Disability and barriers to education: evidence from Nepal

In this article, barriers faced by Nepalese with disabilities in obtaining a school education are discussed. The study employed both quantitative and qualitative method to analyse the barrier using unique data collected from survey and in-depth interviews. It was found that some barriers were impairment-specific, while some were faced commonly irrespective of the type of impairments. People with visual and hearing impairments faced the inadequacy of support systems in schools, whereas participants with physical impairments mainly faced difficulties caused by physical barriers, such as inaccessible buildings and the lack of safe, accessible roads. Additionally, the barriers faced in common by the participants were financial barriers, resulting from parents' poverty; and barriers resulting from parental attitude, social stigma and lack of awareness. Participants with hearing impairments were found to be more vulnerable to the barriers to education, and as a result they had fewer years of schooling than thei...


Introduction
Education is the cornerstone both for personal and, ultimately, national development, recognized by international organizations and national governments alike as a fundamental and basic right. Despite the importance attached to education in international declarations, access to education for people with disabilities is often elusive, particularly in developing countries. Eighteen percent of children worldwide (and 25% of children in South Asia) do not have access to education. Of the estimated 120 to 150 million children with disabilities under the age of 18 around the world, more than 90% of those living in developing countries do not attend school, a statistic which reflects the difficulty people with disabilities have accessing education (UNESCO 2009). Moreover, while much of the basic data on disability, poverty, and schooling in developing countries are simply undocumented, it is generally known that disability, as well as socio-economic factors such as gender, rural residence and economic status in a developing country, greatly affect a child's access to education. In developing countries, disability is furthermore linked with long-term poverty, and the inability to enhance one's human capital (Filmer 2005). A study on Nepal (Lamichhane and Sawada 2009) found high rates of return on an investment in education (19Á32 percent) for people with disabilities where as Psacharopoulos & Patrinos (2004) found it to be around 10 percent for people without disabilities. Education thus not only dramatically improves quality of life for people with disabilities, but is also crucial in achieving development goals which benefit everyone.
Despite education's positive effect on social and economic outcomes, people with disabilities in Nepal are often deprived of these benefits due to barriers to education. The potential barriers associated are many: economic, social, attitudinal and physical. Often in daily life, these all work together, erecting a wall that not only blocks people from receiving education, but also deprives society as a whole of a better future. In this context, what are the historical and contemporary factors acting as barriers to people with disabilities with the continuity of access to education in Nepal? And are these factors differed depending on the type of impairments? These are the main research questions for this study.
The lack of rigorous studies on these issues in Nepal could perhaps be attributed to the limited availability of data with which to examine them, making it imperative that researchers survey and analyse the educational situation of people with disabilities. In an attempt to fill this lacuna, this article addresses the factors associated with the continuity of access to education by focusing people recently out of school as well as older participants, which both paints a full picture of the educational situation for people with disabilities in Nepal. The rest of this article is organized as follows: the next section includes background information on disability and education in Nepal, followed by the methodology, results, and discussion. The article concludes with a discussion of policy recommendations.

