October 16, 2012, Yerevan

Survey Description• Goal: identify the level of access for children with disabilities, to reveal their

participation in different life activities, to identify the barriers to inclusion

• Target: Children with disabilities, aged 0-18

• Primary Source: Pyunik database

• Method: Questionnaire-based face-to-face interviews

• Respondents: Parent (in families), guardian (in orphanages)

• Implementer: Armenian Marketing Association

• Data Collection Period: August- December, 2011

• Analysis: Disaggregated by gender, residence, region and disability

Interview Summary

Interviews by Region

Interviews in the Orphanages

Limitations

• Target group

Primarily children with certified disabilities

• Coverage

• Methodology

Disability classification done based on medical diagnosis in Pyunik database only

GENERAL CHARACTERISTICS OF CHILDREN

Geographical Distribution

145927%

166531%

219841%

Yerevan Regional Urban Rural

Age and Sex Distribution

211(55%)174

(45%)

3633 (68%)

1689 (32%)

Male

Female

Family

Orphanage

20%

20%

16%12%

16%

17%

5%

14%

18%

18%

24%

21%

0-3 y/o

4-6 y/o

7-9 y/o

10-12 y/o

13-15 y/o

16-18 y/o

Orphanage

Family

Type of Disability

Physiological – hematological, cardiovascular, imunological and respiratory functions(b4) , digestive, metabolic and endocrine systems(b5), urino-

genitary, reproductive(b6) and skin and skin-related functions (b8)

32%

2%

32%

4%

4%2%

24% 36%

20%

20%

7%

7%

7%3%

MotorPhysiologicalIntellectual VisualAuditoryEpilepsyCombined

Orphanages

Families

EDUCATION

Kindergarten Attendance

Yerevan Regional Urban Rural Total (Families) Orphanages

50%

43%

23%

36%

9%

44%

37%

23%

33%

14%

48%

41%

23%

35%

12%

Male Female Total

School Attendance

Yerevan Regional Urban Rural Total (Families) Orphanages

13% 18% 23% 18%

72%

12%

13% 10%12%

23%

75%69%

67%70%

5%

General School Special School Does Not Attend

School Attendance

Yerevan

Amavir

Aragatsotn

Ararat

Gegharkunik

KotaykLo

ri

Shirak

Syunik

Vayots Dzo

r

TavushTotal

13%23% 22% 23% 21% 21% 22% 18% 18%

5%

18% 18%

12%

18%

8% 10% 8%14% 10%

13% 14%

7%

2%

12%

75%

59%

70% 68% 70%64% 68% 69% 68%

89%80%

70%

General School Special School Does Not Attend School

School Attendance

Physiological

Motor

Visual

Auditory

Intellectual

Combined

Epilepsy

Total

6%

26%

7%

8%

27%

20%

14%

18%

4%

6%

7%

36%

25%

17%

5%

12%

90%

69%

86%

56%

48%

63%

81%

70%

Does not attend school Special school General school

Out-of-school Children

Yerevan Regional Urban Rural Total (Families) Orphanages

11%

15%

22%

17%

72%

15%

23% 24%21%

72%

13%

18%

23%

18%

72%Male Female

Total

Reasons for Non-attendance

Yerevan Regional Urban Rural Total (Families) Orphanages

36%46%

54%48%

99%38%

39%

29%

34%

19%

18% 19%19%

6%

5%7%

7%9%

7% 4% 6%4%

2% 5% 4%

1%

The child was refused admission to school Distance/transportation

Parents see no need for school The school does not have sufficient conditions

Because of health condition Parents (guardians) think the child cannot study at school

HEALTHCARE

Children NOT under paediatric care

Yerevan Rural Regional Urban Total (Families) Orphanages

11%

23%

18% 18%

3%

13%

28%

20%

21%

1%

12%

25%

19%19%

2%

Male Female Total

Reasons for not being under paediatric care

Yerevan Regional Urban Rural Total (Families)

