International Journal of Educational Development 31 (2011) 478–488

Contents lists available at ScienceDirect

International Journal of Educational Development

journa l homepage: www.e lsev ier .com/ locate / i jedudev

Inclusive educational practices in Kenya: Evidencing practice of itinerant teacherswho work with children with visual impairment in local mainstream schools

Paul Lynch a,*, Steve McCall a, Graeme Douglas a, Mike McLinden a, Bernard Mogesa b, Martha Mwaura c,John Muga c, Michael Njoroge d

a Visual Impairment Centre for Teaching and Research (VICTAR), School of Education, University of Birmingham, Edgbaston B15 2TT, United Kingdomb ICEVI Africa, Nairobi, Kenyac Kenya Institute of Special Education, P.O. Box 48413, Nairobi, Kenyad School of Graduate Studies, Special Education Division, Kenyatta University, Nairobi, Kenya

A R T I C L E I N F O

Keywords:

Inclusive education

Visual impairment

Kenya

Itinerant teachers

Participatory action research

A B S T R A C T

This article presents a findings from an investigation of the work of 38 specialist itinerant teachers (ITs)

supporting the educational inclusion of children with visual impairment in Kenya. The research was

designed around a participatory action research framework involving in-country researchers and

participants (teachers) working in collaboration with researchers in the United Kingdom. Following an

introductory training workshop, participants kept research journals over a 2-month period in which they

recorded details of their itinerant duties (including the processes and content of their visits). Findings

provide information about local practices of ITs support for children with visual impairment in

mainstream schools and raise broader questions about the barriers to learning and development facing

children with disabilities in mainstream schools in Kenya and other developing countries.

� 2010 Elsevier Ltd. All rights reserved.

1. Introduction

Widening access to education and training has been a keyobjective of the Kenyan Government for the past 30 years (Otienoand Colclough, 2009). Recent efforts have focused on attainingUniversal Primary Education (UPE) and improving participation,equity, quality and relevance. Expanding access to primaryeducation is central to the government’s development strategy,and the acquisition of basic literacy and numeracy skills isregarded as a driver for reducing poverty and expanding Kenyans’access to employment opportunities and sustainable livelihoods.

To demonstrate its conviction to widening access, the KenyanGovernment ratified the recommendations of the Dakar Frame-

work for Action in 2000, reiterating the right of every child toeducation and its commitment to providing education to all itscitizens. The subsequent Children’s Act of 2001 granted everyKenyan child the right to basic education. In the Kenyan context,‘basic’ education now means 12 years continuous learning inschool. This consists of eight years in primary school and four yearsin lower secondary school. In 2003 the government abolishedprimary school tuition fees and this resulted in 1.3 millionadditional pupils entering the country’s schools, overwhelming theschool infrastructure and catching ill-prepared teachers by

* Corresponding author. Tel.: +44 121 4146735; fax: +44 121 4144865.

E-mail address: p.lynch@bham.ac.uk (P. Lynch).

0738-0593/$ – see front matter � 2010 Elsevier Ltd. All rights reserved.

doi:10.1016/j.ijedudev.2010.08.006

surprise (World Bank, 2009a). Schools in slum areas found itespecially difficult to cope with the increased numbers. In somedistricts there are now as many as 100 pupils for each teacher(UNESCO, 2009), resulting in an increasing number of parentstransferring their children to private schools (the enrolments inprivate schools rose from around 200,000 in 2002 to over 250,000in 2003, World Bank, 2009b).

Free primary education (FPE) required a substantial increase intheprovisionof learningmaterials inprimaryschools.By2004,publicprimary schools had approximately nine million textbooks for thefive core subjects (English, Maths, Science, Kiswahili and a compositesubject—Geography, History, Civics, Religious Education). Mostprimary schools attained the target of 1:3 textbook-pupil ratio(TPR) in lower primary for English and science subjects (World Bank,2009b). Despite such achievements, implementing the FPE policy hasproved to be a challenging task and crowded classrooms with manychildren sharing few and inadequate facilities remain common,especially in urban informal settlements (World Bank, 2009b).

Harber and Davies (1998) argue that the everyday contexts inwhich schools in developing countries operate is ‘very differentfrom that pertaining to most schools in developed countries,’ (p.10) and they identify six domains where differences are mostmarked: demographic, economic, resources, violence, health andcultural. These contextual differences impact on the education ofall children, but may have disproportionately greater conse-quences for those children in mainstream schools that have beenidentified as having special educational needs.

P. Lynch et al. / International Journal of Educational Development 31 (2011) 478–488 479

1.1. Inclusion as a strategy for achieving EFA

Inclusive education in the context of Education For All (EFA)goals is complex. Inclusion can be implemented at different levelsand can be based on ‘different motives,’ reflect ‘differentclassifications of special educational needs,’ and relate to ‘servicesin different contexts’ (Peters, 2007, p. 117). Inclusive education, inessence, is a process of strengthening the capacity of ordinaryschools to educate all children within their communities (UNESCO,2009). According to Booth et al. (2000, p. 12), inclusion isconcerned with the ‘processes of increasing the participation ofall students in, and reducing their exclusion from, the cultures,curricula and communities of local schools. However, much of thepublished literature that focuses on inclusion in southern contextslacks reference to indigenous knowledge relating to local culturesand communities (Stubbs, 1999). This kind of knowledge tends tobe communicated orally, and where written accounts do exist, theyare often not accessible to a wider international audience (Peters,2007). Dyson (2004) argues that it is important to take account ofthe local elements that influence policy and practice withinparticular contexts and warns against the imposition of solutionsfrom other contexts. Rambla et al. (2008) conclude that ‘inclusiveeducation policies need to be designed and implemented at a localscale’ but national governments should note the ‘potentialsynergies’ of such policies with ‘educational expansion and socialprotection policies’ (p. 73).

Ainscow and Miles (2008, p. 20) referring to work by Ainscowet al. (2004) conclude that inclusive education requires a ‘moveaway from explanations of educational failure that concentrate onthe characteristics of individual children and their families,towards an analysis of the barriers to participation and learningexperienced by students within education systems’. Inclusiveeducation focuses not just on children’s presence in school but on‘their participation and achievement’.

According to Kilonzo (2008) the Kenyan Government hasdeveloped inclusive policies that are generating a change inpractice in terms of budgetary allocation, staff training and betterassessment and placement of children with disabilities. This articlefocuses on a specific initiative by the Kenyan Ministry of Education,Science and Technology that seeks to promote educationalinclusion for children with visual impairment. The article considersthe historical and social contexts of the initiative and the localelements that influence its implementation. The article also seeksto identify and explore the barriers to the participation andachievement of children with visual impairment that are revealedby the initiative and the challenges that teachers, families, schoolsand communities face in seeking to reduce these barriers. Thearticle concludes by considering the general implications of thefindings for educational expansion in an inclusive context.

1.2. Education of children with special educational needs in Kenya

The Government of Kenya established a Special NeedsEducation Section (SNES) in 1975 and appointed the first SpecialNeeds Education Inspector in 1978. The SNES developed a policy in2008 to harmonise education service provision for learners withspecial educational needs (SEN) in Kenya which was approved bythe Minister of Education at the end of 2009.

