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Children & Person with

Special Needs

Dr. Nik Nor Ronaidi bin Nik Mahdi
1. Child:
A child means every human being below the age of
eighteen years unless, under the law applicable to the
child, majority is attained earlier.
(United Nations Convention on the Rights of the Child, Article 1)

2.Special needs:
The Special or unique, out-of-the-ordinary concerns
created by a person's medical, physical, mental, or
developmental condition or disability. Additional
services are usually needed to help a person in one or
more of the following areas, among others, thinking,
communication, movement, getting along with others,
and taking care of self.
(Center for the Improvement of Child Caring (CICC), USA)
3. Impairment:
• reduced function of an organ or body part

4. Disability:
• reduced function and activity of a person

7. Handicap:
• the social, economic and cultural
circumstances that place persons with
impairment or disability at a disadvantage
relative to their peers
(International Classification of Impairments, Disabilities, and Handicaps, WHO)
Disease / injury The level of the organ or body part

The level of the person

The level of interaction of persons with society or the environment

(International Classification of Impairments, Disabilities, and Handicaps, WHO)
Types of special needs
• Hearing Impairment
• Visual Impairment
• Physical Disabilities
• Cerebral Palsy
• Global Developmental Delay
• Down’s Syndrome
• Autisme
• Attention Deficit Hyperactive Disorder (ADHD)
• Intellectual Impairment
• Learning Difficulties (e.g. Dyslexia)
• Slow Learner
Causes of disability
• Congenital or perinatal disturbances
– Mental retardation
– Somatic hereditary defects
– Non – genetic disorders
• Communicable diseases
– Poliomyelitis
– Trachoma
– Leprosy
• Non – communicable somatic diseases
• Functional psychiatric disturbances
Causes of disability
• Alcoholism and drug abuse
• Trauma / injury
– Traffic accidents
– Occupational accidents
– Home accidents
– Violence
• Malnutrition
• An estimated 10% of the world’s population
(approximately 650 million people, of which 200
million are children) experience some form of
• The most common disabilities are associated with:
– chronic conditions (cardiovascular and chronic respiratory
diseases, cancer and diabetes)
– injuries, (due to road traffic crashes, falls, landmines and
– mental illness
– malnutrition
– HIV/AIDS and other infectious diseases.

(World Report on Disability and Rehabilitation )
• Disability is both a cause and a consequence
of poverty.
• About 80% of the world's population of
people with disabilities live in low-income
countries and experience social and
economic disadvantages and denial of rights.
• Most of the developmental initiatives ignore
the need of people with disabilities.
• The UN convention on the rights of persons
with disabilities emphasizesthe importance of
mainstreaming disability issues for
sustainable development.
(World Report on Disability and Rehabilitation )
(Jabatan Kebajikan Malaysia)
(Jabatan Kebajikan Malaysia)
(Jabatan Kebajikan Malaysia)
Primary prevention
• This involves the prevention of the
manifestation of the disability
• It may be:
– universal (i.e. prevention desirable for
– restricted to a selected population (i.e
prevention recommended for high-risk
– to an indicated population (i.e. prevention in
individuals with an identified risk)
Primary prevention
• Primary efforts are directed toward
reducing the actual occurrence of
• Employ measures that prevent the
conception of a disabled individual or
delay the disabling process
• Primary prevention efforts include:
– genetic counselling
• Genetic counselling is an essential part of primary prevention strategies.
It is the process of providing information on genetic (recurrence) risk,
the nature and consequence of genetic disorders and the means
available for the prevention of transmission of defective genes
– immunization programmes
• general immunization during infancy have led to a remarkable decrease
in several infectious diseases that used to be a major cause of disability
(e.g: poliomyelitis, tuberculosis, meningitis and encephalitis)
– improved prenatal, perinatal and postnatal care
• This aspect of prevention concentrates on the management of maternal
risk, factors at the time of delivery and support for the premature or
compromised neonate
– Improved nutrition
– regulations and legislation
• Certain health regulations and legislation, such as mandating
immunization of infants, also play an important role in primary
– environmental and technological interventions to prevent toxicities
and injuries, and educational interventions (to reinforce a variety of
disability prevention programmes)
Secondary prevention
• Aim at reducing the duration or severity of
• These activities provide early identification
of the disabling condition followed by
prompt treatment and intervention to
minimize the development of disability.
• These strategies can be applied either at
the prenatal or neonatal level.
• Neonatal screening is a well established
preventive approach and includes both
clinical and biochemical screening.
Tertiary prevention
• Aims at limiting or reducing the effects of a
disorder or disability that is already
• It involves long-term care and
management of a chronic condition
– (e.g. rehabilitation or correction of the
disability by surgical measures or by adopting
strategies by which the disabled person can
lead a normal or near normal life).
In Malaysia
• Role of :
– Ministry of Health
– Ministry of Women, Family and Community
• Department of Welfare
– Ministry of Education
– NGOs
Ministry of Health
• Services:
– Early assessment by multidisciplinary team,
Occupational therapy, Physical rehabilitation /
physiotherapy, Speech therapy, Hearing therapy /
audiology, Follow-up treatment, Dietitian, and
Flow of management for children with special
needs (0-18 y.o) in MOH
• Step 1 : Initial Assessment
– Initial assessment is conducted by specialists to
determine the child’s type of disability. Get an
assessment from a doctor in a general clinic /
child (paediatric) clinic / rehabilitation specialist.
• Step 2 : Confirmation of Disability
– Submit the ‘Children with Special Needs
Registration and Placement’ Form
– register with the Jabatan Kebajikan Masyarakat
• Step 3 : Detailed Assessment by a Multidisciplinary Team
– for group assessment and treatment planning.

