Center Based Holistic Rehabilitation for Children with Autism

Abreham & Robel

General Objective: to create access for holistic rehabilitation services of children with Autism, empower their parents, and promote for enhancement of community awareness and the protection of their well being.

Beneficiaries: Persons with Autism Spectrum Disorder, their parents and the general community

Area of Operation: Woreda 04, Nifas Silk Lafto Sub City, Addis Ababa, Ethiopia

Project Duration: January 2013 – To date

Donor: Global Fund for Children USA, Finland Embassy, Civil Society Support Program, Individual Donations, Local Fundraising

Project Justification

The prevailing attitude and perception of our community and the associated practices with in the family, working government systems, and the society at large determine the types of services and support systems provided to persons with autism spectrum disorders. It has negatively influenced their life.

While autism is still misunderstood in some cultures, and individuals who suffer from the disorder are often ostracized, many nations are working hard to battle stereotypes, design interventions and provide treatment. In line with that the government of Ethiopia facilitates the implementation of the following three pipeline projects in all regions of the country to serve the needs of children with special needs and integrate them in the society, eventually of inclusive society. These include:

  • The National Strategic Plan for the Rehabilitation of Persons with disabilities (MOLSA 2001),
  • The National Curriculum, for Pre-service Teachers Education Programs (MOE 2OO3), and
  • National Forum of Organizations Working on Disability (MOLSA 2003).

In response to the effective execution and fulfillment of these initiatives, and from the felt stimulation to work for these neglected community members, the Nia Foundation intends to implement a three year project to build on its prior experience on the field for the past ten years and strengthen the system with new scientific approaches to implement intensive holistic rehabilitation services, increase service access, empower parents and raise community awareness in Addis Ababa as well as countrywide.

Specific Objectives:

  • To provide center based holistic rehabilitation services for 100 children with autism.
  • To conduct diagnostic and educational assessment procedures for 150 children with pervasive developmental disorders to identify their disorder status.
  • To empower 100 parents and households of children with autism with provision of psychosocial support.
  • To empower 5 low income parents of children with autism with provision of economic support in the form of employment in the organization’s income generating business.
  • To increase accessibility of special needs education in Addis Ababa in collaboration with 5 public schools.
  • To increase the community awareness on issues related to autism through 6 different organized events addressing an estimated population of over 100,000 in collaboration with relevant government bodies.

Results [Expected Outcome]

  • Early detection and assessment of children with developmental disorders or special needs as per the developed assessment tools promoted and realized
  • Children with autism who are enrolled at the Joy center rehabilitated to be able to take part in day to day engagements within their community
  • Children at the center developed the necessary fine and gross motor skills to coordinate and use their sensory organs
  • Children at the center developed and improve their physical, social and communication skills
  • Children at the center developed the necessary skills to help and take care of them selves
  • The health and nutritional status of children at the center improved and maintained
  • The psychosocial status and their engagement in the community of parents of children with autism who are enrolled at the Joy center improved
  • The economic status of parents of autistic children at the Joy center with low economic status improved
  • Access to special needs education for children with autism and other developmental disorders increased with in Addis Ababa
  • The capacity of selected public schools with special needs unit improved
  • Parents and other community members in the country have an increased awareness level on matters related to what autism is, the needs of autistic children, how to mainstream them within the community system, and protect their rights
  • The level of stigma and discrimination towards persons with autism reduced
  • The overall wellbeing of children with autism improved


  • Holistic rehabilitation service provision addressing children with autism and their parents

The first and key strategy of our intervention towards achieving our project goal is that we maintain and strengthen our center based holistic rehabilitation services incorporating new ways of working and approaches such as introducing additional vocational skills trainings like pottery, wood, jewelry & painting works. It is also very essential to have a strategy to address the psychological, social and economic circumstances of parents of children with autism so as to make the intervention comprehensive and holistic.

