Deaf-blind education and rehabilitation in Zimbabwe.

What motivated a developing country that was hard-pressed for foreign exchange to spend a sizable amount of it on establishing programs for deaf-blind children and adults? We asked ourselves that when the country of Zimbabwe addressed a proposal to the Canadian International Development Agency for short-term training under the title, Teaching Children with Multi-Sensory Handicaps. We received the request at the University of Alberta, but the question remained unanswered until we arrived in that nation.

About Zimbabwe

Zimbabwe is a landlocked country covering 390,700 square kilometers in southeast Africa. It borders the Union of South Africa, Zambia, Botswana, and Mozambique. Until 1980 it was named Rhodesia.

Population. Zimbabwe's most recent census, conducted in 1982, found its population to be 7.5 million, 97.6 percent of whom were African and 2.4 percent other nationalities. Incomplete results from the 1992 census bring its population to 9.75 million persons.

Education. The government has adopted a policy of universal education. The literacy rate for persons 15 years and older was estimated to be 62 percent in 1982; now, it is estimated to be in excess of 85 to 90 percent. The major institution of higher education, the University of Zimbabwe, is located in Harare. United College of Education, a 2-year college that trains teachers, resides in Bulawayo.

Languages. The polyglot nature of Zimbabwe must be of interest to those concerned with its social programs. Its official language is English. The predominant native language is Shona, spoken by about two-thirds of the population. The next most common language is Ndebele, a click language spoken by about 15 percent of the population. Smaller portions speak other African, European, and Asian languages.

With respect to manual communication, the finger alphabet is one-handed, as opposed to the British two-handed version. The hand-motion configurations Zimbabweans have adopted for each letter combine those of the French-American forms with some that seem locally derived. Thus, the letters a through f and i through o are identical to those of the North American hand alphabet, but the remaining letters are not. The signs used by those who are deaf vary from tribe to tribe and within tribes probably by age groups. Under a grant from Sweden, Zimbabwe has a program to standardize signs used in education. Until 1980, schools for deaf students were committed to an oral approach that forbade sign languages. After the revolution, signs were encouraged in the classrooms; however, each school for deaf students adopted a different sign system - generally determined by whatever book of signs they happened to acquire. A committee has chosen approximately 3,000 concepts and assembled a group of experts, including deaf persons, to select the most appropriate sign for each. To date, they agree on about 1,000 signs that they plan to distribute to the schools, while continuing to seek consensus on manual equivalents for the remaining 2,000 concepts.

Disabilities. With the cooperation of UNICEF, Zimbabwe conducted a national disability survey in 1981.(1) Overall, the survey estimated that Zimbabwe had about a quarter of a million severely disabled people. People with disabilities, then, occur at a rate of 33 per thousand population. Of those with disabilities, the survey estimates about 28,000 people (nearly 10 percent) had more than one disability (see Table 1).

                        Table 1
     Number of Disabled Persons, by Type of Disability:
              Zimbabwe, October-December 1981

Type of Disability        Number of Persons

    All Types                 276,300
    Visual                     70,300
    Blind                      22,700
    Lower Limb                 67,200
    Upper Limb                 33,500
    Mental (retardation
    or behavioral)             26,900
    Hearing                    22,600
    Deaf                        8,500
    Speech                     20,300
    Mute                        9,800
    Neurological               15,300
    Other                      20,300
    (respiratory, skin,
    cardiovascular, spinal)

The surveyors regard their numbers as minimum estimates: "The figures could well be higher, but nonetheless they represent the general picture to a far higher level of accuracy than any earlier assessment...." Regarding hearing disabilities, they add," Because this survey concentrated almost exclusively on rural areas, the overall incidence of hearing impairment is likely to be higher, because we under-sampled areas - especially in towns - where industrial trauma is present. In the absence of diagnostic skills and equipment in the field, marginal hearing loss, or more marked hearing loss in situations where this is unlikely to impede normal daily function, was not recorded.(2)

The Seminar Program

Zimbabwe selected 18 psychologists and psychologist trainees to represent the country's nine regions, with the idea that they would serve as future trainers of teachers and other personnel. In addition, three education officers from the Education Department's headquarters in Harare attended. Bulawayo, Zimbabwe's second largest city, served as the site for the training.

Scope

The division between education and rehabilitation is an administrative convenience and tends to work to the disadvantage of persons with disabilities. We, therefore, considered assessment and intervention over the lifespan, rather than arbitrarily dividing it into the first 18 or 19 years (education) and subsequent years (rehabilitation), because the theories and techniques underlying the one discipline do not substantially differ from those of the other. Separating the disciplines inclines educators to lose sight of adulthood, for which they should be preparing their students, and of the accomplishments of disabled adults, which should serve to motivate their best efforts.