According to the Kenyan Ministry of Education, Science andTechnology (MOEST), the policy affords a framework that allowsequal access to quality and relevance in education and training forlearners with SEN. The policy also identifies the additionalmeasures that will be taken by the government and otherstakeholders to redress inequities and inequalities in educationalprovision for children with SEN (MOEST, 2008). A supportingMOEST document – the Kenya Education Sector Support Pro-

gramme (KESSP, 2005–2010) – recognises a number of constraintsaffecting provision for children with SEN, such as the ‘lack of clearguidelines on the implementation of an all-inclusive educationpolicy, lack of reliable data on children with special needs,inadequate tools and skills in identification and assessment andcurriculum that is not tailored to meet special needs’ (p. 38).Therefore, the Special Needs Education Management Unit is nowone of eight units set up under the Basic Education Division tomanage and operationalise the KESSP and seek developmentpartners to support an investment programme. As part of its policyframework, MOEST is strengthening national institutions tosupport SNE. As an example, the Kenya Institute of Education(KIE) is mandated to develop curriculum, conduct research anddevelop relevant curriculum support materials for use at all levelsof education and training outside tertiary education. Importantly,it also has a Special Education Division that undertakes this role inrelation to the education of learners with special needs.

The Government still considers it important to maintain specialschools and special units attached to mainstream schools.However, this largely residential specialist provision is unable toaccommodate the greater numbers of children with special needsentering education as a result of UPE (Lynch and McCall, 2007). Aresponse to this issue has been to increase access to localmainstream schools through the promotion of more inclusiveapproaches and the expansion of the SEN budget. The Kenyangovernment plans to extend the range of its provision, enrollingmore students while addressing a wide range learning needsthrough targeted activities such as earmarking funding forindividual students and schools that include children withdisabilities (World Vision, 2007). The Government has implemen-ted a 5-year investment programme to support seven key areas inSEN including: teacher training, supply of equipment to resourcecentres, advocacy and awareness creation, provision of equipmentand teaching/learning materials, provision of equipment to regularschools, provision of grants to schools and providing support toresource centres at a total cost of KSh 39 Million (US$ 500,000).

1.3. Support for children with visual impairment in Kenya

The systems for supporting children with visual impairment inmainstream schools in Kenya predate the country’s involvement inUPE by several years. Children with visual impairment arecategorised into two groups: those who are diagnosed as ‘blind’(i.e. children with little or no perception of light who will generallylearn through tactile methods) and those who have ‘low vision’ (i.e.children who require additional magnification to read print orcorrective lenses to see at a distance but will generally learnthrough sight). The Kenya Integrated Education Programme (KIEP),established in 1989, is run through a tripartite agreement betweenthe Special Needs Education Unit in the MOEST, Sightsavers andKenya Society for the Blind (KSB). KSB was appointed to run theprogramme with the support of a council comprising threegovernment ministries. The KIEP now operates in 36 of the 74districts scattered across urban, semi-urban and rural parts of thecountry. The KIEP structure is devolved to district level where theDistrict Education Officer heads the team. The programme hasgradually expanded from primary schools to secondary schoolsand even tertiary institutions. In 2008 the programme wassupporting a total of 1537 children with visual impairment, whichis 7.2% of the estimated number of children with visual impairmentneeding education support in Kenya (based on prevalenceestimates, e.g. Gogate and Gilbert, 2007; Chandna and Gilbert,2010).

A KIEP database has recently been established which isaccessible to all three stakeholders. It contains information aboutcaseloads in each of the participating districts including children’s

P. Lynch et al. / International Journal of Educational Development 31 (2011) 478–488480

diagnoses, visual status, details of medical interventions (e.g.cataract operations) and prescriptions such as low vision devices. Atracking system has now been added to the database to follow theacademic progress and movement of children between learninglevels (classes).

1.4. The role of itinerant teachers and vision support teachers

As reported by Mason and McCall (1997), children with visualimpairment face particular challenges in accessing the curriculumand will often require dedicated support in order to cope with thedemands of education within an inclusive setting. This supportcould take the form of enhanced provision within a school (e.g.through additional training for the class teacher or support staff),and/or through input from a specialist practitioner in the form ofan itinerant teacher (IT) who makes regular visits to the school(Spragg and Stone, 1997). The duties of an IT with responsibility forchildren with visual impairment are varied and Benton (1984) andSpungin and Taylor (1986) suggest that the key elements of therole include: assessing pupils’ needs; assessing the learningenvironment; teaching children in special skill areas; advisingclass and subject teachers; advising families; and providing in-service training to staff. In discussing the role of the IT in Africa,Lynch and McCall (2007) note that ITs are usually qualified schoolteachers who have had some formal training in the education ofchildren with visual impairment and ‘travel around localmainstream schools and communities to offer advice, resources,and support to visually impaired children, their teachers, and theirparents’ (p. 26).

However, most of the literature relating to ITs describes theirrole in the context of developed industrialised countries (e.g.Benton, 1984; Spragg and Stone, 1997). Implicit in thesedescriptions of practice is what Harber and Davies (1998) referto in the context of school management and effectiveness as the‘educational conditions and realties as they exist in thesecountries’, highlighting that ‘it would be mistaken to assumeautomatically that these conditions prevail in developing coun-tries’ (p. 10). An example of a notable difference in practice in thecontext of a developing country (Uganda) is reported by Lynchet al. (2007) who refer to the key role of IT in ‘sensitising’communities about the importance of sending children with visualimpairment to school. This role has particular significance incountries where children with visual impairment are notnecessarily expected to attend a mainstream school. ITs undertakesensitisation and awareness building activities during communityevents such as church services on Sunday or at gatherings withvillage elders (Lynch et al., 2007). Some of the challenges faced byITs in seeking to provide effective support to children with visualimpairment in African contexts are outlined by Lynch and McCall(2007), who conclude that despite the difficult circumstances inwhich they operate, these specialist teachers offer a range of skillsthat complement those of other professionals working in eye careand rehabilitation, and ‘can play an essential part in ensuringvisually impaired children receive the care and skills training theyneed’ (p. 27).

In Kenya the training of specialised teachers working withvisually impaired students has been growing steadily since theestablishment in 1986 of a teacher training college (The KenyaInstitute of Special Education, Nairobi) that specialises in trainingteachers to work with children with sensory impairments. Thecurrent programme at the Kenya Institute of Special Education(KISE) offers a 3-year distance education course leading to aDiploma in Special Needs Education. The ITs in Kenya (and teacherswith a similar brief) will normally work under the direction of acoordinating itinerant teacher CIT or an Educational Assessmentand Resource Centre (EARC) coordinator and have responsibility

for a cluster of mainstream schools and homes in a given district.They are usually released for a number of days a week (nominallytwo) in order to undertake their specialist duties. Nevertheless, asLynch and McCall (2007) note, in practice ITs can only travel toschools and homes if they have arranged for colleagues to teachtheir class during their absence from the school.

Vision support teachers (VSTs) follow a different training routeby completing a certificate in low vision at the KISE. This 1-yeartraining programme (one-third residential and two-thirds practi-cal) is aimed at qualified teachers to ‘prepare teachers to supportchildren with visual impairments effectively in the classroom’(MOEST, 2002, p. 9). Unlike the course for ITs, this course preparestrainees to carry out functional low vision assessment (a test todetermine the impact of the visual impairment on the child’sfunctioning in the learning environment) and training on how touse optical low vision devices (LVDs).

2. Research focus

The research presented in this article builds upon methodsdeveloped for earlier work undertaken in Uganda by theInternational Council for Education of People with VisualImpairment (ICEVI), Kyambogo University, Sightsavers and theauthors (see ICEVI, 2005; Lynch et al., 2007).