  • Establishing network and linkage with government schools and other relevant government offices

The other crucial strategy to be taken to reach to our objective is that expanding services and increasing accessibility. To do so, creating and strengthening linkages and networking with relevant government bodies such as education, health, labor and social affairs, women, children & youth affairs offices at city, sub city, and woreda level and other implementing partners such as government schools is mandatory.

  • Community mobilization and awareness creation

As any intervention without public support and community engagement is nothing or brings nothing significant, it is a very important component of our project to have a strong strategy component of addressing public awareness and community mobilization for the ultimate benefit of our beneficiaries (i.e. children with autism and their parents) and proper and successful execution of the project activities.



  • Staffing

Our existing staff is and will be of those who are equipped with the necessary academic and work experience enabling them capable of executing their respective duties and come up with their expected deliverables.

In addition to that, for the purpose of strengthening organizational undertakings and replacing dropouts, we will be introducing newly recruited competent professionals in to our staff during the project life span. We also plan on maintaining our strategy of equipping new staff with organizational guidelines and our ways of working through on-job trainings facilitating smooth implementation of the project.

In collaboration with partners, we will also be addressing the capacity building needs of existing staff continuously both via on-job trainings and sending out for professional trainings locally and abroad.

  • Equipping

Though we have fairly sufficient equipment to start with, as the time of the project execution progress and as we work on addressing more children with autism and expand our service in collaboration with other public schools, the necessary additional office, therapeutic and training materials will be made available at the project implementation facility.

All the purchases and procedures will be as per the relevant national regulations and internal guidance.

  • Programming

The project designing, overall organization, coordination, monthly plan development, continuous assessment, monitoring and evaluation are to be made in a programmed manner managed by professionals with experience in the area.

The detail program executions at the center are to be followed strictly and the progress and success of the intervention will be recorded continuously.

  • Service Provision and Expansion

          Center Based Holistic Rehabilitation: The Joy center is the place for intensively rehabilitating children with autism. In the center we aim at continually supporting enrolled children with a variety of comprehensive educational, therapeutic, and social and self help skills development services. The rehabilitative services are provided on a daily basis at the Joy center and being so it serves the means of letting the children rejoin their parents at the evening and engage in the community where they will be exercising the learnt self help and social skills in an extended mode.

Autistic children at the Joy center will be receiving;

  • Therapeutic services to enhance their sensory system, fine and gross motor skills, stimulation, sound & speech production, maintaining eye contact and communications.
  • Educational services to enhance their academic skills; how to write (using ABUGIDA Phonetics which we have developed earlier), how to count numbers, separate colors, and basic computer skills.
  • Social & self help skills development services to enhance their skills of interacting in the society, participating in community events, exercising shopping skills, taking care of oneself; personal hygiene, toilet usage, cooking skills, and other related occupational therapies.

N.B: The center based holistic rehabilitation service is set up with the necessary equipment and staff. The staff is provided with different trainings making them be able to work on different therapeutic services, as it is the most plausible approach to be working in our country due to the fact that it is difficult to bring such professionals from the available market.

          Center Construction: As part of the expansion and increasing accessibility of autism rehabilitation service, building a huge center of excellence for autism in the capital city Addis Ababa has been a top priority for a while and it is going to be made realized in this project period. The preparatory tasks for acquiring the necessary land slot from the city administration has already been made and preliminary understanding has been achieved between the respective government office and ours that we will be receiving the land by the sooner time possible. The infrastructural design of the center to be built has also been done and the plan has already won interests of some potential partners for the plan to be effected on timely manner.

In this specific project period we will be aggressively working on securing the land and raising the necessary funds to construct the center while making the beginning of the construction happen and progress towards 50% completion.

          Partnership with Government Schools: It will be our major expansion strategy to be implemented as soon as preparatory tasks are complete. We will be working with five selected government schools with special needs unit on the areas of capacity building; technical assistance. The schools will be assisted on how to organize special needs class/training rooms, special needs teachers will get trained on how to work with children with autism; new ways and modern therapeutic materials that found to be helpful in working with children with autism will be introduced, etc.