In practice, videotapes of deaf-blind persons in sheltered and in competitive employment situations delighted and inspired the participants, whether they were largely involved in education or rehabilitation. They could observe for themselves the effectiveness of the techniques we were expounding. The broad scope of the seminar also maintained participants' interest at levels that would have been difficult, if not impossible, to attain had we focused solely on the education of children or the rehabilitation of adults.

Content

Motivation. In our experience, one of the most difficult hurdles to overcome is professionals' lack of confidence that deaf-blind people can be successfully educated and rehabilitated. A balance must be struck between the few who expect a deaf-blind child to be a second Helen Keller and the large number who believe that child's future is hopeless. We countered the second type of resistance in the participants largely with videotaped examples of successfully educated and rehabilitated deaf-blind persons, interspersing these demonstrations with presentations of techniques and procedures for assessment and intervention intended to meet whatever pessimism emerged. Several times, participants displaced their lack of confidence by pointing to parents' unwillingness to enroll their deaf-blind children in educational programs. Our answer was to urge the professionals to overcome such objections with concrete demonstrations - no matter how small - of the effectiveness of sound educational intervention. As good examples emerge from the schools, professionals can direct parents' attention to the successes, an approach we regard as potentially more powerful than debating with reluctant parents.

Assessment. Considerable attention was directed to assessment procedures developed explicitly for highly deviant groups, such as those who are deaf and blind. We did not teach procedures with which an of the participants should have been familiar (e.g., Wechsler, Stanford-Binet, Leiter International Performance Scales). Instead, we introduced the participants to the philosophy underlying nonintrusive measures of behavior, and we demonstrated a variety of these procedures.(3) The impression we sought to make was that everyone can be assessed regardless of disabilities. It is our belief that there is no unassessable person, only inadequate assessors.

Additionally, we emphasized the use of teachers and parents as observers and assistants in observation. Zimbabwe, as is true in most countries, has a shortage of personnel skilled in serving deviant populations. We brought assessment instruments that extend the psychologists' range by enlisting others in the assessment process. We cautioned about the care that doing so demands, but we also made clear the values of using lay observers and assistants - values beyond the purely economic.

Intervention. Critical to our approach is that every assessment procedure must lead directly to steps that forward the individual's progress. We reject assessment for the sake of assessment. On the other hand, the success of intervention steps must be periodically measured, preferably as each is taken, both to determine if the intervention is succeeding and to motivate the intervenor. With that in mind, we provided the participants with illustrations of the Assessment-Intervention Matrix (AIM).(4) It provides developmentally sequenced steps in educating persons who are deaf-blind and combines them with assessment scales to determine how they are progressing. AIM takes nothing for granted about the client's background; each activity begins as close as possible to a zero point of prior learning. Each subsequent step comes from a task analysis of the activity (e.g., eating, dressing, self-care) that broke them into extremely small components. Having tiny steps is essential for the majority of those for whom AIM is appropriate: it assures success, which is so important to maintain client motivation.

Communication. Central to education and rehabilitation is communication. Participants learned about techniques and equipment for using residual hearing and sight for communication. They also became acquainted with the variety of approaches to tactile and kinesthetic senses for communication. Our principal objectives were to assure participants that such methods were available and to familiarize them with training materials. As with assessment and intervention, the underlying message in all of these presentations was that communication is always possible, regardless of the person's disabilities.

Other Material. From our experience, we offered the participants key points in program development. For example, we emphasized the rule: Always test the vision of deaf persons and the hearing of those who are blind. Many participants found this dictum new. It arises from the facts that visual problems occur more frequently among deaf than normally hearing persons and hearing problems occur more frequently among blind persons; and that vision is more important to deaf persons and hearing to blind persons than to those in whom both senses are normal.

Participants studied the factors critical to establishing effective programs of education and rehabilitation. In particular, they learned about the case manager approach to lifetime planning for disabled persons.(5)

Prevalence. Discussions were held about the likelihood of finding deaf-blind persons in the various regions. At first, participants tended to deny that such individuals resided within their areas. By the last day of the seminar, the consensus was that Zimbabwe has a large, untreated, unrecognized number of people with severe, multiple sensory impairments. Why the change? In part, the denial reflected national pride: to admit to a foreigner that their country had unmet needs was unacceptable. However, the entire program brought awareness to a condition that had long been ignored. Now that the participants had found techniques and strategies for serving deaf-blind people it was easier to acknowledge their existence.

