CCT Volunteer McKenna Tychsen Second Blog Post (Hope Home)

McKenna Tychsen

Hope Home

{July 9th-July 25th}

A few weeks ago, I said I would go into detail about each of the children! Here you are!

We have 10 children at Hope Home, however, not all of the children live full time at the home. Each child, very unique in their own way, has specific need which we do our best to cater to in each activity we do throughout the day. Here, I go into more depth about the complexities of each child we work with.

1) Bella, 4 years old, (almost 5!!) with a fatty acid oxidation deficiency and a developmental delay. The fatty acid oxidation deficiency is a condition requiring her to eat every couple of hours, If she doesn't, it could be very serious and turn into a hypoglycemic episode. Bella is also deaf in one ear and partially deaf in the other. She is a VERY sweet, intelligent and dedicated little girl with high potential for success, but can distract you easily with her adorable charm to get out of something. During our learning portion each day, Bella is always very attentive and interactive with the lesson. We work with her to improve discipline, fine and gross motor skills as well as basic educational material, such as colors, days of the week, numbers, etc.

2) Little Guy, 2 years old, was born premature with respiratory problems, so had to have a trachea placed in his throat. Now, he is a very active and talkative little boy. Very smart for his age! It is sometimes hard to know if he fully understands English, (for me to understand him at least) however, he has an easier time with Thai and listening to the Thai staff. We are working with Little Guy on his basic educational skills like learning the Thai and English characters and basic words, as well as colors numbers and other beneficial life skills.

3) Tadpole, 3 years old, came to Hope Home when he was about 1 and a quarter years old. He has Down's syndrome and is one of the sweetest and outgoing kids you'll ever meet. His adorable smile and big hugs will get you every time. He has the most energy of all the children, always running around and getting into some sort of ruckus or mess (usually with Little Guy) but is a blast to be around. We work with Tadpole to improve social and mental skills in our education bit and throughout daily skills. We also try and improve his attention span keeping him focused and interacting with others for a longer period of time while staying focused.  We also are working with Tadpole to develop his vocabulary in English and Thai, learning colors, numbers and basic life skills.

4) Yannie, 7 years old, has a developmental delay, but she loves playing shakers and rattlers, coloring and making messes!! She has a contagious and boisterous laugh as well. At Hope Home, we work on Occupational therapy with Yannie. We do repetitive activities such as put certain items from one box to another in order to work on her focus on one activity at a time as well as her fine gross and motor skills.

We've also been trying to improve Yannie's health, so we do fun activities such as bending down, grabbing balls out of one basket and having to lift her body to put it into another basket, like basketball, but repetitive action of shooting the ball in the hoop!

5)  Will, 20 years old, has cerebral palsy and hydrocephalus. He is also recovering from stroke caused by shunt complications. Will struggles with communication. He is non-verbal, but can make some sounds and slightly points to things that he wants. We try to help involve him in activities and learn but at his own pace and capabilities. We also work on his motor skills and mobility with physiotherapy each day.

6) Clark, 12 years old, has cerebral palsy, but is probably one of the most able children I've ever seen with cerebral palsy. He is very intelligent and is able to use his limbs and noises as a clear way to communicate. We have also adapted ways for him to use his communication strengths (such as his legs and feet) to form a device which speaks when he presses the buttons. He know where each button is and what it says, so it is a good way for him to show his expressions without being able to verbally communicate them. We've also been working with Clark on his standing and arm mobility. These are both skills which will aid in helpful daily activities such as eating himself, or brushing his own teeth. Clark has a lot of potential, and from the three months I've been here, I've already seen many improvements. Keep it up Clark!

7) Yindee, 9 years old, has severe cerebral palsy, epilepsy and a chronic lung disease. Yindee has had a rough few weeks, however, maintained a smile the whole way through. There was a bug going around Hope Home and a few of the kids got sick with a cold and a fever. Unfortunately, Joy's immune system isn't strong enough to fight against the bug, and it quickly turned into pneumonia, and due to Joy's previous conditions, it affected her very badly and she had to be taken to the PICU (Pediatric Intensive Care Unit) in Chiang Mai. She ended up staying there for 15 days. She is doing a lot better now though!! She's back at Hope Home. Yindee is a very sweet, beautiful and a true pleasure to be around. She enjoys musical sounds and silly faces!  She has limited muscle control and struggles to sit/ stand or move on her own, in need of assistance in everything, however we are working on it with her! We work with Yindee to help her communication skills (she uses her eyes as a way to say what she wants), motor skills and muscle strength/ mobility with things like holding her head up while sitting.  Eventually Hope Home wants to have Yindee work with an electronic communication aid, but for now, we've made giant charts so we can see the movement in her eyes for communication and learning techniques.