Preliminary meetings between research partners at Sightsavers’Kenya Country Office in 2008 identified a similar paucity of dataabout the role ITs in Kenya as that found in Uganda. Drawing onearlier work undertaken in Kenya (Best and McCall, 1993) it wasagreed that the planned research should establish the priorityareas for supporting the development of itinerant services forchildren with visual impairment. This article is thereforeconcerned primarily with reporting data in relation to the workof 38 professionals working in the KIEP located in five districtsselected by the Sightsavers’ Kenya Country Office (Embu,Homabay, Nairobi, Nakuru and Trans-nzoia). These five districtswere selected from quite different geographical locations—urban(Nairobi), semi-rural (Nakuru) and rural (Trans-nzoia) eachexperiencing their own challenges in terms of travelling distances,access to resources, levels of supervision by IT coordinators andreported levels of performance. Apart from Nairobi, which has itsunique differences (easier transport links, greater access tolearning materials and clinical services), it was hoped that findingsfrom all five districts could provide some explanations on whatwas happening in other districts in the same programme.

2.1. Research framework

The research was designed within a ‘participatory framework’(Fals-Borda and Rahman, 1991). Within this framework participa-tory action research (PAR) was used to emphasise dialogicengagement with the co-researchers and the development andimplementation of context appropriate strategies oriented to-wards ‘empowerment and transformation at a variety of scales’(Kindon et al., 2007, p. 2). PAR was considered to have particularrelevance to the study in that it encourages ‘professional reflexivityand proaction’, is ‘contextually rooted’, and ‘provides opportunitiesfor professional engagement and reflection, and developingprofessional agency’ (Dyer, 2005, p. 68). The approach alsorecognises the plurality of knowledges in a variety of institutionsand locations (Kindon et al., 2007, p. 11) and was considered to beparticularly appropriate when engaging with practitioners work-ing in a wide range of contexts such as ITs.

The research process was designed, co-ordinated and moni-tored jointly by a team made up of UK-based and in-countryresearchers. Sightsavers, a main sponsor of the research, consid-ered it important for the UK-based researchers to work in tandem

P. Lynch et al. / International Journal of Educational Development 31 (2011) 478–488 481

with an independent Kenyan teaching and research institution tomaximise the indigenous knowledge, to develop mutual under-standing of what research processes would be effective in the localcontext, and to ensure that that research findings would be sharedwith project partners including the Ministry of Education anddedicated advisory groups (e.g. KIEP Advisory Group). The UK-basedteam members took the lead on organising workshops for teachersinvolved in the study, the research tools were jointly developed andthe in-country researchers took the lead in monitoring the progressand implementation of the study. The in-country researchers whowere a mixture of academics and teacher trainers had in-depthindigenous knowledge of the itinerant teaching programmes andwere in regular contact with the coordinators in the selecteddistricts. The research also incidentally provided them with a uniqueopportunity to liaise with ITs in the field and encourage them to beinvolved in the design of the district workshops which wereorganised for the participating ITs.

3. Methods

3.1. Design and sample

All practitioners involved in supporting children with visualimpairment in the five districts (i.e. coordinating itinerantteachers, itinerant teachers and vision support teachers) wereinvited to participate in the project. A total of 60 professionalsattended the introductory workshop held in Nakuru, including 41itinerant teachers and vision support teachers (collectivelyreferred to as ITs unless otherwise stated). The aims of thisworkshop were:

� t

o encourage knowledge sharing using a variety of techniques(including role play group discussions); � t o help participants reflect on their role and bring sensitive issues

to the surface about their work in a supportive environment;

� t o gather relevant information about the work of ITs through an

‘introductory questionnaire’;

� t o introduce the project research ‘journal’ that would provide

data about the ITs’ visits to children’s schools and homes.All the attendees at the workshop signed forms to consent to

their participation in the research and agreed to fill out a two-partintroductory questionnaire and to keep a research journal over an8-week period between June and July 2007. The UK research teamonly had direct contact with the participating ITs at these twoworkshops. The Kenya-based researchers assumed the responsi-bility for the field visits to the participants during the testingperiod (see Section 3.4).

Following the 2-month data-collection period, 38 of 41 journalswere completed and submitted, a response rate of 93%. The 38journals represented ITs working in each of the five districts (fiveEmbu, nine Homabay, 11 Nairobi, five Nakuru and eight Trans-nzoia)and were selected for more in-depth analysis. Of the 38 respondents,33 were itinerant teachers, and five were employed as VSTs. Thoseparticipants who had completed the journal were invited to thesecond project workshop in October 2007. The main aim of thissecond workshop was to offer feedback and to explore withparticipants emerging themes and implications in relation to therole of the IT. A subsidiary aim was to review the level of knowledgeand understanding of ITs in key skills such as assessing functionalvision and teaching braille, and to discuss issues arising from theteacher’s journal. It was also an opportunity for the in-countryresearchers to share with participants their reflections on thefieldwork that they had carried out in-between the two workshops.

The two workshops were delivered in English; this being thestandard language for alleducationalworkshops conducted inKenya.There was no need to use another language (e.g. Swahili) or

interpreters to explain what was being said at any point during theworkshop.

3.2. Questionnaire

The questionnaire, based upon that developed for another studyin Uganda (see Lynch et al., 2007), was presented to all theparticipants at the introductory workshop. Part One of thequestionnaire was concerned with the participants’ training andaccess to equipment and the number of children they supported(i.e. caseloads). Part Two requested information about the caseloadproviding such details as name, gender, visual status (low vision orblind). Respondents were also asked to indicate whether the childon the caseload had been (1) identified only, (2) received an initialassessment by the IT or (3) received a clinical eye assessment froma trained clinician (e.g. an ophthalmologist, ophthalmic coordinat-ing officer). They were also asked to provide data about the child’slevel of school attendance and their estimates of how frequentlythey were planning to visit the child’s school or home.

3.3. Journal

The principal tool used to collect information about the dailyduties undertaken by an IT was a journal based on that developedfor the Ugandan study (Lynch et al., 2007), and slightly adapted toinclude additional information about children’s assessments andvisual acuity. It contained two templates:

� te

mplate 1—a form for planning visits to schools, homes andother locations (e.g. clinics, community centres); � te mplate 2—a form to record post-visit information including the

mode of transport used, the contact time, the personnel theyworked with and ‘action points’ agreed with the class teacher,parent or other person visited.

Training was given within the introductory workshop to theparticipants on recording and presenting data in the journal. Theparticipants were informed that the tool should be used tosupplement, rather than replace, any existing data recordingsystems, e.g. children’s files, progress reports, end of year report.

The two main research tools (the questionnaire and the journal)were developed in full collaboration with the in-country researchers.

3.4. Monitoring and evaluation

To ensure the ITs were recording data systematically and reliably,a set of validation tools was developed with the two in-countryresearchers from KISE and one from the Special Needs EducationDepartment, Kenyatta University. These comprised a ‘journalverification checklist’ and a set of tools to help the researchersmonitor and evaluate the teachers’ journals in the field. The toolswere designed to help the researchers check that the journals werebeing filled in regularly and to record verbal feedback from the ITs.‘Spot check’ visits by the national researchers verified that ITs hadindeed visited schools on the stated dates and ITs were also asked tocollect signatures and stamps from the host school as furtherevidence of their engagement. Updates on the progress of theresearch were disseminated to participants through project news-letters.

4. Results

The results are presented under two broad headings todistinguish between the data from the questionnaires and thatobtained from the analysis of the journals. Figures are rounded tothe nearest percentage for ease of reading.

Table 1Distribution of children on the caseload and levels of training across the ITs (n = 38).

n %

Number of children per IT

0 (work in resource centre) 6 16

0 2 5

1 2 5

2 0 0

3–6 14 37

7–10 8 21

11–20 4 10.5

20+ 2 5

Highest level of training of ITs (either completed or in the process of completing

qualification)

Certificate in Low Vision (1 year)a 6 16

Diploma in SNE (3 years)b 21 55

Degree in SNE (4 years)b 11 29

38 100

a Kenyatta University.b KISE.