• Step 4 : Treatment Planning

• Step 5 : Treatment Begins

• Step 6 : Follow-up Treatment and Re-assessment

• Step 7: Proper placement in pre-school / special school /
vocational school
– Children who fulfill the entrance criteria can register with the State
Education Department to enter the Special Education Programme of
the Malaysia Ministry of Education.
– Children who do not meet the entrance criteria for the Special
Education Programme or who have severe disabilities will be referred
to the Social Welfare Department for further action.
Social Welfare Department
Dasar OKU menjadi asas kesaksamaan hak dan peluang
kepada OKU bagi penyertaan penuh dalam masyarakat.
Dasar ini turut mengutamakan nilai hak kemanusian
seperti kemuliaan, kehormatan dan kebebasan bagi
membolehkan mereka hidup berdikari.
4. Memberi pengiktirafan serta penerimaan prinsip bahawa
OKU mempunyai hak dan peluang yang sama bagi
penyertaan penuh dalam masyarakat;
5. Memastikan OKU menikmati hak, peluang dan akses
secara saksama di bawah undang-undang negara;
6. Menghapuskan diskriminasi terhadap seseorang atas
sebab ketidakupayaannya;
7. Mendidik dan meningkatkan kesedaran masyarakat
mengenai hak OKU.
Services provided for persons with disabilities:
• Registration and Identity Card:
– The purpose of registration is to collect data and
statistics for the planning of services,
rehabilitation programmes, prevention, training,
education and early intervention.
– The Identity Card For Persons With Disabilities
(Kad Kenal Diri Orang Kurang Upaya) are issued
to those who register themselves to make
communication with the relevant authorities
• Assistance with Orthotic/Assistive
Devices (Bantuan Alat Tiruan/Otortik):
– The purpose of this is to help persons with
disabilities purchase orthotic/assistive devices
such as wheelchairs, calipers, artificial limbs and
other equipment they cannot afford.
• Launching Grants (Geran Pelancaran):
– To assist persons with disabilities who have the
knowledge and skills but who do not have the
financial capital or equipment for self-supporting /
small business / agricultural projects.
– Maximum Launching Grant - RM2,700
• Disabled Worker’s Allowance (Elaun Pekerja
Cacat EPC):
– This scheme is to encourage persons with disabilities to
continue working and be self-supporting without
depending on their family or others, and to obtain
supplementary income for their basic necessities.
• Sheltered Workshop (Bengkel Terlindung):
– JKM works to obtain job opportunities for the disabled in
the private/public sector, or placement in Sheltered
Workshops such as Bengkel Daya Klang, Bengkel Daya
Sg. Petani, or any of the 13 other workshops run by
voluntary organizations.
• Vocational Skills Training:
– Courses offered include computers and secretarial,
tailoring and fashion design, manufacturing of assistive
devices, computer support, electrical wiring, electronics,
baking, photography and driving.
• Entry into Rehabilitation Institutions (Taman
Sinar Harapan):
– Rehabilitation is given to persons with intellectual disabilities to
acceptable levels based on individual capabilities and desires.
– Shelter and care are also provided for persons with severe disabilities.
– Activities include training daily living skills, pre-vocational education,
informal academic classes, religious/moral lessons, sports/recreation
and outdoor activities.
• Community-Based Rehabilitation CBR
(Pemulihan Dalam Komuniti PDK):
– CBR is a community development strategy for persons with
disabilities to obtain rehabilitation within their family and community
whereby they are given the equal opportunity for rehabilitation and
interaction with society.
– Activities include gross motor skills, fine motor skills, language
development, social development, self-care, pre-
Reading/Writing/Math skills, creativity, sports and recreation.
Assistance and benefits provided for persons with disabilities
• Education Assistance:
– MOH’s Special Education Department provides special
classes for children with disabilities.
• Public Transport Assistance:
– MAS gives up to 50% discounts on domestic airfares
– KTM provides up to 50% off all classes of rail travel
– TRANSNATIONAL busses gives up 50% discounts of
ticket prices
– PUTRA-LRT also provides discounts for the disabled
• Housing Assistance:
– Kuala Lumpur City Hall (DBKL) also provides the disabled
with rental assistance for low-cost housing and DBKL
• Exemption from Medical Treatment Bills:
– Persons with disabilities are exempted from paying for
third-class wards, specialist bills and medication.
• Exemption from Travel Document Bills:
– exemptions from costs of preparing and
processing travel documents (International
• Tax Relief and Exemptions:
– Tax relief/exemptions are provided for parents
who have children with disabilities below the age
of 18 years.
– Tax deductions are given for the purchase of
special equipment for personal use or for the use
of children/parents with disabilities.
– Tax deductions are also given to employers of
the disabled.
– Additional tax exemptions are given to person
and spouses with disabilities.
• Derivative Pension:
– The government, through the Public Service
Department’s Pensions Division, has approved a
derivative pension for children/dependants of civil
servants who have passed away.
• Assistance with Prosthetic / Assistive Devices:
– Exemption from import duties and sales tax for equipment
designed specifically for use by persons with disabilities.
• Job Opportunity Assistance:
– The government’s commitment to provide job
opportunities for the disabled includes the allocation of
1% of all public sector jobs.
– The Department of Labour (Jabatan Tenaga Kerja) also
provides registration services of job opportunities for the
• Assistance with Purchasing National
– 10% off the sales tax of National cars /
• Telekom Assistance:
– exemption from monthly phone rental rates, free-
of-charge 103 operator calls, and call waiting / call
divert services.
Ministry of Education
• Dengan adanya Dasar Pendidikan Wajib
2002, pendidikan peringkat sekolah rendah
untuk semua kanak-kanak termasuk kanak-
kanak berkeperluan khas adalah wajib di
negara ini. Ibu bapa yang gagal mendaftar
anak dalam umur persekolahan peringkat
rendah boleh didakwa.
• Mempunyai matlamat yang sama dengan
Falsafah Pendidikan Negara, menyediakan
perkembangan optimum kanak-kanak
dengan keperluan-keperluan pendidikan
khas agar dapat berfungsi sebagai individu
yang berkemahiran, berdikari, berhaluan,
boleh merancang, mengurus kehidupan
sendiri, boleh menyedari potensi sendiri dan
boleh menyesuaikan diri dalam masyarakat.
Program Pendidikan Khas
Kementerian Pelajaran Malaysia
• Sekolah Khas:
– Untuk murid kurang upaya dari segi
• Deria (hearing and vision)
• Kognitif
• Program Pendidikan Khas Integrasi:
– untuk murid-murid berkeperluan khas bermasalah
pembelajaran, bermasalah pendengaran dan
bermasalah penglihatan.
– Program ini diwujudkan di sekolah harian biasa
menggunakan pendekatan pengajaran pembelajaran
secara pengasingan dan separa inklusif.
• Program Inklusif:
– menempatkan murid berkeperluan khas
belajar dalam kelas yang sama dengan murid
• Program Pendidikan Pemulihan:
– kelas khas yang terdapat di semua sekolah
aliran perdana (gagal 3M)
Peranan NGOs
• Membantu agensi kerajaan menyediakan
kemudahan seperti berikut:
– Mengadakan Pusat Harian dan Pusat Latihan
– Program intervensi awal
– Aktiviti multidisiplin di komuniti
– Bimbingan dan sokongan melalui laman web
– Kaunselling
– Pusat sumber dan rujukan
Associations and Support Groups in Kelantan
Name : Persatuan Insan Istimewa Kelantan (INSANI)
Address: No 33 Kampung Raja, Panyit, 18500 Machang