8) Dontri, 5 years old, has cerebral palsy, multi-cystic encephalomalacia (scars on the brain), micro-cephaly (undersized brain), epilepsy, a heart defect, and is blind. Dontri is a sweet little boy with an adorable laugh and smile, but with very little ability to communicate. Dontri is very sensory oriented. He needs a lot of different types of stimuli but not all at once, which may be overwhelming for him. He likes textures, calm music, head being rubbed, being held and certain smells. We've been working on having him sit up when possible so he's not laying on his back all the time (so muscle development), as well as an educational system we developed specifically for him, which includes a brail alphabet in English and Thai. As of now, we can't really tell how much he has retained, but it's a start!

9) Namchock, 10 years old, has Down's syndrome and very poor vision and goes to a special education school during the day. I don't get to spend too much time with Choppy because he leaves for school before I get to Hope Home and comes back just before dinner, and I leave right after dinner. BUT... for the time that I do spend with him, he never fails to put a smile on my face. He has such a unique personality and is a sweetheart. As for what my other coworkers have told me, they work with Choppy on his attention span. He gets very distracted very quickly.

10) Andy- 13 months. Andy was born two months prematurely, however, doesn't express any characteristics of a disability. Because he is so young, it is difficult to tell. However, Andy is very sweet and is just now starting to babble. It is quite the task to get a smile out of him, but once you do, it's the cutes little grin with only two front teeth!  We work with Andy to improve basic motor, cognitive, physical and social skills, such a waving hello and goodbye, putting a spoon into his mouth by himself, drinking out of a cup, putting objects into a box, etc... he seems to be developing quite normally so far. (I have only been here three months, but babies grow fast!!)

He loves to try and walk, with our assistance, but soon he'll be able to do it by himself!

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As the weeks dwindle down, I can't help but reflect on my time here thus far. From the classes I took at Chiang Mai University, to the friends I've made along the way and the impact the people have made on my life over the course of my three months here. People at Home Home, TEAN friends and every genuinely kind, random person I've met in Thailand. I am incredibly grateful for this opportunity I've been given and have loved and cherished every moment of it.  I couldn't have asked for a better summer, I've learned a lot about myself, a better view on different disabilities and how to adapt to their abilities, Thai culture,  medicine, and the world around me. I'm now headed to travel for a bit but will stop by Hope Home before I head back to the states, for another goodbye!

Sah-wa-dee-ka for now!

CCT Volunteer Mansur Alam 2nd Blog Post (BEAM Foundation)

It has already been a month since I landed here in the beautiful city of Chiang Mai, Thailand but it only feels like a week. I have no idea how the time has passed so quickly and I only have 3 more weeks to go.

So here is what I have been up to for last five weeks. When I came here, first I had my orientation with the executive director of Cultural Canvas Thailand. We went out to a coffee shop where we talked about my work and everything that I needed to know about Thailand, Thai culture and places I can visit here in Chiang Mai.  It was an amazing day and I was so excited and looking forward to next day.

On the first week I did very little, I went out to meet with the people at BEAM foundation (the place where I will be working for the 8 weeks I am here) and had orientation with the ART relief director. Later on we visited the Hope home. Hope home is a foster home for children with disabilities. The home is for seven children but it also serves as respite for families of children with disabilities and provides loving and caring environment. 

BEAM

Teaching is never something I thought I would do, in fact, if someone would have suggested a year ago that my next job would be teaching high school level science I might not have believed them. It was not until few weeks before I came here I read about the lives and circumstance of the kids I would be working with that I felt it was something I had to do. I think I was very affected by the stories of the kids and how they relate to my own story.

 At the beginning I was extremely nervous, and still sometimes I have to put in a lot of extra work to keep up but so far I have loved every moment of it. I am proud that I have managed to grow and pick up other skills I may have been worried would hold me back in this position.

 It turns out that having a lot in common with the students has really helped me to connect with them and build some meaningful relationships. I love that the students are engaged and interested in learning, they try their best in every moment and some of them seem to love science as much as I do. I also enjoy moments in the class where I can hear small pieces of their stories and share small pieces of mine. I love how unique they all are, and how they are able to laugh at themselves and feel comfortable enough to bring their sense of humour to the class and make it more fun for everyone including me. 