53% 52%43% 48%

19% 22%30% 26%

4%11%

23%16%

5%

13%

13%

12%

8%

16%

10%

12%

Insufficient Quality

Are not aware of the service

Service is not available in the community

Cannot afford the service

Parents think there is no need

Use of services as per the Individual Rehabilitation Plan

Physiologica

l

Moto

r

Visual

Auditory

Intelle

ctual

Combined

Epile

psy

Total

(Fam

ilies)

Orphan

ages

16%

30%

12%

23% 22%

32%

17%

23%

82%

Frequency of use of paediatric services

Daily Weekly Monthly 3-4 times a year 1-2 times a year Only if necessary

82%

7%4% 5%

2%3%

21% 21% 21%

33%

Families

Orphanages

Provision of Technical Devices

Yerevan Regioanl Urban Rural Total (Families) Orphanages

28%

24% 24%25%

22%

35%

33%

31%

32%34%

30%

27% 26% 27%28%

Male Female Total

Provision of Technical Devices

Physiological Motor Visual Auditory Intellectual Combined Epilepsy Total

8%

43%

33%

75%

9%12%

3%

27%

Reasons for not getting rehabilitation services and technical devices

Other

Cannot afford

Service unavailable in the community

Parents see no need

Are not aware of the service

8%

13%

12%

26%

54%

8%

4%

87%

6%

Technical Device Rehabilitation

SOCIAL PROTECTION AND COMMUNITY-BASED SERVICES

Disability pension Other social protection/support

Medical Services Social Services

Payments

Yerevan Regional Urban Rural Total (Families)

29% 33% 33% 32%

57% 49% 50% 52%

25%16%

24% 22%

23%

29%31% 28%

9%

4%

5% 6%

Equipment Examination Medical Staff Medicine

No Payment

Yerevan Regional Urban Rural Total (Families)

91%82% 86% 86%

4%11% 9% 8%

2% 3% 5% 4%2% 5% 2% 3%

Hard to respond Disab pension provision

MSEC Evaluation No Payment

Daycare centers

Yerevan

Amavir

Aragatsotn

Ararat

Gegharkunik

Kotayk

Lori

Shirak

Syunik

Vayots Dzor

Tavush

Total

10%

9%

2%

3%

9%

0%

3%

8%

10%

1%

17%

7%

Yerevan

Amavir

Aragatsotn

Ararat

Gegharkunik

Kotayk

Lori

Shirak

Syunik

Vayots Dzor

Tavush

Total (Families)

Orphanages

14%

6%

14%

11%

12%

2%

11%

11%

15%

0%

12%

11%

83%

NGOs

Participation

© Armenian Caritas

Leaving home/orphanage premises

Physiologica

l

MotorVisu

al

Auditory

Intellectu

al

Combined

Epilepsy

Total (Familie

s)

Orphanages

1% 4% 1% 3% 4% 2% 2%

13%2%

4%1% 2%

4%6%

3% 3%

10%

5%

11%

5% 6%

11%11%

6% 9%

30%

93%

81%

92% 92%82%

78%

89% 86%

42%

0.05

Periodically, at least a few times a week

A few times a month

A few times a year

Only for visiting a doctor

Never/Rarely

Friends

Physiological Motor Visual Auditory Intellectual Combined Epilepsy Total (Families) Orphanages

6% 12% 5% 4%21% 20%

8% 12% 16%

71% 65% 70% 71%54% 66%

67% 65%

3%

81% 71% 81% 79%55%

52% 78% 71%

6%

6%10%

12%28%

19% 9%

6% 12%

56%

57%45%

58%40%

27% 27%

50% 44%

6%

0.3

Children of the orphanage Non-disabled classmates Classmates/kids with disabilities Neigbour's children Relatives' children Has no friends

Participation in community events

Physiological

Motor

Visual

Auditory

Intellectual

Combined

Epilepsy

Total (Families)

77%

61%

76%

78%

54%

55%

66%

66%

Sports

Yerevan

Regional Urban

Rural

Total (Families)

