Community-based inclusive development for children with disabilities in Chinese communities

Objective
Community-based inclusive development aims to ensure that persons with disabilities are fully included in community life and have full and equal access to all services and opportunities. Education is one of the major component of community-based rehabilitation (CBR) (World Health Organization, 2011). This study aimed to examine the success outcomes of CBR programs that work with children with disabilities (CWD) in China.

Methods
This study adopted a qualitative approach with an embedded case study design to examine five CBR programs that work with children with disabilities in China. The unit of analysis was the five CBR programs. Based on the literature, a proposed framework was delineated to describe (1) the core elements of CBR to promote participation, (2) the major needs of Chinese families with CWD, and (3) the desirable outcomes of inclusive education. Five CBR programs that worked with children with disabilities in China were purposefully selected to embrace a diversity of program nature. Data was collected through a 4-day field visit to each program. Data was collected through interviews, observations, home visits and reading documentations. All data were transcribed, coded and organized in a case description matrix. Within-case analysis was done using pattern matching logic to identify the success outcomes of program. Across-case analysis was also done to compare and contrast the similarities and differences of programs.

Results
The results of within-case analysis were presented in a program description matrix and it formed a comprehensive profile of each program to reveal the process and outcomes of each program. The results of across-case analysis were collated with the framework. For the first dimension, in the outcomes related to enhancing participation, all five programs focused on enhancing cognitive skills, psychosocial and physical well-being of CWD. The least commonly identified elements were the gaining of government support, enhancing spiritual health and empowerment status of CWD and their parents. For the second dimension, in meeting the needs of the Chinese CWD and their families, the five programs worked mainly to give information to parents, meet the physical health needs of CWD and enhance the opportunity for children to get education and therapy service. It was rarely reported by the programs to work on enhancing financial situation, and enhancing the growth and health of the family. The third dimension is the actualization of inclusive education, most programs worked to enhance the awareness of the local community but worked less in the areas of involving the persons with disabilities and their family as decision makers, enhancing accessibility of local schools and advocating to make a comprehensive policy to facilitate inclusive education.

Conclusion
The successful outcomes of the five CBR programs that work with CWD were identified. To better achieve inclusion and participation, these programs were recommended to enhance empowerment, improve governmental support and collaboration, and enhance the growth and health of the family with children with disabilities. Copyright © 2017 The 1st Asia-Pacific Occupational Therapy Symposium Secretariat c/o K&A International Co., Ltd.