A parent of a small child with a hearing impairment from birth to 6 years of age may apply, in the psycho-pedagogical clinic appropriate for the place of res-idence, for the decision of a team of specialists (doctor, pedagogue, psycholo-gist, speech therapist) and referral to the early development support programme.
Conditions for WWR implemented from education funds are specified by the Regulation of the Minister of National Education of 2013.5 The general assumptions across the country are the same. Between 4–8 hours of individual or group sessions are carried out per month (groups of 2–3 children over 3 years old). It is assumed that the support can be organised in a children’s home, kindergarten, elementary school, including a special school, in special centres and regional psycho-pedagogical clinics. It is carried out by a team appointed by the director of each institution which, in the case of children with hearing impairments, includes: a speech therapist (aural rehabilitation speech therapist), a psychologist, a pedagogue (aural rehabilitation pedagogue) and/or other spe-cialists depending on the needs of the child and/or his family. The task of the team includes, among others, cooperation with the family, “through: the pro-vision of assistance in the area of shaping the attitudes and behaviours desired when dealing with a child, to strengthen the emotional connection between par-ents and child, recognition of the child’s behaviour and maintaining appropriate responses to these behaviours, providing instruction, advice and consultation in the field of working with a child, helping to adapt conditions in the home envi-ronment to meet the needs of the child and in obtaining and using the appropri-ate resources and the necessary teaching equipment”.6
5 The Regulation of the Minister of National Education of 11 October 2013 on organizing early development support for children. The need for the early rehabilitation of a child with a hearing impairment was identified already in Poland in the 1950s. Maria Góralówna is the undisputed pioneer of modern organised, comprehensive care of individuals who are deaf in Poland (after: Kurkowski, 1995). She wrote, among others, letters to parents of young children with hearing impairments con-taining guidelines for work at home. These guidelines, gathered together in a book written jointly with Bozena Hołyńska The rehabilitation of young children with hearing impairment, published by the State-owned Medical Publications House in 1984 (edition I), and completed and republished in 1993, are partially applicable today.
6 Journal of laws 2013, item 1257.
The system for early diagnosis and therapeutic intervention in Poland
-development support and education of children and youth with hearing impairment – comparative analysis on the example of five European countries aborniak-Sobczak, Katarzyna Ita Bieńkowska, Edyta Tomińska • Wydawnictwo APS • Warsaw 2017
The regulation leaves a range of possible interpretations. In individual municipalities, despite the development of standards in the regulation, prac-tical solutions vary. The professional preparation of specialists in the various establishments remains a separate problem. It may happen that a child with a hearing impairment is the first one who comes under the care of the team.
While the situation of children with functional hearing (those whose speech will benefit from hearing aids (Krakowiak, 2011) and can be rehabilitated by the audio-verbal method) is very good, most professionals, particularly in small centres, do not have the qualifications to teach sign language and in critical cases, it happens that a teacher is learning together with the child. It is difficult in such situations to talk of effective help for deaf children.
Crèches
Although most people in Poland consider that in the situation of raising chil-dren under the age of 3 the mother should temporarily or permanently give up work (after: Piętka-Kosińska et al. 2010), individual families with children with hearing impairments, mostly forced by their financial situation, decide to use the services of a public crèche. Due to a change in the rules in force there are increasingly numerous private care institutions of the nature of care-edu-cational establishments for children aged from 6 weeks to about three years.
The activities of crèches are governed by the law on the care of children under 3 years7. Crèche fees include the cost of tuition and food, and are borne by the parents, although in some cases they are financed by the municipality. A crèche frequently provides children nutrition, health-care treatments and sometimes educational activities (among others, languages, swimming, calisthenics). They can also be run on the site of other services within the framework described in the earlier section on early development support. Crèches usually work from 10 to 12 hours. Parents choose the amount of time that a child spends in the centre. Because crèches do not work in the structure of compulsory educa-tion, those institutions are rather reluctant to accept children with disabilities, although it undoubtedly depends on the qualifications of the staff. Research by A. Piętka-Kosińska and A. Ruzik-Sierdzińska shows that, “generally, in 37%
7 Journal of laws 2013, item 1457.
Katarzyna Ita Bieńkowska
-development support and education of children and youth with hearing impairment – comparative analysis on the example of five European countries aborniak-Sobczak, Katarzyna Ita Bieńkowska, Edyta Tomińska • Wydawnictwo APS • Warsaw 2017
of cases accepting children with disabilities depended on various conditions.
10% expressed a willingness to accept such a child depending on the extent of the disability; the following 8% declared readiness only in the case of a small disability. There was a greater willingness to accept a child in a case of only an intellectual disability” (Piętka-Kosińska et al., 2010, p. 21).
Kindergarten
After the age of 3 to 6 years8 children with hearing impairments, like their peers, can start their education in kindergarten. From 2012/2013 the overall rate of pre-primary education among children of 3–4 years old was 59.3%
(after: Piętka-Kosińska et al., 2010, p. 61). The easiest access to all types of kindergartens, especially integrated, can be found in the big cities. Parents have the choice of State-owned kindergarten and numerous private establishments.
Due to a change in the system of financing of private institutions (2013), the municipalities finance both private and public day-care in the same way. Parents choose the institution due to its availability, or their offer tailored to the needs of a small child with a hearing impairment. In practice, however, this means the most common choice of institution is the one nearest the child’s place of residence.
From 2014, five-year-olds have been subject to a statutory obligation to attend one-year pre-school preparation. In many municipalities this obligation is performed in pre-school units in primary schools. All the children with dis-abilities in the general education kindergartens accounted for only 1% of all preschool children [Piętka-Kosińska et al., 2010, p. 63]. At some educational centres for children with hearing loss there are kindergarten units, which take children from 2.5–7 years of age (e.g. in Warsaw, Wejherowo, Krakow, Katow-ice). Classes are conducted in groups of 6–8. After classes, children have the opportunity to take advantage of a common room or dormitory. Mostly children with a hearing impairment or additional related impairments go to special kin-dergartens. In many municipalities integrative kindergarten units are created.
8 The pre-school obligation exists from 5 years of age – children with a hearing impairment can be deferred for one year on the basis of a decision issued by a psycho-pedagogical clinic.
The system for early diagnosis and therapeutic intervention in Poland
-development support and education of children and youth with hearing impairment – comparative analysis on the example of five European countries aborniak-Sobczak, Katarzyna Ita Bieńkowska, Edyta Tomińska • Wydawnictwo APS • Warsaw 2017
From 5 years of age (reaching the age of compulsory education) when the distance to school is more than 3 km, the commuting of a child with special edu-cational needs can be financed by the municipality. The funding is not depend-ent on the income of the family. Most often there are buses that collect children from the whole municipality and take them to the centre. In specific cases, the parents may apply to the municipal government for reimbursement of the cost of fuel.
With a hearing impairment coupled with intellectual disabilities, a child from 3 years of age can take advantage of a stay in one of many educational and upbringing rehabilitation centers (EURC), where they can attend up to 25 years of age.