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Submission to National Inquiry

into Children in Immigration Detention from the

Multicultural Disability Advocacy

Association of NSW

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Acknowledgements

This submission to

the Human Rights and Equal Opportunities Commission's Inquiry into Children

in Immigration Detention Centres is the result of the work and contributions

of many people.

Most of all we would

like to thank the individual refugees for sharing their experiences with

us.

We also would like

to thank all the individuals from across many different agencies, sectors

and across communities who gave up time and contributed their knowledge

to this submission.

Over 25 people from

across Australia contributed to this submission and their knowledge of

the different areas either through personal experiences, through their

work as visitors to or workers in the centres, as lawyers for people in

the centres, as ethnic community workers once people live in the community,

as disability workers, etc. made this submission possible.

Whilst some people

were happy to be named as contributors to this submission, others were

not and others felt that they could not be named. Therefore we have decided

no individual and no individual agency would be identified as contributors.

MDAA would like to

thank everyone who contributed and we hope that this submission will assist

with getting children out of immigration detention centres.

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Article 23 (1),

Convention on the Rights of the Child

States

Parties recognise that a mentally or physically disabled child should

enjoy a full and decent life, in conditions which ensure dignity, promote

self-reliance and facilitate the child's active participation in the community.

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1. Principle Statement

We

state unequivocally that children and their families do not belong in

immigration detention centres and that all children and their families

need to be released immediately from those centres.

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Article 23 (3),

Convention on the Rights of the Child

States Parties shall ensure that the institutions, services and facilities

responsible for the care or protection of children shall conform with

the standards established by competent authorities, particularly in the

areas of safety, health, in the number and suitability of their staff,

as well as competent supervision

Article 22 (1),

Convention on the Rights of the Child

States Parties shall take appropriate measures to ensure that a child

who is seeking refugee status or who is considered a refugee in accordance

with applicable international or domestic law and procedures shall, whether

unaccompanied or accompanied by his or her parents or by any other person,

receive appropriate protection and humanitarian assistance in the enjoyment

of applicable rights set forth in the present Convention and in other

international human rights or humanitarian instruments to which the said

States are Parties

Whilst we believe

the detention centre environment is harmful for all children, we are particularly

concerned that children with disability and unaccompanied minors are especially

vulnerable in the detention environment.

2. Recommendations

2.1 Principle

We recommend that the principle stated above be applied to all children

with disability and their families in immigration detention centres.

In addition, based

on the issues outlined below, we put forward the following recommendations:

2.2 Establish

alternatives to detention

Considerable work has been done by a range of organisations and individuals

to develop viable, less expensive and more humane alternatives to the

current detention regime.

2.2.1

MDAA supports proposals, such as those put forward by the Refugee Council

of Australia, which include a short period of closed detention and then

open detention and/or community release.

2.3 Urgent changes

needed to make the current system better

In order to protect and maintain the rights of children with disability

in detention centres now, MDAA recommends the following immediate changes:

2.3.1

All children have an initial examination by independent experts (including

medical experts, psychologist, physiotherapist, speech therapist, and

other allied health professionals) with expertise in the various areas

of child health and development to detect possible congenital and acquired

disabilities. All these examinations need to be accompanied by a qualified

interpreter who is not only trained in health interpretation, but has

also undertaken training in the area of disability.

2.3.2

In order to ensure access to the above mentioned specialists and to

ensure the assessments are of high quality all children and their families

need to be detained in metropolitan immigration detention centres.

2.3.3

Once a child has been identified as having a disability, that child

and their family are moved to a detention centre located in one of the

capital cities to facilitate access to specialist services and expertise

and ensure that the quality of assessment of the child's needs is not

compromised. Access to those services can be provided either in the

detention centre or, if more appropriate for the child's best interests,

in facilities in the community.

2.3.4

The parents are involved in all aspects of the child's' 'treatment'.

2.3.5

All detention centre facilities are made accessible for people with

disability, consistent with

State standards and the provisions of the Disability Discrimination

Act 1992.

2.3.6

All detention centre education is provided in a manner accessible to

children with disability,

by qualified education professionals with training in special education.

2.3.7

Good dental care is provided to children with disability in detention.

2.3.8

All detention centre staff undergo training in disability issues.

2.3.9

All instruments of restraint (including the use of 'observation rooms')

as outlined in the Immigration Detention Standards 7.10, be prohibited

in relation to children.

2.3.10

Incidences which for adults would involve the use of observation rooms,

will trigger a review as outlined in 2.3.1

2.4 Independent

monitoring, review and establishment of an independent guardian

The Minister for Immigration, Multicultural and Indigenous Affairs

is the guardian of all unaccompanied minors in detention centres. MDAA

believes this creates a conflict of interest for a Minister responsible

for both administering the Government's immigration detention policies

and promoting the best interests of children detained under those policies.

Similarly, DIMIA

is responsible for appointing a contractor (ACM) and monitoring the detention

services the contractor provides. There is an inherent conflict of interest

in these two roles: DIMIA has a vested interest in ACM being seen to perform

the contract well and this may adversely affect the way it monitors that

performance.

The following recommendations

introduce measurable standards that DIMIA would be obliged to monitor

to ensure ACM's compliance with them. These measurable standards would

increase ACM's accountability. To reduce these conflicts and as DIMIA

and ACM do not have the specialist training or expertise needed to deliver

services to children with disability, MDAA recommends:

2.4.1

The responsibility and guardianship over children is transferred from

the Minister for

Immigration, Multicultural and Indigenous Affairs to the Minister for

Children and Youth

Affairs, who has responsibilities under the Family and Community Services

portfolio.

2.4.2

Regular monitoring and review of children in detention centres is undertaken

by independent experts (including medical experts, psychologist, physiotherapist,

speech therapist, and other allied health professionals) with expertise

in the various areas of child health and development. All these examinations

need to be accompanied by a qualified interpreter who is not only trained

in health interpretation, but has also undertaken training in the area

of disability.

2.4.3

Once a child with a disability has been identified, an independent,

external case manager is appointed (i.e. through the appropriate State/Territory

authorities). The case manager should work with the detention centre

contractor's health and education staff to monitor implementation of

any programs recommended.

2.4.4

Once a child with a disability has been identified, the child has access

to an 'external guardian' or advocate who liases with the family and

whose main role is to ensure that the best services and options are

available to the child. (This is not to replace the parents as the guardians,

but to ensure that the relative powerlessness of the parents is not

reflected in bad services and loss of opportunities for the child.)

The Refugee Council of Australia in their submission on unaccompanied

minors has put forward a model which could be modified to be also used

in relation to children with disabilities.

2.5 Transparent

complaints processes

Given that the current complaints mechanism as outlined in Immigration

Detention Standard 7.11 is inadequate, we recommend:

2.5.1 All

children with disability in detention centres and their families have

access to effective complaints mechanisms. These complaints mechanisms

could be those used by the relevant State/Territory agencies in relation

to all people with disability, and more general complaints mechanisms

available to all people accessing services provided by that State/Territory.

