watches from a bouncinette will be the toddler who applies a plastic screwdriver to a cupboard hinge, sweeps the floor with a tiny broom, drops the carefully measured amount of fish food into the tank under close supervision, and stacks the toilet paper in the linen cupboard. All those objects and actions have names and qualities. "The floor is dirty. The hinge is broken. The clothes are clean. I am washing the car. Let's feed the fish." Whole sentences come from watching the family work. Be sure to talk about what you are doing, and the little one will begin picking up the language for these interesting ideas.

Play is creeping and cruising. When your baby can move independently, play becomes discovery of anything within reach. Your job and your language are those of a play partner and of a policeman. The language of limits as well as the language of discovery is important. "No, no. Don't touch" are part of learning, but they will probably not be enough. You will have to work at getting your baby to look at your language, when the objective is much more interesting and the idea of giving it up is distasteful. So now is the time for you to learn about the language of distraction: "Look at that!" "Here is something new." "Let's play with this." Redirecting the infant or toddler to a new idea or game can help her forget about the TV knob or the plant dirt (at least until the next time it gets her attention!)

Play is settling down to sleep. Bedtime is for sharing books and for experiencing lullabies that include familiar melodies, rocking and closeness. Even when a baby cannot hear lullabies, they can still be enjoyed through movement and vibration. Bedtime is for requesting a favourite stuffed animal and giggling when it comes flying down to tickle and cuddle. Bedtime is for crooning and gesturing to a special cot friend after the overhead light is off and parents are gone. Long before any of the words that go with bedtime, the comforting routines are there to build words on.



3.5 Encouraging family involvement in educational programme and participation in community based rehabilitation programme


As for any other group, education is critical to expanding the life prospects of people with disabilities. In addition, the socialization of children with disabilities (CWD) through education assumes an unusually important role in societies such as India where social exclusion of PWD is significant. Despite its importance, educational outcomes for children and adults with disabilities remain very poor. Illiteracy rates both for all PWD and for school-age disabled children remain much higher than the general population, and school attendance among school age CWD massively lags that of non-disabled children. 

Strategies for Enhancing Family involvement in Education

There is a need for enhancing the involvement of families in inclusive education. Some of the strategies which we can use for increasing family involvement are mentioned below:

·      School should develop a written policy to promote family involvement

·      Parents are welcome in the school and their support and assistance are essential for success

·      Including families as full partners in decision making

·      School should promote and support the parenting skills

·      Inviting families to visit the school

·      Maintain a school environment that is comfortable for families

·      Encourage networking between families

·      Keep a suggestion box in the school; it helps the parents to give suggestions that they have difficulty to tell open

·      Respect each family and accept them as they are

·      Implement policies that provide financial support to families

·      Facilitate parent-teacher collaboration at all levels of services

·      Organize training programmes for families

·      Help families to identify and utilizes local resources

·      Develop a sense in the families that they are always welcome to the school

Community Based Rehabilitation (CBR) was first started in 1970s with the aim of providing low tech rehabilitation services for Persons with Disabilities in low income countries and then in 1980s, it started focusing on people and community development. In 1989, World Health Organization (WHO) published the manual training in the community for the persons with disabilities with the aim of providing guidance and support for CBR programmes and stakeholders.

CBR was defined in 2004 by the International Labour Organization (ILO), United Nations Educational, Scientific and Cultural Organization (UNESCO) and WHO as “a strategy within general community development for the rehabilitation, equalization of opportunities, poverty reduction and social inclusion of all people with disabilities. CBR is implemented through the combined efforts of people with disabilities themselves, their families, organizations and communities, and the relevant governmental and non-governmental health, education, vocational, social and other services.”

The principles of CBR are based on the principles of the CRPD. The principles are:

·      Respect for inherent dignity, individual autonomy including the freedom to make one’s own choices, and independence of persons

·      Non-discrimination

·      Full and effective participation and inclusion in society

·      Respect for difference and acceptance of persons with disabilities as part of human diversity and humanity

·      Equality of opportunity

·      Accessibility

·      Equality between men and women

·      Respect for the evolving capacities of children with disabilities and respect for the right of children with disabilities to preserve their identities.

Benefits to people with disabilities and their families

·      Addresses impairment, improves functioning and independence, and promotes participation of all people on an equal basis.

·      Empowers people with disabilities to make informed decisions, attain their goals and understand their individual rights.

·      Enhances the quality of life of people with disabilities and their caregivers by addressing gaps in basic needs.

The aim of community-based rehabilitation (CBR) is to help people with disabilities, by establishing community-based programs for social integration, equalization of opportunities, and Physical therapy rehabilitation programs for the disabled. The strength of CBR programs is that they can be made available in rural areas, with limited infrastructure, as program leadership is not restricted to professionals in healthcare, educational, Occupational therapy vocational or social services. Rather, CBR programs involve the people with disabilities themselves, their families and communities, as well as appropriate professionals.

A CBR Network is a formal or informal relationship among CBR implementers/ practitioners or their organizations to promote and strengthen CBR. The strength of the network depends on the strength of individual or organizational members and the coordination and collaboration between members. It is expected that the benefits from the network will be greater than any individual's effort. To enrich CBR further for the benefit of the people with disabilities, their family, community and the country, a network of CBR practitioners/implementers/promoters is required at least at a national level, regional level and global level.