Enabling Inclusion

There are nearly 240 million children with disabilities in the world (UNICEF, 2021). According to UNICEF’s Child Disability report (2021): children with disabilities are 34% more likely to be stunted, 25% more likely to be wasted,  24%  less likely to receive early stimulation and responsive care, 25% less likely to attend early childhood education, 16% less likely to read or be read to at home, 42% less likely to have foundational reading and numeracy skills, 49% more likely to have never attended school, 47% more likely to be out of primary school, 33% more likely to be out of lower-secondary school, 27% more likely to be out of upper-secondary school, 32% more likely to experience severe corporal punishment, 41% more likely to feel discriminated against, 51% more likely to feel unhappy and 20% less likely to have expectations of a better life.

Based on the official census data, there are 7.8 million children with disabilities in India, constituting 1.7% of the child population (Ministry of Statistics and Program Implementation, 2016). Other studies estimate that nearly 10% of children in India have some form of developmental, physical or learning delay, making the true burden of childhood disability much higher. 

 According to the World Health Organization's Early Childhood Development and Disability discussion paper, “If children with developmental delays or disabilities and their families are not provided with timely and appropriate early intervention, child rehab, support and protection, their difficulties can become more severe—often leading to lifetime consequences, increased poverty, and profound exclusion” (WHO, 2012).

India’s Right to Education Act (2010) guarantees universal access to education for all children independent of ability. Samagra Shiksha (Education for All—Integrated Education for Disability) is a government program in India that aims to improve school enrollment and integration for children with disabilities through the implementation of consultative special educator, resource teachers and resource classrooms, provision of therapy aids in school, transportation support, and home school support .  However, the success of these interventions has been varied,  as schools across India are still under-resourced. In government schools in India, there is 1 special educator assigned to cover 12 schools on a consultative basis and 1 resource room and teacher attached to every 12 schools.  The majority of schools in India do not have the supports in place to promote inclusion of children with disabilities in the classrooms. 

According to UNESCO’s State of Education Report for India (2019), school enrollment for children with disabilities in India remains low with 23% of all children with disabilities aged 5–19 having never attended an educational institution, while 99.4% of all children attend school. The UNESCO report also highlights that there are fewer girls with disabilities in school than boys, highlighting that child gender is another barrier to school enrollment. 

A lack of child rehab and development services within and outside schools, has been cited by UNICEF as the main barrier for children with disabilities to achieving and maintaining school enrollment, engagement, retention and inclusion (UNICEF, 2021). Interventions promoting child development should address physical, social, emotional, language, and cognitive areas of development. Services targeting these domains of development are referred to as child rehab and development services or early intervention therapy and can encompass physical therapy, occupational therapy, speech-language therapy and special education. These services have a significant impact for children who have delayed development in physical, cognitive, emotional, sensory, behavioral, social and communication domains of development. With quality child rehab and development services, children can reach their potential, enrol and be included in schools, live a meaningful life, integrate into their communities and eventually contribute to society. 

The major barrier to accessing child rehab and development services is lack of special educators in schools, lack of teacher training and support and lack of rehab therapists. Though India has a population of 1.39 billion, there are only 120,000 registered special educators (RCI, 2021),  31,000 pediatricians (Indian Academy of Paediatricians), 50,000 registered physiotherapists (IAP, 2021), 6000 registered occupational therapists (AOIT, 2021) and 3000 registered speech therapists (ISHA, 2021) in the country. The vast majority of these service providers work in the private sector and are not available to children within schools and not affordable or accessible to parents in the community. This lack of early intervention and child rehab services within homes and schools has led to low school enrollment, engagement, retention and integration of children with disabilities in India. 

The COVID-19 pandemic has further exacerbated challenges for children with disabilities, as many have been unable to access or engage in online school. Return to in-person learning has been challenging for all children, but even more pronounced for those with disabilities and especially for girls with disabilities. 

