Project TEACH (Therapy, Education, Assimilation of Children with Handicap)
City Government of Mandaluyong

A. Problem Analysis

 1. What was the problem before the implementation of the initiative?
Due to the high cost of medical, rehabilitation, and educational services for youth with special needs, many families cannot afford to avail of quality intervention for them. Individuals with disabilities need these services to be more independent in self-care, school, play and work activities. Their enhanced capabilities largely contribute to a better quality of life for them and for their families. The brain-drain phenomenon resulting in the shortage of competent professionals such as developmental pediatricians, special education teachers, physical therapists, occupational therapists and speech therapists, makes access to these services even more difficult. To demonstrate, for an estimated number of 10M Filipinos with disabilities, there are only ~1,400 occupational therapists, ~259 speech therapists and 49 Developmental Pediatricians available to serve in the country. Most of whom work in private hospitals and clinics. Prior to Project TEACH, children with disabilities belonging in poor families were not able to access much needed help since local government units nationwide did rarely subsidized comprehensive and integrated services for youth with special needs. As a result, the children’s condition ultimately lead to activity limitations that prevented them from fully participating in meaningful life activities such as self-help, play and school. Feelings of desolation and despair prevailed among the parents of these children. For families who can barely earn enough to bring food to their table, it was impossible for them to afford an already conservative amount of US$3,370/year for therapy and special education services. Special Education Teachers in public schools were underworked and underpaid. The absence of standard programs, tools and protocols to assess students, develop and implement individualized education programs made their task very challenging. The very heterogenous composition of their class in terms of their students’ age, diagnosis, limitations and skill levels further aggravated the situation. As an additional consequence, little success was achieved in including youth with learning difficulties in classrooms together with their typically developing peers. Stigma against persons with disability prevailed thus further isolating them and their families from society.

B. Strategic Approach

 2. What was the solution?
The local government of Mandaluyong City, through Mayor Benjamin C. Abalos Jr., spearheaded the conceptualization and implementation of Project Therapy, Education and Assimilation of Children with Handicap (TEACH). This is a community-based rehabilitation program that directly benefits youth with disabilities residing in depressed areas. It is a joint project with the Rehabilitation and Empowerment of Adults and Children with Handicap (REACH) Foundation Inc., a non-stock non-profit organization based in Mandaluyong City. It aims to enable youth with disabilities to attain their optimum level of functioning and quality of life. The direct beneficiaries of this project are at least 600 children with developmental conditions. The percentage distribution of their diagnosis is as follows: Intellectual Deficiency 18%, Cerebral Palsy 16%, Autism 15%, Down Syndrome 14%, Global Developmental Delay 11%, Attention Deficit Hyperactivity Disorder 10%, Communication Disorder 7%, Learning Disability 4% and others 5%. The numbers are expected to increase through information campaigns and with the project’s newly constructed building. Playing a crucial role in Project TEACH are 27 lay Community Rehabilitation and Education Workers (CREW) who underwent rigorous training to help professionals implement therapy and educational programs for special children. They receive as much as 4,000 pesos (about US$100)/month allowance which significantly augments their family’s income. The CREW are lay women residing in depressed areas of Mandaluyong City; 37% of them are related to a special child. By providing youth with special needs access to an innovative and cost-effective network of free medical, rehabilitative, educational and related services, Project TEACH helps enable them to become integrated and productive members of society. To address false perceptions about children with special needs and to prevent the increased prevalence of disability, Project TEACH has also conducted numerous community education programs. Capability building activities have been implemented to help government doctors, public school teachers, social workers and barangay health workers and family members become more effective in serving youth with special needs. To sustain these initiatives, an inter-agency and multi-sectoral committee was formed to develop the aforementioned service delivery framework. This committee meets at least once a month to evaluate Project TEACH’s programs and to discuss ways to enhance these accordingly. Pieces of local ordinances were instituted to make Project TEACH a permanent program of the city.

 3. How did the initiative solve the problem and improve people’s lives?
The project’s streamlined service delivery framework effectively provides services pertinent to youth with special needs. Services that were insufficient were strengthened or if, unavailable, introduced like the Mandaluyong Center for Alternative Rehabilitation and Education Services which was specifically created to provide diagnostic, therapy, special education tutorials services. Another is the creation of Kitchen Specials that addresses young adult beneficiaries’ need for vocational training. The framework enables providers in day care centers, public schools, government hospitals, and other participating non-government organizations to identify children who have or are at risk of having special needs at the grass root level. To give priority to the poor, the families of the special children are screened by the DSWD-Mandaluyong, and if eligible, are then referred for proper diagnosis to partner specialists like developmental pediatricians and psychologists at the Mandaluyong CARES. For therapy and special education tutorials, the CREW assist the licensed staff in handling them. To prevent a dole-out culture, parents render community service or serve as CREW who help children with disabilities other than their child. All stakeholders attain a sense of ownership over the program thru this approach, making them invested not just in the program’s sustainability but also in its growth.