Table 2Summary of IT caseloads: frequency of planned visits, age ranges, visual status,

reading and writing medium. Base: children on caseload reported in questionnaires

(n = 248).

n %

Frequency of planned visits

Once a week or more 15 6.5

Less than once a week—once a month 145 62

Less than once a month—once a term 43 18.5

No data 30 13

Age ranges (years)

0–5 28 11

6–12 96 39

13–18 101 41

19–26 8 3

No data 15 6

Visual status

Blind 33 13.5

Low vision 200 81

Othera 3 1

No data 12 4.5

Assessment categories (3 stages)

Category one (identified but not assessed) 30 12

Category two (initial assessment) 46 18.5

Category three (medical assessment) 162 65

No data 10 4.5

Reading and writing medium

Braille 26 10.5

Print 176 71

Large print 2 1

Pre-braille 1 0.5

Multiple disability 1 0.5

None 14 5.5

No data 28 11

Total 248 100

a Other disabilities described.

P. Lynch et al. / International Journal of Educational Development 31 (2011) 478–488482

4.1. Questionnaires: IT background and caseload

The questionnaire was completed by a total of 38 ITs whoattended the workshop. Over half (57%) of the respondentsreported having more than 6 years or more experience as an ITwith 20% of respondents reporting more than 11 years ofexperience.

In terms of qualifications and training, all respondents reportedthey had (or were currently gaining) some credited training inspecial education (i.e. either at certificate, diploma or degreelevel)—see Table 1. Over half of respondents had either beenawarded a Diploma in Special Needs Education or were in thesecond year of a distance education course (n = 21). Over a quarterof respondents had completed (or were in the process ofcompleting) the 4-year degree course in Special Needs Educationat Kenyatta University. The remaining six respondents reportedcompletion of a 1-year certificate course in low vision to become avision support teacher. Some respondents had more than onequalification.

The majority of the respondents indicated they had someknowledge of Braille with 92% reporting they knew ‘Grade 1 withsome contractions’1 and 50% (half of whom were in the Nairobidistrict) reporting a knowledge of the more advanced and highlycontracted Grade 2 Braille code. Only four respondents reportedthey did not know Braille.

Participants were asked to provide a list of equipment andmaterials they took on visits to the children on their caseload.Although the question did not specifically ask, many responsesreferred to assessment materials with 25 ITs reporting taking avisual acuity chart (either a Snellen chart or an E-Chart) on theirvisits, which implies that they undertook assessments of vision aspart of their work. Two respondents reported carrying a Braille kit(which contained a slate and stylus with additional writingmaterials), four reporting that they carried a wooden case thatholds LVDs such as a telescope or hand-held magnifier, and fourreported that they carried the child’s file on visits to schools andhomes.

4.2. Description of children on ITs’ caseloads

A total of 248 children were reported on the caseload of the 38ITs (112 male, 136 female). As shown in Table 1, almost a fifth

1 Braille is a tactile code based upon dots arranged in two by three matrix,

forming a Braille cell. Grade 2 Braille contains ‘contractions’ which include many

common letter clusters (e.g. ‘sh’, ‘ou’) represented by a single Braille cell. Grade 1

Braille does not use contractions.

(n = 8) of the respondents reported they had no children on theircaseload. However, six of these respondents worked in resourcecentres in Nairobi and so may not be expected to have designated‘‘caseloads’’. Forty-two percent of ITs (n = 16) reported havingbetween one and six children and 21% (n = 8) had between 7 and 10children on their caseloads while four ITs reported that they hadbetween 11 and 20 children (10.5%). Two ITs in Trans-nzoiareported having 25 and 26 children, respectively. The IT who had25 children did not provide full details of where the children werelocated.

Table 2 shows ITs planned to visit the majority of the children(62%) less than once a week (though at least once a month). Thereappeared to be some recognition that children who were blindrequired more visits than children with low vision (18% of the blindchildren on the case load had a visit planned at least once a week,compared to only 4.5% of those reported low vision). Even so, overhalf (55%) of blind children still only had a visit planned betweenonce a week and once a month.

4.3. Details of the caseloads

The age spread of children reported as being on the participants’caseloads ranged from 0 to 26 years of age (Table 2). Gaps in therecording of data on the caseload spreadsheets mean that the agesand dates of birth of 15 (6%) children are unknown. It is unclearwhether this was due to the lack of data in school records or theparticipants’ lack of access to this information when filling out thequestionnaire. Whilst a small number of pre-school aged children(11%) were recorded on the participants’ caseloads, the majority ofthe caseload was within the 13–18 age group (n = 101) or the 6–12age group (n = 96). Nearly two-thirds of the caseloads across thefive districts were located in primary schools (n = 160). About 12%of children visited by ITs attended secondary school (n = 29) and

Table 3Number of visits carried out by ITs over an 8-week testing period. Base: ITs taking

part in field work (n = 38).

No of visits over 8 weeks testing period n %

0 0 0

1–5 7 19

6–10 24 63

11–15 5 13

16–20 2 8

21+ 2 5

Total 38 100

P. Lynch et al. / International Journal of Educational Development 31 (2011) 478–488 483

approximately the same number were on home-based pro-grammes or starting school.

Participants were asked to categorise the visual status of allchildren on their caseload using either the term ‘blind’ or ‘lowvision’ (the categories commonly used by medical staff when fillingout assessment records). As shown in Table 2 approximately 13.5%were categorised as blind (n = 33) and 81% as having low vision(n = 200). A small number of children (1%) were categorisedaccording to other disabilities, e.g. ‘‘multiply disabled’’ or aparticular visual condition, e.g. ‘‘squinting eyes.’’ The respondentswere also asked to indicate the level of assessment each child hadreceived using a three-step category (see Section 3.2). As shown inTable 2, over 65% of children on the ITs’ caseloads had beenassessed by an eye specialist (n = 162). Almost 20% of children hadonly undergone an initial assessment by the IT (n = 46) and 30children were reported under Category 1 (identified but notassessed). In 14 cases, no category was indicated. Closer analysissuggested some variation between districts in how visual acuitywas recorded. While some ITs were able to record results directlyfrom to children’s medical files other were reliant on their ownassessments of children’s levels of acuity. In Homabay and Embu,for example, respondents did not always indicate the visual acuityfor left and right eye separately, whereas greater detail was givenby ITs in Nairobi and Nakuru.

Participants were also asked to indicate the children’s readingmedium (e.g. print or Braille). As shown in Table 2, a total of 26children (10.5%) were identified as Braille users and 178 (72%) asusing printed material. 15 children were reported as not usingeither Braille or print (including one with multiple disabilities). Nodata were provided on the reading medium for 28 children.

Participants were asked to provide information about childrenon their caseload who did not attend school but were instead on‘home-based programmes’. About 12.5% (n = 31) of children on thecaseload were reported to be on these programmes with more thantwo-thirds being in one district (Trans-nzoia) (n = 17). Overall thehome-based children divide equally into blind and partiallysighted. Given the relatively small number of blind children inthe overall caseload, this suggests that they are more likely thanlow vision children to fall into this category. The majority ofchildren on home-base programmes fall between the 0 and 5 agerange although in Homabay two ITs reported visiting fourteenagers aged between 15 and 22.

4.4. Analysis of journals

A total of 307 actual visits were recorded in the journals duringthe 8-week data-collection period for the 38 participants. Table 3provides a breakdown of the number of visits the participantscarried out over the 8-week period covered by the journals. Thissuggests that they typically managed to carry out one visit a weekeither to a school or a child’s home. These visits took place over atotal of 287 days. Almost two-thirds of the participants (n = 24,63%) carried out between 6 and 10 visits over the period of theresearch and 27% (n = 9) carried out more than 11 visits.Approximately one-fifth of the participants (19%) carried outbetween one and five visits.