          Parents Empowerment: Any intervention targeting to benefit children with autism would not be effective unless has a comprehensive approach of addressing their families and households as well. In doing so, we will be undertaking different parents’ empowerment activities to alleviate their economic and psychosocial challenges.

Monthly parents meeting sessions will be held by which parents will get the opportunity to reflect on their children’s status, progress and overall concerns as others will be sharing their views on the raised issues and guidance given from the Joy Center. Annual trainings will also be provided for parents and households to enhance their skills of coping with their autistic children, technically managing behaviors, and working and educating their children.

On the other hand, economically empowering parents whose economic level is not in a state to sufficiently support themselves and their children is a very crucial component of the project. At least five destitute parents of children with autism will be supported in terms of employment in income generating business established by the Nia Foundation getting monthly salary.

          Community Awareness: A very crucial component of the project that will have a great impact on the community is the activities to be implemented to raise community awareness level. Building on our previous experience, we will be continuously working hand in hand with signatory government offices and their respective sub city and woreda level offices on different awareness creation means such as organizing national symposiums, erecting big city billboards, and publishing brochures and flyers.

The symposiums are planned to be organized in line with the annual celebration of World Autism Awareness Days in the month of April, during which different stakeholders are gathered, high profile speeches delivered, discussions held on different issues, and ways forward of working in collaboration.

Using IEC/BCC materials for the sake of addressing the community awareness is inevitable and is believed to be effective in addressing most segments of the community. Therefore, we are planning to produce at least three big city billboards and multiple copies of brochures with up-to-date information about autism, persons with autism, country status, what the community role should be on the issue, and the available services for persons with autism.

Beneficiaries Selection Criteria

Our selection criteria are a bit flexible for the purpose of creating equity in accepting a range of in need children and parents confined in different circumstances, but the main selection criteria of enrolled in the project as a beneficiary are;

  • A diagnostic certificate indicating that he/she is a child with autism
  • The child must be under the age of 10 years and always preferable for the most youngest ones
  • Parents who are clearly in a difficult economic situation to support their children and themselves. It should be evidenced from their respective woreda offices with a letter of support
  • Priority is given to single mothers and families who have more than one child with autism

Inputs [material, finance, and manpower]

  • Material: we have the necessary though insufficient infrastructure in terms of classrooms, play ground, and other facilities in addition to the necessary training and therapeutic materials available in our center. We have also sufficient rooms and apparatuses for administrative tasks and our staff are equipped with necessary office materials.
  • Finance: For the purpose of executing the project successfully there is an apparent need for convenient financial allocation. As the total budget needed is expected to be 13,365,858.00 birr, we are committed in making the necessary moves towards maintaining our existing organizational donors such as; Global Fund for Children USA, Finland Embassy, and Packard Foundation,    to continue working with us in this project and also attract new donors in to our system in addition to our effort to raise funds locally during our annual fundraising programs each year. Individual contribution from interested people and organizations is also to be expected to share a significant amount of our budget as in the previous times. Taking these all into consideration, the financial input necessary for the project implementation is to be realized at different stages of the project implementation period.
  • Manpower: Full time employed and to be employed administrative and programmatic personnel are the key inputs for the successful achievements of our project objectives. The necessary project staff will be maintained and recruited for the whole project duration as they hold a crucial role in the overall project execution and success. So far we have a total of 35 full time employees working on our center for autism and we will be adding additional 20 staff during the project period totaling 55 of which 44 would be females. The staff will be comprised of different professionals including managers, programmers, psychologists, special needs educators, teachers and other administrative staff. (The detail manpower plan of the project is annexed)