2.5.2 Information

about complaints processes is available in all languages read at a Detention

Centre at any point in time.

2.6 Temporary

Protection Visa (TPV) holders

Because families with children with disability have no chance of

coming to Australia through the onshore program, we recommend:

2.6.1

Families with children with disability, once successful in their application

for refugee status, are given a Permanent Protection Visa as a special

needs group, to ensure access to the full range of Commonwealth (Disability

Support Pension, Carer's Pension, family reunion, etc) and State funded

services and to ensure care is provided commensurate with Australian

standards.

2.7 Legislative

changes

To ensure that children with disability are protected in line with

the conventions and obligations Australia is signatory to, we recommend:

2.7.1

Removal of the exemption of the Migration Act from the Disability Discrimination

act

2.7.2

Incorporation of international conventions to which Australia is signatory

into domestic law.

2.7.3

Creation of a 'Bill of Rights' accessible to all people living in Australia.

3. About MDAA

The Multicultural

Disability Advocacy Association of NSW (MDAA) is the peak body in NSW

for people from a non-English speaking background (NESB)[1]

with disability and their families and carers.

MDAA is the only

advocacy service in NSW available specifically to people from NESB with

disability, their families and carers.

MDAA is working towards:

• Promoting, protecting

  and advocating for the rights of people from a NESB with disability

  and their families and carers in NSW; and
  

• Contributing

  to a process that ensures the implementation of access and equity for

  people from a NESB with disability and their families and carers in

  NSW in the government and non-government sectors.

4. Scope of this

submission

The focus of this

submission is on children with disability, including all disabilities

except psychiatric disabilities/ mental health conditions. The reason

for excluding children with mental illness from this submission is not

that we don't believe this to be a major issue. In fact, we believe the

mental health of children in detention centres is a major area of concern.

However, there has been significant focus on the mental health of children

and we understand that there will be a range of submissions forthcoming

which focus on this specific aspect.

This submission is

specifically concerned with children with other disabilities, namely children

with intellectual disability, physical disability, sensory disability,

brain injuries, etc. and unless stated otherwise, wherever we refer to

children with disability in this submission we specifically exclude children

with psychiatric disabilities/ mental health conditions.

Furthermore, this

submission will not focus on the prevention of disability in immigration

detention centres, but the scope will largely be limited to identifying

the consequences of having children with disability locked up in immigration

detention centres, in a prison-like environment without adequate services

and facilities. Finally, this submission focuses on immigration detention

centres on Australia's mainland.

This submission brings

together experts from the field of disability who provided their professional

advice on the issues raised and some of case studies included.

5. The case studies

The purpose of the

case studies is to illustrate a particular area of concern in relation

to children with disability in immigration detention centres, not to highlight

the plight of a particular individual. In addition, MDAA is particularly

concerned to ensure that any individual's identity remains anonymous.

Therefore the case studies used in this submission have been developed

in four ways:

Firstly, some of

the case studies used in the submission are based on 'stories' given to

MDAA to be used in this submission. To ensure people's anonymity, we have

made changes to disguise the individual's identity (such as gender, nationality,

disability, etc.). Secondly, some case studies have been developed out

of conversations and anecdotal evidence and again efforts have been made

to disguise the identity of the individuals. Thirdly, some case studies

are composites, made up of different cases and anecdotal evidence. Lastly,

a small number of the case studies are hypothetical, based on the likelihood

of such a situation occurring.

MDAA's concern is

with the validity of the issue raised and the consequences of not identifying

and not dealing with these issues within the immigration detention centres.

To clarify this point, the case study below about the unavailability of

a modified spoon which would assist Declan to feed himself is used as

an illustration that specialist and modified equipment is often not available.

Whether every detail of the case study is based on a detainee's experience

is irrelevant to the point being made.

6. Number of children

in immigration detention centres on the Australian mainland

On the 18th of February

2002, DIMIA made the following information available to the National Ethnic

Disability Alliance (NEDA):

1. As of the 1st

February 2002 a total of 378 children were residing in detention centres

on the Australian mainland.

2. As of the 5th

February 2002 a total of 16 (or 4.2%) children with disability were

residing in detention centres. Children with disability are currently

located at Port Hedland, Curtin and Woomera detention centres.

3. The types of

disability affecting these children include cerebral palsy, hearing

impairment, vision impairment, acute dwarfism, trauma, Perthes disease

and cardiac, asthmatic and genetic (including Fragile X) disabilities.

It appears that DIMIA

did not identify any children with cognitive and other 'non- visible'

disabilities. MDAA has great concerns about disabilities not being identified

and detected (see below). Through our discussions with people, we have

been told of children with other disabilities than those identified by

DIMIA. MDAA believes the DIMIA figures underestimate the number of children

with disability, particularly as 'trauma' is included by DIMIA in the

category of disability.

There are several

factors which need to be taken in account when estimating the number of

children with disability in immigration detention centres. These factors

are based on:

6. 1. Available

Australian data:

Whilst any disability

data is to be treated cautiously, the following data about children and

disability appears to be reliable as 'guiding' data:

• According to

  the Australian Bureau of Statistics (ABS) (1998, p15), within the Australian

  population 3.7% of children aged 0 - 4 years have a disability, and

  9.5% of children aged 5 - 14 years have a disability. This ABS report

  doesn't provide a breakdown of "disability types": instead

  it classifies disability according to level of activity restriction.

• ABS recently estimated

  (ABS 2001) that 7% of the NSW school population (aged 5 - 19 years)

  had a disability and, of this group, three quarters had a schooling

  restriction including attending a special school or class.

• Of the dependent

  children in NSW, roughly half were more restricted by a physical condition

  (52%) than a mental or behavioural disorder (48%). Of children with

  disability aged between 5 and 14 years in NSW, an estimated one third

  had an intellectual / developmental disorder.

• According to a

  1994 survey of families in the USA, 18% of children younger than 18

  years of age had a chronic physical, developmental, behavioural, or

  emotional condition and required more than the usual level of health

  and related services (Newacheck et al 1998 cited in Nickel 2000, p2).

  Nickel (2000, p100) also notes that the prevalence of intellectual disability

  in children is generally agreed to be at 2 - 3% of the US population.

6. 2. Incidence

of disability in country of origin, incidence of disability amongst refugees

and lack of access to services in country of origin and during the duration

of being a refugee:

According to the

WHO (1981), refugee children are at increased risk of disability, including

developmental disabilities, as a result of:

• maternal malnutrition;
• inadequate antenatal

  and obstetric care;

• malnutrition;
• vitamin deficiencies,

  especially vitamin A and D;

• lack of immunizations

  eg. polio;

• burns and other

  accidents;

• injuries related

  to armed conflict, torture and other severe trauma;

• complications

  from pneumonia and gastroenteritis;

• severe ear and

  eye infections;

• lack of infant

  screening for congenital defects; and

• reduced surveillance

  of development especially vision and hearing.

