HISTORICAL BACKGROUND

2.1 The Starting of Hospital Schools,the Earliest Educational Provision for the

Physically Handicapped

Before the 1960's, physically handicapped children who could not fit in the architectural setting, withstand the daily routine or learn the inflexible curriculum of ordinary schools were simply kept out of schools because there were no special provisions for them in Hong Kong. However, children admitted to hospital began to have a chance of education in 1954 when the Hong Kong Red Cross sent the first teacher to

Lai Chi Kok Hospital to teach

school age children who were waiting for operation or were convalescing but confirmed by the medical superintendent to be fit to study. The majority of them were only temporarily "physically handicapped" recovering from illness or injuries while some were likely to be permanently physically handicapped. For the former group, teaching was mainly focused on the continuation of the curriculum and textbooks which they had been learning before admission to hospital. For the latter and those who had not been to school before, the teachers decided on the curriculum and textbooks for them which were being used in ordinary schools.

The third hospital school,

the Duchess of Kent Children's

Hospital Red Cross School opened in 1956. The hospital was a children's orthopaedic hospital where children stayed between a few months to a few years. Three classrooms were purposely built in the hospital. While

bed-side teaching was carried out for the bed-bound children, the mobile ones could have their lessons in the classrooms at fixed school hours. In this long term hospital, the teachers could use more discretion in selecting curricula and textbooks from those being used in ordinary schools and made some adaptations to suit their pupils.

2.2 The Establishment of the

Special Education Section in the Education Department and the Beginning of

Schools for the Physically Handicapped

In 1960, the Special Education Section was established in the Education Department. Advisory service was then available to special education sponsors. The first

inspector, education of the physically handicapped, conducted the first

training course

for teachers of

physically handicapped children which as one year part-time in 1962-63.

In 1962 the first school for physically handicapped children was established by the Hong Kong Red Cross in Kwun Tong accommodating 60 children in 3 primary classes. Majority of the pupils were post-polios whose learning capacities were not affected. (A survey done by the Education Department in that year on 100 physically handicapped children who were treated in government clinics and hospitals in Hong Kong indicated that about 82.5% of them suffered from

poliomyelitis, about 8% suffered from

T.B. bones or spines and about 5% suffered from

cerebral palsy). Ordinary curriculum and textbooks were used. Adaptations in teaching methods and curriculum were made for over age rather than pupils' ability or other learning disabilities. In 1964 the school was subsidized by the Education Department and this was the first time the Government undertook the responsibility of financing schools for the physically handicapped.

In the same year the

Spastics Association of Hong Kong started a school for 20 young cerebral palsied children in the premises of

the Boys' and Girls' Clubs Association of Hong Kong in Wanchai. In the middle of the 1960's, cerebral palsy children of primary or secondary school age were few. The school took in other types of physically handicapped children as well in the course of its development in later years.

From this time to the 1970's the Hong Kong Red Cross and the Spastics Association of Hong Kong each opened several schools for the physically handicapped in various parts of Hong Kong.

The Hong Kong Christian Service opened one in Tsuen Wan. All were government aided schools.

2.3 Increased Intensity and Complexity of Pupils' Physical and Learning Difficulties and Compatible Change of Curriculum

During the 1970's, causes of handicaps of children in schools for the physically handicapped changed gradually but significantly. Perhaps due to the improving standard of hygiene and medical service in Hong Kong, the incidence of poliomyelitis kept on decreasing, especially after the introduction of oral vaccine against the disease, to almost zero in the late 1970's. T. B. bones were also disappearing. Instead, cerebral palsy became the most predominant occupying perhaps more than 50%. One of the main reasons could be that improved medical technology had saved the lives of many of the most seriously affected cerebral palsied babies.

Muscular Dystrophy was the next as perhaps heredity factors of the disease were difficult to avoid.

Unlike children suffering from after effects of poliomyelitis or T.B. bones, cerebral palsied children might have other problems in addition to mobility difficulties. They might have deficits in vision, hearing, speech, perception, conception, expression or co-ordination of sensory functions with motor functions. Some might have

emotional problems,

hyperactivity or

mental retardation associated with

brain injuries. Teaching of these children required considerable adjustments of the ordinary curriculum and the using of special teaching methods and materials. Many of them needed slower learning paces. Those with moderate grade mental retardation might not be able to use ordinary textbooks at all. Teachers had to design special curriculum to suit their individual needs.