Aside from occasionally being showered with messages in the evening about homework confusion and wifi “not working,” I really have nothing negative to say about my experience with the students at BEAM. I am just over half way through my time with them and I am already starting to feel sad about leaving.

ART Relief

I have had the privilege of working with Art Relief International by participating in some of their workshops in my free time. I spend most of my time preparing for my class at BEAM as it is my first time teaching I am not yet very fast with creating my own lesson plans.

I have enjoyed every workshop I have participated in, they are all great and educational. There are  great lessons behind every workshop and I am very glad to be a part of it.

Here are a few of the workshops I have attended: 

Hope Home

I had five workshops with the kids at the Hope Home and they have been my favourite ones out of all the workshops with ARI. Our main goal here is to improve and practice sensory and motor skills including touch, sight, and sound. Therefore our workshops involve drawing, painting, folding etc. It is very important that every workshops we do include everyone in the house so that we don’t leave out anyone just because they can’t do it in certain way, therefore we help them to get involved in the activity with whatever way possible.

We go to hope home every Wednesday and do small workshop with the kids and it is really amazing, I absolutely love going there and doing different activities, playing and laughing with the kids, they make me smile so much and I really hope I can make a difference in their lives by just helping them in whatever way I can.

So far some of the things I have done with the kids at hope home are making Tambourines, Paper Plate Animals, sensory jet packs, kites, and textured painting. 

Wat Muen Ngen Kong

I have done two workshops with this school and both have been very fun and successful. I particularity  enjoyed one where we had the kids do portraits of their friends and were not allowed to look at their page. It was a fun way to get the kids to think differently and create something interesting they may not have made if they were allowed to look.

nd do small workshop with the kids and it is really amazing, I absolutely love going there and doing different activities, playing and laughing with the kids, they make me smile so much and I really hope I can make a difference in their lives by just helping them in whatever way I can.

So far some of the things I have done with the kids at hope home are making Tambourines, Paper Plate Animals, sensory jet packs, kites, and textured painting. 

Elderly Care

Going into the Elderly Care program, I was curious about how Art would be used or relevant as I am more familiar with working with kids using arts and crafts. I was pleasantly surprised by the ability that the simple art activities had to uplift the seniors and it made me happy to see them so happy. I was also quite entertained by the fact that many of them seemed to think I was Thai and made me feel quite welcomed (thanks to P’Noom translating everything they said.) So far I’ve only been able to attend one workshop with them where we did dot painting which they took to quite well. I would love to go back to Elderly Care before I leave.

CCT Volunteer McKenna Tychsen Blog Post (Hope Home)

{June 19th-July 4th}

These past 3 weeks I've been working at an amazing organization in Chiang Mai, Thailand called Hope Home. Hope Home is a foster home and community with the goal of providing a loving, caring and therapeutic environment for children with special needs who are a part of government social welfare system or families affected by disability in the community.

We work with the children to provide proper medical, nutritional and emotional needs as well as daily physical therapy, occupational therapy and special education. With the combination of volunteers and the full time staff who have experience in different areas, we are able to provide the children with useful resources and proper therapy.

The children we work with range from a variety of physical and mental disabilities as well as multiple health complications including: Down's syndrome, blindness, fetal alcohol syndrome, cerebral palsy, developmental delay, respiratory issues, sound and temperature sensitivity hypoglycemia and hydrocephalus.

Each child is unique in their own way, whether this be with their disability, or their personality, they truly stand out individually. 

When I first arrived at Hope Home, I was overwhelmed with the warm welcome they gave me. Ryan, one of the other volunteers through CCT from Canada, gave me the run down on each child as well as the home and where everything was and what they do each day. I was introduced to each child and was able to slightly interact with them the first day to learn the ropes, however, some of the children were timid with me because I was a new stranger in their home.

As the weeks went on, the children were more trusting with me and I felt more comfortable to take on responsibilities to help out where needed. Even though we are on week 3, I am still learning everyday. Whether it be what needs to be done with a certain child, which medications to use or even just how to speak Thai. Its nice being able to ask so many questions and the other people I work with are very nice about helping me out.