Many of the children

currently in immigration detention centres would have been exposed to

those increased risks. Little 'hard' evidence is available, but it has

been found that the rate of congenital malformations in Iraq has risen

dramatically over the last decade (Wareham S. 2002). Dr Shant Raman, a

paediatrician who visited Villawood unofficially, reported that there

were many young babies and toddlers who had developmental delay (ABC Lateline

19 03 2002). Developmental disabilities may be higher in some detention

centre populations because of inter-marriage of first and second cousins

in some cultures.

6. 3. Australia's

refugee policies

Australia's off-shore

program excludes close family members on health grounds. As a result,

those who have a child with a disability are unable to bring their family

through the conventional resettlement program. There is no 'queue' these

families can join. It can therefore be argued that current policies and

programs force families with a child with disability into the hands of

'people smugglers', exposing them to the dangers of clandestine travel

and leaving them no option but to try their luck as 'on-shore' asylum

seekers. This means that unlike families with children without disability

who can apply for refugee status, these families have really no other

option than to come as 'illegal entrants' and spend time in an Australian

detention facility. The vast majority of these people will only ever be

eligible for a temporary protection visa.

Based on those factors

we conservatively estimate the number of children with disability currently

in immigration detention centres (based on figures given to us by DIMIA)

to be about 30 or about 8% of all the children currently in immigration

detention centres on the Australian mainland.

It is important to

note however, that irrespective of how many children with disability there

are in immigration detention centres, these children ought to be treated

in accordance with the Convention on the Rights of the Child to which

Australia is signatory. DIMIA's letter to NEDA assures NEDA that 'all

necessary steps are taken to ensure that the needs of these children are

met'. Below we will demonstrate that this is not the case and that the

needs of children with disability are largely not identified or met.

7. The Legislative

Framework

The current legislative

framework and the lack of enforceable legislation lie at the heart of

many of the problems identified in this submission.

7.1 The Commonwealth

Disability Discrimination Act

"The Australian

government has recognised its obligations under international law to eliminate

discrimination against people with disabilities, and has enacted domestic

legislation making such discrimination unlawful. The Disability Discrimination

Act 1992 (Cth) (the DDA) prohibits direct and indirect discrimination

against people on the ground of their disability" (HREOC, National

Inquiry into Children in Immigration Detention, Background paper 5).

Whilst the DDA applies

to all Commonwealth, State and Territory agencies, it does not

(a) affect discriminatory

provisions in the Migration Act 1968 or any regulation made under that

Act; or

(b) render unlawful

anything done by a person in relation to the administration of that

Act or those regulations." (DDA, 1996)

MDAA understands

that the current interpretation of the exemption of DIMIA from the DDA

effectively means that all DIMIA run and funded agencies (such as ACM)

and activities relating to the administration of the Migration Act are

exempt from the DDA. By contrast, we believe the purpose of the exemption

was largely to prohibit the immigration of people with disability, whose

disability may constitute a cost to the community. Applying the exemption

well beyond that purpose surely goes beyond the original intent of the

legislation and stretches the definition of what is the administration

of an Act beyond its legally intended meaning.

7.2 Compliance

with International Conventions

As many of the international

conventions are not incorporated in Australian domestic law, they are

not enforceable. Compliance with international conventions is not built

into current legislative structures, but left to individual courts. There

is also no Bill of Rights which would strengthen the use of international

conventions within the Australian legislative framework.

8. The situation

in on-shore Immigration Detention Centres

Children with disability

have all the needs that ordinary children have and by definition many

of these are unable to be met in the confines of a detention centre. Children

with disability have a number of additional needs that are particularly

compromised by their life in detention. This section of the submission

seeks to highlight some of these additional needs and how not meeting

them is a breach of Australia's human rights obligations.

8.1 Non-detection

and non- identification of children with disability; lack of early intervention,

Article 23 (3), Convention on the Rights of the Child

Recognising the special

needs of a disabled child, assistance … shall be designed to ensure

that the disabled child has effective access to and receives education,

training, health care services, rehabilitation services, preparation for

employment and recreation opportunities in a manner conducive to the child's

achieving the fullest possible social integration and individual development,

including his or her cultural and spiritual development.

Article 23 (2),

Convention on the Rights of the Child

States Parties recognize

the right of the disabled child to special care and shall encourage and

ensure the extension, subject to available resources, to the eligible

child and those responsible for his or her care, of assistance for which

application is made and which is appropriate to the child's condition

and to the circumstances of the parents or others caring for the child.

In general, experts

agree that a lack of early identification and appropriate intervention

is likely to lead to:

• delayed development;
• poor health;
• development of

  patterns of movement and behaviour that inhibit functional patterns;

• impaired learning

  and development;

• increased physical

  deterioration (especially for children with cerebral palsy) including

  abnormal postural development; muscle shortening; contractures and deformities;

  decreased mobility; decreased motor abilities;

• increased need

  for adaptive/ specialised equipment which is costly and ongoing (as

  a result of non-identification and increased physical deterioration)

  including such items as customised wheelchairs; specialised seating;

  modified bathing/ bed items; technological support; hand/ arm/ leg splints;

• increased communication

  and behavioural support needs (especially for children with autism or

  intellectual disability) with poor communication, lack of speech/ oral

  development and onset of irritability, self-stimulating/ repetitive

  and non-compliant behaviours, as a result of increased self-care needs/

  decreased attainment of independence in self-care/ personal hygiene

  skills, resulting in increased long-term responsibilities for caregivers;

• increased financial

  costs re long-term 'burden of care', on the caregiver, the community

  and future government agencies;

• family breakdown/

  severe stress/ severe impact on other siblings in the family;

• long-term social/

  emotional problems;

• nutritional/ diet

  concerns/ consequences in non-identified children with disabilities

  can also involve the development of Type 1 diabetes (especially in under-nourished

  communities); the increased rate of oesophageal cancer in Iranian populations;

  the impact of vitamin A deficiencies in refugee populations (eg, vitamin

  A deficiencies resulting in blindness; vitamin D deficiencies resulting

  in rickets and often prevalent in Asian populations;

• examples of other

  disabilities and the implications if undetected are

  • Praeder-Willie

    syndrome (failure to thrive; poor sucking ability; short stature;

    low muscle tone);

  • short bowel

    syndrome (malabsorption/ anaemia);

  • cardiac disease

    (often associated with disability - growth delay, malnutrition,

    chronic illness);

  • Down syndrome

    (short stature; low muscle tone; cardiac problems; obesity; oral/

    motor problems);

  • cleft lip/

    palate (difficulty sucking; swallowing; breathing; poor growth;

    feeding problems);

  • spina bifida

    (poor sucking; hydrocephaly; feeding problems; orthopaedic/ postural

    problems).

