JIS News

Early and intensive intervention can have a profound impact on the quality of life of children living with developmental disabilities and their families.
At the downtown Kingston-based Early Stimulation Programme (ESP), this kind of early intervention is patiently provided by a caring and supportive community of clinicians, child development officers and parents, who prod and push tirelessly to get the best developmental outcomes.
Thirty years after it was started, the ESP continues to foster the development of children with disabilities from birth to six years. Facilitated by government policies, and a more educated society, increased provisions are being made to enable Jamaican children born with autism, cerebral palsy and a spectrum of other physical and mental challenges, to enjoy many of the same activities as other kids their age.
Many of the graduates of the ESP have gone on to regular school, with a few even attending college. While many have transitioned to semi-independent living, still others continue to live at home but are able to hold on to jobs, thus finding their own success in society. And, this was the vision of Dr. Molly Thorburn, who founded the programme in 1975.
“At the time, there were not enough services for these children so Dr. Thorburn thought of what she could do to assist these children with developmental disabilities, and so she started this programme. The programme was taken over by the (Labour) Ministry in 1977,” recalls Antonica Gunter-Gayle, the programme’s director.
She tells JIS News that the ESP has evolved into an internationally accredited programme for early intervention, stimulation and socialization that now actively serves 510 special needs children in Jamaica.
“We see a number of disabling conditions. We see children with autism, with cerebral palsy, downs syndrome, we see children with multiple disabilities here, as well as children with behavioural problems,” she outlines, noting that many of the referrals are from health centres, hospitals, and schools.
The programme also attends to the needs of disabled children in state homes, nurseries and places of safety.
Once a child comes into the ESP’s Hanover Street-based clinic, a developmental assessment is done by a team comprised of a family nurse practitioner, a clinical officer, a child development officer, a physiotherapist, a guidance counsellor and the programme director.
In addition, Mrs. Gunter-Gayle explains, “the child and/or the parent may be interviewed in order to ascertain information about what tasks the child is able or not able to do. The child is also given a task and assessed based on that.”
The team decides on the most suitable intervention for the child, and the parent or the caregiver is invited to an orientation session where the assessment findings and therapy regime for the child’s developmental needs are discussed.
“Each child is placed in a special programme tailored to meet his/her developmental needs,” she notes, adding that, “no two programmes (are) alike, and so mother, guardian or teacher is shown what to do”.
She points out for example, that if a child is not talking at the age that he/she should, or the child is not using the hands, “we show them (caregivers) how to carry out activities that encourage the use of the fingers, the hands, words or speech therapy that will stimulate development. So whatever is wrong developmentally, we work within the child’s weakest areas to help the child reach his or her highest potential.”
Child development officers are assigned to make home visits and together with the caregivers, they ensure the best developmental outcomes for the child. There are 14 child development officers in the programme.
According to Mrs. Gunter-Gayle it is not unusual to find babies, sometimes as young as three months old in the programme. “As soon as the child is born and you suspect something is wrong, it is best that you take the child here or have the child referred to a special intervention programme. The sooner the intervention is started, the better,” she advises.
Last year, the programme opened the first ever government-owned basic school in Jamaica for children with disabilities in the three to six age group. “We started the school with about 10 children and we have 30 children that are now attending the school and a waiting list of 40 for September. It is located in Kingston, and we have children coming from Portmore,” the director says.
As is to be expected, the programme differs somewhat from the regular early childhood programme as activities are geared towards developing a range of skills, as in “the cognitive, language, fine motor (using the fingers) and gross motor (using legs and feet), as well as infant stimulation, socialization and self-help skills,” Mrs. Gunter-Gayle tells JIS News.
The instruction is at once creative and time-consuming and requires patience and dedication. For example, Mrs. Gunter-Gayle illustrates, classes for children with underdeveloped fine motor skills may require activities where “the teacher will hold the hand of the child, using the finger to make the circle in some cornmeal, sand or flour.”
Class sizes are kept small with a ratio of five students to one teacher, with students grouped according to their mental age. Six teachers are on staff and all are trained early education specialists with additional training in childhood disabilities.
The school has a play area and ramp for persons using wheelchairs, as well as other adaptive aids.
According to the director, there is room for more children. “If all goes well, we should be having 120 children there,” she states. “It’s a really large area, and there’s land for much more development,” she points out.