Orphanages

17%

11%

5%

10%

1%

11%

4%

2%

5%

15%

9%

4%

8%

1%

Male Female Total

Physiological

Motor

Visual

Auditory

Intellectual

Combined

Epilepsy

13%

9%

14%

18%

6%

7%

8%

5%

6%

3%

6%

4%

2%

3%

11%

8%

11%

13%

5%

5%

7%

Art and Culture

Physiological

Motor

Visual

Auditory

Intellectual

Combined

Epilepsy

Total (Families)

Orphanages

13%

9%

16%

16%

6%

8%

10%

10%

9%

Family Awareness

UN Convention On the Rights of the Child

UN Convention for the rights of disabled people

RA Law “On persons in need of special conditions for education”

RA Law “On social protection of disabled people in the RA”

64%

66%

60%

59%

32%

31%

35%

35%

4%

4%

5%

6%

Completely unfamiliar Has Heard of Quite familiar

Priority Services

Yerevan

Regional Urban

Rural

Total (Families)

40%

63%

66%

58%

26%

34%

39%

34%

28%

30%

35%

32%

25%

33%

30%

30%

17%

6%

9%

10%

4%

4%

3%

4%

Specialized medical care Inclusive schools, preschools Special transportation Job Opportunity Leisure, playgrounds

Financial aid

Facts of Concern• 1 out of every 6 children with disabilities surveyed (16%) lives or studies in

seggregated settings (orphanages or special schools).

• Girls with disabilities are relatively more frequently taken to orphanages than boys, and are relatively less frequently visited.

• Only 1 out of every 20 children with disabilities (5%) in the orphanage attends a mainstream school; 23% attend special schools, and 72% do not attend school at all.

• 1 out of every 4 (23%) never leaves the orphanage or leaves the orphanage only for the health services.

• The majority (around 88%) of the children do not have friends without disabilities outside of the orphanage.

Facts of Concern• 1 out of 5 children with disabilities (18%) does not attend school. The

figure is 23% (1 out of 4) in the villages. Children with motor and intellectual issues are more likely to be out of school (26 to 27%).

• 51% of the parents of children not attending school in the regions and 36% in Yerevan believe that their child cannot study in school.

• 12% of the children with disabilities attend special schools, and 70% of them are in boarding settings. The figure is much higher for children with disabilities related to auditory (36%) and intellectual (25%) functions.

• Only 48% and 56% of the children with intellectual and auditory disabilities, respectively, attend mainstream schools.

• 1 out of 5 children with intellectual and combined disabilities (20%) does not have friends, and only half of them have friends among their neighbors (directly in their community).

• 1 out of 3 children with disability (33%) does not participate in community activities. Children with intellectual and combined disabilities are included less (50% of them do not participate in activities).

Facts of Concern

Facts of Concern

• 1 out of 4 children with disabilities (23%) receive services prescribed by the individual rehabilitation plan.

• 4 out of 5 children with disabilities (81%) do not receive services of social protection (support), other than the pension.

• 2/3 of the parents have never heard about the Republic of Armenia laws and international conventions related to disabilities.

Recommendations

• Actively seek out children with disabilities who are not certified and stay invisible to the social protection system

• Revise disability certification and service eligibility criteria based on the ICF principles (biopsychosocial model)

• Ease bureaucratic procedures and involve the multidisciplinary team directly working with the child

Improve identification and assessment procedures

Create a continuum of services for the child throughout the life-cycle

• Ensure cooperation between healthcare, education and social protection services (via the case manager) through mechanisms of referral, exchange of information and coordinated service provision to children.

• Create new community-based prevention and early intervention, as well as health and social rehabilitation and care services.

Enable access to all mainstream preschools and schools.

• Streamline the professional capacity and resources of special school towards inclusive education

• Sensitize and train the teachers and headmasters

• Ensure infrastructure accessibility

• Improve special education needs assessment procedure

Prevent Institutionalization of Children with Disabilities

• Prevent child abandonment through providing early and comprehensive information, services and support to children with disabilities and their families

• Provide alternative care within the wider family or in a foster family

Promote awareness to improve participation

• Organize campaigns

• Ensure active and appropriate media coverage

• Sensitize service providers and parents

personal contact with persons with disabilities

is the most effective way to influence

the way of thinking about disability

Thank you for your attention

IT’S ABOUT INCLUSION!