Monday, April 26, 2010

A Look at Special Education in Bulgaria

The education of children with special needs in Bulgaria is in its infancy. Like so many things here, you can compare it to the United States about 50 years ago. Traditionally any child with a physical or mental handicap has been institutionalized and like many of our institutions in the 60’s and 70’s, they have been pretty deplorable.

There are no children in the schools here with physical limitations with the possible exception of deafness, or blindness. There is a school for the deaf near my school, but you will not find these students in a regular classroom. I know of a very bright high school student who is blind and attends one of the better Plovdiv high schools and does very well. I know there are teachers in the municipality who work with special needs students, but it is usually for a minimal time per month, and rarely in the school setting. Mitko is a first grader, who on the very first day of school I picked out of the crowd as someone who was probably ADHD. He has an engaging smile and is always eager to greet anyone he meets, but he quickly demonstrated the confines of school were challenging for him. I believe by Christmas he was no longer coming to school. The explanation was that he was seeing a resource teacher. On a few occasions following that I did see a man who visits the school periodically try to work with Mitko in the library. Mitko was having his way, dictating the terms of engagement, and I have not seen them working together since. I don’t know what has happened to Mitko, whether he is attending a different school, is receiving a few hours of education a week from the “specialist” at home, or has just fallen through the cracks. Whatever it is, it is not enough.

On Friday of this week, I visited a friend whose assignment here in BG is to work with the special needs population. She works in two settings, an orphanage and a day care center for disabled students. I spent about three hours at the orphanage and two at the center with her. They were very different, and rightly so. Though they both serve a special needs population, their directives are very different.

The orphanage is just that on one level. There were healthy children who are orphans or whose parents can not care for them for whatever reason, but do not want to give them up to the state permanently. The families may have contact with the child, while others are put up for adoption. The second group is the severely physically or mentally handicapped. As difficult as it was to see some of these children lying in their cribs, often with contorted emaciated bodies, and to be acutely aware of the quiet due to lack of verbalization, you can see that efforts are being made to change the way things are done in Bulgaria regarding these children. The facility I visited was a “campus” of three buildings, a lot of outdoor space in an enclosed compound on the far edge of a village outside a larger city. It was very clean, bright, and well staffed with both professionals and “helpers”. The children were clean, well dressed, and noticeably missing was the “institutional” smell, as we traveled from one room to another. It is clear, however, the caregivers think of their jobs as just that…”caregivers”. I could not help but think of the complaints I used to mentally lodge against the nursing homes where both Mike’s and my mothers lived out the end of their lives. Attendants would care for the physical needs of their charges, but attempts at engaging them seemed minimal. Perhaps it is a necessary outcome of institutional care.

The orphanage does have a “baba” program, which pairs some of the children with a “baba” (grandmother) for several hours a day. They have their own playroom and are encouraged to interact physically with the children, engage them in play and in general stimulate them. For some “babas” it is an opportunity to chat with their friends, but to their credit, they were always holding a child when they did. These children may not be getting the directed intervention US educators would like to see, but they were getting more than those who did not have a “baba”. The “baba” culture here in BG (as in so many places including the US) is to “do for the child”, so independence is not encouraged, though many of the kids are capable of independence with directed skill building.

There is also a special wing of one building which houses a “day care center”. The group is small and most of the children who attend the day care program are actually residents of the orphanage. The funding for the creation of the center was from an EU grant or program, thus relatively new. It is currently under the budget of the orphanage. There is a different staff for this program and there was a more interactive environment here. It was closer to a special needs classroom in the states, but the intention to teach was not as strong.

The frustrations experienced by my friend revolve around knowing what can be done with these children, but working with people who can be openly hostile about change and the possibility that it could be different. Even the professionals….doctors and psychologist are not supportive. Some practices are so contrary to those of the U.S. it is extremely difficult to not get upset when seeing them. For example, in two of the buildings there were bedrooms with the most physically disabled kids who generally spend 22 hours a day in their cribs. We went into both of these rooms and there was not a staff member present. Perhaps the kids are checked on periodically, but there is not a constant vigil. They are also tucked furthest away from any activity, making it less likely someone will just “pop” in to see or talk to them. There was not music or radio to fill the space, and rarely was there anything on their cribs to look at. This seemed worse than solitary confinement in prison. Many of these children’s deformities have worsened because of being in these cribs for such prolonged periods of time. There is no muscle on their bones. Stripped they would look like the ads of the children in a campaign against starvation. Some have lived their fifteen years of life like this. We entered playrooms to find eight children on the floor unsupervised or with an adult sitting on a couch disengaged from the kids. Again, no music, no attempts to encourage language, very little physical contact. It was explained to me that children with epilepsy are the worst off because it is believed that if you touch them it will cause a seizure. They most often are the ones in the cribs.

The high point of my visit was to get a little guy sitting in a foam padded play space to giggle out loud. Just some tickling, talking, and floor play had him laughing. I had seen this child earlier in the day care and he was so serious and afraid. The care taker in the room where I played with him was sitting on a nearby seat just watching. The power of suggestion can be a strong one. I hope it left a mark here.

After three hours, we headed back to the city, took a lunch break and walked the 25 minutes to the day care center. Whereas there are about 80 residents at the orphanage, the center serves the needs of about 40 children. It is chartered to serve students 3-18 years. Some come for the whole day, others following a half day in the public school and still others just for services such as speech therapy. Again the facility was bright and clean, with plenty of space. The kids were divided between two floors or activity areas. The staff here was engaging and excited about the PCV’s work. Within the last six weeks she had had a major breakthrough with an autistic child she started a behavioral program with. I watched the videos the center recorded of her work and was so excited myself about the changes in this little boy in six weeks. No one believed it possible, but it is difficult to argue with reality. The videos will be a wonderful tool to use in discussions with the psychologist and doctor who were sure nothing could be done for this child.

In the back of my head since I arrived has been the thought that I would like to work in some way in an orphanage. Plovdiv has about five of them, though I have not been able to locate them. This summer will be the perfect time to get started. Even if I am simply a “baba”, I may be able to model and encourage some “new and unusual” ways of interacting with these special needs children. It is a challenge to be patient when there is so much work to be done.


1 comment:

Anonymous said...

Lynn, if anyone can make a difference, it's you!