C. Execution and Implementation

 4. In which ways is the initiative creative and innovative?
Project TEACH has organized an inter-agency and multi-sectoral committee that developed an innovative and cost-effective service delivery framework that effectively streamlined services that are pertinent to youth with special needs. This committee meets at least once a month to evaluate Project TEACH’s programs and to discuss ways to enhance these accordingly. Project TEACH’s service delivery framework enables community helpers such as public school teachers, social workers, day care center workers, government hospital workers, barangay health workers, and civil society partners to find and identify children who have or who are at risk of having special needs. These children are then referred to their Barangay Health Center for developmental screening by doctors. To give priority to the poor, the families of the special children are screened by the Department of Social Welfare and Development (DSWD). If determined to be eligible, these children are then referred to partner developmental pediatricians for free and proper diagnostic services. These specialists are affiliated with The Medical City, a premier private hospital in Manila, and who come to the Mandaluyong Center for Alternative Rehabilitation and Educational Services (CARES). The Mandaluyong CARES is a city-operated therapy and special education tutorial services center specifically instituted for Project TEACH. Mandaluyong CARES is staffed by licensed professionals from top universities in the Philippines. Empowerment and transfer of knowledge is emphasized by recruiting experts to teach essential competencies to lay people. Community Rehabilitation and Education Workers (CREW) and volunteer parents undergo rigorous training activities to enable them to assist in the implementation of therapy and educational programs. To ensure the quality of services, they work under the close supervision of licensed therapists and special education teachers. The CREW in turn, help parents of children with special needs care for their child more effectively. Once a child is diagnosed, necessary interventions are provided by the appropriate local line agency/ies. For education services, Project TEACH’s multi-disciplinary team of professionals recommends the most suitable educational program for the child and offers ongoing technical support to the public school teachers. Project TEACH’s clustering and mainstreaming scheme renders more effective the special education programs of the Department of Education-Mandaluyong City. Measures taken, like the formation of more homogenous class groupings based on age, developmental skills and behavior as well as the assignment of specialty special education programs per public school, significantly made the teacher’s efforts more focused and efficient. The Kitchen Specials, a vocational training program helps youth with special needs produce healthy, delicious and affordable snacks which are then sold to public school canteens. The parent-teacher association of the school helps market these products where certain part of the income goes to the students/trainees under the Project TEACH.

