Promoting the rights of Children with disabilities innocenti digest no

internats
), although only 11 per cent of 
them were orphans, and a further 30,000 children 
with severe physical and intellectual impairments, 
half of whom were orphans, were cared for outside 
the education system in 151 boarding homes run by 
social protection agencies. A further 20,000 young 
children, mostly abandoned, lived in 249 infant homes 
run by health authorities.
55
The practice of institutionalization is by no means 
restricted to Central and Eastern Europe and the CIS. 
Recent reports examine conditions in institutions, for 
example in Latin American countries,
56
as well as in 
the Middle East and South-Eastern Europe.
57
For countries with a strong tradition of institutional 
provision, a major priority must be to develop 
appropriate services and financial supports in the 
community, especially to prevent abandonment and 
neglect.Wherever possible, if children cannot live 
with their own families they should be in alternative 
family situations, that is, living in ordinary homes 
in the local community. These families should be 
supported by experienced professionals and should 
be financially rewarded for their work and care. 
The children should receive appropriate education 
tailored to their needs, preferably in a regular school 
with appropriate support or, failing that, in a special 
class or special school. Continuing contact with the 
natural family needs to be maintained, with a view 
to their resuming care for the child at some point 
in the future, this time with additional support from 
professionals in the community. In the meantime 
professionals like these should be recruited and 
trained. In many cases there is scope to increase 
the capacity and involvement of other existing social 
networks, including faith-based groups and trade 
unions, in support of such initiatives.
Many countries in Central and Eastern Europe and the 
Baltic States have begun to address these problems 
and to develop alternatives to institutional care, such 
as adoption, fostering and guardianship. However, 
the pressure for institutional placement remains 
strong. Outside this region, a number of countries 
have closed all their residential institutions for children 
with disabilities and developed the kind of provision 

---

19
Promoting the Rights of Children with Disabilities
Innocenti Digest No. 13
summarized above. Others are in the process of 
doing so, not only for children but also for younger 
and older adults with disabilities. As described more 
fully below, in addition to creating alternatives to 
institutional care, effective mechanisms of social 
protection need to be put in place that reach the 
most vulnerable families and caregivers.They include 
educational and health care support, including fee 
waivers, provision of day-care facilities and home-
based care, material support to families living with 
disability (tax breaks, cash transfers, in-kind support), 
counselling and social work services.
In the meantime there is much that can be done 
to create better conditions within the institutions. 
Accommodation can be altered to enable children 
to live in small family groups and to be looked after 
by staff who act as consistent surrogate parents 
in environments that resemble an ordinary home 
to the greatest possible extent. National standards 
of care can also be established and rigorously 
monitored through an independent inspectorate, as 
recommended by international standards, including 
the CRPD.
The training and support of residential care staff 
is of paramount importance in this process. It is 
not surprising that totally inadequate numbers of 
untrained and unsupported staff working in very poor 
conditions will resort to institutional methods of block 
treatment that leave children without toys, stimulation 
or personal attention. Given additional resources and 
training, however, staff can adopt more humane and 
child-centred approaches to caring for children. 
The provision of high quality and well-staffed 
educational facilities in all remaining institutions 
should be a high priority, so that children are given 
an effective opportunity to enjoy their rights to 
education, regardless of where they are living.