• increased frustration

  and difficult behaviour; and

• increased worry

  and uncertainty for parents.

Children with disability

need early intervention and expert assessment of their conditions and

needs. Children with disability are more vulnerable than the average child

to poor nutrition. Hearing and sight difficulties need to be detected

early to prevent secondary difficulties. Failure to recognise disabilities

can lead to emotional and behaviour difficulties due to unreasonable demands

being placed. Like all children, children with disability need acceptance

and love, a stable environment, and realistic nurturing.

Over 50 years of

research on children with many types of disabilities receiving a range

of specialized services in many different settings has produced evidence

that early intervention can:

• ameliorate and,

  in some cases, prevent developmental problems;

• result in more

  children having a chance to experience a 'meaningful' life;

• reduce costs;

  and

• improve the quality

  of parent, child, and family relationships.

Albert

Albert lived in

an immigration detention centre for almost 1 year from the age of 3. He

basically didn't develop any speech and did not communicate verbally with

anyone. Albert's parents and Albert communicated in a type of sign language

which whilst rudimentary was sufficient to communicate day to day needs.

Albert's parents were worried and they had raised it with the nurse who

checked Albert's ears and told the parents that she thought he was a bit

of a 'slow learner'. For the last 15 months, Albert and his family have

lived in the community and Albert's family has just made contact with

an advocacy agency who is currently trying to organise an assessment for

Albert.

According to Wang

and Baron (1997), social interaction and purposeful communication are

essential for children's emotional health and development. It is important

to identify whether a communication difficulty is part of a general developmental

impairment or an isolated problem. If the former, it is critical to exclude

that the child is affected by a reversible condition such as some metabolic

disorders. Early identification and treatment of children with communication

impairments decreases their frustration and increases the likelihood of

minimising disabling conditions later.

Bega

Bega was born

8 years ago and has spent almost 5 of those years in refugee camps, mostly

in South East Asia, and for the last 6 months in Australia. Unbeknownst

to Bega and her family, she has polio. Over the last three months her

ability to speak clearly and her physical abilities have deteriorated

significantly, but her parents are scared to talk to a medical officer

about it, fearing that this will just make it harder to be successful

in their application for refugee status.

Early intervention

may begin at any time between birth and school age, however, there are

many reasons for it to begin as early as possible. There are three primary

reasons for intervening:

• to enhance the

  child's development,

• to provide support

  and assistance to the family, and

• to maximise the

  child's and family's benefit to society.

Karnes and Lee (1978)

have noted that "only through early identification and appropriate

programming can children develop their potential".

Pellegrino (1998)

identifies that it is often common for the mobility problems of cerebral

palsy to be over-emphasised, even though related cognitive problems may

have a much greater effect on the long-term well-being for a child in

the areas of communication, socialisation and ability to care for themselves.

Unrecognised hearing loss may interfere with language development. Additionally,

children with cerebral palsy are at risk of abnormalities in swallowing

and digestion, which can have significant effects on their growth and

breathing. For musculoskeletal problems, early recognition and timely

referral are important, as conservative treatments introduced at an early

age have a better chance of success and are less costly than more invasive

and complex procedures introduced later.

For children with

autism early intervention support is critical. Hands on early intervention

can make amazing life-long differences for children who are diagnosed

with autism at an early stage. A lot of work is done teaching young children

with autism to interact physically with their families. It is much harder

when a person is older. Like all of us, kids will learn ways that help

them to survive or "win". If these behaviours manifest into

challenging behaviour, an older and bigger child makes it very hard for

parents and specialists to cause breakthroughs.

8.2 Lack of access

to or difficulty in accessing facilities in Immigration detention centres

According to DIMIA

most centres have the following non- medical facilities available to detainees:

• entertainment

  facilities;

• newspapers;
• sports programs/

  activities;

• education;
• induction courses.

Everyone MDAA has

contacted said that there are virtually no education classes happening

anywhere and play facilities are at best limited. At one time there was

1 swing for almost 150 children at Woomera.

Whatever limited

facilities are available to all children, children with disability are

unlikely to access many of those facilities as they have not been made

accessible to children with disability.

It is generally agreed

that when working with children with disability the following five general

principles can be used to guide the selection of effective practices:

• least restrictive

  environment;

• family-centred

  services;

• transdisciplinary

  service delivery;

• inclusion of

  both empirical and value-driven practices; and

• inclusion of both

  developmentally and individually appropriate practices (Christine L.

  Salisbury and Barbara J. Smith, June 1993).

Below we demonstrate

that none of these principles is applied in Australian immigration detention

centres.

8.2.1 Lack of

access to appropriate educational facilities

Article 28 (1),

Convention on the Rights of the Child

States Parties recognize

the right of the child to education and with a view to achieving this

right progressively and on the basis of equal opportunity, they shall,

in particular

(a) Make primary

education compulsory and available free to all

(d) Make educational

and vocational information and guidance available and accessible to

all children.

For all children,

but especially for children with disability, there is a particularly sensitive

learning period between the ages of two and seven. This is when children

learn basic perceptual skills, object reasoning and spatial awareness,

concepts of time, etc. A false environment, such as a detention centre

environment, is not conducive to learning broader skills.

Cecilia

For almost all

of the 1.5 years Cecilia lived with her Mum in an immigration detention

centre, her Mum wanted her to go to the school, but Cecilia was banned

from the school as she was seen as disruptive and too difficult. She used

to walk around and leave the classroom, talk loudly to herself, sometimes

scream for no apparent reason.

If a teacher tried

to 'calm her down' she became very distressed, screamed and bit herself.

The teachers could not cope and asked her Mum not to bring her to school

any more.

To provide Cecilia

with equal opportunity and enable her to learn in the class with the other

students, there needs to be in place:

1. Teachers with

appropriate training. There is not necessarily a need to have teachers

with full special education qualifications, but teachers who have had

some level of in-service training around teaching mixed ability classes;

and

2. Back up for teachers

by consultants with special education training who can assist teachers

to learn to:

• modify curricula;
• utilise teaching

  strategies best suited for mixed ability classes;

• minimise disruptive

  behaviours;

• use teachers'

  aide support, not to isolate the child but to support all children learning

  together.

Appropriately supporting

Celia in the 'school' at the detention centre may provide the following

benefits:

• may help to set

  up mutual support networks among the students;

• may lead to decrease

  in challenging behaviours; and

• will decrease

  anxieties and fears of parents.

The fields of early

childhood and early childhood special education promote the incorporation

of instructional goals and curriculum content into normally occurring

routines in the home, preschool, day-care centre, and kindergarten settings

(Bredekamp, 1987; Rainforth & Salisbury, 1988). Recognising that children

with special needs require efficient, effective, and functional instruction

directed at achieving socially and educationally valid outcomes (Carta,

Schwartz, Atwater, & McConnell, 1991) it is important that practitioners

identify the nature of each child's needs and the extent to which accommodations

and supports will be necessary for each child to be successful. The best

program for a child is the program that is designed for the specific needs

of that child. Instructional arrangements, curriculum content and instructional

procedures can and should be varied to coincide with the intensity of

each child's learning needs. Such accommodations increase the likelihood

that children with special needs can be included in a vast array of typical

classroom activities.