Name: Persatuan Membantu Orang-orang Cacat Pendengaran Negeri Kelantan
Address: c/o Jobstan Orl,
Pusat Pengajian Sains Perubatan
16150, Kelantan
Description: For persons with hearing impariment

Name: Persatuan Orang Cacat Pendengaran Kelantan (POCPK)
(Kelantan Association for Persons with Hearing Impairment)
Address: PT 31 386-F Tingkat 1, Kedai Buluh Kubu, Jalan Pintu Pong
15300 Kota Bharu, Kelantan.

Name: Persatuan Sindrom Down Negeri Kelantan
(In Partnership with Persatuan Sindrom Down

Name: State Council for Rehabilitation Negeri Kelantan
Address: Wisma Insaniah Tengku Anis,
Jalan Bayam, 15200 Kota
Description: It's priciple objective is to make available various rehabilitation services to
the handicapped in Kelantan, so that they are able to earn a living.
Provides workshops for the resourceful rehabilitation at care centres for
disabled children.
Thank you
– Komitmen dan Peranan Guru dalam Pelaksanaan
Pendekatan Pendidikan Inklusif di Malaysia. Supiah
Saad, Jabatan Pendidikan Khas Kementerian
Pelajaran Malaysia 2005.
– Early recognition and intervention for prevention
of disability and its complications, Mohsen A.F.
El-Hazmi, Eastern Mediterranean Health
Journal, Volume 3, Issue 1, 1997, Page