Rehabilitation Services for Persons with Special Needs

 

Abstract

In cases where daily living functioning, capacity and ability are suddenly lost or become deficient, rehabilitation services are required to reduce the effect of disability. Persons with special needs require rehabilitation services in form of specially designed programmes to help them re-adjust or compensate for lost capacity/ability and daily living functioning. Where persons who otherwise had the ability to see or hear eventually become blind or deaf, or when persons who have lived and used their limbs suddenly lose any of such limbs (legs or hands), they do require rehabilitation services to re-adjust to daily living functioning. This paper focuses on the types of  rehabilitation services provisions for persons with special needs. Therefore, this paper discusses the conceptual meaning of persons with special needs, meaning of rehabilitation, principles of rehabilitation, medical rehabilitation, psychosocial rehabilitation, educational rehabilitation and vocational rehabilitation services. Lastly, a conclusion and recommendations were drawn.

Keyword: Rehabilitation, Services, Persons with Special Needs.

Introduction

The field of rehabilitation stands out as a rescue mission for the purpose of restoration, conservation and advancement of individuals who live under the threat and incapacitation of special needs. Some special need limits access to education and employment, and leads to economic and social exclusion. Such individuals are down and out when they are left on their own without programmed services of rehabilitation. The rescue mission will require an integrated approach requiring linking prevention and rehabilitation with empowerment strategies and changes in attitudes (UNESCO, 2000) cited in (Ozoji, 2005).

Virtually, any organized activity channeled towards the sustenance and improvement of life of persons with special needs during and in some specified cases after their rehabilitation programme may be considered a rehabilitation service. Literally, it means something, usually planned, that improves the life of persons with special needs, that makes life easier to manage, that reduces handicaps imposed by impairments, that enables them to lay claim to liberties, rights and responsibilities in a democracy. Ultimately, these services are intended to enable clients to achieve their rehabilitation goal. Client's areas of needs usually found in many fields like health, education and vocation, etc. (Ozoji, 2005). 

Concept of Persons with Special Needs

According to Ozoji, Unachukwu & Kolo (2016), persons with special needs are identified as those with various forms of exceptionalities including: visual impairment, hearing impairment, mental retardation (intellectual disability/intellectual developmental disability), physical and health impairment, behavioral disorder, communication and speech impairment, learning disabilities, Multiple disabilities, at risk children, autism, albinism and the gifted and talented, to mention but a few.

Considering these definition, persons with special needs are those individuals in society who manifest any of the following conditions: sensory impairments, behavioral/mental or cognitive difficulties, multiple disabilities, who because of their disabilities, impairments or difficulties need rehabilitation services provisions in order to live independently and contribute their quota towards development of the society (Obani, 2004).

Conceptual Definitions of Rehabilitation

Abosi and Ozoji (1985) explained that rehabilitation “is an activity to assist the person with disability shift from the position of dependence to independence, inadequacy to adequacy, psychological wreck to self-confidence, happy contributing member of the society”. Rehabilitation refers to the process bound delivery of services targeted at the restoration of persons with disability to the highest levels of academic, vocational, socio-emotional and economic functioning he/she is capable of (ozoji, 2005). According to Stucki & Melvin (2007) rehabilitation is the process of removing or reducing as far as possible, the factors that limit the activity or functioning and participation of a person with disability, so that he/she can attain and maintain the highest possible level of independent and quality of life: physically, mentally, socially, educationally and vocationally.  Moreso, Stucki and Melvin (2007) stated that rehabilitation measures focus on:

1. Prevention of the loss of function;

2. Slowing the rate of loss function;

3. Improvement or restoration of function;

4. Compensation for lost function;

5. Maintenance of current function.

According to Ozoji, Unachukwu & Kolo (2016), “the issue of restoration denotes loss of capacity which is deemed to affect some facets of an individual. That is why rehabilitation involves medical aspects (to treat the person to attain physical fitness); mental aspects (to educate the person through special education without which mental fitness will be precluded); social aspects (through planned programmes the person is equipped to relate adequately to others); vocational aspects (training in a competitive skill is necessary) and economic aspects (employment is essential for the individual to be economically self-reliant). Any rehabilitation of persons with disabilities that does not end in employment is incomplete, it is like a cup of tea without sugar”.