Journals contained details about each visit undertaken includ-ing: child’s name, destination, distances from base schools orhomes, modes of transport (bicycle, motor-bike, mini-bus or onfoot), and purpose of visits. In terms of the purpose of the visit,participants provided a narrative account and in order to gain amore detailed understanding of the nature of the visits over the 8-week period, all 38 journals were analysed to extract key themesand illustrative examples from these accounts. All the timetablesand diary entries in the 38 journals were scanned to identify keyconstructs. Units of data were extracted and placed under

emerging themes as a means of summarising and comparingstatements made by the 38 participants, and they provide usefulinsights into the realities of the role of the visiting teacher. Themajority of the journals (90%) contained rich information writtenwith clarity. Data from the remaining 10% were also extracted, butthere was often less detail about the circumstances of visits andwhat teachers taught children.

4.5. Overhead: other duties and travel

The respondents filled out a timetable for each day theyundertook visits to schools or children’s homes. The analysisconfirmed that teachers are expected to fulfil their itinerant rolearound managing and teaching their own class at their base school.They usually arrive at their base school around 7.30–8.00 a.m. AllITs apart from two in Nairobi performed mainstream classroomteaching duties, e.g. teaching their subject area to their class. Evenon the days they performed their itinerant duties most ITs (85%)reported that they were required to teach in the base school. Forexample in Homabay five ITs out of eight went to their ‘base school’to ‘sign in’ and teach a class, and they also sometimes returned totheir base school in the afternoon after visiting a school or home toresume mainstream teaching duties. Outside of Nairobi, there islittle evidence to suggest that ITs were able to take a full day toconduct itinerant duties. However, only in a small number of cases(three ITs) did they report having difficulties obtaining permissionto leave the school. Nevertheless ITs were generally limited to asingle visit on a given day, and often managed only a single visit perweek. A limiting factor was the significant proportion of time givenover to travel. For some respondents journey distance wasreported as being as little as 3 km, while for others, journey timewas much higher. As an extreme example, in Nakuru, an ITreported travelling to a school with his CIT by motor-bike to‘introduce the Braille cell and the white cane’ to a 19-year-old blindstudent attending a primary school 120 km from the base school.

4.6. Focus of visits

A distinction is made here between ‘child-focused’ and‘community-focused’ activities. Child-focused visits capture thoseactivities arising from the ITs’ interaction with the child and thechild’s teachers and family and include tasks such as one-to-oneteaching, taking a child for screening, discussion with the classteacher, meetings with parents of the child, sensitising specialneeds education teachers (SNETs) on how to work with the child,etc. In contrast, ‘community-focused’ visits do not relate to aspecific child on the caseload but involve ‘sensitising’ thecommunity, i.e. raising general awareness about blindness andlow vision and about the educational opportunities that exist forchildren with visual impairment. In some cases community-basedactivities also included the mass screening of sighted children forvisual loss.

P. Lynch et al. / International Journal of Educational Development 31 (2011) 478–488484

4.7. Child-focused visits

The majority of children on the ITs caseload (81%) were thoseITs identified as having low vision. Of particular note is thatapproximately a third of the children (30%) visited by ITs had notbeen formally clinically assessed. Further, even when children hadbeen clinically assessed there were often long gaps between thetesting of a child’s vision, the prescription of glasses and thedispatching of glasses to the child. Children sometimes spent longperiods of time waiting for their glasses and, as a result, ITs wereinvolved in compensatory activities such as helping children takedown notes from the blackboard until the glasses arrived.

Home visits accounted for just over 12% of the total plannedvisits in the five districts. Of the children receiving home visits, asmall number (n = 7) were of school age or older (e.g. one ‘child’ inHomabay was 22 years old). The majority of home-based childrenwere between the ages of 0 and 5 (14 blind and 10 with lowvision).

The analysis of the journals revealed that the ITs carried out awide range of tasks when visiting children at school or at homeincluding, assessing children’s vision in schools; tutoring childrenon how to use low vision devices such as telescopes; providingcounselling to children and parents; observing and advising classesand subject teachers on how best to accommodate and teach achild with low vision in the classroom; visiting pre-schoolchildren’s homes to teach mobility and orientation and dailyliving skills.

The analysis of the journal entries revealed that the ITs alsoplayed a key role in following up children to ensure they receivedthe right treatment once they had been clinically assessed ashaving a visual impairment. In a small number of cases ITs reportedthat some parents did not respond to clinical advice to ensurechildren were taken to hospital.

The journal analysis revealed that ‘functional vision assess-ments’ were seen by ITs as an important activity, and these were aregular feature of their visits to schools where a child had beenidentified with low vision. The accounts provided by the ITs do notelaborate upon the procedures they used for this task but seemedmainly to focus on observation of the child in the classroom andproviding advice, e.g. on the child’s seating position in the class,access to information on the blackboard, lighting conditions, aswell as access to textbooks. They also advised on learning supportssuch as thick lined exercise books or other large printed materialsand the use of felt tip pens or a book-stand.

A total of 15 pre-school functional vision assessments were alsoundertaken at children’s homes in the five districts. These includedobserving a child’s ability to move around the home andimmediate environment, assessing how the child interacted withobjects and materials in the immediate environment as well asproviding advice to parents or family members on how to developdaily living skills.

The testing period for the journal ran into the final schoolexamination period and as a result some information was collectedabout how blind children participated in examinations. Access toexamination papers in the appropriate format was identified as anissue by some teachers. As an example, one 17-year-old girl did notreceive her exam papers in Braille in time due to a ‘busyprogramme’ and logistical problems in sending the paper fortranscription to Braille.

ITs reported difficulties with notification concerning childrenwho were absent from school or who had moved without notice ordropped out of the school system. One IT reported for example thathe travelled 20 km to teach a girl addition using the abacus only tofind that she was absent from school that day.

A small number of ITs reported spending some time visitingschools just to check on students’ academic progress. During these

monitoring visits they spoke to subject teachers as well as thestudents themselves. This approach tended to be more common insecondary schools than primary schools, although secondaryschool visits constituted only a small part of ITs’ work. Theinvolvement of ITs in secondary education is expected to increaseas more children with visual impairment successfully completeprimary education and make the transition to secondary schools.

4.8. Community-focused visits

Analysis of the journals shows that community-focused workaccounted for between a quarter to a half of all visits. These visitsoften included large scale vision screening of classes of children orsometimes even entire primary schools. ITs normally used an E-chart to screen a child and then referred those who wereexperiencing problems to an eye clinic or district hospital. Fiveof the 11 ITs in Nairobi carried out screening in schools on morethan one occasion, and after the screening, any children identifiedwith vision problems were reported to the head teacher who wasasked to recommend the parents to take their child to an eye clinicor hospital for a clinical assessment. In the other districts, ITscarried out screening exercises not just in schools but at mobileclinics or health centres. For example in Trans-nzoia, an IT assistedwith screening of 19 cases at a dispensary for mobile eye unitservices. The following week, the same IT reported walking to ahealth centre (10 km from his base school) to carry out morescreening with an eye health professional.

Vision screening activities accounted for the majority of‘community-focused’ visits, but other activities under this categoryoften involved organising and running seminars and workshops to‘sensitise’ local communities to issues related to visual im-pairment. These types of activity would often take place duringthe early stages of a programme and may be a necessary element inusing the community to help identify children with visualimpairment and to raise public awareness that children who areblind can benefit from education. However it is not always clearfrom the journal entries what the term ‘sensitisation’ means inpractice. The analysis reveals that Trans-nzoia and Nairobi districtsconcentrate more effort on ‘sensitising’ activities than the otherthree districts, and Homabay district did not report any sensitisa-tion activities at all.