References

UNICEF 2021: Seen, Counted, Included: Using data to shed light on the well-being of children with disabilities. United Nations Children’s Fund Data and Analytics Section Division of Data, Analytics, Planning and Monitoring.  https://data.unicef.org/resour...

Ministry of Statistics and Program Implementation. Disabled persons in India: A Statistical Profile. (2016). Available online at: https://ruralindiaonline.org/l... (accessed May 28, 2020).

World Health Organization. Early Childhood Development and Disability: A Discussion Paper. (2012). Available online at: https://apps.who.int/iris/hand... (accessed May 28, 2020).

United Nations Educational Scientific and Cultural Organization (UNESCO). N for Nose - State of the Education Report for India - Children with Disabilities. (2019). Available online at: https://en.unesco.org/news/n-n... (accessed May 28, 2020).

All India Occupational Therapy Association (AIOTA) (2021). http://aiota.org/otindia

Indian Speech-Language and Hearing Association (ISHA) (2021).  https://www.ishaindia.org.in/

Indian Association of Physiotherapy  (IAP) (2021) . https://world.physio/membership/india

Rehabilitation Council of India (RCI) (2021). http://www.rehabcouncil.nic.in/

Our solution overcomes the challenge of lack of rehab therapists, by harnessing the strengths of existing workers in India, where there are 1 million community health workers, 2.5 million Anganwadi (child development) workers and 9.7 million teachers. 

The Enabling Inclusion (EI)® innovation powered by the EI® app overcomes the barriers to early identification, intervention and child rehab by providing private, non-profit and public-sector organizations with a cost-effective solution with huge impact.

We license the EI® app to organizations, both government and non-governmental and provide training, software and logistical support to launch the Enabling Inclusion® model. These organizations deploy the EI® app and innovation amongst their own service providers and ecosystem of workers in their communities which include teachers, community workers, special educators and rehab therapists. 

Organizations licensing our services, provide teachers and community workers with the EI® app, which they use to screen children for all forms of developmental delays/disabilities using validated tools in the app. These children, and their caregivers are then connected through the EI® app to rehab specialists (physiotherapists, special educators, occupational therapists, speech therapists, psychologists) via tele-rehab.  Tele-rehab is used to overcome the barrier of scarcity of rehab specialist and these specialists are mobilized from within the organization or through partnerships with govt and private regional health and education centres. During these tele-rehab sessions, rehab specialists use internationally validated tools within the EI® app to assess children in all developmental domains to identify impairments and strengths. 

These assessments, along with family-centric inputs, help co-create an individualized education and therapy plan that cover all domains of development and types of impairments. These interventions are inputted into the EI® app using pre-populated drop down menu options by the rehab specialists. These interventions are easy for community workers and teachers to understand. Many of these interventions are connected to video modules within the app to clearly illustrate the therapeutic activity for community workers, teachers and parents. 

These plans and interventions are seen by community workers and teachers in the EI® app on their mobile devices and guide them in provision of regular rehab and education support for children with disabilities. Community workers do regular visits to a child’s home to support their development and follow through on the individualized education and therapy plan (IETP). The community workers check in and check out using GPS-enabled technology and document what was done during the home visits in the EI® app, so that it can be tracked. Similarly, teachers also document the activities done in the classroom that are part of the IETP with children in the EI® app. 

Rehab specialists conduct periodic re-evaluations, goal resetting and updating of the ITEP every 6-12 months via tele-rehab.  This overcomes the barrier of rehab specialists’ scarcity and reduces costs as each rehab specialist can cover more children, and ensures quality as rehab specialists are guiding and monitoring therapy and special education interventions. 

The EI® app uses cloud-based storage in mobile and web versions and provides organizations with individualized case management with family-centered goal setting and intervention planning. The EI® app helps organizations achieve their organizational goals by tracking child and parent outcomes, workers outputs using GPS-enabled technology and has scheduling, planning, monitoring & evaluation and reporting features. The EI® app provides organizations with robust real-time data which allows them to maximize the efficiency and effectiveness of their service providers including community workers, teachers and rehab specialists and guides them with real-time data for research and decision making.