Rehabilitation is the process of helping an individual achieve the highest level of function, independence, and quality of life possible. Rehabilitation does not reverse or undo the damage caused by disease or trauma, but rather helps restore the individual to optimal health, functioning, and well-being. Rehabilitation programmes are designed to meet each person's specific needs; therefore, each program is different. Some general treatment components for rehabilitation programs include the following:

1. Treating the basic disease and preventing complications;

2. Treating the disability and improving function;

3. Providing adaptive tools and altering the environment;

4. Teaching the patient and family and helping them adapt to lifestyle changes.

The success of rehabilitation depends on many variables, including the following:

1. The nature and severity of the disease, disorder, or injury;

2. The type and degree of any resulting impairments and disabilities;

3. The overall health of the patient;

4. Family support (Obani, 2004).

Principles of Rehabilitation

The basic principles of rehabilitation emphasizes the needs of individuals with disabilities as the following: persons with disabilities need skills and environmental supports to achieve goals and fulfill the role demands of their living, learning, social, and working environments (Anthony, Cohen, Farkas & Gagne, 2002) cited in (Azar, Isola & Ajobiewe, 2015). The field of rehabilitation strives to support individuals with disabilities in moving toward their specific goals. According to Anthony et al. (2002) cited in Azanr et al. (2015) the key values or principles of rehabilitation are:

1. Person orientation – focus on the person as a whole rather than on their limitations;

2. Functioning – focus on everyday activities and how the person can perform the tasks of everyday living;

3. Support – provide help for as long as needed or wanted;

4. Environmental specificity – focus on the context of the person’s life and where daily activities take place;

5. Involvement – individuals with disabilities should be full participants in all aspects of the rehabilitation process including planning and implementation;

6. Choice – the individuals preferences should drive the plan for rehabilitation;

7. Outcome orientation – rehabilitation should focus on outcomes for the client; and

8. Growth potential – improvement in the success and satisfaction of the person.

The basic principles of rehabilitation include but are not limited to the ideas that treatment should vary and be flexible to deal with the special characteristics of each person. Every person should assume as much initiative and participants as possible in the rehabilitation plan and its execution. Rehabilitation programmes must be conducted with interdisciplinary and inter agency integration. Rehabilitation is a continuous process that applies as long as help is needed and the client is seen not as an isolated individual but as part of a larger group that includes other people. In other words, rehabilitation is a person focused, client guided programme that involves multiple individuals and agencies to accomplish a client’s goals and is focused toward the needs, interests and preference of the individual(Azanar et al., 2015).

Medical Rehabilitation Services

According to Bioson (1986) cited in Ozoji (2005) rehabilitation is the third phase of medicine, preventive and care being the first and second respectively. The main feature of medical rehabilitation services is the restoration of the physical or mental properties of a client that might need treatment or surgery as the case may be. Such a need must have been identified and diagnosed during the eligibility test.

Medical rehabilitation is concerned with improving functioning through the diagnosis and treatment of health conditions, reducing impairments and preventing or treating complications. Doctors with specific expertise in medical rehabilitation are referred to as physiatrists or physical and rehabilitation specialists. Medical specialists such as psychiatrists, pediatricians, geriatricians, ophthalmologists, neurosurgeons, and orthopedic surgeons and a broad range of therapists are involved and offer medical rehabilitation services (Stucki & Melvin, 2007).

According to Ozoji (2005) medical rehabilitation services therefore are meant to examine all organs of the client so that under-functioning ones are attended to through any of the underlisted medical care services.

1. Biomechanics: The strengthening of the muscles or the overcoming of any disability that might follow upon convalescence or the healing of an injury.

2. Physiotherapy: The re-alignment of a body part or bones and improving joint and lime function.

3. Provision of prosthetic and orthotic devices such as crutches, wheelchairs, calipers, hearing aids, eye-glasses, artificial limbs and arms (legs and hands), etc.

4. Various therapies which are concerned with restoring and compensating for the loss of functioning and preventing or slowing deterioration in functioning in every area of a person’s life.

Psychosocial Rehabilitation Services

According to Ozoji (2005) psychosocial rehabilitation services fall within the realm of restoring the social functioning and dignity of an individual within the community. Psychosocial rehabilitation is to teach emotional, cognitive and social skills that help those diagnosed with mental disorders, behavioural disorders, and emotionally disturbed live and function in an desired manner within their communities as independent as possible.