Background
According to UNICEF figures (UNICEF 2010), Nepal has a per capita income of 400 US dollars, and a population of 29 million, of which 80% are in agriculture. Previous to 1964, Nepalis with disabilities had no real access to education, as there were no schools either in special or inclusive settings that could accommodate their individual needs. In 1964, however, education for people with visual impairments was formally begun in an inclusive setting in the Laboratory School in Kathmandu. Three years later, the first school for people with hearing impairments was also established in Kathmandu (UNICEF 2003;Prasad 2003). Similarly, schools for people with learning disabilities were established in the 1960s. Even after five decades of education for people with disabilities, however, gaining access to schooling can still be prohibitively difficult. Ahuja and Filmer projected that South Asia, 'which is currently the least educated region, is expected to substantially augment its stock of human capital by the year 2020' (Ahuja and Filmer 1995). Filmer (2005) additionally showed that disability is likely to be a stronger determining factor in inequality than other factors. Thus it is imperative that efforts be made to ensure that people with disabilities in South Asian nations like Nepal are included in this projected development of human capital.
In Nepal, though no precise statistics are available on how many children with disabilities attend school (UNICEF/NPC 2001) reported that 68.2% of the people they surveyed, with all kinds of disabilities, lacked any formal education. This percentage is significantly higher compared to the national estimate for those with no education of 43.9% (UNICEF/NPC 2001). Likewise, the report further estimates that 59.6% of boys and 77.7% of girls with disabilities had had no education. When coupled with other sources of inequality such as economic disadvantage or rural residence, it is even less probable that children with disabilities will be able to attend school.
There are three educational options for people with disabilities in Nepal: integrated schools, special schools, and mainstream schools. Integrated schools are for people both with and without disabilities which are able to offer specific resources and facilities to their students with disabilities. Specials schools are specifically for students with hearing impairments that have appropriate equipment and training to match the students' educational needs. Mainstream schools are facilities that offer no special resources or support for students with disabilities. Both integrated and special schools have limited capacity. For example, in the three districts that comprise Kathmandu Valley (the most urban area in Nepal), there are only three integrated schools, with very small capacities for students with visual impairments, and one special school for students with hearing impairments. Nationwide, there are 16 special schools for students with hearing impairments. Integrated schools are primarily designed for students with visual impairments, whereas the special schools are for students with hearing impairments. Meanwhile, there are no special schools designed to accommodate students with physical impairments, for whom the primary obstacle is usually not teaching, but accessibility. Children with physical impairments thus normally attend mainstream schools.
Community attitudes towards people with disabilities in Nepal can also present social barriers to children's educational achievement. Nepalese society is still mostly rural, and religious beliefs have a strong influence: even those living in urban areas, like our respondents, are likely to be affected by prevailing, traditional views. Views on disability are often inflected by religious teachings which regard it as a punishment for the prior misdeeds of the parents. UNICEF and the NPC's 2001 study surveyed the head of the household as to what they believed was the cause of their child's disability. More than one third of their respondents misperceived disability as the result of various supernatural factors such as fate, punishment of the gods, evil eye curses, or punishment for parents' sins (UNICEF/NPC 2001). Because of the strong social stigma accorded to disability in Nepal, this study also looks the effect of parental attitudes on children's educational achievements. Those families perceiving their child's disability as negative might choose not to educate their children both because of the prevailing belief that such a child would not benefit from education, and because of the belief that disability is simply the child's Á and the parents' Á fate. Rousso (2003, pp.4) says, in her examination of the challenges faced by girls with disabilities, that to 'avoid being ''shamed'' some families not only deny girls who are disabled access to school, but hide them away entirely.' As Hegarty (1998) points out, attitudes toward people with disabilities are centrally important to any effort to reform education provisions because these attitudes are a crucial determinant of educational attainment.

Methods
The study design is based on mixed method. Mixed method not only draws the strengths but also minimize the weakness of both quantitative and qualitative techniques (Johnson and Onwuegbuzie 2004). The quantitative part of the study has been analysed descriptively whereas thematic content analysis has been used for qualitative interviews.

Participants
People with hearing, physical, and visual impairments were the participants. To approach the respondents, we randomly selected participants from the name lists of the five main disability-related national organizations in Nepal: Nepal Association for the Welfare of the Blind, National Association of Physically Disabled Persons, Nepal Association of the Deaf and Hard of Hearing, Nepal National Federation of the Deaf and Hard of Hearing, and the Nepal Association of the Blind. We further divided the members in each impairment group, aged between 16 and 65 years, into male and female subgroups. Then 409 respondents were randomly selected using proportionate stratified random sampling out of a total of 993 potential participants. Kathmandu Valley, which covers three districts Á Kathmandu, Lalitpur, and Bhaktapur, was chosen for the study area. All required procedures were completed from the University of Tokyo. The study was carried out with oral informed consent from the participants, who were aware that they could withdraw from the study at any time, during or after, without incurring any personal consequences.