Thus far, we have licensed the EI® app to 5 NGOs across 4 states in India and to two government organizations – the Tamil Nadu Disability Dept and Tamil Nadu Education Dept, (covering 3 full districts in the state of Tamil Nadu). The organizations we partner with may vary in their approach slightly, but they all harness the technology in the EI® app to promote development in children with disabilities and support their school enrollment and inclusion and are in line with our guiding principles of inclusivity and gender equality.

Our solution directly serves children with disabilities. Our solution also supports mothers and caregivers of children with disabilities and teachers working with children with disabilities in their classrooms.  Our solution serves communities by enabling inclusion of children with disabilities in society. 

23% of children with disabilities age 5-19 in India are not enrolled in schools and many of those that are enrolled, do not have the supports in place to be integrated, included and thrive in the classroom learning environment (UNESCO, 2019). 80% of children with disabilities in India do not have access to regular early intervention and child rehab services (UNESCO, 2019). 

Our solution serves children in the two most critical places of their lives, in their own homes and in schools. Our solution serves children with disabilities and their caregivers in their own homes by providing them with child rehab services by connecting community workers doing home visits to rehab specialists via the Enabling Inclusion® app and solution. This allows children to improve their development and function, so that school enrollment can be achieved 

The Enabling Inclusion® solution then continues to support children within the classroom by providing teachers with individualized educational support and therapeutic activities which they follow and track through the EI® app. For those children with barriers to school enrollment despite home based child development services, the Enabling Inclusion® app guides community workers to support parents in rendering home based educational programs and supports. 

By focusing on empowering community workers, caregivers and teachers, the majority of whom are women, our solution has a special focus on women empowerment. In addition, we train partner organizations specifically on providing interventions for girls with disabilities, to ensure we reduce the gap in rehab and education services and school enrollment seen with girls with disabilities.  

To illustrate the  impact, I will highlight a true case study: An 8 year old girl was enrolled in school in grade 2, but not attending because of teachers concerns over emotional outbursts, low tolerance to touch and lack of interest in self-care. She was lucky to be in a community where the Enabling Inclusion® program was launched. A community worker screened her using the app and found her to have impairments in behavioral, emotional and social development. She was then assessed by a special educator and occupational therapists via tele-rehab and a home and school based individualized education and therapy plan was inputted into the EI® app, based on child, family and teacher priorities and goals. A community worker did weekly visits to the child’s home where parents were trained in how to engage her in sensory challenges through activities such as lifting heavy objects and assisting with cooking. Self-care activities were practiced by the family with the support of the community worker and through the written guidance and videos in the EI® app.  A school plan was also created whereby, the teacher was guided to provide her with a fidget toy during class that allowed her to focus better and introduced brain-body activities such as jump rope and stretching when she had behavioral outbursts. The activities completed were documents in the EI® app by both the teacher and the community worker and monitored by the program management. The rehab specialists reassessed her 6 months later via tele-rehab and her social, emotional and development had improved significantly as measured by standardized scales. She has been attending school regularly and her teachers, parents and the school feel empowered to support her and ensure her education continues. 

 References

 United Nations Educational Scientific and Cultural Organization (UNESCO). N for Nose - State of the Education Report for India - Children with Disabilities. (2019). Available online at: https://en.unesco.org/news/n-n... (accessed May 28, 2020).

Krishna D, Mutthukarrupan S, Bharathwaj A,  Ponnusamy R, Srinivasan, S, et al.  Rapid-cycle evaluation in an early intervention program for children in South India: optimizing service providers’ quality of work-life, family program engagement and school enrollment. Frontiers in Public Health. (2020).