Something that has been pretty challenging is the language barrier. I am taking the Thai Language class at Chiang Mai University, so I do pick up on certain phrases and words I recognize, but I can't completely converse with them, which I wish I could. But the other women are very good at understanding what I have to stay with help of my gestures and broken Thai!

I've worked with children with disabilities before back home in the United States, and I've realized that most adults don't really understand how difficult some of the most simple activities such as eating, going to the bathroom, brushing teeth etc, (to people without disabilities) is. We don't recognize the simplicity because it is such habit and we don't even need to think about it. But for most of these kids, it is a lot more challenging and some require assistance, so we are here to help them adjust and improve their daily cognitive, social and physical skills to eventually be able to do these skills on their own. Although it may seem like we don't do much throughout the day, bare in mind that these activities take a lot longer than normal because we are working to improve their skills, not ours.

A typical day at Hope Home:

-Start out the day with breakfast

-Go for a walk around the block for some exercise

-Come back and start physiotherapy

-Lunch time (for the kids who don't go to school)

-Some children come back from school around this time, take showers and a nap

-snack time

-Special education

-Play time break outside on the playground

-Dinner

(Then I usually leave around 5:00pm)

With each of these activities, we try and include certain skills that are catered toward each child and their disability. For example, one of the children, Phil, has cerebral palsy but still is very able to use his limbs (mainly is legs and feet) as a way to communicate. We have a portable chart with buttons where he presses it with his toes and the speaker says something in Thai/English. He knows where everything is on the board, so if he wants to say something, this is a good way to express his thoughts without actually being able to form sentences by voice.

 

Next week, I will go into detail about each of the children and the specifics of their needs!! 

Farewell (Stacey Braun)

Pick a city. Any city. Any one of the thousands of thriving metropolis' around the globe.

The roadways are blanketed in a chic coat of chrome cement or asphalt as black as night. The polychromatic signage forms an eclectic gallery along each avenue. And amongst all the radiating bulbs and the mod-podge of reverberations, your journey through the city almost always comes to an abrupt halt. A halt at a red light.

Throughout history, the colour red has carried multiple meanings. Red was noted as the hue of extremes. In fact, our prehistoric ancestors saw red as the colour of fire and blood - anger, fear and danger. As the centuries have past, as a species we have evolved from living in caves to driving automobiles and red became recognized as the international colour for stop.

A stop. By definition, a stand still; a termination; a hindrance; a roadblock. A pain-staking colour that signals us to come to a standstill. And though we like to see ourselves as "upgraded models" in comparison to our Neolithic predecessors, our interpretations of red, in this sense, is remarkably similar. For these modern red lights bound within their metallic casings catalyze feelings of frustration and rage within each of us.

However, we don't just encounter these negative red lights on the physical roadway. Instead, as a wise woman once pointed out  in the backseat of a truck, we encounter these unexpected stoppages in our personal lives as well. In fact, being immersed in a foster-care facility in Chiang Mai for children with disabilities has illustrated that exact fact to me each day, for the past 87 days.

Like a pedagogic documentary projecting onto a screen in front of me, my eyes have bore witness and my ears have absorbed through narration each child's different and unique red lights. Each of them has experienced the life roadblock of their disability. The roadblock of all the developmental delays. The roadblock of the health related ailments. The roadblock of the cloud of stigma that surrounds their everyday life in their native land.

Nonetheless, I have not just witnessed these life roadblocks through living beings under the age of ten. Alternatively, two exceptional women have also allowed me to take a peak into their metaphorical closets and absorb their skeletons of roadblocks faced. One has had to experience: the roadblock of moving long-term to a foreign country ripe after academia, and the roadblock of volunteering in a misunderstood field.

The other has had to experience: the roadblock of garnering and juggling funds to help an under serviced  sector, and the roadblock of making decisions invariably linked with the life of vulnerable children.

While cumulatively, both women have grappled with the ever-growing roadblock of holding onto themselves in an environment where it is so easy to lose oneself completely.

In the end, each and every one of us will face red lights; interruptions in our journey forward. But what all of these individuals' life hindrances has shown me is that it is not always about moving forward. Sometimes that extra time spent stopped is a gift - a treasure. Sometimes in that time, you will battle through treacherous rain and hail and your inner strength will grow. Sometimes in that time, you may find an unanticipated route that will change your perspective completely. Or sometimes in that time, you may just have an extra moment to stop, take a breath, and realize all the miles that you've put behind you and all the growth that has already occurred.