Community-focused activities also include the provision of inservice training for class teachers. For example in Nairobi, ITs basedin a resource centre arranged a training workshop for classteachers working with children with visual impairment and one ITspent two allocated itinerant days to delivering invitation letters toschools. In Nakuru, the CIT organised a ‘Basic Vision ScreeningWorkshop’ for ITs and class teachers concerned with identifyingvisual impairment in children.

5. Discussion

This study used a participatory action research approach toexplore the daily activities undertaken by a group of specialistpractitioners who support the educational inclusion of childrenwith visual impairment in a developing country. We considerbelow the themes and challenges emerging from the data and offerprovisional recommendations for how they might be addressed.

5.1. Assessment of children

Since its foundation in 1989, the KIEP has established a formalsystem for identifying and clinically assessing children suspectedof having a visual impairment. The recent introduction of a centraldatabase has helped provide an overview of children formallyidentified within the KIEP.

P. Lynch et al. / International Journal of Educational Development 31 (2011) 478–488 485

ITs have been instructed to provide services only to childrenwho have been formally clinically assessed and medicallyconfirmed as having a visual impairment. However, a challengefor managers of IT services is to decide when a baby, child or youngperson should be entered onto the caseload of an IT. An influx oflarge numbers of ‘informally’ assessed cases could obviouslydamage the support system by increasing individual caseloads andreducing contact time with children who have been clinicallyassessed and have clearly established needs. Without clinicalconfirmation of the child’s status as ‘visually impaired’, there is adanger that caseloads could be dominated by children withrefractive errors that can be fully corrected by the prescription ofspectacles. This is particularly likely where ITs are involved in themass screening exercises evidenced above under ‘communityfocussed work’.

On the other hand, ITs have an important role in identifyingchildren with visual impairment within their communities andthere may be a delay between identification by the IT and clinicalconfirmation of visual impairment. This raises the possibility thatsome children with severe low vision may have to await supportfrom an IT for a considerable period pending confirmation of thecondition by a clinician.

In practice children who have not been clinically assessed (i.e.only identified and informally assessed) constitute about a third(n = 77) of ITs’ caseloads and they receive regular visits. Solutionsto this issue clearly depend on close cooperation betweeneducational and community health services. This is recognisedby the recent establishment in some districts of regionalComprehensive Eye Services (CES) that seeks to bring togethereye health, enabling strategies (e.g. partnerships) and inclusion(e.g. social rehabilitation and educational services) for people withvisual impairment. As part of the solution, specific guidelines onidentification and assessment could be incorporated into a jobdescription for ITs. Such guidelines could clarify their role in theassessment of vision and emphasise the importance of targetingtheir attention to the children who need their help most, i.e.children who are blind and children who have severe low vision.

The findings of the study support the literature in revealing thewide-ranging role of ITs in relation to children and young peoplewith visual impairment (e.g. Spragg and Stone, 1997). Although themajority of children on ITs’ caseloads attend primary school (65%),over a quarter of their caseload (30%) comprises children who areeither at home, or attending nursery or secondary school. ITs areexpected to be able to provide suitable intervention to infants andpre-school children with visual impairment, although this is anarea that most will have little experience prior to appointment. TheITs’ role develops into secondary education as they follow childrenon their caseload who have been successful in the national entryexaminations. Evidence from the journals suggest that ITs tend totake on a pastoral role with such children rather than a directteaching role, sometimes mediating with children’s families andschools to find solutions to problems such as paying school feesthrough church or NGO bursaries. A successful system forsupporting children at primary level will inevitably increase thenumber of children making successful transitions and will increasethe demand for a system of support in local secondary schools andthis needs to be factored into the design of support systems basedon the itinerant model.

5.2. The training of ITs

The Kenyan Government aims to empower teacher trainingcolleges to operate within ‘‘an all-inclusive education’’ (MOEST,2005, p. 13). It has pledged to strengthen the capacity of teachertraining colleges to train teachers to ‘‘address special needseducation’’ and is working with KISE in the training of SNETs.

Of note from this study is that while all respondents reportedhaving undertaken some credited training, the bulk of the teachersreceived their training on the 3-year distance education diplomathat is delivered through Teacher Training Centres (TTCs) acrossKenya. This training replaced a traditional face to face taught 2-year diploma course designed specifically to produce qualifiedteachers trained to support children in specific areas of disabilitysuch as visual impairment. There are a number of DistanceEducation Diploma courses preparing teachers to work with arange of children with SEN (e.g. autism, learning disabilities) but asof 2010 no courses specialise in visual impairment (KISE, 2008).

Clearly not all children with visual impairment will requireregular intensive support from a specialist teacher. Often withsome simple adaptations to learning materials (such as access topersonalised copies of blackboard materials) and relatively smalladaptations to the delivery of curriculum (such as access to hand-held magnifying glasses to read textbooks) then children and theirteachers will quickly move to requiring occasional monitoringvisits. This type of advisory support should be well within thecapabilities of a generically trained SEN teacher. However,evidence from other developing countries (e.g. Best and McCall,1993) suggests that blind children present a particular challengefor teachers in mainstream settings and require more thanoccasional monitoring visits.

Children with severe low vision and those who are blind requireparticular interventions to support their educational developmentthat are different in nature from those required by children withvision. These interventions are often referred to as forming an‘‘expanded core curriculum’’ that includes the development oftravel skills (orientation and mobility training), self-help andindependence skills, Braille literacy skills, and listening skills (e.g.Douglas and McLinden, 2005; Koenig and Holbrook, 2000; Masonand McCall, 1997). To take Braille as a specific example, teachersrequire not only a detailed knowledge of the Braille code but a clearunderstanding of techniques for the development of literacythrough touch. This issue highlights an important issue relating tothe skills that teachers require to successfully support theeducation of children with complex needs (such as blindness) inlocal mainstream schools. If children who use Braille are to receivetheir education in local schools they will need support fromteachers with specialist knowledge and expertise. It is unlikely thatregular classroom teachers could be trained to this level, and evengenerically trained specialist visiting teachers may be unable tofulfil this role. The problem that faces administrators working incontexts of severe stringency where there is huge demand for SENsupport is whether training specialist teachers focused on specificareas of disability such as visual impairment constitutes efficientuse of resources. Should they accept that children with complexneeds are best educated in specialist provision where they canhave access to specialist expertise and children with less complexneeds should receive their education in mainstream supported bygenerically SEN trained teachers? This has implications for aneducation system that espouses inclusive education, such as inKenya. Disability specific approaches are generally adopted indeveloped industrial countries, but they will generally besupported by additional support staff, e.g. teaching assistants,para-educators (see Koenig and Holbrook, 2000 for a description inrelation to the USA), but are they sustainable in conditions ofstringency?

The question also arises about the level of training that shouldbe available to mainstream class teachers in relation to childrenwith severe low vision. The findings of this study suggest thatchildren with visual impairment receive less than one visit a weekfrom a specialist teacher. For the vast majority of their timechildren rely on instruction from their class teacher. In cases ofmild visual impairment this may be practical but where children

P. Lynch et al. / International Journal of Educational Development 31 (2011) 478–488486

have severe low vision it is unlikely that the class teacher will beable to supply the regular individual support such children require,especially in rural areas where class sizes may be well above 100 inlower primary.