Muthukaruppan S, Cameron C, Campbell Z, Krishna D, Srinivasan, S,  et al.. Impact of a family-centred early intervention programme in South India on caregivers of children with developmental delays. Disability and Rehabilitation. (2020).

Hunt M, Ponnusamy R, Goulet A, Anthonypillai C, Krishna D. An integrated knowledge translation project to develop, implement, and evaluate a train-the-trainer program at a community rehabilitation program in Tamil Nadu, India. Disability and Rehabilitation. (2020).

The visionary behind our innovation is Mr.Sankara Raman. When he was 3 years old, he lost the ability to walk and was diagnosed with muscular dystrophy.  His parents were told by the local schools that they could not accommodate his wheelchair and he was denied schooling. His parents’ home schooled him for a few years and eventually fought with the school board until ramps were built in the school and his special needs were accommodated. He was a brilliant student and went on to become a Chartered Accountant and had a blossoming private practice. In 1992, he left this practice to dedicate his life to growing Amar Seva Sangam, a non-profit-organization dedicated to people with disabilities in India that now benefits more than 30,000 people with disabilities per year through centre and community based programs that focus on education, rehabilitation, vocational training and advocacy.  He has been honoured with numerous awards, media appearances and has become a household name in many parts of India. His mission in life is that every child has the opportunity to go to school like he did and he dreams of an inclusive world in which children, families and communities are given the resources that allow all children with disabilities to reach their full potential.

The founder of our organization, Mr.Ramakrishnan suffered a spinal cord injury that left him paralyzed from the neck down when he was a young adult. He founded Amar Seva Sangam (ASSA) to serve the educational and vocational needs of children with disabilities. He is winner of Padhma Shree award (3rd highest civilian award in India) and CNN Hero of the Year award for his work at ASSA. 

The lead applicant, Dr.Dinesh Krishna, is a physician and Director of Strategy for the Enabling Inclusion program. He is an award winning teacher, researcher, clinician and leader and helped conceptualize this innovation and continues to strategically direct its scale-up.  He lives with and supports a brother in law with cerebral palsy and has a niece and uncle who are wheelchair users.  

Led by these dynamic and inspirational leaders, who understand the challenges faced by children and people with disabilities, our team has the expertise to deliver the solution at scale. 

We have a dedicated technology team that works closely with our partner organizations that license our EI® app. Out technology team trains partners’ IT teams, sets-up and customizes their servers to meet their needs and provide around the clock tech support, help desk services, maintenance and updates. Our technology team works closely with our third party software vendor to continuously upgrade the app based on user feedback and new insights and innovations. These upgrades are driven by regular, formal user feedback we obtain from users and beneficiaries of the innovation including govt and NGO management, teachers, community workers, rehab specialists, children with disabilities and their parents. 

We have a dedicated training team that provides a training curriculum for partner organizations’ teachers, community workers, rehab specialists and management. This team trains and on-boards organizations to the logistics of setting up, launching and maintaining the Enabling Inclusion® model and trains each provider on their role in this ecosystem. This team also provides targeted training and support on education and rehab topics for other organizations. The training team produces and shares rehab, and education video content, resources and manuals and is integral to providing education and rehab inputs that go into the EI® app. The team also collaborates with leaders in the field of disability rehabilitation, disability education and early childhood development in order to ensure the latest innovations in the field are included in the Enabling Inclusion® app, model and training curriculum. 

We have a dedicated partnership development team focusing on awareness building around the innovation, promotion, marketing and government lobbying to develop new and sustain existing NGO and government partnerships.  

We have a dedicated Monitoring and Evaluation and research team involved in robust monitoring of outcomes with rapid cycle action to enhance programming for all stakeholders and to perform collaborative research with partner organizations. This team has cultivated partnerships with leading research institutes including Harvard Centre on the Developing Child, University of Toronto, McGill University, Manipal Academy of Higher Education, University of British Columbia and  Utretch Centre for Global Challenges. This team has produced numerous publications and presented at numerous international conferences and continues to study innovative approaches to disability education and rehab with a focus on dissemination of results to benefit millions of children with disabilities globally. 