 5. Who implemented the initiative and what is the size of the population affected by this initiative?
Project TEACH is an outstanding example of how a local government unit can collaborate with the private sector, civil societ, the academe and the PWD sector. The REACH Foundation, Inc. and the local government of Mandaluyong City collaborate in funding, conceptualizing, planning and implementing this community-based program. Partner agencies and units under the local government are the City Health Office, Department of Education-Mandaluyong, City Social Welfare and Development Department, Persons with Disabilities Affairs Division, Mandaluyong City Medical Center, City Public Information Office and the Mandaluyong Center for Alternative Rehabilitation and Educational Services. Other non-government organizations that support the program are the Hands of Mercy, Inc., the Parent-Teacher Community Association-Mandaluyong and the Kapisanan ng mga Magulang ng mga Batang may Kapasanan ng Mandaluyong, Inc. - an association of parents of children with disabilities. These non-government organizations have members that regularly volunteer in Project TEACH. The University of the Philippines-Manila and the University of Sto. Tomas as well as The Medical City have signed into a Memorandum of Agreement with the REACH Foundation which commits them to regularly send occupational, physical and speech therapy interns as well as Developmental Pediatrics Fellows to Project TEACH. The interns assist Project TEACH’s staff in developing and implementing treatment programs. All the above participating organizations have been assigned to perform functions that are consistent with their mandate.
 6. How was the strategy implemented and what resources were mobilized?
The project receives an allocated budget from the City Government and the Department of Education’s Special Education Fund. This ensures enough resources to sustain and expand Project TEACH’s operations. When it was initially introduced in 2007, a counterpart grant amounting to one million pesos ($25,000-) was received from the Philippine-Australia Community Assistance Program. The local government’s main contribution was the provision of space and in helping institute a cost-effective service delivery mechanism. This was achieved by utilizing existing structures and human resources within the local government. Minimal amounts were spent for basic materials and training activities. In 2009, the city funded 59.62% of the budget required. This has increased to 71.59%, 93.5% and 100% in 2010, 2011 and 2012 beyond, respectively. Prior to 2011, non-government organizations such as the Rehabilitation and Empowerment of Adults and Children with Handicap Foundation, Inc. (REACH Foundation, Inc.) helped source funding from the private sector. Roughly PhP2.57M ($64,250-) or 77.7% of Project TEACH’s current yearly operational budget, which amounts to more or less PhP3.3M ($82,500-), is allocated for the salaries of staff and CREW. The premium placed on salaries is to help attract the most competent and compassionate professionals such as Occupational Therapists, Physical Therapists, Speech and Language Therapists, Special Education Teachers to serve in depressed communities. The honorarium that the CREW receive significantly helps augment their family’s income. The table below presents a breakdown of the types of services rendered from 2007-1012 as well as the monetary equivalence of the free services rendered. Amounts were computed based on industry rates of private service providers. As of 2013, Project TEACH offers services amounting to PhP4.8M ($120,000-) to PhP6M ($150,000-) per year. This clearly illustrates the cost effectiveness of the program. The impact of the developmental gains achieved by the on themselves and on their loved ones further underscores the value of Project TEACH. TYPE OF SERVICES RENDERED FOR FREE TIME PERIOD Amount of Free Services Rendered in Php (Standard Rate x No. of Sessions) I. Client Care Services A. Diagnostic Services October 2007- March 2012 628,000 B. Screening and Re-evaluation 332,050 C. Therapy Sessions and Special Education (SPED) Tutorials in the Community Center 6,615,600 D. Home Therapy Sessions 1,293,000 E. SPED Classes (Bridging for Developmental Conditions and Hearing Impaired) 3,153,600 F. Prevocational Skills Training 1,858,400 Total Monetary Equivalence of Client Care Services 13,880,650 II. Other Services Seminars, workshops and training activities for beneficiaries, family members, volunteers, government employees and professionals September 2007 – March 2012 110,300 GRAND TOTAL OF MONETARY EQUIVALENCE OF SERVICES RENDERED ($349,773-) 13,990,950

 7. Who were the stakeholders involved in the design of the initiative and in its implementation?
The project has significantly enhanced the special children’s skills as evidenced by objective assessments administered by consultant diagnosticians and direct testimonials given by the beneficiaries and their families. Advocates and beneficiaries have noted that many of these children can now participate more competently in activities pertinent to self-help, home management, school, play and leisure. In the most recent quality assurance survey conducted by Project TEACH, 93% of the parent respondents observed improvements on their children. 100% felt that interventions given were appropriate. Moreover, 100% of the parent respondents expressed satisfaction over the services rendered. The capability-building activities provided to the CREW and family members have empowered them and have given them a renewed sense of purpose. The 4,000 pesos (about US$100) honorarium that the full time CREW receive significantly augments their family’s income. Government employees have also benefited from Project TEACH’s capability building programs. Specialists have conducted workshops for the doctors in the health centers. Department of Education-Mandaluyong’s special education programs, specifically its self-contained SPED classes, mainstreaming and inclusion programs have been revitalized. Through Project TEACH, public school special children have been clustered into homogenous groups which were advised to enroll in the public school that has been assigned by Project TEACH to implement the most appropriate ‘specialty curriculum’. Through this ‘clustering scheme’, the students belonging in a class would present similar needs and baseline skills. Hence, the teachers’ lesson planning process and classroom management is much simplified. To maintain good standards in mainstreaming and inclusion, Project TEACH has developed implementing rules and guidelines that have been recently taught to guidance teachers. The World Bank recognized Project TEACH’s pioneering efforts when it was awarded the top prize in a competition for innovative ideas, the 2008 Panibagong Paraan (New Method): Building Partnerships between non-government organizations and the local government unit. Project TEACH has been selected twice by the Australian government as a beneficiary of the Philippine-Australian Community Assistance Program grant. The Center for Health Development-Department of Health recognized Project TEACH as among the top 3 most innovative health care programs in Metro Manila. Project TEACH is given much credit for having Mandaluyong City awarded as the Most Child Friendly City in the Philippines in 2011. And most recently, the Project was awarded as one of the ten most innovative projects by the Galing Pook Foundation, an institution that commends and highlights significant and innovative projects among local government units.