Overall - thank you Chiang Mai and Hope Home for all that you have entailed. Thank you, for my trip - my unexpected life stoppage, my red light - has taught me so much.

Cerebral Palsy & Blindness (Stacey Braun)

Visual impairments can result from problems with any part of the visual system, including the eyes, eye muscles, optic nerve or areas of the cerebral cortex that process visual information (Book et. al). Because cerebral palsy frequently affects the visual system, children with CP are more likely to have visual problems than are other children. In fact, according to a study conducted by Black, "up to 75% of children with CP are impaired".

One such of these specific impairments is labelled cortical visual impairment. Cortical  visual impairment or CVI results from injury to the brain's visual centres on the cerebral cortex (Book et. al). A child with CVI is thus able to pick up visual information with their eyes but the child's brain cannot process and interpret the information correctly. It is analogous to an imperfect computer chip which cannot fully process the input from the keyboard.

Generally speaking, the most common CVI symptoms presenting in children include an abnormal light responses, inconsistent visual responses to the same stimuli, and decreased responses to visual stimuli when auditory stimulation is present (Giord et. al). But the loss of vision does not only exhibit itself in symptoms directly related to the field.

When a child is blind they have lost one of their basic senses - they are under stimulated. Many of these children resort to other behaviours and forms of self stimulation to compensate for this under stimulation. These behaviours can include head banging, poking, rocking or staring at sources of light (Edelson). It has been reasoned that the head banging may even provide a form of pleasure related to movement titled kinaesthetic drive.

Though these behaviours can be a negative influence in many spheres, developmentally these behaviours are important for blind children as connections are made in the brain where the body is (Coots).

In fact, in the past two months I have witnessed the importance and predominance of these behaviors. In specific, one CVI-blind child at Hope Home fully engages in these actions, though there are two additional CVI children at the home.

However, though these children may seem lost in their world of behaviors that are difficult to comprehend - these children have NOT lost all of their senses: they still have viable feelings remaining. Most importantly, these remaining sensations need to be exercised to promote development. Presently, at Hope Home the developmental pursuits revolve around two core senses: sound and touch.

Stimulating the sense of sound is one experience that is constantly integrated into these children's lives. A variety of genres of music are being incessantly played on the stereo or sung. In addition, at times the children actively engage in creating their own music using instruments such as tambourines, bells, and drums. Therefore, not only to they to revel in the therapeutic auditory sensation but they also get to experience the tactile stimulation associated with banging ones hand against the firm surface of the percussion instrument.

Similar to the sense of sound, the sense of touch is almost effortlessly innervated into each of the three children's our times. In conjunction with the unintentional "touch" lessons, such as putting on clothes and feeding, toys such as a ball-pits and sensory boards provide opportunities to optimize each of these children's development.

Overall, though their condition has robbed their sight from them like a thief in the night - not all is lost. And this can be no more clearly than in this smile below.

More Than Just A Set of Wheels (Stacey Bruan)

According to the AARP, it is estimated that only 5-15% of people who need wheelchairs actually have them. That means that spanning the globe and its seven continents, as many as 350 million people are lacking the support, accessibility and mobility that these devices provide.

In the year 1967, Joni Eareckson Tada became one such of these persons who required a wheelchair. After misjudging the shallowness of the water in Chesapeake Bay, Joni became a quadriplegic at 17 years of age. Following years of struggle and rehabilitation, she founded an organization called Joni and Friends.

Since the year 1979, Joni and Friends International Disability has been dedicated to assisting people affected by disability and those around them. One of the organizations means of doing this is through their program called "Wheels for the World". As according to the program's mission statement, this project "provides FREE wheelchairs to children and adults affected by disability around the world".

As can be extrapolated by the immensity of that goal, this is not a single link chain of delivery but instead it is a step-wise process. Overall, it can be defined by the following steps: drop-off, transportation, restoration and distribution.

Initially, donated chairs are dropped off at specified locations. These chairs are given for a variety of reasons. Sometimes the donor's condition has changed and they require a different chair or no chair at all. Sometimes the donors outgrow their chairs. But regardless of the reason, the chairs are collected. Following collection, the chairs are transported to shipping ports. These ports serve as hubs where each piece of equipment is routed to a different restoration centre.

Currently, "Wheels for the World" operates restoration shops at correctional facilities across the United States. Inmates are trained to restore the chairs to "like-new" conditions. After each of the individual wheelchairs have been mended, they are shipped internationally to various distribution centres. Interestingly, the Kingdom of Thailand is one of these sites.  Though their movement spans the geographical range of the country, Chiang Mai is one site within the country where dispersal occurs.