In addition, we have a finance, legal and admin team led by our Chief Finance Officer,  Mr.Rajeshwaran, who suffered a spinal cord injury as a youth and understands the issues faced by youth with disabilities. 

Our senior leadership team including our Director of Research, Associate Director of Research and Capacity Building, Chief of Learning and Capacity Building and Chief Information Technology Officer are women. Their unique perspectives on women and girl empowerment drive our agenda.  

The design of this innovation was a ground up approach, in which we surveyed and listened to the needs of all major stakeholders, including children with disabilities, their parents, teachers, rehab specialists, program management, governments, and national and international experts. Their inputs led to the formulation of the Enabling Inclusion® solution. Our solution is constantly evolving. It undergoes a constant iterative process of rapid cycle changes based on stakeholder feedback, that is well documented in our publication in the Frontiers in Public Health (Krishna, et.al 2020 https://www.frontiersin.org/articles/10.3389/fpubh.2020.567907/full)

Our innovation brings rehab and education services to children with disabilities in their own homes and into schools, by empowering community workers and teachers with training and provision of the Enabling Inclusion® app we have created. The results from our innovation have shown high impact and cost savings while maintaining high quality services prompting us to scale-up through government and non-government partnerships throughout India and eventually globally. 

The MIT Solve Prize will take us to the next level and allow us to scale-up further, bring transformative system change and elevate humanity. The MIT Solve Prize will amplify our innovation, build connections and provide access for new partnership development, to accelerate our national and global scale-up vision.  We will utilize the connections and network obtained through this award to make this social enterprise sustainable by building and  improving our public relations strategy including. branding/marketing, social and global media, in order to expand our client base. 

The bottom line is we have the solution in place and the infrastructure to support its scale-up. We need to convince and engage new customers – NGOs and governments to license our solution to make us financially sustainable and in order to scale the impact of our innovation. We believe the MIT Solve award will give us the connections and platform to achieve this. 

The prize will allow us to realize our dream that no child should be denied access to school and education because of their disability.

To address the gap in school enrollment for children with disabilities, the traditional solution has been to put rehab services and resources to support students into the schools themselves. However, nearly 25% of children age 5-18 in India have never attended a single day of school and therefore there is no chance of reaching them this way. In addition, in India there is 1 special educator and 1 resource room and teacher assigned to every 12 government schools. Teachers don’t feel empowered to support students with disabilities in the classroom. Parents, especially those from lower socioeconomic and educational backgrounds inIndia don’t know the strategies to get their children with disabilities prepared for school enrollment and engagement. 

The traditional solution to providing rehab services for children with disabilities is to have them come to rehab centres. However, most of these are located in urban centres attached to government hospitals and transportation and costs are major barriers for most families, especially low income families. In addition, shortage of rehab professionals and special educators makes it very challenging for children and families to access rehab and special education services. 

Our solution connects the most important community stakeholders in a child’s life by engaging community workers who do home visits and teachers who teach in the classroom to the expertise of rehab specialists via tele-rehab, all in one platform that provides individualized case management for children with disabilities. Our solution has also proven to be lower cost than having children go to rehab centers and has better outcomes, as interventions are provided in the natural environment of children (their homes and schools). 

Enabling Inclusion® is the only child rehab app that provides a holistic solution on the market that is designed for use in Low and Middle Income Countries. Other child rehab apps exist, but they all provide generic interventions for teachers, children and parents and are often disability or impairment specific. Enabling Inclusion®  is the only app that provides individualized interventions for all domains of development and all forms of impairments, based on the exact needs of children with disabilities using a system to obtain expert consultation with rehab specialists. Other apps are sold directly to parents or teachers and are thus only affordable to high income families that can afford a smart-phone, data plan and monthly app subscription fees. We sell our product and services to organizations, both government and non-government, who provide early intervention and child rehab services to children and families either free of cost or subsidized, thus making it accessible to all families, including those without smart phones and those with low income. Other apps provide minimal technical support, while we provide full tech support for our app and also provide logistical advice and support and assist organizations in integrating the app into their organizations and their workflow and community’s ecosystem of services and service providers including schools, rehab centers, community workers, rehab specialists  and management. 