Results

At the penultimate session, we asked participants what they believed we had presented that was of little or no value and what they wished we had included or expanded upon further. Several comments suggested the need for more cultural relevance to the materials. In this regard, we put in motion plans to obtain written feedback about particular items or wordings in our materials that participants felt were out of place in Zimbabwe's cultures. One point we made frequently that did seem to get across: Zimbabwe's problems in educating and rehabilitating people with severe multiple sensory disabilities are shared throughout the western world. As one participant succinctly put it, "I was delighted to learn that I am not living and working in some primitive backwater."

A grave initial concern was that we would not bring appropriate materials. On the last day of the seminar, participants rated the usefulness of the assessment materials, suggested adaptations to make them as appropriate as possible for the populations they were to serve, and commented on where additional training would be helpful. Most of the participants were pleased with the materials. They gladly accepted the trend away from single scores and rigid use of standardized items and procedures that often lead to the conclusion that a person is "untestable." Such notations too frequently appear on the records of individuals with severe multiple sensory disabilities.

Participants commented to the effect that this part of the course had helped solve some assessment dilemmas. They appreciated that the instruments are relatively culture-free - not standardized solely for North Americans - and could easily be adapted for local use. Participants recognized that the observational techniques can apply to other disabled pupils in addition to those who are deaf-blind, another concern in a country with limited resources. Because there is such a large range of abilities and levels of socialization shown by, disabled people, assessment instruments must encompass many skill levels and be flexible in administration. If limited to use with only a small group, they require too large an investment in funds to purchase and in time for staff to learn.

Closing Comments

Returning to our initial question - why Zimbabwe requested this program - we learned about a 7-year-old deaf-blind boy, Benson Mruha. As he opened the seminar, the Regional Director remarked: "Early in 1989 the School Psychological Services at St. Patrick's House had the case of a boy whose 'exploring behavior' with his hand indicated that he was trying hard to understand his environment. He was hyperactive and frustrated, and the psychologists were at loss to provide much help ... This case made our educational psychologist very aware of a gap in their skills and brought about the request for training - hence your presence here today."(6)

As has happened before in special education, a single case provided Zimbabwe with the impetus for programming to fill a hole in its services for uncounted numbers of individuals - those with multiple sensory impairments. Benson Mruha, deaf-blind from birth, lived in dire poverty. He did not have the charisma of a Helen Keller, but, for Zimbabwe, he has had even a larger influence than that grand lady. Thanks to him, Zimbabwe is on its way to developing programs for those who are deaf-blind. We are delighted to add, in closing, that Zimbabwe has continued to use our services. We returned for our fourth training meeting early in 1995.(7)

Notes

(1.) Report on the National Disability Survey of Zimbabwe. (Undated). Harare: Department of Social Services. (2.) Ibid., page 30. (3.) For example, B. Ruttenberg, E.G. Wolf-Schein, & C. Wenar. (1991). Behavior Rating Instrument for Autistic and Other Atypical Children (BRIAAC). Chicago: Stoelting; E.G. Wolf-Schein. (1990). Wolf Inventory of Psycholinguistic Progress (WIPP). Edmonton: Psychometrics Canada. (4.) E.G. Wolf-Schein & J.D. Schein. (1991). Assessment-Intervention Matrix. Revised. Edmonton: Psychometrics Canada. (5.) J.D. Ziev, J.D. Schein, & P.I. Johnson. (1989). An empirical demonstration of the case-management approach to rehabilitation of multiply sensorially disabled clients. Journal of the American Deafness and Rehabilitation Association, 22, 86-93. (6.) Gordon, R.M. (1991). Opening remarks. In E.G. Wolf-Schein & J.D. Schein, Education and rehabilitation of persons with severe sensory disabilities in Zimbabwe. Edmonton: Western Canadian Centre of Studies in Deafness, University of Alberta. (7.) We wish to express our appreciation to the Canadian International Development Agency for its support of our training efforts in Zimbabwe and to the University of Alberta, under Dean Harvey Zingle, whose continuing support has greatly facilitated our work. We are also grateful for donated materials to our colleagues in Great Britain: Paul Ennals, Royal National Institute for the Blind; Malcolm Matthews and Bob Snow, National Deaf-Blind and Rubella Association; and Heather Murdoch, University of Birmingham.

Dr. Schein and Dr. Wolf-Schein are both Adjunct Professors of Education, University of Alberta. Dr. Schein is also Emeritus Professor of Sensory Rehabilitation, New York University, and Senior Research Fellow, Gallaudet University.