 8. What were the most successful outputs and why was the initiative effective?
The project has significantly enhanced the beneficiaries’ skills as evidenced by objective assessments administered by diagnosticians and direct testimonials of their families. A parent satisfaction survey tool was developed to measure the appropriateness and effectiveness of the programs being received by the beneficiaries. They have noted that many of these children can now participate more competently in activities pertinent to self-help, home management, school, play and leisure. In the most recent quality assurance survey conducted by Project TEACH in March 2014, 93% of the parent respondents observed improvements on their children. All the parents expressed satisfaction over the services provided and all felt that interventions given were appropriate. To sustain these quality outcomes, an inter-agency committee was formed to develop, implement and evaluate an innovative and cost-effective service delivery framework that effectively streamlined services that are pertinent to youth with special needs. This committee meets at least once a month to evaluate Project TEACH’s programs and to discuss ways to enhance these accordingly. Project TEACH regularly welcomes visitors and external evaluators from both the private and public sector. Feedback and insights obtained from them are used constructively to further enhance Project TEACH’s efforts. Project TEACH takes pride in National awards and citations such as the Galing Pook Awards given by reputable evaluation bodies for being among the country’s best practices in local governance.

 9. What were the main obstacles encountered and how were they overcome?
An initial obstacle encountered was the lack of openness of families to bring their children to Project TEACH due to the stigma associated with people with disabilities. This was addressed through various seminars and community education activities. Moreover, they have been involved throughout the conceptualization and implementation process and this allowed them to attain a sense of ownership of the program. Working with youth with developmental conditions is a very specialized field. As such, the local government collaborated with the private sector in order to acquire the needed technical knowhow. The Rehabilitation and Empowerment of Adults and Children with Handicap Foundation, Inc. (REACH Foundation, Inc.) is a main partner that helped equip the program with capable professional and lay service providers. Institutions of higher learning like the University of the Philippines, University of Sto. Tomas and The Medical City were tapped to detail interns and residents to Project TEACH. This significantly augmented the professional manpower. Transfer of learning activities were emphasized to continue building the skills of Project TEACH’s service providers. Since funding was limited during the initial phase, grants were obtained from agencies such as the Philippine-Australian Community Assistance Program. Funding agencies chose to support Project TEACH primarily due to concrete measures set-up by the local government to ensure its sustainability. Among such measures include the passing of ordinances that would make Project TEACH a permanent program of the city. Streamlining the efforts of various government agencies pertinent to the care of persons with disabilities significantly helped the local government save time, effort and physical resources. This streamlined effort can be gleaned from the service deliver framework discussed above.

D. Impact and Sustainability

 10. What were the key benefits resulting from this initiative?
The project has significantly enhanced the skills of about 600 children under this program. This is evidenced by objective assessments administered by consultant diagnosticians and direct testimonials given by the beneficiaries and their families. Advocates and beneficiaries have noted that many of these children can now participate more competently in activities pertinent to self-help, home management, school, play and leisure. In the most recent quality assurance survey conducted by Project TEACH in March 2014, 93% of the parent respondents observed improvements on their children. 100% felt that interventions given were appropriate. Moreover, 100% of the parent respondents expressed satisfaction over the services rendered. Government employees have also benefited from Project TEACH’s capability building programs. Specialists have conducted workshops for the doctors in the health centers while the Department of Education-Mandaluyong’s special education programs, specifically its self-contained special education classes, mainstreaming and inclusion programs have been revitalized. Through Project TEACH, 122 public school special children have been clustered into 10 more homogenous groups which were advised to enroll in the public school that has been assigned by Project TEACH to implement the most appropriate ‘specialty curriculum’. Through this ‘clustering scheme’, the students belonging in a class would present similar needs and baseline skills. Hence, the teachers’ lesson planning process and classroom management is much simplified. To date, Mandaluyong City has placed at least 26 special students in the mainstreaming or inclusion program in five of its public schools. To maintain good standards in mainstreaming and inclusion, Project TEACH has developed implementing rules and guidelines that have been recently taught to guidance teachers of the City’s 18 out of 21 public schools. Project TEACH continually aspires its inclusion and mainstreaming protocols to be fully implemented in all the City’s public schools. Also, CREW members and volunteer parents undergo rigorous training activities to enable them to assist in the implementation of therapy and educational programs. To ensure the quality of services, they work under the close supervision of licensed therapists and special education teachers. To encourage a cooperative culture, the parents of beneficiaries are expected to render community-services. They enlist in any of the following working committees that match their interests and skills: housekeeping, programs support, information dissemination, family support. This cost-effective model helps Project TEACH meet the community’s vast demand that is at risk of being left unaddressed partly due to the exodus of qualified professionals such as therapists and teachers abroad.