Children with cognitive

disability need:

• individualised/

  specialized schooling with a modified educational curriculum approach;

• specific programs

  that are functionally oriented and integrated into their daily routine/

  every day activity;

• appropriate schooling

  and individualized educational programs that focus on attainment of

  'life skills' with the long-term outcome of independence and transition

  into the community (and including vocational/ after school options):

  without this opportunity such children will most definitely require

  increasing financial/ resource support, assistance and supervision as

  young adults.

By way of example,

Cecilia (above) needs a daily structured routine; a breakdown and presentation

of appropriate educational input; and consistent behavioural expectations,

in conjunction with a very individualised program that has a varied activity

base and that functionally addresses her communication, physical/ sensory,

social, self-care, leisure and cognitive needs.

8.2.2 Lack of

access to appropriate equipment

Article 28 (1),

Convention on the Rights of the Child

States Parties recognize

the right of every child to a standard of living adequate for the child's

physical, mental, spiritual, moral and social development

Declan

Declan has cerebral

palsy and needs a modified spoon to be able to feed himself. Whilst readily

available in the community, these spoons are not available in the immigration

detention centre. Therefore Declan relies on his sister to feed him which

basically means that because of the speed with which meals are served

and need to be eaten, both Declan and his sister are not getting enough

food.

Without modified

equipment, a child with cerebral palsy will be unable to develop independent

living skills and in the long-term will need a much greater level of support.

Children with cerebral palsy frequently have oral-motor impairments which

can affect their development of speech, language and feeding skills. Promoting

feeding skills is best initiated at early ages. There are physiological

reasons to stimulate the development of feeding at that age when a child's

brain has greater plasticity. Early intervention also stops development

of poor patterns which can be difficult to change later. Professional

assessment of a feeding difficulty would consider treatment options from

a range of solutions including modified utensils, as well as modified

food texture and postural changes (Solot, 1998).

With appropriate

physiotherapy, 70% of children with cerebral palsy will walk by the age

of 3 years. In general, the time for really learning new physical skills

lasts until age 8 and then it is a question of maintenance of skills and

prevention of the type of muscle tension that causes deformity and loss

of function in people with cerebral palsy.

Modified equipment

is important in aiding the development of children with disabilities for

the following reasons:

• in the short-term

  such equipment is integral to the children's daily function; improves

  muscle tone/ strength, hand grasp; improved postural responses and mobility

  enhances access and participation to educational, leisure/ physical

  development opportunities and promotes independence in self-care tasks;

• in the long-term,

  the use of such equipment decreases the dependence on others; decreases

  the development of abnormal postural responses and contractures/ deformities;

  facilitates and enhances independence in self-care/ life skill tasks

  and participation in the wider community; and socially promotes dignity

  and acceptance (ie, consider the impact for a person with disability

  of being spoon fed in public due to the lack of appropriate modified

  utensils; or being unable to maintain privacy and comfort when toileting

  due to a lack of modified toilet/ chair facilities);

Also in the long-term,

there is a need for increased financial resource, support and assistance

being required if equipment is not readily available for those who need

it, as these children will miss out on early learning experiences as a

result and may remain dependent on adult care-givers to achieve basic

self-care/ living skill tasks (ie, meal times/ toileting, etc) in the

future.

8.2.3 Lack of

consideration, inflexibility of the system to take into account individual

needs

The detention centre

environment causes massive disruption to 'normal' family practices, such

as the parents and children's ability to choose what the child has to

eat, to learn how to prepare food, to prepare and eat alone as a family

together, etc. Breaking those routines can have a considerable impact

on children with disability, particularly for those with an intellectual

ability. For those with eating difficulties, disruptions to diet can have

a profound effect on nutrition.

Enda and his

Daughter

Despite the fact

that Enda had offered to pay money for additional and gluten free foods

for his daughter, who has multiple disabilities and is quite frail, this

was not allowed. Meals are only served at specific times and no food is

allowed to leave the "dining" area. Detainees are checked for

food before they leave. Since living in an Australian detention centre,

Endas' daughter has lost a lot of weight.

Children with particular

conditions such as cerebral palsy and coeliac disease are at increased

risk of developing problems with nutrition and growth. Studies show that

children and young people who are undernourished are at increased risk

of illness such as respiratory disease and pneumonia, and adverse developmental

outcomes (Kessler & Dawson, 1999).

Persons with developmental

disabilities are at increased nutritional risk because of feeding problems,

drug/ nutrient interactions, metabolic disorders, decreased mobility,

and altered growth patterns. Nutrition assessment and care plan development

demand specialist knowledge ad skills in an interdisciplinary team setting…

persons with developmental disabilities should receive comprehensive nutrition

services as part of all health care, vocational and educational programs

(American Dietetic Association, 1992)

Rose

Rose is 14 years

old and has diabetes. Ideally Rose needs to eat several times a day and

needs to be able to access juices or something similar any time day or

night. The detention centres serves three meals a day and other than water

no food or drink are available outside these times.

8.2.4 Lack of

physical access to buildings and facilities

"To the extent

possible, the Department is also currently taking steps to ensure that

all infrastructure development at each of the centres takes account of

the needs of detainees with physical disabilities. The new purpose-built

facility being constructed at Baxter Immigration Reception and Processing

Centre (IRPC) includes two disabled unit buildings, each containing three

bedrooms with the capacity to accommodate two people per room. Refurbishment

planned for Port Hedland IRPC includes provision for persons with disabilities

such as building access, installation of ground floor amenities, and fit-out

of ground floor bedrooms." (DIMIA letter to NEDA, 18. 02.2002).

Felix

Felix is 13 years

old and has a physical disability. An old hospital wheelchair has been

made available for Felix. Whilst Felix is not strong enough and the wheelchair

too heavy for Felix to push himself around, he can be pushed by adult

males. This means that Felix is largely isolated from peers and is dependent

on adults to get him to places. Furthermore, many of the facilities in

the detention centre are not accessible, leaving Felix dependent on adults

to carry him in and out of the dining room, bathrooms, etc.

As a child moves

through childhood and puberty, their musculoskeletal system is more susceptible

than an adult's to both internal and external mechanical forces which

can alter the shape and angle of immature bones. The abnormal internal

forces affecting children and young people with physical disabilities

must be addressed and ameliorated, to prevent further exacerbation of

their impairment and restriction (Walker and Stranger 1998, p392). An

additional consideration is the sudden and rapid growth patterns of children

and adolescents that may require fast response to address both clinical

and therapeutic need.