A programme that recognises the need for training of classteachers is currently being piloted and monitored by staff at KISEand other stakeholders (KSB, ICEVI and Sightsavers) in the form ofshort in-service training courses on how to teach children withvisual impairment in local schools. The programme is training 150class teachers in seven KIEP districts, and depending on its impact,could go some way to answering part of the question relating to in-class support and merits further research.

5.3. Curriculum resources and equipment

The availability of resources for assessment and teaching variesbetween ITs in different districts. ITs serving rural areas (mainlyHomabay, Trans-nzoia and parts of Nakuru) have less access tolearning and teaching materials than their urban counter-parts inNairobi. Much depends on whether the IT can access a resourcecentre to source materials such as card and coloured paper and feltpens to make flashcards and worksheets for children with lowvision. ITs seem generally to be making effective use of localmaterials to support low vision children’s learning in the classroombut issues relating to inadequate supplies of textbooks surfacewhere students with low vision have to share texts with one ormore students. ITs do not necessarily have access to specialisedteaching materials and outside large population centres, andaccess to mechanical Braille writers (such as the Perkins Brailler) israre.

ITs visiting children with low vision often raised in theirjournals the need for more appropriate learning materials andspecifically for books in ‘large print’. Currently there do not seem tobe any textbooks in large print available in schools and some ITstake it upon themselves to enlarge curriculum materials forchildren. An IT in Nakuru, for example, decided to take coursebooks in a range of subjects to the resource centre to be ‘enlarged’during the August school holiday. Clearly where children are givenindividual worksheets or flashcards in lessons, it is important toensure that they are provided in clear, large handwriting. However,the transcription by hand of complex textbooks is unsustainableand does not appear to constitute an efficient use of ITs’ time. Inmany cases the effective provision and training in the use of simplelow vision devices such as a magnifying glass will obviate the needfor enlarged texts. More sophisticated electronic magnifyingdevices such as closed circuit television (CCTV) magnifiers appearlimited to the resource centres in Nairobi and, in any case, areunlikely to be effective in village schools where electricity suppliesare often unreliable or unavailable.

5.4. Managing caseloads

The continued drive for UPE means that schools are straining tomanage dramatically increased enrolments. There is evidence fromthe research that increased classroom sizes and shortage ofexperienced staff make head teachers reluctant to release teachersfrom their regular teaching responsibilities to undertake their ITduties, and make fellow teachers more hesitant to cover for them.This is one of the factors that may account for relatively smallnumber of visits carried out by some ITs and suggests thatcontinuous monitoring is necessary to ensure that head teachersunderstand the nature of their responsibilities in relation to ITs ontheir staff.

Even the most experienced ITs who manage to maintain theirfull quota of visit days seem to face difficulties in caseloadmanagement. Deciding the balance between monitoring a child’s

progress, enabling others to support the child and providing directlearning support to the child is a major challenge. Decisions aboutthe level of support required by children often seem arbitrary andappear to be largely determined by the demands that the IT mayhave elsewhere. There is a danger that ITs take on responsibilitiesfor the child that should be the class teacher’s thereby removingany sense of ‘ownership’ of the child that the class teacher mightfeel. However the expanding developments in the role of the SNETcould help alleviate this problem by increasing the specialistexpertise available within local schools. The MOEST is committedto training SNETs (who undergo shorter training course of up to 3months in a specialist area) but constraints on financial and humanresources make this a long term development. The widespreadtraining of SNETs will require extra funding by the MOEST andsuitably qualified teachers who already posses a Primary TeacherEducation Certificate with a minimum of at least 2 years teachingexperience.

From the journal accounts there does not seem to be anyevidence of guidelines providing advice to ITs on determining thelevel and type of support a child should receive. The developmentof indicators that might help ITs or their managers (CITs) todetermine the level of support individual children need might helpITs to target their work more effectively. These indicators mayinclude factors such as the degree and nature of the visual loss; thechild’s location; the level of the child’s academic skills and theexpertise available within the school. It might be possible todevelop a prioritisation formula based on an assessment of need(perhaps using a colour coded system such as red for urgent andamber for less urgent). Since needs will change, any such a formulashould be regularly updated and guidelines would need to beflexible enough to accommodate district variations (e.g. ruralversus urban, travel time from teachers base, etc.) The question ofhow caseloads are allocated to ITs and what would constitute amanageable allocation are among the issues that need to beaddressed if services are to function effectively.

It is particularly noticeable from the data that ITs reporteddifferent levels of engagement with children who are blind. InTrans-nzoia, for example, some are visiting schools to discussteaching Braille with classteachers; others are working directlywith the child. Four out of the eight ITs in this district had blindchildren on their caseloads. Half of the 12 blind children receivedbetween one and four visits over the 2-month period, the rest didnot receive any visits at all. Posting an IT to a school where there isa blind child is perhaps one way to ensure more support for thatchild although this would restrict the reach of the IT service.

Whilst it is clearly unrealistic to define a generic minimum ormaximum caseload size, setting guidelines about the managementof caseloads for ITs needs to be established centrally at theplanning stage of services. Such planning should account for thedifferent needs of children (e.g. Braille readers versus low vision)and urban/rural contexts (the findings illustrate the large amountof time many ITs must give to travel particularly in rural areas).

6. Conclusion

Harber and Davies (1998) argue there is ‘a danger that instressing the problematic context of education in developingcountries too negative a picture will be painted’ highlighting that itis ‘important to bear in mind that considerable progress has beenmade in developing countries in a whole range of fields over thepast two or three decades’ (p. 10). This is certainly the case in thecontext of the inclusive educational practices reported in this studyand illustrates the central role of itinerant teaching support forchildren with visual impairment in Kenya. In addition to providingimportant information about local practices in relation tosupporting children with visual impairment in local schools, this

P. Lynch et al. / International Journal of Educational Development 31 (2011) 478–488 487

study also raises a number of key questions about barriers tolearning and development facing children with SEN in mainstreamschools in many parts of the developing world. The questions areparticularly challenging in relation to the education of childrenwith more complex SEN. This would include children in localmainstream schools who are blind and require access to Braille:How can blind children in local mainstream schools be sufficientlysupported to ensure they develop the skills necessary to follow thecurriculum at the same rate as their peers? How can teachers beenabled to develop and maintain the skills required to supportchildren successfully? Is it realistic to expect class teachers to teachspecific skills to blind children in the absence of the specialistsupport? How can specialist resources such as Braille textbooks besuccessfully supplied to local schools? What is the role of resourcecentres and special schools in a system committed to inclusion?

A number of these questions are being addressed in a relatedstudy being undertaken by VICTAR, Sightsavers and the Malawigovernment, which builds on the research in Kenya and explores inmore detail the specific case of children who are Braille users inlocal mainstream schools (Lynch and McCall, 2010). One of theemerging findings from the research in Kenya is the extent of thechallenges facing ITs in supporting those children who are Brailleusers in local mainstream schools. As Malawi also has anestablished itinerant teaching system for educating children withvisual impairment, it would be useful to conduct further researchto help answer these questions.

A focus on the plurality of knowledges in a variety ofinstitutions and locations was considered to be particularly helpfulin investigating the wide-ranging work of practitioners involved insupporting the education of children with complex needs in localmainstream schools. Further, the PAR approach adopted for thisstudy has been helpful in encouraging the sharing of ‘knowledges’through ‘action-oriented’ research involving researchers andparticipants working together to bring about change. This studyrevealed that ITs had had little experience of recording their worksystematically and the study has revealed the potential of buildinginto the role of ITs the collection of data that can feed into themanagement and development of the service.