Children attending the ESP basic school graduate at the age of six, and may be referred to special education units set up in several of the government’s primary schools. “We have had children gone to George Headley Primary, St. Aloysius Primary, St. George’s; so depending on how the child comes out after the intervention programme at six, the child may well need special education or the child is able to go into the regular school setting,” she explains.
Before they leave, however, the child’s progress is reviewed and re-evaluated, and depending on the progress report, recommended for further physical therapy, parent and/or child counselling, or referred for psychological counselling.
Mrs. Gunter-Gayle notes that graduates of the programme have gone on to high schools. “One of them is at Wolmer’s Boys, another passed for Calabar High but because of the inaccessibility of that facility, is now at Mona High; we have another who has gone on to university in Grand Cayman,” she boasts.
She continues that, “we have a very good carpenter too who resides in the Olympic Gardens area. He’s one of those who was said wouldn’t make it, and he’s one of the best carpenters around.”
While most of the programme’s clients are from Kingston, the director says that child development officers conduct home visits to St. Thomas and Portmore communities and come September, one officer will be assigned to Spanish Town as a number of parents have been requesting home visits in that area. In addition, she informs that the government has allocated $4.2 million towards the establishment of a programme in Portland. Six officers with varying backgrounds in early childhood training or social work have been employed for this project and are currently involved in an eight-week training programme focused on childhood disability.
As for the rest of the island, she notes that clients still travel in to utilize the services of the ESP, while there are two non-government organizations – the 3-D Projects and the Rural Service for Children with Disabilities, which cater to rural needs.
According to Mrs. Gunter-Gayle, the programme engages parents in their children’s recovery in a big way, with 70 to 75 per cent of parents directly participating in the support process. She lauds the number of fathers, who demonstrate an interest and participate in their child’s intervention activities.
Mrs. Gunter-Gayle notes that the programme offers counselling, seminars and support to parents, who, impatient with the slow progress of their children or the financial burden that are sometimes associated with raising a disabled child, can easily become demotivated.
“We work with both children and parents because we have to motivate them. We have to encourage them. It’s a challenge to really bring up a child with a disability. It’s not an easy task,” she points out.
She notes that parents’ emotions especially run high at graduation. “We see tears more than anything and when you ask, why are you crying, they say they can’t really contain themselves to know that this child has made so much progress. I remember when we started the school, I met this parent downtown and she squeezed me and she jumped up and said, ‘Mrs. Gayle, I can’t believe my little girl wearing uniform; I never know my little girl would be wearing uniform. I thank you, I thank you.’ It gives them a good feeling; it really melts your heart”.
She further recalls the joy of one father whose seven-year old daughter, who was physically challenged, made her first steps. Elated, he called to express his joy. “Oh my God, if I didn’t get anything for Christmas, this would be enough for my Christmas. Latoya is walking! And then the walk was not even much, but it was a big achievement,” she notes.
The programme director tells JIS News that she would like to see the programme broaden its support network to enable parents to access items such as medication and hearing aides for their children, which can be very expensive.
She says that parents, who have to stay home to care for a disabled child can access funds through the Ministry of Labour and Social Security’s Rehabilitation Grant to start income generating projects.
“Quite a number of parents we know have received,” Mrs. Gunter-Gayle notes. “Many of them have returned and reported that they have started various income generating projects. I know one lady (who) says she’s now sewing and selling sheets; one is selling pampers from her home,” she relates.
In the meantime, Mrs. Gunter-Gayle is encouraging parents to look for early signs of developmental delays in their babies and seek assistance. “Parents, as soon as you suspect that your child may be having some delays, the child is not walking, talking, sitting up.you need to seek assistance. Really try and reach a special intervention programme where they can be advised. the earlier the better. Come and get the child assessed and we’ll take it from there,” she urges.
The ESP, she says, continues to engage in public education activities to increase the awareness level of parents, and has taken the message to parent teacher’s association meetings, wellness fairs and other community fora.
Mrs. Gunter-Gayle informs that seminars have been held in Portland to sensitize parents “of the importance of stimulating their children, what to do and use and we have been talking also with community health aids and social workers”.
Recently, a meeting was held in the Olympic Gardens community and a series of educational seminars will be embarked on with the Programme of Advancement Through Health and Education (PATH).
As for the public, the ESP Programme Director appealed for greater tolerance for people with special needs. “I would say we need to really understand that people with disabilities do need opportunities. They need a chance. So allow them to be a part of your communities. Don’t . tease them. They want to be integrated, they want to be involved. So allow a child with disability in your park, in your schools. I appeal for more tolerance, allow them to be given a chance in society,” she implores.

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