Equipment needs may

become more evident during adolescence, when a person has grown and become

heavier. The possibility of injury may be heightened, such as the young

person developing scoliosis as a result of poorly fitted wheel chair seating,

or back injury for carers due to lifting and transfers. Providing appropriate

equipment at that time can reduce future costs on government health and

social services.

Appropriately equipping

children addresses safety issues, enhances functioning, assists in pain

relief, and stops or lessens further physical complications, such as bone

fusion, reduced lung capacity, dislocated hips or arms, and swallowing

problems. Ultimately, this reduces the long-tem financial and social costs

which can be associated with a disability.

In the short-term

lack of access to facilities decreases mobility and physical and social

function and contributes to continued dependence in self-care and community

living skills. In the nog-term, it limits overall learning, development

and independence; inhibits social interactions/ environmental opportunities;

and discriminates against/ denies the disable the basic right to be 'included'

with others.

8.2.5 Lack of

expert medical attention

Article 24 Convention

on the Rights of the Child

1. States Parties

recognize the right of the child to the enjoyment of the highest attainable

standard of health and to facilities for the treatment of illness and

rehabilitation of health. States Parties shall strive to ensure that no

child is deprived of his or her right of access to such health care services.

2. States Parties

shall pursue full implementation of this right and, in particular, shall

take appropriate measures:

…

(b) To ensure the

provision of necessary medical assistance and health care to all children

with emphasis on the development of primary health care;

Gertrude

Gertrude was three

years old when she lived for 7 months in an isolated immigration detention

centre. Gertrude has a physical disability (Cerebral Palsy) and under

the contract the Government has with the detention centre management,

medical attention needs to be provided for.

Whilst Gertrude,

due to her disability, would have needed at least some specialist medical

intervention, reality in the detention centre was that once every 2 months

Gertrude and her mother went to a general practitioner.

This doctor then

merely looked at Gertrude and said "she is ok" and sent her

back without any medical intervention.

Gertrude is now five years old and she has just started going to weekly

physio therapy.

The physiotherapy

costs about $200 per week. Gertrude and her family now know that the medical

needs of Gertrude were overlooked because they were seen as too expensive.

Since children with

cerebral palsy have difficulties with a number of areas of their development,

a team of qualified professionals needs to be involved in interventions,

these include physiotherapists, occupational therapists, speech pathologists

and early special educators. Areas in which a child will often need specialist

intervention include:

• communication;
• mobility;
• thinking and

  reasoning skills;

• play skills;
• classroom skills;
• eating and drinking

  development;

• social and emotional

  development;

• behavioural concerns;

  and

• specialist equipment.

It is important that

children with cerebral palsy receive support and intervention from an

early age to ensure they have every opportunity to reach their full potential

(from Spastic Centre letter, 26th March 2002, attached to hard copy of

submission).

8.2.6 A crisis

as the best option to get expert advice

The best chance children

with disability have of receiving qualified and expert intervention is

when they slip into a crisis which constitutes a risk to their life or

the lives of others. As appears to be happening with people who experience

a severe episode of mental illness, people with complications due to their

disability are hospitalised when critical.

Crisis intervention:

• never addresses

  the individual needs of a child with a disability: it is a stop-gap

  measure only;

• is not cost-effective

  and is a reactive approach, not proactive;

• ignores the long-term

  needs of people with a disability and creates increased dependency;

• has poor outcomes

  for children with a disability and their families: it is traumatic and

  disempowering and ignores the fact that the best outcomes for children

  with disability are achieved as a result of addressing their individual

  needs through specific intervention programs that are incorporated into

  their daily routine (for maximum performance/ enhancement) and which

  include the education of their care-givers in the daily execution and

  carryover of these tasks.

Kilian

Kilian has a severe

intellectual disability with physical disabilities, including breathing

problems. Kilian had several extremely serious medical crises whilst at

a desert immigration centre and he and his family were moved to a city

detention centre, where he was referred to hospital for surgery. After

the surgery, there were several visits to a specialist medical clinic

8.2.7 No access

to medical equipment and essential aids

Article 24 (1+2),

Convention on the Rights of the Child

1e. States Parties

recognize the right of the child to the enjoyment of the highest attainable

standard of health and to facilities for the treatment of illness and

rehabilitation of health. States Parties shall strive to ensure that no

child is deprived of his or her right of access to such health care services.

2. States Parties

shall pursue full implementation of this right and, in particular, shall

take appropriate measures

(b) To ensure the

provision of necessary medical assistance and health care to all children

with emphasis on the development of primary health care.

Much is known about

the ill-effects of institutional settings on people with disability. It

is widely agreed that those settings have negative effects on people with

disability in terms of their health, emotional, intellectual and social

developments, etc. In terms of health, in order to ensure and maintain

the health of people with disability it is important to have:

• access to appropriate

  and regular health care services;

• identification

  and screening of specific health conditions;

• access to immunisation

  programs; and

• high levels of

  infection control.

Henry

17 year old Henry

lived in an immigration detention centre for over 18 months. Like most

desert Immigration detention centres his was mostly very hot in summer

and quite cold in winter. Henry has asthma which means he has difficulties

breathing. Since Henry started living in the community he has had access

to a ventilator. In the detention centre, all Henry could do on a hot

day was hope that he could spend the day in a hut that had functioning

air conditioning.

Ita

Ita is 7 years

old and has spina bifida. Ita's Dad has to queue to see the centre's nurse

every day (that can take up to three hours) to get a daily supply of continence

aids. Mostly he can't get enough continence aids for Ita or has to make

do with alternatives ( ie. babies nappies) which means that Ita is basically

always wet and has developed sores.

8.3 Lack of skills

and knowledge about disability amongst staff, detainees, families and

children with disability

8.3.1 Overall

lack of disability skills of staff

According to DIMIA

the following professionals are employed at the different detention centres

(not all centres have all the personnel):

• General Practitioners

  (all centres);

• Psychologists

  (Curtin, Port Hedland, Villawood, Woomera);

• Nurses (all centres);
• Psychiatrist (Port

  Hedland, Villawood);

• Dentist (Port

  Hedland).

The health services

that are delivered according to DIMIA are:

Curtin: Primary

Health Care; First Aid, Health Education, Mental Health Nurse

Maribyrnong: Primary Health Care; First Aid, Health Education,

Psychiatric Nurse

Port Hedland: Primary Health Care; First Aid, Health Education,

Mental Health Nurse

Perth: Primary Health Care; First Aid, Health Education, Mental

Health Nurse on call

Villawood: Primary Health Care; First Aid, 'Shared Care'-antenatal

Management, Psychology Services

Woomera: Primary Health Care; First Aid, Health Education, Mental

Health Nurse, Psychologists, Women's Health, Stress Management, Child

and Family Health; Immunisations; Oral Hygiene; Pro-active Health Management.

