“If he has education, there will not be any problem”: Factors affecting access to education for children with disabilities in Tamil Nadu, India

included in this study, which would be helpful to explore their perspective on delivering educa- tion to children with disabilities. Further, some children with severe intellectual impairments and hearing impairments without knowledge of sign language could not be interviewed as they could not communicate with available supports during the study timeframe. These chil- dren are arguably most at risk of exclusion, and so further research–potentially involving trian- gulation with classmates or siblings–is needed to better understand their experiences at school. Still, this study had important strengths. For example, the sample was recruited from a large- scale population-based census, improving the generalisability of results. Qualitative studies with people with disabilities often involve recruitment through civil society organisations, and people affiliated with these organisations may not be reflective of the broader population [46]. Overall, this study carries implications for the delivery of inclusive education and for future research on the access of children with disabilities to education. Importantly, this study emphasises the limitations of traditional quantitative metrics in measuring access to education. Other studies have also found that school attendance, grade level, or attainment may not be indicative of children with disabilities’ learning [47, 48]. Quality of education is a universal challenge affecting all children, but children with disabilities are particularly affected due to

the unmet need for inclusive education strategies and supports [49]. As such, indicators for tracking educational progress, including towards meeting the Sustainable Development Goals, may mask the exclusion of children with disabilities from the learning and social experience even if they are in school. Further research is needed to co-develop and trial innovative strategies to deliver teaching that meets the needs of diverse learners, with input from children with disabilities, caregivers, and teachers on the current gaps and inputs required to overcome them. Overall, there is a lack of evidence on the effectiveness of interventions to improve educational outcomes for children with disabilities–in both India and other settings [50, 51]. India and other settings’ laws and policies reflect a strong commitment to achieving an “inclusive and equitable equality education for all”; however, this commitment is unlikely to be achieved without increased investment and prioritization of disability-inclusive planning in education and other sectors. Supporting information S1 File. STROBE statement. (DOC) Acknowledgments The authors wish to thank all the study participants and community members who have par- ticipated in or supported this study. We thank our field managers Rajeshkumar Rajendiran and Chinnaduraipandi Paulsamy, field supervisors and field workers at the study sites in India for logistical support during data collection activities in the field. We thank Angelin Titus, and Yesudoss Jacob for their support in data collection, and Uma Mageshwari for preparing the

transcripts from audio files. We thank Mr. Veeraraghavan Srinivasan, President-Nesam, Timiri, for orienting the study team on disability. Author Contributions Conceptualization: Tom Shakespeare. Data curation: Kumudha Aruldas, Lena Morgon Banks, Jabaselvi Johnson, David Musendo, Isaac Arpudharangam. PLOS ONE Access to education for children with disabilities PLOS ONE | https://doi.org/10.1371/journal.pone.0290016 August 16, 2023 15 / 19