Psychosocial rehabilitation promotes personal recovery, successful community integration and satisfactory quality of life for persons who have a mental health concern, behavioural disorders and emotional disturbances. Psychosocial rehabilitation services and supports are collaborative, person directed, individualized and an essential element of the human services spectrum. Some specific areas that psychosocial rehabilitation address include skills training and experiences designed to boost:

1. Mental, behavioural and emotional adjustment or management ;

2. Social and interpersonal skills and functioning (Stucki & Melvin, 2007).

Educational Rehabilitation Services

According to Stuck and Melvin (2007), educational rehabilitation is a form of therapy used to treat individuals with learning difficulties, disabilities and challenges. This form of therapy offers a wide range of intensive interventions that are designed to resolve learners’ learning problems. These interventions are individualized and unique to the specific person. Educational therapy is one of the educational rehabilitation services provided by specialized educational personnel. Educational therapy provides individualized, remedial instruction to a child with leaning difficulties and disabilities such as dyslexia, dyscalculia, dysgraphia, poor attention span, ADHD, visual and auditory discrimination disorders, etc. educational therapy focuses not only on remediation, but also on building the foundational attention, memory and learning skills to allow child to become a more self aware, self reliant and efficient learner.

Vocational Rehabilitation Services

These are meant to support young people and adults with special needs to acquire independence through training and counseling on job placement. Its ultimate goal is employment; this is an aspect of the entire rehabilitation services. According to Onuzurike (2001), vocational training is activities which essentially aim at providing the knowledge and skills required for employment in a particular occupation or group of related occupations in any field of economic activity. While proposing appropriate skills or career training for persons with special needs. Ihenacho (1989) argues that training should be a response to need and a reaction to a problem. There are various jobs that persons with special needs can be engaged in; they can be empowered in various trades that will enable them to contribute their own quota to the society in which they live. For instance, persons with special needs can be trained in various artworks like pottery, tie and dye, carpentry, leather work, weaving. Other entrepreneurship skills include poultry, piggery, fishery, tailoring, barbing and salon, etc. engaging persons with special needs into various vocational and entrepreneurship skills will support them to earn their livelihood means of survival; this will eradicate begging on streets, making them self reliant and economically independent.

Conclusion

Persons with special needs have been provided with rehabilitative programmes and services in various schools, hospitals, institutions and centers by government and non governmental organizations in Nigeria right from colonial era to post colonial period. These rehabilitative programmes and services seek to remove the handicapping effects of disability and lead to improvement in the quality of life of persons with special needs either medically, educationally, socially or vocationally.

Recommendations

For successful pursuit of rehabilitation goals for person with special needs in Nigeria, the following recommendations are proposed:

1. Government should reform policies, laws and delivery systems, including development or revision of national rehabilitation plans.

2. Rehabilitation service delivery should be expanded and decentralized.

3. Affordable assistive technology, devices should be provided in rehabilitation institutions.

4. Rehabilitation service providers should provide the highest quality of rehabilitation services.

5. Effective family and community involvement in the rehabilitation process for persons with special needs.

References

Abosi, C.O. & Ozoji, E.D. (1985). Educating the blind: A descriptive approach. Ibadan: Spectrum Books.

Azanr, F.O. Isola, S.A. & Ajobiewe, T.A. (eds) (2015). Essentials for special needs education: A practical guide for teachers. Lagos: Pee & gree press and publishers.

Ihenacho, I.J. (1989). Introduction to special educational, administration, management and planning issues. Jos: Government printers.       

Obani, T.C. (2004). Handicap disability and special education. Ibadan: Book Builders.

           

Onuzurike, J.O. (2001). Dictionary of Special Education and related terms. Jos: Deka publishers.

Ozoji, E.D. (2005). Special Needs Education and Rehabilitation for Beginner professionals. Jos: Deka Publications.

Ozoji, E.D. Unachukwu, G.C. & Kolo, I.A. (eds) (2016). Modern Trends and Practices in Special Education. Lagos: Foremost Education Service Ltd.

Stucks, G. & Melvin, J. (2007). A unifying model for the conceptual description of rehabilitation services. New York Boston Press.