Microsoft Word Turkey all pages 012406 aj doc

Recommendations – Children with Intellectual Disabilities

1. 
   There should be no child considered incapable of responding to a well-planned program of service.
   
2. 
   The institutional model of care should be abolished and replaced with a family- centered approach.
   
3. 
   Everything should be done to keep a child with a disability in his/her natural home, if that home has the capacity to be nurturing given sufficient support.
   
4. 
   When the natural home is not an option, specialized foster care should be the next option of choice.
   
5. 
   Children should have an option for a permanent family through subsidized adoption if their natural families are incapable of assuming the responsibility over a reasonable period of time.
   

6. 
   Children with neuro-developmental disabilities, such as cerebral palsy, should have assistance from developmental therapists (e.g. physical, occupational and speech therapists) to assure the following:
   

Y That the child’s needs for physical and nutritional management (movement, positioning and handling, eating and communication) are assessed, programmed and taught to the family and educational program.

Y That each child who is not able to move on his/her own has a range of positioning options that alter weight-bearing surfaces and facilitate active movement.

Y That each child has support to move around and explore his/her environment and interact with non-disabled peers.

Y That each child is promptly reassessed when lack of progress or significant progress occurs.

Y Lack of progress should be placed on the circumstance and not on the child.

7. 
   Children with behavioral issues should be presumed to be communicating in a language not readily understood by others and provided with some means for more acceptable communication.
   
8. 
   Medical antecedents to behavior or lack of such should be explored before resulting to psychiatric or behavioral medication.
   
9. 
   For children who must remain in congregate care until other options are developed, caretaker ratios should be reduced to no less than 1 caretaker for each 4 children during waking hours, and every effort made to assure that the fewest number of caretakers interact with each child.
   
10. 
    Children should be held and talked to for at least two hours each day regardless of the perceived level of disability.
    

Conclusion

I approach the task of analyzing conditions of children in Turkey with the humility of an American who has observed very serious human rights abuses in my own country. At the same time, I have also seen tremendous progress. This gives me great optimism, even as I observe very disturbing photographs from Turkey. The most serious abuses experienced in the United States have been largely eradicated -- and there is no reason to believe the Turkish experience will be much different. The United States is a rich country, but the mistreatment of people with developmental disabilities is ultimately not caused by a shortage of financial or technical resources. It is caused by the lack of recognition for the basic humanity of individuals with developmental disabilities. People with developmental disabilities have now demonstrated that, no matter how serious their disabilities, they are capable of living and enjoying life in the community. Even with limited resources, we now know how to remove the barriers and provide the supports people with developmental disabilities need to thrive as members of our society.

References

1. 
   President’s Committee on Mental Retardation; MR76: MENTAL RETARDATION PAST AND PRESENT, January, 1977, DHEW Publication No. (OHD) 77-21016, p. 1.
   

2. 
   Lakin, Charlie, David Braddock, and Gary Smith, eds.; TRENDS AND MILESTONES: Placement of Children and Youth in State Institutions: 40 years After the High Point, It is Time to Just Stop.” By Lynn Breedlove, Curtis Decker, K. Charlie Lakin, Robert Prouty and Kathryn Coucouvanis. (In Mental Retardation, Volume 41, Number 3; 235-238. June 2005, p. 235.
   

3. 
   The Parents Network for Post-institutionalized Children, 1995: The Long Term Effects of Institutionalization on the “Behavior of Children from Eastern Europe and the Former Soviet Union: Research, Diagnoses, and Therapy Options” by Teri Doolittle, PA-C, MHP, p. 6.
   

4. 
   Ibid, p. 7.
   

5. 
   Braddock, David and Susan L. Parish “An Institutional History of Disability” in Braddock, D (Ed.) DISABILITY AT THE DAWN OF THE 21^ST CENTURY AND THE STATE OF THE STATES. American Association on Mental Retardation, 2002, p. 38.
   

6. 
   Lakin, Braddock and Smith, p. 235.
   

7. 
   Parent’s Network, p. 9.
   

8. 
   Paper presented at a Conference held by the World Health Organization in Copenhagen, Denmark in March, 2004 called “Mapping the number and characteristics of children under 3 in institutions across Europe at risk of harm, 2.1.1 Consequences of institutionalization for young children: A review.” Dr. Rebecca Johnson, University of Birmingham, United Kingdom.
   

Appendix 3 The Case for a Turkish Mental Health Law¹

Introduction
Human rights in Turkey are under international scrutiny as the country begins the process of accession into the European Union (EU). As part of its pre-accession strategy, Turkey has passed a series of constitutional and legal reforms that demonstrate Turkey’s commitment to human rights and the democratic rule of law. Despite these valuable reforms, Turkish law does not adequately protect the human rights of people with mental disabilities.