Development and pilot evaluation of a teacher training to support children with developmental disorders in mainstream school settings in Ethiopia

在埃塞俄比亚，严重缺乏对患有发育障碍（DD）的儿童的服务，包括自闭症谱系障碍（ASD）和智力残疾（ID）（Tekola等人，2016）。DD周围的柱头高（Tilahun等人，至关重要的是，参加结构化问卷调查的47.1%的照顾者报告说，他们的DD儿童在接受专业支持方面的需求未得到满足（Tilahun等人，2016）。74.5%的看护者报告说，他们的孩子的教育需求没有得到满足，这一比例甚至更高。2016）。最新的埃塞俄比亚教育部门发展计划（埃塞俄比亚联邦民主共和国教育部，2015年）发现，只有4%的有特殊需要的儿童获得了小学教育。虽然该计划报告了到2020年将这一比例提高到75%的愿望，但它也确定了实现这一目标的财政障碍（埃塞俄比亚联邦民主共和国教育部，2015年）。共有120名儿童在首都阿迪斯的两所自闭症儿童学校就读，和包容性的9/12教育方案存在于一些主流学校（Tekola等人，2016）。然而，大多数患有DD的儿童仍然没有上学，因为这些方案的能力低（Tekola等人，2016年），耻辱和缺乏教师的专业知识和特殊需要教育的培训（弗兰克和乔希，2017年）。考虑到与隔离教育相反的全纳教育在国际上被公认为是DD儿童的一项权利（林赛，2007年），并得到埃塞俄比亚教育部的认可（联邦埃塞俄比亚民主共和国教育部，2015年），提高主流学校教师的专业知识尤其可取。阿迪斯的两所自闭症学校之一JoyCentre的创始人也确定了培训主流学校教师以提供包容性教育的必要性，并开始亲自提供这方面的培训（Tekola等人，2016年），但其影响尚未得到正式评估。一个具有成本效益，易于交付的手工教师培训，结合她的经验，以及最佳的包容性教育实践，从国际文献，可以有助于改善和扩大包容性教育的儿童与DD在埃塞俄比亚。在全球心理健康的几项心理社会干预中成功实施了任务分担方法（Patel等人，2018年），其中更多的specialistresponsibilities转移到不太专业的工作人员，asupersonal全纳教育模式将被开发，包括监督和复习training.Research aimsThe我提出的研究的主要目的是发展和评价教师培训模式的全纳教育，以支持主流的小学DD儿童在埃塞俄比亚。我打算通过三个研究阶段来实现这一目标，每个阶段都有一个单独的目标：A）系统地审查现有的关于包容性教育干预和教师培训的文献，以支持高收入、低收入和中等收入国家的DD儿童;B）定性探索性研究，以评估埃塞俄比亚教育系统内教师和关键利益相关者在满足学校环境中DD儿童需求方面面临的主要挑战以及克服这些挑战的可能方法;先前已经调查了由学校确定的教育需求（Tilahun等人，C）共同开发、试点和评估一项基于成本效益高、易于交付的主流小学教师手册化培训模式的全纳教育任务分担干预措施，旨在促进对残疾儿童的有效支持。

In Ethiopia there is a severe lack of services for children withdevelopmental disorders (DD), including autism spectrumdisorders (ASD) and intellectual disabilities (ID) (Tekola et al.,2016). Stigma surrounding DD is high (Tilahun et al., 2016).Critically, 47.1% of caregivers who took part in a structuredquestionnaire survey reported unmet needs in receivingprofessional support for their children with DD (Tilahun et al.,2016). An even higher proportion, 74.5% of caregivers,reported that their children's educational needs were unmet.This failure has been identified as the largest gap in serviceprovision for children with DD in Ethiopia (Tilahun et al.,2016). The most recent Ethiopian Education SectorDevelopment Programme (Federal Democratic Republic ofEthiopia Ministry of Education, 2015) found that primaryschool education was provided to only 4% of children withspecial needs. While the programme reported an aspirationto increase this proportion to 75% by 2020, it also identifiedfinancial barriers to the achievement of this goal (FederalDemocratic Republic of Ethiopia Ministry of Education, 2015).A total of 120 children are enrolled in two schools for childrenwith ASD in the capital city, Addis Ababa, and inclusive9 / 12education programmes are present in some mainstreamschools (Tekola et al., 2016). However, most children with DDremain unschooled, because of low capacity of theseprogrammes (Tekola et al., 2016), stigma and lack ofteachers' expertise and training in special needs education(Franck & Joshi, 2017). An increase in teachers' expertise inmainstream schools is particularly desirable, considering thatinclusive education, as opposed to segregated education,has internationally been recognised as a right for childrenwith DD (Lindsay, 2007) and is endorsed in Ethiopia by theMinistry of Education (Federal Democratic Republic ofEthiopia Ministry of Education, 2015). The founder of the JoyCentre, one of the two autism schools in Addis Ababa, hasalso identified a need for training teachers in mainstreamschools to provide inclusive education and started providingthis personally (Tekola et al., 2016), but the effects have notbeen formally assessed. A cost-effective, easily-deliveredmanualised teacher-training incorporating her experience, aswell as best inclusive education practice from theinternational literature, can contribute to improving andexpanding inclusive education for children with DD inEthiopia. Applying the task-sharing approach successfullyimplemented in several psychosocial interventions in GlobalMental Health (Patel et al., 2018) in which more specialistresponsibilities are transferred to less-specialised staff, asustainable inclusive education model will be developed,including supervision and refresher training.Research aimsThe main aim of my proposed research is to develop andevaluate a teacher training model of inclusive education tosupport mainstream primary-school children with DD inEthiopia. I intend to achieve this through three researchphases, each with an individual aim:A) A systematic review of the existing literature on inclusiveeducation interventions and teacher trainings to support tochildren with DD in high, low and middle income countries;B) A qualitative exploratory study to assess the mainchallenges faced by teachers and key stakeholders within theeducational system in meeting the needs of children with DDin school settings in Ethiopia and the possible ways toovercome them; educational needs identified by caregivershave previously been investigated (Tilahun et al., 2016)C) The co-development, piloting and evaluation of aninclusive education task-sharing intervention based on acost-effective and easily-delivered manualised training modelof mainstream primary-school teachers aimed to promoteeffective support to children with DD.