Assumption and  risks

  • Assumption
  1. Willingness of schools and other stakeholders: the complete cooperation of the major stakeholders of the project including the government schools planned to be working with and other relevant government bodies is assumed to be in place for the successful execution of planned tasks.
  2. Commitment of the city government in provision of the required land: as a result of our intensive multiyear effort towards securing the necessary plot of land to construct the Autism Center of Excellence as part of our expansion plan, it is recently paying a dividend as it has reached to its final stage. We assume that the decision will be made anytime sooner by the committee responsible for the matter letting us have the required amount of land for the construction.
  3. Relevant governmental bodies’ involvement is expected: for the successful execution of the project activities and for the sake of monitoring and evaluation of the overall project progress and outcome, the relevant government stakeholders’ active involvement during all the stages of the project is expected to be in place.
  • Risk
  1. Risk of securing funds and maintaining donor partners: the major risk we see towards the project is the fact that we are dependent on our donors and maintaining adequate funds from our existing partners and securing new ones would be totally in the hands of these stakeholders apart from our effort and strategic approach putting the implementation of the project at risk. But we strongly believe that through early preparations that we have made towards securing funds and donation, and the individual promises that has been due to our organization earlier, the risk will be minimized much if not avoided.


Stakeholders Analysis

S.N Stakeholder Role
1 Addis Ababa Finance and Economic Development Bureau –      Facilitate and coordinate the signing of the project agreement

–      Signing the project agreement

–      Circulating government policies and regulations

–      Mediate and provide the necessary support if conflict arises

–      Monitor and evaluate the project

–      Facilitate duty free importation of items and other privileges

2 Addis Ababa Education Bureau –      Appraise the project proposal and forward comments on it

–      Signing the project agreement

–      Monitor and evaluate the project

–      Assist the project implementation and provide necessary technical support

3 Addis Ababa Health Bureau –      Appraise the project proposal and forward comments on it

–      Signing the project agreement

–      Monitor and evaluate the project

–      Assist the project implementation and provide necessary technical support

4 Addis Ababa Labor and Social Affairs Bureau –      Appraise the project proposal and forward comments on it

–      Signing the project agreement

–      Monitor and evaluate the project

–      Assist the project implementation and provide necessary technical support

5 Addis Ababa Women, Children and Youth Affairs Bureau –      Appraise the project proposal and forward comments on it

–      Signing the project agreement

–      Monitor and evaluate the project

–      Assist the project implementation and provide necessary technical support

6 Woreda and Sub City Respective Signatory Offices –      Supervise and provide comments on ongoing project activities

–      Participate in beneficiary selection and screening

–      Provide technical/ administrative support in community mobilization, networking, …

–      Share information about government policies and directions

–      Participate in baseline survey

7 Autistic Children Participate in and utilize the rehabilitation services provided to them
8 Parents of Autistic Children Actively participate in project activities targeting them and Efficiently utilize the multifaceted project support
9 Donor Partners Financial assistance to the project and monitor its proper implementation
Selected Public Schools Utilize the technical assistance provided to them and serve better children with special needs including those in the autism spectrum.


Monitoring and  Evaluation

  • Monitoring

The overall monitoring of the project implementation will be made on a daily, weekly, monthly, quarterly and yearly basis by the organization’s management and program personnel. Whenever, the need for timely amendment for any falters will be made timely so that we can reach towards the successful completion of the project.

The project signatories (signatory bureaus) also have a great role in the project progress monitoring through means of project site visit and physical & financial performance reporting. (i.e. quarterly, annually, and at the end of project)


  • Evaluation

Midterm and end term evaluation will be conducted in coordination with relevant stakeholders and signatories of the project agreement as per the preset indicators.

Phase out  and   Sustainability  Strategy

The nature of the project being community based (i.e. as the beneficiaries are mainstreamed to be in the community and reside within their families while getting the rehabilitation service) indicates its sustainability. Different communities and families are hugely involved in all the stages of the project ultimately empowering them to be owners.

The service expansion strategy of working with other public schools with special needs unit is also the other way of assuring sustainability by means of creating the chance of continuous service availability in different parts of the town regardless of phasing out of this project.

In case of project phase-out, though this project is meant to be rolling and lasts for many years, the necessary handing over of fixed assets to Charities and Societies Agency will be made according to the effective proclamation.