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

well-being, as well as improved socio-economic development and decreased inequalities [1]. The importance of equitable access to quality, inclusive education for all children is recognised in many national and international laws and frameworks, including the Sustainable Develop- ment Goals 4 [2, 3]. However, globally, around 240 million children with disabilities frequently remain excluded from the benefits of education [4]. The right of children with disabilities to education is recognized explicitly by 37 national constitutions and in other laws and policies in 113 countries [3]. Article 24 of the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), which has been ratified by 185 countries, also codifies the rights of children with disabilities to accessing education without discrimination [5]. Despite these laws and policies, children with disabilities are less likely to attend school, progress to secondary and higher levels of education, and have lower overall attainment com- pared to their peers without disabilities, particularly in low-income countries (LMICs) [4, 6]. Across 15 LMICs, children with disabilities were, on average, 31 percent less likely to attend school then non-disabled peers [6]. Children with intellectual and communication impair- ments are particularly likely to be excluded from school [7]. Even when children with disabili- ties do attend school, skill acquisition is often hindered by the lack of provisions for an inclusive education, including inadequate teacher training, inaccessible facilities, and poor

availability of specialist education resources [8, 9]. Further, children with disabilities frequently have negative social experiences while at school due to isolation, discrimination and violence from teachers and peers [10, 11]. India is an important country to assess and impact the access of children to an inclusive education, given its population size, policy climate, and regional and global influence. The 2011 Census estimated that there are at least 65.8 million children of school-going age (5–19 years) who have a disability [12]. This number is recognized to be underestimated, given the restrictive definition of disability used in the Census [13]. The Constitution of India guarantees the right of all children to education and Government policies in India have increasingly focused on improving education for children with disabilities [14, 15]. The Right of Children to Free and Compulsory Education Act (RTE) 2009 builds on the rights in the Constitution, and explicitly codifies the rights of children with disabilities to primary education, and prohib- its discrimination based on disability [16]. The Rights of Persons with Disabilities Act 2016 defines inclusive education as a “system of education wherein students with and without dis- abilities learn together and the system of teaching and learning is suitably adapted to meet the learning needs of different types of students with disabilities” [17]. This Act outlines active identification of disabilities amongst children in school, making facilities accessible, providing

specialist educational resources, and other modifications for children aged 6–18 years having 40% or more difficulty and are attending school at a government-funded or recognised institution. The National Policy on Education 2020 also includes a significant focus on improving access to and quality of education for children with disabilities. For example, it calls for main- streaming disability-inclusive teaching methods into standard teacher training [18]. Specialist educators, particularly for middle and secondary schools, were also recognized as a priority area for investment, as were resource schools that can provide specialist educational resources and teaching strategies for children with multiple or severe disabilities. Further, the Govern- ment of India supports two national programs, Sarv Shiksha Abhiyan (SSA) and the Rashtriya Madhyamik Shikhsha Abhiyaan, for promoting access to and quality of primary and second- ary education respectively for all children, including children with disabilities [19]. They include specific provisions for children with disabilities, such as specialist curricula and teach- ers, access to assistive devices and other learning supports, and medical and educational assess- ment. While far ranging in scope, in practice there have been large gaps in their PLOS ONE Access to education for children with disabilities PLOS ONE | https://doi.org/10.1371/journal.pone.0290016 August 16, 2023 2 / 19 Funding: This research was funded by the United Kingdom Foreign, Commonwealth and Development Office (PENDA grant: PO8073, PI-

HK) and the Bill and Melinda Gates Foundation (DeWorm3 grant: OPP1129535, PI-JLW) to the Natural History Museum, London. The funders had no role in study design, data collection, analysis, manuscript preparation, or the decision to publish. Competing interests: Authors have no competing interest.