To support schools in meeting the increase of children with

multiple handicaps in schools for the physically handicapped, the Education Department decreased the size of class from 20 to 10. However in the 1980's and 1990's the degree of handicap of children in these schools became even severer both physically and mentally. The reasons might have been that integration of the mildly handicapped in ordinary schools was more earnestly attempted and more babies with severe

congenital defects survived. Now physically handicapped children with moderate grade mental retardation in special schools seem to be on the increase. Very often their physical and mental handicaps are coupled with emotional instability and hyperactivity.

The range of abilities in schools for the physically handicapped is now very great. The brighter ones are learning the mainstream curriculum and sit for the Hong Kong Certificate of Education Examination or enter technical institutes. The less bright are learning a more practical curriculum preparing for vocational training. Those with moderate grade mental retardation are learning a special curriculum and preparing for entry to

sheltered workshops or

day activity centres. This is only the general situation. In fact there are no rigid dividing lines and the choice of curriculum for the pupils actually depends on their individual mental and physical capacities, emotional states, learning attitudes, family support etc.

2.4

The Contribution of Paramedical Staff in the Education for Physically Handicapped Children

In the early years of educational provision for physically handicapped children the emphasis was on teaching. The need for paramedical professions such as

physiotherapists(PT),

occupational therapists(OT),

speech therapists(ST) and school nurses was not adequately met by government aids. Schools were trying to deploy their own resources to employ professional staff in these fields to carry out the special educational services more completely. In the 1980’s the Education Department undertook the responsibility of providing a fuller team of paramedical staff.

The importance of

team approach for the education of children with

neurological and motor disabilities was much more strongly felt in the '80s when Ester Cotton was invited to Hong Kong to introduce Andre Peto's

Conductive Education Model. The Hungarian approach emphasized all-round training of staff responsible for the education and therapy of physically handicapped children. Hong Kong's response to Conductive Education was immediate and innovative. Several schools for the physically handicapped and pre-school units immediately adopted the approach and soon a new version of Conductive Education emerged in Hong Kong. Conductive Education in Hong Kong was practised without the trained all-rounded conductors but with the emphasis of a trans-disciplinary approach whereby professionals from different disciplines play the role of conductor in turn. Since then

paramedical staff have been working in closer collaboration with teachers in schools for physically handicapped children and such a working pattern has become a major characteristic of the educational approach for physically handicapped children.

2.5 Examples of Special Curricula Devised by Schools

1. To cope with the varying needs of different groups of pupils, individual schools, apart from using the mainstream curricula, have been devising their school based special curricula such as :
2. Tailored Curricula of various subjects for children with slow progress who cannot digest the curricula completely
3. Functional or Practical Curricula for children with low academic potential preparing them for vocational training, open or sheltered employment and successful adjustment in the community
4. Special Curricula in lieu of Mainstream Curricula and Textbooks for children with mental retardation who cannot absorb mainstream curricula and textbooks
5. Computer Training for Communication and Learning for those who have difficulty in communicating with speech and / or writing
6. Conductive Education for the cerebral palsied.
   
   Oral Motor Training and
   
   Pre-language Training for those who have difficulties in speech and hearing.
7. 
   Perceptual Motor Training for those who have perceptual motor difficulties or inco-ordination
8. Individualized Educational Programmes and Social Skills and Daily Living Training for those who need them
9. Formal and Informal Curricula of Moral Education, Civic Education and Family Life Education including Sex Education for all pupils.
10. These curricula are devised by
    
    multi-disciplinary teams involving, where necessary, teachers,

PTs,

OTs,

STs or

TASTs,

social workers and

educational psychologists.

2.6 The Need for Curriculum Guidelines for Schools for Physically Handicapped Children

With the increase of severity and complexity of handicaps in schools for the physically handicapped, teachers are facing higher demands in curriculum planning. It is generally felt that there is a need for a central curriculum development guide to be worked out by heads and teachers of schools together with specialists in the Education Department and the institutes of education for reference by schools in their curriculum development endeavours.