An important aspect of the work was that it provided a space forITs to voice their concerns to administrators and managers and toensure their views were translated into tangible outcomes whichlead to improvements in their effectiveness analysis of the journalsrevealed limited reflective content and much of the informationprovided by participants was largely descriptive in style. Onreflection this was an area that could have been addressed moreexplicitly in the workshop, since it appears that participants needto be confident in the managing the factual elements of the journalkeeping before they can be asked to adopt a more reflective writingapproach. Similar experiences were found in a study conducted inTanzania by Otienoh (2010) who reports evidence of teachers notbeing able to move away from the descriptive to deeper analyticallevels of reflection when exploring their perceptions of thefacilitators’ feedback on their journal entries.

Encouragingly a follow-up assessment conducted by Sightsa-vers in 2008 in two of the five districts participating in this study(Nakuru and Embu) revealed that the research had helped improveITs practice particularly in relation to record keeping. The follow-up report confirmed that ITs were keeping their records up-to-dateand that the ‘frequency of visits by the ITs and the outputs werebeing recorded systematically’ (KIEP, 2008, p. 5). The CITs and ITshave continued to maintain detailed case files with relevantclinical and educational information and there was evidence ofappropriate interventions, e.g. in most instances children hadaccess to low vision devices and spectacles (p. 6). The reportconcludes that the majority of the children in the programme nowhave confirmed diagnoses and in most instances are deemed to be

receiving services which are ‘enabling them to participate andlearn’ (p. 8).

References

Ainscow, M., Booth, T., Dyson, A., 2004. Understanding and developing inclusivepractices in schools: a collaborative action research network. InternationalJournal of Inclusive Education 8 (2), 125–140.

Ainscow, M., Miles, S., 2008. Making education for all inclusive: where next?Quarterly Review of Comparative Education 145, 15–34.

Benton, S., 1984. Supporting visually impaired children in ordinary school. BritishJournal of Visual Impairment 2 (1), 3–7.

Best, T., McCall, S., 1993. Planning mainstream education services for childrenwith visual impairments in developing countries. In: Mittler, P., Brouillette,R., Harris, D. (Eds.), Special Needs Education: World Yearbook of Education1993. Kogan, London, pp. 65–75.

Booth, T., Ainscow, M., Black-Hawkins, K., Vaughan, M., Shaw, L., 2000. Index forInclusion. Centre for Studies on Inclusive Education, Bristol.

Chandna, A., Gilbert, C., 2010. When your eye patient is a child. Community EyeHealth Journal 23 (72), 1–3.

Douglas, G., McLinden, M., 2005. Visual impairment. In: Lewis, A., Norwich, B.(Eds.), Special Teaching for Special Children? Pedagogies for Inclusion. OpenUniversity Press, Milton Keynes.

Dyer, C., 2005. Cross-cultural collaborative action research and practitioner devel-opment. In: Hammett, D., Wedgwood, R. (Eds.), The Methodological Challengesof Researching Education and Skills Development in Africa. Centre of AfricanStudies, Edinburgh.

Dyson, A., 2004. Inclusive education: a global agenda? Japanese Journal of SpecialEducation 4 (16), 613–625.

Fals-Borda, O., Rahman, M.A. (Eds.), 1991. Action and Knowledge: Breaking theMonopoly with Participatory Action-Research. ITCG Publications, London.

Gogate, P., Gilbert, C., 2007. Blindness in children: a worldwide perspective.Community Eye Health Journal 20 (62), 32–33.

Harber, C., Davies, L., 1998. School Management and Effectiveness in DevelopingCountries: The Post-bureaucratic School. Continuum, London.

International Council for Education of People Visual Impairment, 2005. An Investi-gation into the Educational Inclusion of Children with Visual Impairment inUganda. ICEVI.

Kenya Integrated Education Programme, 2008. Kenya Integrated Education Pro-gramme Follow-up Assessment. Sightsavers International.

Kenya Institute of Special Education, 2008. List of Diploma and Certificate Courses. ,Available:.http://www.kise.co.ke/index.php?option=com_content&view=arti-cle&id=48&Itemid=137 (accessed 12 February 2010).

Kilonzo, M., 2008. Inclusive Education in Kenya: Challenges and Opportunities.Taken from Proceedings of the Fourth Africa Forum on Social Inclusion. Insti-tutional Development Programme (IDP).

Kindon, S., Pain, R., Kesby, M., 2007. Connecting people, participation and place. In:Kindon, S., Pain, R., Kesby, M. (Eds.), Participatory Action Research Approachesand Methods: Connecting People, Participation and Place. Routledge, London,pp. 1–32.

Koenig, A., Holbrook, M.C., 2000. Foundations of Education. Volume II: InstructionStrategies for Children and Youths with Visual Impairment, 2nd edition. AFB,New York.

Lynch, P., McCall, M., 2007. The role of itinerant teachers. Community Eye HealthJournal 20 (620), 26–27.

Lynch, P., McCall, M., Douglas, G., 2007. The Role of the Itinerant Teacher in Kenya:Evidencing Practice. University of Birmingham.

Lynch, P., McCall, M., 2010. Impact of educational inclusion on children with visualimpairment in Malawi. The Educator 22 (2).

Mason, H., McCall, S., 1997. Visual Impairment: Access to Education for Children andYoung People. David Fulton Publishers, London.

Ministry of Education, Science and Technology, 2002. Certificate: Vision SupportTeacher In-Service Training Curriculum. KISE, Nairobi.

Ministry of Education, Science and Technology, 2005.In: Kenya Education SectorSupport Programme 2005–2015, Nairobi, Kenya.

Ministry of Education, Science and Technology, 2008. Ministry of Education: SpecialNeeds Education Policy. Ministry of Education, Science and Technology, Nairobi,Kenya.

Otieno, W., Colclough, C., 2009. Financing Education in Kenya: Expenditures. Out-comes and the Role of International Aid. RECOUP. University of Cambridge.

Otienoh, R., 2010. Feedback on teachers’ journal entries: a blessing or a curse?Reflective Practice 11 (2), 143–156.

Peters, S., 2007. Inclusion as a strategy for achieving education for all. In: Florian, L.(Ed.), The Sage Handbook of Special Education. Sage, London.

Rambla, X., Ferre, F., Tarabini, A., Verger, A., 2008. Inclusive education and socialinequality: an update of the question and some geographical considerations.Quarterly Review of Comparative Education 145, 65–76.

Spragg, D., Stone, J., 1997. The peripatetic/advisory teacher. In: Mason, H., McCall,S., Arter, C., McLinden, M., Stone, J. (Eds.), Visual Impairment Access toEducation for Children and Young People. David Fulton Publishers, London.

Spungin, S.J., Taylor, J.L., 1986. The teacher. In: Scholl, G.T. (Ed.), Foundations ofEducation for Blind and Visually Handicapped Children and Youth. AmericanFoundation for the Blind, New York.

P. Lynch et al. / International Journal of Educational Development 31 (2011) 478–488488

Stubbs, S., 1999. Engaging with difference. In: Stone, E. (Ed.), Disability andDevelopment. Learning from Action and Research on Disability in the MajorityWorld. The Disability Press, Leeds.

UNESCO, 2009. EFA Global Monitoring Report. Overcoming Inequality: Why Gov-ernance Matters. UNESCO, Paris.

World Bank, 2009a. Six Steps to Abolishing Primary School Fees: Operational Guide.The World Bank, NY.

World Bank, 2009b. Abolishing School Fees in Africa: lessons from Ethiopia, Ghana,Kenya, Malawi and Mozambique. The World Bank, NY.

World Vision, 2007. Education’s Missing Millions: Including Disabled Children inEducation through EFA FTI Processes and National Sector Plans. World Vision,UK.