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

will they take me in and out of class’. Not a single child is with him at that time, he stays alone in class on the fourth floor.” (Mother of a boy, mobility limitation–“cannot do”) The accessibility of school toilets was also a challenge. Several caregivers and children reported that the toilets were generally poorly maintained, with issues such as poor cleanliness, no proper wall around the toilet, and toilets being out of service (e.g., locked, no running water). Even if on-site toilets were in a usable condition, some children with disabilities faced additional barriers in using them. For example, caregivers of children with cognitive impair- ments instructed their children to come home if they needed to use the toilet because they are unable to clean themselves. Overall, about a third of children in school–particularly chil- dren with mobility and cognitive impairments—returned home to use the toilet. Returning home could lead to time out of school or shortened days. Further, children with physical impairments sometimes needed assistance in using inaccessible on-site toilet facilities. This assistance was often provided by peers, which could lead to feelings of embarrassment and awkwardness: “They [peers] are ready to help but my son is not ready to accept their help. All his classmates are physically equal to him, yet my son fears that they might drop him. . .. children need to lift him. The second reason is my son feels embarrassed, so we go to school to be with him.” (Mother of a boy, mobility limitation—“cannot do”)

The mother of a 13-year-old girl with mobility limitations discouraged her daughter from using the school toilet because of a lack of privacy. She said, “She goes to toilet only after coming back home after she attained puberty. . .. I tell her not to go in school and tell her to use at home. Toilet is not good. It is just open without wall. . . So, I tell her to come and use at home. She will rarely use in school.” (Mother of a girl, mobility limitation–“a lot of difficulty”) The lack of accommodations and poor physical accessibility of schools led in a few instances to families making significant sacrifices to support their child’s schooling. For example, the mother of a boy with a severe physical impairment explained how his father could not go to work because he would accompany their son to school to provide needed assistance: “Someone needs to be present in school with him to open the lunchbox and water bottle, carry him when he wants to go to bathroom. . .., his father stays there, he feeds him food, takes him to bathroom, and brings him back to home from school. My son will say he wants to go to bathroom after having lunch.” (Mother of a boy, mobility limitation–“cannot do”) Resources for inclusive education. In addition to poor physical accessibility, most schools did not have adequate resources to support inclusive education, particularly for chil- dren with sensory and intellectual impairments. For example, many children with visual impairments faced difficulties in reading from the classroom board even when they were PLOS ONE

Access to education for children with disabilities PLOS ONE | https://doi.org/10.1371/journal.pone.0290016 August 16, 2023 9 / 19