MDAA is confident

that the training received by those professionals employed by ACM is not

sufficient to deal with the disability issues inside the centres. Training

received by any of the professional groups above focuses almost exclusively

on the basic medical needs (including the mental health medical needs)

of the children with disability. Mainstream health professionals do not

usually have the expertise in disability required. Nurses, occupational

therapists, physiotherapists and speech pathologists receive only very

limited training in disability during their undergraduate years and as

a result, most complete/ undertake specific post-graduate training in

disability relevant to specific clinical streams and courses, or complete

a Post-graduate Diploma in Disability. We understand that nurses in particular

receive only a one week clinical placement in disability (maximum 6 hours)

throughout their undergraduate training and only one semester of tutorials,

mainly behavioural in focus and not clinical/ health specific.

Specialised knowledge

of physical, motor, social, language, cognitive and personal hygiene/

self-care development is necessary. Specialised assessment skills, including

'acute' clinical observations; cognitive/ standardised assessments; and

functional assessments (motor; language/ communication; self-care/ living

skills, etc) and on occasions, neuro/ developmental assessments are all

essential when determining the nature of the disability and its degree/

severity.

Specialist disability

clinical staff required include:

• occupational

  therapists;

• physiotherapists;
• speech pathologists;
• psychologists;

  and

• nurses with additional

  training and expertise in disability.

Early intervention

by a specialist physiotherapist is important for any physical disability

in the short-term. If the child with disability is left without early

intervention they will have to compensate posturally in some way to counter

the effects of the disability. In the long-term, the body of a child with

a physical disability will compensate in such a way that it will lead

to problems greater than the initial disability itself. Short-term compensations

include muscle shortening and require surgery and intensive post-operative

physiotherapy. Long-term compensations result in contractures and deformities,

generally requiring the need for specialised equipment/ resources such

as modified wheelchairs, customised seating, splinting, etc. In the long-term,

the lack of early intervention for children with a disability results

in increased care and spiralling medical, therapy and equipment costs.

8.3.2 Not inviting

disability experts into detention centres

Article 19, Convention

on the Rights of the Child

1. States Parties

shall take all appropriate legislative, administrative, social and educational

measures to protect the child from all forms of physical or mental violence,

injury or abuse, neglect or negligent treatment, maltreatment or exploitation,

including sexual abuse, while in the care of parent(s), legal guardian(s)

or any other person who has the care of the child.

2. Such protective

measures should, as appropriate, include effective procedures for the

establishment of social programs to provide necessary support for the

child and for those who have the care of the child, as well as for other

forms of prevention and for identification, reporting, referral, investigation,

treatment and follow-up of instances of child maltreatment described heretofore,

and, as appropriate, for judicial involvement.

MDAA has spoken to

a wide range of disability service providers in NSW and several in some

of the other States and territories. We have been unable to find even

one single incident, where disability experts were invited into an immigration

detention centre to provide the quality and expert services needed by

some of the people with disability.

Jude

Jude is a 13 year

old girl with mild to moderate intellectual disability. Jude refuses to

attend school and in the past she often went wandering. A couple of weeks

ago, Jude went off and did not return to her family for several hours.

When she did, she was crying, her clothes were dirty and torn. Since then

Jude has been hitting and biting herself. Her family assumes she was assaulted

and they reported the incident to centre management. The centre doctor

saw her two days after the incident and gave her some sedatives. Since

then Jude has continued to harm herself and has been placed in isolation

(euphemistically called the 'observation room') on several occasions.

Wilson & Brewer

(1992) found that people with intellectual disability were 3 times more

likely to be a victim of violent crime than people without disability.

Sobsey (1994) and Crossmaker (1991) documented that there is an increase

of abuse in congregate care, especially in institutional settings.

Whilst no particular

research has been done on the abuse rates of people with intellectual

disability in immigration detention centres, the institutional nature

of the centres is similar to other institutional settings.

Article 34, Convention

on the Rights of the Child

States Parties undertake

to protect the child from all forms of sexual exploitation and sexual

abuse.

It is important to

note that whilst children with disability display a similar range of symptoms

and behaviours as reactions to the abuse, for children with disability

these behaviours are more often interpreted, especially by non- experts

as being part of the disability. It is also important to note here that

as with people without disability there is a range of behaviours and symptoms

synonymous with Post Traumatic Stress Disorder (PTSD), which in the setting

of the immigration detention centres is likely to be diagnosed ( if it

is diagnosed at all) as part of other traumatic experiences.

Finally, the weight

of evidence from institutional settings has irrefutably proven that punishment

is a completely inappropriate way to deal with behaviours such as those

displayed by Jude and the only intervention that will have a good impact

and outcomes are positive approaches.

8.3.3 Lack of

knowledge amongst detainees and families about disability

One of the reasons why children with disability are discriminated against

is because of other people's attitudes towards them. In detention centres

there are different cultural groups with different attitudes. As discussed

above staff are most likely to have no training in disability issues,

therefore staff need training to overcome their own attitudinal barriers

towards people with disability to ensure that they can use that training

in addressing negative attitudes towards disability amongst detainees.

A social approach

to disability is needed that highlights the interaction between persons

with disabilities and the environment. Such an approach is also needed

to ensure the effective protection, development and inclusion of children

with disability.

Leo

Leo is a 12 year

old boy who is HIV positive. Somehow other detainees learned that and

Leo is isolated and people do not want to sit next to him or his family.

Catching 'AIDS' is a fear amongst many of the detainees. Although there

is information about HIV/AIDS available in different languages, no such

information is available to the detainees.

It cannot be assumed

that the people in immigration detention centres have been exposed to

the same levels of public health education and more broadly public education

about disabilities.

Marian

One day in the

detention centre Marian collapsed and started foaming from the mouth.

Her parents didn't know what to do and screamed for help. They wanted

Marian to go to hospital immediately. Two guards arrived and recognised

that Marian had an epileptic seizure. They did everything to ensure that

she did not hurt herself and also tried to calm the parents. Whilst Marian's

parents are educated, they have never seen an epileptic seizure. They

don't believe and do not trust the centre's doctor and they worry about

what has really happening to their daughter.

9. Issues once

children with disability are released from Immigration Detention centres

into the Community

Article 2 (2), Convention

on the Rights of the Child

States Parties shall

take all appropriate measures to ensure that the child is protected against

all forms of discrimination or punishment on the basis of status, activities,

expressed opinions, or beliefs of the child's parents, legal guardian

or family members.

9.1. Temporary

Protection visas

It is important to

note that a large number of the people who apply for refugee status when

in immigration detention centres are currently granted refugee status

and given Temporary Protection Visas (TPV) Subclass 785. Temporary Protection

Visas exclude people from a range of services and entitlements available

to people who are granted permanent protection visas and others. These

services and entitlements are regulated through either Commonwealth or

States and Territory jurisdictions. Over 40% of all TPV holders currently

reside in NSW.

Neot

Neot's dad sent

him to the immigration detention school facility whenever school was on.

