Opportunities For Rehabilitation of Children with Autism in Kazakhstan
Tatyana Pritvorova* and Balsulu Tasbulatova
Karaganda Buketov University, Republic of Kazakhstan
Submission: June 01, 2022; Published: June 9, 2022
*Corresponding author: Tatyana Pritvorova P, Karaganda Buketov University, Universitetskaya str., 28, Karaganda city, Republic of Kazakhstan
How to cite this article: Tatyana Pritvorova, Balsulu Tasbulatova. Opportunities For Rehabilitation of Children with Autism in Kazakhstan. Glob J Intellect Dev Disabil, 2022; 10(1): 555780. DOI:10.19080/GJIDD.2022.10.555780
Abstract
The article deals with the issue of providing children with autism with rehabilitation services in Kazakhstan. The low level of purchasing power of the allowance for a disabled child and the pronounced lack of the necessary range of services from public services created the problem of access to rehabilitation for middle- and low-income families. The market value of rehabilitation services, according to our expert calculations, exceeds the funds for rehabilitation by 8.5 times. In our opinion, it is necessary to introduce vouchers for private sector services for these children and increase the tax deduction utilization level.
Keywords: Children with autism; Rehabilitation; Costs; Kazakhstan
Opinion
Children with disabilities in Kazakhstan make up 1,5% of the total number of children under 16 years of age and in the last 5 years this value has not changed. The proportion of children recognized as disabled for the first time is also stable at the level of 0,2% [1].
The stability of the proportion of children with disabilities in their total number and the increase in the absolute number of children with disabilities indicates that there is no real effect in the prevention of childhood disability, and, consequently, that the problem persists in the medium and long term.
Economic issues of life support for disabled children imply a set of various kinds of benefits in cash, tax benefits, as well as in-kind transfers, including in the form of services. The latter can largely solve the problems of households with children, because they provide part of the necessary services free of charge. The vast majority of studies express concern that even in developed countries, the financial costs of child health and upbringing, despite the variety of forms of economic and social support, the income of a family with children is insufficient for full participation in the life of society [2-5].
Children with autism diagnose make up about 8% of the total number and the problem of rehabilitation of these children is especially acute.
Our pilot sociological study of the conditions of rehabilitation of 85 families revealed that for many types of rehabilitation services there is no adequate availability of public (free) services.
The aggregate share of respondents who chose the options “not satisfied” and “rather dissatisfied” for all types and characteristics of services has a share of more than 50%, with the exception of the quality of socio-pedagogical services.
By types of medical services, there is no compensation for the high cost of some imported medicines, the absence in the rehabilitation package of a number of services relevant for this diagnosis (for example, ABA therapy for children with autism). As a result, parents either do not have the opportunity to purchase these services at market prices, or purchase single services.
What opportunities do parents have to purchase services on the market if parents do not receive the full amount of available rehabilitation for the child?
The source of resources can be transfers and tax benefits related to the disability of the child.
With the adoption of the Law of the Republic of Kazakhstan dated October 12, 2021 No. 67-VII LRK “On Amendments and Additions to Certain Legislative Acts of the Republic of Kazakhstan on Social Protection of Certain Categories of Citizens”, starting from 2022, the following main changes concerning disabled children came into force:
1. separation of children aged 7 to 16 years by v disability groups;
2. an increase in the amount of allowance provided to both disabled children and parents raising a disabled child;
3. the right to get simultaneously benefits for disability and survivor has been granted [6].
4. The amount of the allowance for disabled children under seven years of age and disabled children of the third group, taking into account the increase in the volume of the subsistence minimum, is 116,37 USD or 1.40 times of the subsistence minimum (hereinafter referred to as the SM) (Table 1).
The subsistence minimum in the Republic of Kazakhstan is calculated according to the absolute method. The cost of a food basket of 48 items is taken as 55%, and the remaining 45% is considered a non-food component.
The amount of the allowance for disabled children of the first group is 159,60USD (1,92 SM), and of the second group is 132,17USD (1,59 SM). Information on basic rehabilitation programs and market prices for services was obtained during an expert survey of specialists and a sociological survey of households in five regions of Kazakhstan. We have calculated a possible package of services that can be purchased with an allowance and determined the cost of a standard rehabilitation package. For children with autism diagnosis can be assigned all three groups of disability, the first group of disability was chosen for calculations.
The complex of rehabilitation services for a child with autism is presented in Table 2.
Child allowance minus the consumer basket is 76,46USD per month. However, this amount is not enough to cover the standard rehabilitation course, which includes the purchase of medicines and vitamins, classes with a speech therapist, such types of therapy as “Tomatis” hardware technology, sensory integration, ABA therapy, as well as massage and classes in the pool with a specialist. Also, many note the importance of visiting a psychologist and receiving the “Micropolarization” hardware service. On average, such rehabilitation course costs 720,06USD and involves intensive visits to various specialists, at least 3 times a week for a month. For the amount of 76,46USD, eight types of services can be available to a child for only one lesson per month, excluding the purchase of medicines, which negatively affects the quality of rehabilitation.
Possible methods of solving the problem may be:
1) The development of a subsidizing mechanism for a child with autism in the form of a voucher, which will allow parents to use the services of private companies to obtain services of the necessary range and quality. It is proposed to introduce vouchers specifically for children with autism, since currently this type of disability is relatively less supported by affordable services from public services due to the shortage of specialists (ABA tutors) and the high cost of hardware services.
2) Increasing utilization of the tax deduction percentage (currently it’s 30% due to low earnings for 80% of families) due to the permission to use the remains of the tax deduction in the amount of 882 monthly calculation index by the second parent (including those who has adopted disabled child),as well as by other close relatives living together (adoptive parent, grandparents, brother / sister), which will increase the level of its use up to 100%.
Funding
The results of the study were obtained within the framework of the grant funding project supported by the Science Committee of the Ministry of Education and Science of the Republic of Kazakhstan, “The system of support for households with disabled children: conceptual foundations, effective practices, development mechanisms in Kazakhstan”, 2020-2022. Registration number: AP088056616.
References
- Agency for Strategic planning and reforms of the Republic of Kazakhstan. Bureau of National Statistics.
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- Penne T, Hufkens T, Goedemé T, Storms B (2020) To what extent do welfare states compensate for the cost of children? The joint impact of taxes, benefits and public goods and services. Journal of European Social Policy 30(1): 79-94.
- Adema Willem, Clarke Chris, Frey Valerie (2016) Paid parental leave and other supports for parents with young children: The United States in international comparison. International Social Security Review 69 (2): 29-51.
- Shaha, A, Greco G (2021) The Economic Costs of Childhood Disability: A Literature Review. International journal of environmental research and public health 18(7): 3531.
- Law of the Republic of Kazakhstan dated October 12, 2021 No. 67-VII LRK. On Amendments and Additions to Certain Legislative Acts of the Republic of Kazakhstan on Social Protection of Certain Categories of Citizens.