THE EDUCATOR

JULY 2004

MULTIPLE DISABILITY IN WEST AFRICA: THE CASE OF CHILDREN WHO ARE DEAFBLIND IN GHANA AND NIGERIA -ISUWA J. JURMANG

Department of Special Education, University of Jos

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Introduction:

    In present day Ghana and Nigeria, the need for appropriate identification and intervention programmes for individuals who are Deafblind or multiply disabled cannot be overstated. There are hardly any formalized programmes for these groups and the only school for the Deafblind in the entire West African region is Manpong Akwapim in Ghana. Kelley and Vergason (1978) define persons who are Deaflind as "persons whose vision or hearing are deficient as to require specialized methods of communication different from those used in the fields of the deaf and blind". Such individuals may not be equally disabled in each modality and might not meet the legal definition of either deafness or blindness and many will have additional disabilities.

However, the term "Deafblind" is used in this article to refer to a range of conditions including:

    • Dual Sensory Impairment
    • Multi-Sensory Impairment (MSI)
    • Hearing Impairment with additional disability
    • Multiple Disabilities and Visual Impairment (MDVI)
    • Profound Multiple Learning Difficulties (PMLD)

The main objective of this article is to consider the challenges that face children who Deafblind, their teachers and their parents and to provide an overview of the principles and materials used in instructing these children in our region. It focuses on the curriculum and provides suggestions for positive action by advocates and other professionals interested in the welfare of define Deafblind individuals in Ghana and Nigeria, and in the African region as a whole.

Case Study 1

This boy attended school for the deaf in Manpong Akwapin in Ghana. His performance in academic work as a deaf child was outstanding. He later developed a visual impairment which led to his transfer to the Unit for the Deafblind. When his parents saw that their child had become both deaf and blind, they withdrew him from his new school because they feared that their neighbours would get to know of their childís condition. At home, the boy was kept locked up in a room. His food was delivered to the room and he had to crawl around to find it. He stayed there alone and ate, slept, urinated and defecated in the same room. He was kept in this confinement for two years. The hazard to his health and the psychological torture the boy went through is beyond description.

By the time the teachers discovered his situation, the boy was in a terrible physical, mental and psychological condition. When he was brought back to school he exhibited many abnormal behaviours. At mealtime while other children sat at the table, he squatted on the table to eat. He resisted any attempt to sit him down on a chair and tried to bite anyone who touched him. After every meal he lay down behind the door and folded himself up. After tremendous efforts by his teachers, especially the head of the Unit, the boyís behaviour and his relationship with others. improved significantly.

Four years later the boy left the Deafblind school and was enrolled in the regular primary school in his local community. He was taught craft skills and members of the community have now accepted him. People are proud of him and he makes a living with the sale of his products.

Case Study 2


Grace was fifteen years old when I first met her. She was the third child in her family and lived at home. She was partially sighted and hard of hearing and she had no speech except for a babbling sound. She displayed a pattern of self abuse which involved her continuously hitting and wounding her head. Grace had extraordinary
energy and strength and she destroyed items around her in her house. Her mother was still changing her nappies for her.

Mama Grace (her mother) had a great deal of difficulty looking after Grace. Once Grace was awake the mother would have to stop all her household chores. She often had to grasp the girl's two hands and pin her legs under her in a sitting position to prevent her from wounding herself or destroying things in the house. Sometimes after several hours of being in that position, the mother could quickly feed the girl and Grace would go back to sleep.

The mother then quickly did all her jobs before the girl woke up again.

The local women wanted to help Mama Grace. The few that tried giving her a helping hand could not cope. When the news went round, other women declined to offer a helping hand. House girls that were employed to look after Grace did not come back after their first experiences.

The mother did not know the whereabouts of Grace's father and her two oldest children. They could not tolerate the presence of Grace in the family and left. Mama Grace was always in trouble with her landlords. Co-tenants complained about the disturbances the girl caused especially when she began crying out aloud. Three times they were evicted from the house they lived in. It became increasingly difficult for the mother to find a new place to live. Friends and relatives advised Mama Grace to get rid of the girl to enable her to have some rest in her life but the woman was determined to take care of her daughter.

One day I took Grace and her mother out in a car for an enlightenment television programme with the Plateau Radio / Television station in Jos, Nigeria. When we were driving along the road, Grace remained quiet, calm and stared at the trees. Her face was full of joy and an expression of pleasure. A few weeks after the making of the television programme, Grace passed away. It was clear that what Grace wanted was not confinement. She wanted to see outside like any other child.

Priorities in Ghana and Nigeria

There is little or no formal training and education available for many children with impaired sight and hearing in Ghana and Nigeria and for those in the community who are involved with them. Very little use is made of residual hearing and vision, yet we know that children can benefit enormously from early training and development in this area. Modern optical and auditory aids can be of real help in teaching the child to understand their environment but these are usually not available in the community.If a child with defective sight and hearing can be identified early, even in infancy, the preschool years can be made profitable and the margin of delay due to lack of communication can be narrowed considerably. If a mother can be taught to show her child how to explore the environment and understand it through touch, if she can enable her child to relate to other people and play with other children, then she can give her child a basic preparation for school and life. Resources in the community such as mainstream nursery classes can sometimes be of great help, and (with the right training) various types of professionals can offer useful counseling and advice to parents. Social Workers, public health nurses, occupational and physical therapists and
teachers of nursery school classes can also make valuable contributions if they are provided with specialist advice.

Our schools for the Deafblind and Multiply Disabled have not published pamphlets or offered advice to parents of Deafblind children or to the professionals who come into contact with them since up to now they have not been properly involved with them. It is of the utmost importance therefore that specialist schools take on the role of furnishing guidance and counselling to others in the wider community.

Principles and approaches:


The fundamental principles of teaching have not changed, approaches to an individual child must be adapted to take account of that child's special needs. When working with children that have sensory impairment with additional physical, emotional and learning difficulties, the teacher must understand the significance of all these factors and create a favourable climate for learning. The teacher must initially develop rapport with the child and watch closely for signs of an inner language. The teacher who recognizes that the child has concepts that are unexpressed will be able to break through the barrier of
communication and reach the mind and personality of the child.

The development of communication is a crucial element in the life of any individual who is Deafblind or multiply disabled. Communication is a process of the exchange of information by any means possible in which the person who is Deafblind plays an active part. Activities in the process need to be meaningful and motivating. The child must have a need to communicate something to another person and therefore the environment and the context in which interaction takes place is crucial. The child must be given opportunities that will promote communication and this includes the use of a range of approaches including speech, gesture, signing, finger spelling, the written word (both print and tactile) and symbols such as Objects of Reference. In order to give the child an understanding of the realities around him, the teacher must aim at providing the child with a variety of concrete experiences that are in line with the childís individual needs.

Conclusion and Recommendations:

Multiply disabled persons in Ghana and Nigeria can take their places in the community if appropriate programmes are in place for them to develop the necessary skills. A team approach to identification, assessment and programming should be initiated. The Ghananian and Nigerian governments should consider the training of teachers of Deafblind children and the provision of services for children in specialized and regular settings. Government should also consider the approval of separate funding for multiply disabled persons in Ghana and Nigeria. Tertiary institutions of learning that train special educators should include in their training courses for producing personnel for children who have multiple disabilities.

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