Neot would usually sit in the back and say nothing. Sometimes he was asked

to answer a question but he never did. He never talked to any of the other

children and in general he hardly every spoke to anyone, except to his

dad or his Mum.

Whenever Neot

was given the opportunity to do any written work he excelled in writing

stories and in maths. A Psychiatrist was called in to do an assessment

but he could not communicate with Neot.

A mental health

nurse three months later finally discovered that Neot had a severe hearing

impairment and urgently needed hearing aids. Neot and his family are living

in the community but as a temporary Protection Visa holder Neot cannot

access the hearing services and has been using an ill - fitting second

hand hearing aid for some time.

TPV holders are not

eligible for the full range of social security benefits. The 'Special

Benefit' designed for TPV holders is less than the dole. TPV holders are

not eligible for Job assistance programs or English language programs.

For minors with a disability this means that they cannot enter specialist

training programs. Without specialist skills minors with a disability

who are TPV holders face an almost insurmountable barrier to the labour

market. As many TPV holders are likely to be granted continued refugee

protection, the cost of continued unemployment and under utilization of

skills will be transferred to the broader community.

TPV holders are also

not eligible for disability pension or the full range of benefits attached

which place them at a financial disadvantage. That financial hardship

is compounded by the cost of disability, such as medication, equipment,

transport costs, etc. Not being eligible for some Commonwealth benefits,

such as the Disability Support Pension, means people are ineligible for

some Commonwealth / State funded programs such as PADP (Physical Aids

for the Disabled Program).

As TPV holders have

no right to family reunion, this combined with the ineligibility for a

range of services, means that any care which might need to be undertaken

for the child with the disability is largely being provided by one person

(usually the mother).

Albert

Albert's family

( as shown on page 8 of this submission) has made contact with an advocacy

agency and has tried to organise an assessment for Albert, but has been

unsuccessful in accessing the assessment through the appropriate disability

government agency in NSW (the Disability Directorate of the NSW Department

of Ageing, Disability and Home Care) as Albert is not a permanent resident

(DADHC; policies for Working with People with Disabilities Version 2 Departmental

Intake Process [clarification on this point is currently being sought

by MDAA])

Whilst TPV holders

can access Commonwealth funded Early Health Assessment and intervention

programs provided by torture and trauma services, these assessments and

programs do not focus on disability. The expertise of those services is

torture and trauma counselling, not identifying disabilities and designing

intervention programs.

It appears that children

with disability who are TPVs in NSW are not eligible for the specialist

early intervention services available to other children with disability.

Children with disability who hold a TPV appear to be able to access 'mainstream

school' and are most likely to experience the same or greater difficulties

as all children with disability experience in 'mainstream' school settings.

The consequences

of TPV holders' ineligibility for case management offered to other refugees

by settlement services is that other services, often small, under-funded

ethno-specific community based services, have to spend huge amounts of

time trying to procure specialist and affordable services to assist children

with a disability.

Financial hardship

is also compounded by TPV holders' ineligibility for specialist housing,

or in most states, such as NSW, not even being allowed on the public housing

waiting list. They are also ineligible for Commonwealth funded services

which could assist with finding housing that is appropriate for the child

with disability.

Overall there is

a lack of clarity about what TPV holders are and are not eligible for

in NSW and there are clear inequities across different State and Territory

jurisdictions. We understand that DIMIA has refused to produce comprehensive

information for service providers on what services TPV holders are eligible

for. There is also some lack of clarity about what state funded services

TPV holders can access.

9.2 Cost shifting

It is clear from

the evidence available that if a person with a disability cannot access

disability services, there is a high cost to them in terms of their opportunities

and options as discussed previously in this submission, but there is also

a greater cost to the community. In most cases this cost will be carried

by the States and Territories, not by the Commonwealth.

To highlight again

the point about the importance of early intervention, the range of studies

below emphasise the long-term cost effectiveness of early intervention.

The highly specialised, comprehensive services necessary to produce the

desired developmental gains are often, on a short-term basis, more costly

than traditional school-aged service delivery models. However, there are

significant examples of long-term cost savings that result from such early

intervention programs:

• A 3-year follow-up

  in Tennessee showed that for every dollar spent on early treatment,

  US $7.00 in savings were realised within 36 months. This saving resulted

  from deferral of special class placement and institutionalisation of

  severely behaviour disordered children (Snider, Sullivan, and Manning,

  1974).

• A recent evaluation

  of Colorado's state-wide early intervention services reports a cost

  saving of US $4.00 for every dollar spent within a 3-year period (McNulty,

  Smith, and Soper, 1983).

• A longitudinal

  study of children who participated in the Perry Preschool Project (Schweinhart

  and Weikart, 1980) found that when schools invest about US $3,000 for

  1 year of pre-school education for a child, they immediately begin to

  recover their investment through savings in special education services.

  Benefits included US $668 from the mother's released time while the

  child attended preschool; US $3,353 saved by the public schools because

  children with pre-school education had fewer years in grades; and US

  $10,798 in projected lifetime earnings for the child.

• Wood (1981) calculated

  the total cumulative costs to age 18 of special education services to

  children beginning intervention at: (a) birth ; (b) age 2; (c) age 6;

  and (d) at age 6 with no eventual movement to regular education. She

  found that the total costs were actually less if begun at birth! Total

  cost of special services begun at birth was US $37,273 and total cost

  if begun at age 6 was between US $46,816 and US $53,340. The cost is

  less when intervention is earlier because of the remediation and prevention

  of developmental problems which would have required special services

  later in life.

A number of specialist

disability services do not offer services to people who are temporary

residents, but it appears that many non- government disability agencies

have a 'don't ask, don't tell' attitude.

Those agencies are

placed in the position of having to undertake extensive case work assistance

which can create a significant burden on their existing resources. This

again highlights a significant cost shifting from the Commonwealth. In

addition, many disability services have little experience in working with

newly arrived refugees and often have limited experience with unsupported

NESB clients.

9.3 No links between detention centres and services in the community

On release from the

detention centres families are not referred to the services they need

and any useful assessments, case notes or programs from detention are

lost. Without this, families are left to negotiate the maze of services

alone, without interpreters. Most families not only don't know the words

for services, but they also don't understand the service system. The disability

service system in particular, with its multiple entry points and with

many, many 'dead-ends' is a challenge to most families, let alone those

without language interpreters and without any understanding of the Australian

service system.

8. For more Information

Australian Bureau

of Statistics (ABS) 1998, Disability, Ageing and Carers: Summary of findings.

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---

1. The

definition of NESB refers to a person:

• born overseas

  and whose language or culture is not English or Anglo-Celtic / Saxon
  

• born here in

  Australia and the first language or culture of at least one parent is

  not English or Anglo-Celtic/ Saxon
  

• born in Australia

  with linguistic or cultural background other than English or Anglo-Celtic

  / Saxon who wish to be identified as such.

Last

Updated 30 June 2003.