Data collection
The survey was conducted over the course of two study-specific informationgathering trips, in six-week sessions from May to June of 2008 and again from October to November of the same year. To obtain the information from the participants, face-to-face interviews were carried out using carefully-structured questionnaires. The survey covers a wide variety of socioeconomic information including impairment, demographic characteristics, educational background, barriers to education, and attitudes of the participant's family. The questions were either closed-ended or asked participants to answer based on a one to five scale. The factors associated with barriers to education included in the survey were generated by the result of the 2007 preliminary survey. Sign language interpreters were hired for interviewing participants with hearing impairments.
Additionally, to further capture subjective reality and mechanisms to the barriers to education emerged from the quantitative analysis; semi-structured in-depth interviews were undertaken with 12 participants in February, 2009. These 12 individuals were aged between 25 and 43, and were among the previously selected 409 survey respondents.
In the interview sample, there were six men and six women. Furthermore, an equal representation of each of the three categories of impairment, i.e. hearing, physical, and visual impairments, was purposely chosen.
The interviews were held in the participants' homes or at their workplace and lasted from a minimum of one hour to a maximum of 2.5 hours. Interviews were conducted in Nepali and were recorded digitally and later translated into English.

Data analysis
To analyze the quantitative dataset, the information about the barriers to education based on the type of impairments has been presented in percentage points. The average years of schooling by people with hearing, physical, and visual impairments has been calculated and compared among them.
For the qualitative data analysis, thematic content analysis was used. Following repeated re-reading of the anonymized transcripts, excerpts from the transcripts were broken down thematically for the in-depth interpretation of the phenomenon.

Trustworthiness
In order to maintain the trustworthiness of the study, beside systematic sample selection procedures, measures such as appropriate interviewer training, and standardization of both questions asked and the interview process were adopted to enhance its internal validity or credibility. The pro-long engagement in analysing qualitative data further assures the credibility of the themes. Table 1 shows the basic socio-demographics characteristics of the participants. Female participants covered 42.1%. Similarly, 30.6%, 36.9%, and 32.5% participants had visual, hearing and physical impairments respectively. The mean age was 32.5 years. Females were on average younger (31.1 years) than their male counterparts (33.5 years). The average year of schooling was 8.8 years indicating that males were less educated (8.6 years) than females (9.1 years), which gives the impression that parents are becoming more aware on the education of both female and male in urban areas. Table 2 presents the basic data on the length and institutional form of education participants received. Among 347 participants who attended school have an average of 8.8 years of schooling. Comparatively, UNESCO data indicates that the average for Nepali children is 9.4 years. Participants with hearing impairments had an average of 6.9 years, participants with visual impairments had an average of 9 years, and participants with physical impairments had the highest average of 10.9 years. Of the total participants, 35.4% received education in integrated schools. In contrast, 24.8% obtained their education from special schools. The majority (39.8%) received education through mainstream schools. Additionally, majority of participants with visual impairments (58.1%), hearing impairments (59.1%) and physical impairments (55.8%) respectively, attended integrated, special and mainstream schools. Table 3 compares the highest level of education achieved by participants across type of impairments. The results indicate that participants with hearing impairments had the fewest years of schooling, compared with those with visual and physical impairments. Among the total participants, 2.7% had informal education, 20.9% gave up after completing five years of schooling. Almost an equal number (22%) did not continue after eight years of schooling, 15.5% completed only 10 years of While looking at students with and without disabilities, the government data shows that 27.8% of students without disabilities could not reach beyond full formal education of 10 years (Department of Education, Government of Nepal 2008) in contrast to 58.4% of those with disabilities.