In fact, on November 11, 2014 I was on hand at an event that occurred at Payap University's Faculty of Nursing. At this event, there were 3 special guests in the spotlight. Two of these guests were selected cerebral palsy children from Hope Home and the third was a foster child affected by Dushenes Muscular Dystrophy.

In a room filled with occupational therapists, physical therapists and mechanics, each child was fitted with a new wheelchair. Firstly, this process began with a subjective interview with the therapists gathering information about the condition and lifestyle of each child. Questions posed ranged from range of motion to the arrangement of each child's home. Progressively, as increasing amounts of information was acquired, the focus was shifted to a more objective view. During this time, measurements were taken. For example, these tabulations included hip breadth and chest width. Subsequently, it was these numbers that were used to determine specifications such as the size of the seat and seat back. Lastly, once all sizes were gathered, the appropriate chair was then selected and the mechanics then altered each chair to fit the child as best as possible.

Though simply owning a wheelchair is imperative, having a proper fitting wheelchair may be exponentially more important. A proper fitting wheelchair can slow the rate of degenerative conditions, prevent scoliosis, eliminate pressure sores and many other secondary disturbances. However, a wheelchair is important for more than just its role as a sponge for medical jargon.

The query of "what does a wheelchair mean to a person" is impossible to intricately answer. Each individual is defined by a unique set of circumstances and variables that would cause infinite variation in their responses. Nevertheless, from an observational perspective I can generally state that a wheelchair means so incredibly much.

A wheelchair can mean that a child previously unable to feed without being physically held, now has increased independence and self-actualization by feeding in the chair. A wheelchair can mean that a child heavily impaired by hypo sensitivity now has an environment that accommodates learning. A wheelchair can mean that a previously confined child now has the tool necessary to experience adventure and personal discovery. Overall, a wheelchair is more than just a set of wheels. A wheelchair provides hope for a fulfilling future.

Two Million (Stacey Braun)

Two million. A number that contains a whooping 6 zeros. A number that contains 7 digits. Two million. A number that can be broken down into 2 x one million or 4 x 500,000. But no matter how you approach it, the number commands attention . For this reason, the fact that Thailand has over two million people living with disabilities makes this number an important one (NSO).

Though individuals with disabilities have faced hardships world wide, their challenges have been particularly pronounced in Thailand. So why is this so?    More than 90% of Thais are Buddhist. Accordingly, in the teachings of Buddhism disability is an outcome of a vice that a person had in his/her previous life (Driedger). Because of this, Thai children with disabilities have been viewed by a large number to be useless and worthless (Hill). In fact, the stigma was so predominant that many Thai children with disabilities were kept at home and even denied basic education. Even "with the compulsory Education Act of 1935, the Ministry of Education allowed a child to stay at home because of his/her disability (Sukbupant, Shiraishi & Kuroda).

Furthermore, this trend continued for another half-century following the 1935 act. Before 1998, only 7.3% of children with disabilities in Thailand of school age were receiving an education ("Country Profile on Disability: Kingdom of Thailand", 2002). After this shocking statistic was published, the Ministry of Education designated the year 1999 as the "year of education for disabled persons". Several plans to enlarge educational opportunities for persons with disabilities were drawn up. Largely, this education was to occur through the promotion of inclusive  learning in regular schools. By definition, inclusive learning is an approach to education where students with disabilities spend the majority or all of their time with non-disabled students (Allen & Schwartz). However, contrary to the plans - this idea has not held in practice over a decade later.

Predominantly, Thai children with disabilities receive their educational services through special education schools located throughout the kingdom (Traiwicha). It is at one of these schools, Special Education Centre Region 8, that Hope Home's children attend school. Each of the children spend varying amounts of time at the school catered toward their individual needs. For example, one child attends every day all day. Whereas, some attend once a week.

So what doss their learning consist of at Special Education Centre Region 8? The intellectual lessons include activities such as counting and colouring. Whereas, the physical components range from threading (for hand-eye coordination) to physical and occupational therapy. Chiefly, the later of these lessons are what I have specifically witnessed.

From passive stretching and ring stacking to light therapy - a variety of therapeutic avenues were travelled on Tuesday. Overall, I would say that the children seemed to enjoy this change in sensory environment. However, such a stimulating day lead to some overload and exhaustion.