 11. Did the initiative improve integrity and/or accountability in public service? (If applicable)
A Memorandum of Agreement on Project TEACH was signed in September 2007 among the proponents: City Government of Mandaluyong, the Rehabilitation and Empowerment of Adults and Children with Handicap Foundation Inc. and other stakeholders, wherein the roles and responsibilities of each stakeholder pertinent to the project are stated. City Council Resolution No. 1348, S-2008 ratified and confirmed the MOA relative project implementation, while City Ordinance 405, S-2008 stipulated the institutionalization and strengthening of the project as well as the creation of the Mandaluyong City Children’s Code. The participating government agencies have already institutionalized protocols specific to Project TEACH. A help desk was created at the City Social Welfare and Development Department to determine the eligibility of special children applying to be beneficiaries of free services. This help officer then gives the child an appointment with the developmental pediatrician for proper diagnosis and intervention. The City Health Office has trained its doctors how to screen children suspected of having special needs and on how to make timely and appropriate referrals to specialists such as developmental pediatricians. The other agencies have likewise appointed focal personnel to assist families of special children. The heads and/or representatives of the partner agencies meet once a month to discuss issues and plans. Project TEACH prime movers have been invited to speak and to present its service model like from the Department of Social Welfare and Development. Demonstrating the replicability of the program, the Municipality of Carmona, Cavite and the City of Dipolog, Zamboanga del Norte have established their own community-based rehabilitation program which were Project TEACH-inspired, in consultation with the Project TEACH’s program director. Likewise, the project has been presented in international venues such as the United Nations General Headquarters in New York, USA and in conferences in in various international conferences in Korea, Taiwan, Thailand. International delegates from Myanmar, Laos and East Timor, among others, have also conducted study tours in Project TEACH. The University of Toronto, Canada, has affiliated with Project TEACH as a training ground for one of its Master of Physical therapy students.

 12. Were special measures put in place to ensure that the initiative benefits women and girls and improves the situation of the poorest and most vulnerable? (If applicable)
Project TEACH is an excellent example of how a local government unit can collaborate with the private sector in effectively delivering much needed care to a marginalized sector. The sustainability of this collaboration was supported by a Memorandum of Agreement (MOA). Clearly defining the roles, responsibilities and expectations of each stakeholder from the onset proved to be most useful. In the MOA, the local government clearly stipulated its commitment to keep the project as a permanent project. The pieces of legislation passed to facilitate this established the project’s legitimacy which made it even more attractive for funding agencies and technical partners to support. Physical facilities are important but any project’s ‘soft-ware’ should be given equal importance. Project TEACH demonstrated that it is not merely about photo-ops amidst shiny and imposing structures. In fact, early on, Project TEACH was housed in a simple room borrowed from an underutilized government building. Funding was focused on hiring the best and most service-oriented staff possible. Staff were continuously developed to be the most competent professionals that they can be. Programs and protocols were standardized and documented to ensure consistency and efficiency. In time, better facilities were built. Now, Project TEACH enjoys a three-storey building within a spacious park making it more conducive to serving more youth with special needs. The project emphasizes empowerment and transfer of knowledge by recruiting experts to teach essential competencies to lay people and local professionals. For example, 3 out of the 45 developmental pediatricians in the country are committed to conduct long-term training to Mandaluyong City’s government doctors. Also, CREW members and volunteer parents undergo rigorous training activities to enable them to assist in the implementation of therapy and educational programs. To ensure the quality of services, they work under the close supervision of licensed therapists and special education teachers. To encourage a cooperative culture, the parents of beneficiaries are expected to render community-services. They enlist in any of the following working committees that match their interests and skills: housekeeping, programs support, information dissemination, family support. This cost-effective model helps Project TEACH meet the community’s vast demand that is at risk of being left unaddressed partly due to the exodus of qualified professionals such as therapists and teachers abroad. Proper documentation facilitated the objective of inspiring other local governments to replicate Project TEACH in their respective communities. Accomplishment reports submitted to partners projected transparency and a sense of collaboration. These helped keep partners interested and involved. A multi-sectoral approach facilitated the creation of a streamlined service delivery framework. This proved to be cost-effective since it allowed sharing of resources and it prevented work redundancy. Meetings held by representatives of all the sectors concerned allowed the program to evolve accordingly and stay relevant to the community’s needs.

Contact Information

Institution Name:   City Government of Mandaluyong
Institution Type:   Government Agency  
Contact Person:   BENJAMIN JR. ABALOS
Title:   Project Chairperson  
Telephone/ Fax:   (632) 532.2332 / 532.2224
Institution's / Project's Website:  
E-mail:   illcphilippines@yahoo.com  
Address:   City Government Complex, Maysilo-Boni Avenue, Brgy. Plainview
Postal Code:   1550
City:   Mandaluyong
State/Province:   National Capital Region
Country:  

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