The Enabling Inclusion® solution is an absolute game changer. We have  licensed to 5 NGOs and 2 government departments and have many more partnerships in the pipeline. With rapid adoption and further scaling by the NGO and public sector, the Enabling Inclusion® solution will lead to system change, whereby millions of children with disabilities can be supported to maintain school enrollment and thrive.

In 1 year, our goal is to support school enrollment, engagement and retention for 15,000 children with disabilities through active engagement in our innovation. We will achieve this through Enabling Inclusion®  licensing partnerships with 10 NGOs and 3 government departments covering 7 states in India. 

In 5 years, our goal is to support school enrollment, engagement and retention for 500,000 children with disabilities through active engagement in our innovation. We will achieve this through Enabling Inclusion®  licensing partnerships with 40 NGOs and 5 government departments covering 18 states in India. Our goal is to have it become a statewide program in Tamil Nadu state in India, covering 150,000 children with disabilities. Our goal in 5 years is to start entering the global market and reach 3 other countries outside of India.

UN SDG #4 - Quality Education -   Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all.

 School enrollment. We will measure the rates of school enrollment for children engaged in our innovation. 

School attendance. We will measure the school attendance rates of children engaged in our innovation. 

School retention: We will measure the rate of retention in school for children engaged in our innovation. 

Intervention adherence: We will measure the rate of completion of prescribed interventions by teachers and community workers. 

UN SDG #3 – Good Health and Well-being -  Ensure healthy lives and promote well-being for all at all ages

Improved health and development. We will measure the number of children who had improved health and development in all domains of development including gross and fine motor, cognitive, social, academic, emotional and communication through standardized scales within the EI® app. 

UN SDG #5 - Achieve gender equality and empower all women and girls.

We will measure the number of women empowered through training programs for teachers, community workers and rehab specialists. 

We will measure the number of women who gained employment as a result of our innovation. 

We will measure the number of girls impacted with quality education and improved health and development and ensure gender equality in our intervention. 

All impact goals listed above can be measured through the Enabling Inclusion® app.

UN SD #17 - Partnership for the Goals. Strengthen the means of implementation and revitalize the global partnership for sustainable development

We will measure the number of partnerships -  public sector, NGO and private sector that strengthen the goal of improved school enrollment, engagement and retention for children with disabilities. 

The impact goals listed above can be measured through the Enabling Inclusion® app.

Please see: 

https://earlyintervention.amar...

We have conducted a number of research studies which have shown major impact and proven our theory of change listed above. A study conducted with a third party research team from University of Toronto with 1,136 children from 2017 – 2020 found that the Enabling Inclusion® app based program improved therapy engagement from 60 to 95%, improved child development, increased school enrollment for children with disabilities from 70 to 85%, and improved worker job satisfaction (Krishna, et al.2020). In addition, the Enabling Inclusion® model when compared to the traditional centre based model of providing rehab services was found to have a 75% cost reduction with better outcomes. 

Another study conducted by University of Toronto found that the Enabling Inclusion® app based program significantly reduced caregiver strain and improved parent empowerment.( Muthukaruppan S, et al. 2020). A study conducted by McGill University found that the teacher and community worker training program we conduct provides a key example of how a tailored program can be developed, and highlighted the importance of stakeholder-driven design processes.(Hunt, et al. 2020).

References

 Krishna D, Mutthukarrupan S, Bharathwaj A,  Ponnusamy R, Srinivasan, S, et al.  Rapid-cycle evaluation in an early intervention program for children in South India: optimizing service providers’ quality of work-life, family program engagement and school enrollment. Frontiers in Public Health. (2020).