Though I do value that these children are getting the best education available to them and their providers, I cannot help but wonder where 1999's plans got left. Still to the date, less than 40% of Thai children with disabilities actually attend inclusive school programs (Traiwicha). Yet, time and time again studies have illustrated the benefits of inclusive education.

As illustrated by a study comparing integrated and segregated students with disabilities, "disabled children in the integrated sites progressed in social skill development whereas segregated children regressed" (Sale & Carey). In fact, additional studies have demonstrated "increased self esteem, increased motivation, and increased completion of learning goals" in students with disabilities in inclusive education settings.

However, the reason I believe that inclusive education should be the end-goal for Thailand is not just for its benefits for disabled children. Research has shown  that non-disabled students in inclusive school settings show remarkably improved perception and increased positive attitudes towards people with disabilities (Bennett et al). As Gandhi so clearly highlighted, "if we are to reach real peace in this world, we shall have to begin with children". Therefore, if the end goal is to change the perspective towards disability in Thailand - inclusive education may serve as a catalyst for this movement.

Movement Physical Therapy (Stacey Braun)

 The earliest documented origins of actual physical therapy as a professional trade date back to a man by the name of Per Henrik Ling (Chartered Society of Physical Therapy). Through the years, this practice has morphed and changed until its current form in the 21st century. It is this form that is instructed at Chiang Mai University's Faculty of Associated Medical Science Physical Therapy Department to their students. And it is these students that implement their new knowledge on Hope Home's children with cerebral palsy weekly.

As illustrated by children with cerebral palsy, neurological disorders often cause increased muscle tone - or too much tightness. In the muscles of the arms and legs, spasticity results from increased muscle tone, limiting movement and joint mobility (Verschuren et al.).Therefore, the therapeutic goal of physical therapy for children with cerebral palsy is largely focused around "improving ones ability to walk or perform other functional activities" (Verschuren et al.).

Chiefly, passive stretching is the major component of the children's program at CMU. By definition, passive stretching is when "the stretch is performed by another person and the child does not actively participate"
 (Wiart et al.). Notably, this type of stretching is integral to the physical therapy for Hope Home's children. This is because the children who have cerebral palsy at the home, have severe cerebral palsy. The number of controlled muscle movements they are able to perform is extremely limited. Ergo, applied external force is required to complete any stretch.

Foremost, after arriving for our weekly session the physical therapy students started with each child's upper extremities. Initially, a gentle soft tissue massage was completed by each therapist. This was performed to loosen up the desired muscle group and to promote a convivial connection with the child.

Subsequently, each therapist then moved to performing palm extension exercises. These exercises are salient for children with cerebral palsy. For these children, the clenched fists come from the damaged brain sending improper impulses to muscles causing "excess flexion" (Soon et al.). Accordingly, the physical stretching of the palm helps relieve this tension.

Following several minutes of these types of exercises, the students shifted to bicep flexion and shoulder rotation. Overall, in our group this is commonly met with a rousing chorus of grunts, groans and tears. Due to the children's inability to communicate verbally, the reason for the crying cannot be completely understood. The child could be feeling pain resulting from their stuff muscles being elongated. Or if the child has experienced damage to their cerebral cortex, their ability to perceive  their world could be hampered (Gerztiman et al) . Therefore, the child could be perceiving a fearful situation.

Following the choir of cries, the physical therapy students focus shifted to the lower limbs. Largely, a similar routine was performed as on the upper extremities. However, the physical therapy students did preform a new type of exercise to each child's legs that was not performed on the child's arms.

Accordingly, prolonged stretching is when "positioning is used to achieve a longer duration stretch of a muscle group (Wiart et al.). Often this type of therapy is completed with the assistance of splints or braces. In respect to our physical therapy session, 3/4 leg braces allowed the physical therapy students to stretch the major lower extremity muscle groups while simultaneously assisting the child with sitting or standing. Overall, there is something exceptional about seeing a child stand who cannot do it individually. It is almost as if you can see the pride fill their eyes and confidence seep out of their pores. I do not believe there is a better education for the students than that image right there.

Not only are these children living models for the students to practice their craft on, but they are also tangible models of life lessons. Walking should not be taken for granted. Siting should not be taken for granted. Life un-assisted should not be taken for granted. Though confined by their disability - they are not defined by their disability. And that in itself may be a lesson for more than just this small student  sector of Thailand.