Muthukaruppan S, Cameron C, Campbell Z, Krishna D, Srinivasan, S,  et al.. Impact of a family-centred early intervention programme in South India on caregivers of children with developmental delays. Disability and Rehabilitation. (2020).

Hunt M, Ponnusamy R, Goulet A, Anthonypillai C, Krishna D. An integrated knowledge translation project to develop, implement, and evaluate a train-the-trainer program at a community rehabilitation program in Tamil Nadu, India. Disability and Rehabilitation. (2020).

The core technology that powers our solution is the Enabling Inclusion® app. 

Screening 

The screening module within the EI® app has internationally validated screening tools including the UNICEF / Washington Group Module and the Trivandrum Development Screening chart which can be used by community workers and teachers to screen for developmental delays or disabilities. Once screened positive, there is an option in the EI® app to refer children into the Enabling Inclusion® therapeutic and educational program. 

Child Assessments and Evaluations

Children that are referred are initially assessed by community workers through a general assessment in the app which captures child and family demographic information and also all relevant child developmental, education and health information through parental interview. The General Assessment follows the WHO’s International Classification of Functioning, Disability and Health (ICF) model covering body structure and function, activity, participation, environmental factors and personal factors. In this assessment, the developmental impairments identified in a child are selected by the community worker using a drop down selection which includes physical, cognitive, speech and language, hearing, vision and behavioural impairment.  Based on these selections, the EI® app auto-assigns specialized assessments and evaluations to the relevant rehab specialists working in the program or the organization ecosystem which could include physiotherapy assessment, speech & language assessment, functional hearing and vision assessments and special education assessment (which includes ADHD, specific learning impairments and autism screening tools), amongst others. These assessments can be assigned to a physiotherapist, special educator, occupational therapist, speech therapist / trainer, psychologist or social worker, depending on the cadre of specialists in the program or in the community ecosystem. 

Family-Centred Goal Setting and Intervention / Therapy Planning 

In the general assessment, a primary impairment is selected. This triggers a primary rehab specialist to be assigned. This primary rehab specialist then performs an environmental assessment, to allow them to better understand the home, family, community and school environment of the child and the existence of barriers to participation and inclusion that need to be addressed. The COPM (Canadian Occupational Performance Measure),  a standardized tool, is used with families to identify their priorities and set functional and educational goals for their child. Based on these goals, each rehab specialist involved in the child’s care selects the therapeutic goals and intervention plans in all relevant domains of development using drop down selections in the EI® app for the intervention period (usually 6-12 months) for both home and school based interventions. The COPM is repeated at 6-12 month intervals to review goal achievement and set new priorities and goals. 

Intervention Assignment and Therapy Scheduling and Monitoring 

The interventions are then assigned to community workers and the child’s primary teacher. Based on consultation with families, the home interventions / therapies are scheduled using the EI® app on particular days of the week or particular dates for the next 6-12 months and assigned to individual community workers. This schedule then appears on the calendar of these workers in their EI® app. Similarly, teachers are assigned certain interventions to work on with that particular child in the classroom at set intervals. For every activity that community workers and teachers are assigned, they have to check-in at the beginning of the activity and check-out at the end and this is captured via GPS coordinates. This ensures the completion of activity and location of activity completion and time spent on that activity can be monitored by the program management and tracked to ensure fidelity. 

Dashboard and Reporting

The Dashboard provides each user of the EI® app with a birds eye view of the program, including the number of children under their care and their details including their disabilities. It also provides an overview of their intervention task assignments, their task accomplishment rate, etc. The management dashboard provides a comprehensive overview of the entire program including total children impacted by the program, total active children receiving services, children on wait list, children discharged, caregivers impacted, number of service providers, intervention  completion rate, children screened, number of positive children identified, school enrollment, retention and attendance of children in the program.  The dashboards have drill-downs, so clicking into any category will give you a detailed breakdown.  The EI® app also flags children and families who are having worsening outcomes on any of the various child development, school or family outcome measures, so they can be identified for further follow-up. The EI® app collects a multitude of data and through the power pivot reporting features, reports can be generated for any data query and can be exported into Excel. 

EI® App Technical Features

The EI® app is available on android devices and has a web and mobile platforms which has an off-line mode, so that data entered can be synced when internet is available. The EI® app follows Indian and GDPR data security regulations and standards.

We have set our guiding principles for our human resource development that embodies the values of diversity, equity, and inclusion built on ethical, transparent, accountable and non-discriminatory practices which are measurable, recognizing rights of the stakeholders, safety of products and services and ethical practices in all domains. 

Our organization serves people with disabilities and we prioritize their inclusion in our leadership team.  We have five people on our leadership team with visible disabilities including our president, vice-chairman, chief financial officer, board director and marketing director. Our senior leadership team has an equal number of women and men and we are guided by the principle of having equal or more women on our senior leadership team as part of our hiring practices. We also actively recruit and hire people with disabilities to be part of our team.  We serve people of all ages, religions, caste, gender, sexual orientation, ethnicity and socioeconomic backgrounds and our leadership teams is reflective of these diversities.

We provide fair remuneration for all without any discrimination based on gender, gender identity, race, sexual orientation, caste or religion and are transparent about salaries, benefits, and working conditions. We have an ombudsman to guide, monitor and measure compliances including tracking percentage of women and persons with disabilities employed and resolution of complaints. We have documented policies on employee code of conduct, child protection, prevention of sexual harassment, whistle-blower, data protection and web security and informed consent.

Our business model is both B2B and B2G, as we sell our services to both organizations and governments. We charge an initial training and software set-up fee that ranges from $3000 to $9000 USD depending on the size of the organization and then a per child licensing fee of $3  per child per month to organizations that are licensing our EI® app. The services we provide licensing organization both governments and NGOs include:

Training 

1. Train the trainer model 

2. Setting up and launching the EI® model

3. Using and maintaining the EI® app for all levels of workers in the partner organization and ecosystem 

4. Monitoring, Evaluation and Reporting 

5. Continuing Rehab Education 

Technology

1. Web, Mobile EI® App Setup

2. Domain creation

3. App Configuration and customization   

4. App Deployment

5. Annual Maintenance Contract (AMC) for software

6. Usage of App - Unlimited users

7. Updates

8. Application and data server space 

Support

1. IT and Rehab Help Desks 

2. Quality Management support

3. Monitoring and Evaluation Support  - including dashboard, report generation and data analysis

4. Post onboarding support for processes & procedures, scales, tools, modules and service provider training 

5. Continual Feedback from partners to drive improvements, changes and upgrades to the EI® app 

We also provide value added services at extra costs that could include: 

1. Direct training of service providers including community workers, teachers and rehab therapists

2. Field Support for Implementation of program

3. Impact evaluation and collaborative research 

4. Recruitment support

5. Program Implementation 

6. Fundraising, Advocacy, networks, relationships 

7. Program Innovation and development

Our long term plan for financial sustainability is growing our partnership and generating income through our training and software licensing services. We need to reach 40,000 children licensed with our licensing partners to break-even. To bridge the gap until we achieve that level of enrollment, we have obtained funding starting in 2022, over the next 4 years in the form of grants from Grand Challenges Canada and Handi-care Intl. for $1.6 million USD. Our goal is to become financially sustainable within this next 4 year period. 

As noted above, we have received a grant from Grand Challenges Canada and Handi-care Intl. for $1.6 million USD over the next 4 years to maintain the innovation until we achieve enrollment of 40,000 children which is our break even point. We have generated $250,000 USD in training and licensing fees for Enabling Inclusion solution thus far.