Results
A majority of the participants with hearing impairments did not complete their full 10 years of school education, 12.5% completed no more than five years, and an additional 15.8% of participants did not complete more than eight years. A mere 4.9% of participants with hearing impairments successfully completed 10 full years of schooling.
Comparatively, only 4.1% of participants with visual impairments had given up their education after five years, decreasing to 1.6% when looking at participants who did not continue passed grade eight. The number of students with visual impairments who did not continue to higher education after graduating from 10 years of schooling was also low, at 2.1%. Participants with physical impairments had a similar pattern to those with visual impairments at school education: 4.3%, 4.6%, and 8.5% did not continue their education after five years, eight years, and 10 years, respectively.
In terms of education past the formal 10 years, participants with visual (16.9%) and physical impairments (18.5%) had higher rates of attendance than participants with hearing impairments, where only 3.5% had obtained education past the 10 year mark.

Type of impairments and barriers to education
Participants cited different factors contributing to their decision to discontinue their education, primarily lack of support in schools, financial difficulty, scarcity of schools, and rejection from an institution, as shown in Table 4. Table 4 includes data from 214 participants, the total number of participants who responded to the question. The questionnaire asked whether the various factors contributed to leaving school, so participants who did not leave school (i.e. graduated from college) or never attended school did not respond to the question in addition to some non-responses. Lack of support on the part of institutions was cited by 25.7% of total respondents with 21% of participants with hearing impairments, as opposed to 3.3% and 1.4% of participants with visual and physical impairments. In addition to this evidently serious problem of inadequate support within schools, participants from all groups said that they had faced significant challenges in finding schools at all. The unavailability of schools to enrol was cited by 21% of the total respondents, with 15.4% of people with hearing impairments, 0.9% of those with visual and 4.7% of physical impairments claiming it as a barrier. Irrespective of the type of impairments, the cost of education was also a major concern. Those who missed out on the chance to go to college were most vocal on this topic. Of all our participants, in total 40.2% cited financial difficulties as preventing them from continuing their education. Among participants with visual impairments who had left school before completing the full 10 years of formal schooling, 7.1% had encountered serious financial difficulties. This figure is twice as high for participants with physical impairments, 14.9% of whom indicated that this had been a serious problem, while a much higher 18.2% of respondents with hearing impairments who had discontinued their education cited the same reason as one of the main causes. A small percentage of participants (3.7%) also cited being rejected by a school as the reason they discontinued their education. Similarly, 22.4% of respondents cited barriers such as difficulty in communication and school infrastructure being inaccessible and school being a long way from home.

Parents' attitudes
It was found by this study that parents' attitudes toward their children with disabilities can be a major determining factor in students with disabilities' quest for education. Participants were asked to rate their parents' attitudes toward them Á specifically, how well their parents understood disability issues, how well they understood the rights of individuals with disabilities, and whether or not their parents' attitudes toward their children with disabilities' potential for personal advancement were positive. We then investigated whether there was any relationship between parents' perceived attitudes and respondents' education levels. Table 5 summarizes the average years of schooling according to parents' attitudes toward their children with disabilities. The results indicate that as the perceived attitudes of the participants' parents were more positive, the average years of schooling participants received also increased. For example 10.3 years of average schooling was positively correlated to their parents' highest level of awareness of disability issues whereas 5.6 years of schooling was found to the respondents whose parents' level of awareness of disability issues was in lowest level. The same pattern was found on parents' understanding of rights of people with disabilities and attitude toward abilities of people with disabilities. Each of the factors cited by the participants in the quantitative study were discussed in the qualitative in-depth interviews. The following sections explicate how these factors function as barriers to continuing education.

Lack of support
Interviewee A, a man with hearing impairments, 28-years-old, who gave up his education after completing grade eight, indicated that he would have liked to continue his education beyond grade eight, but was prevented by the difficulty of finding a school that would provide the necessary sign language facilities. Similarly, interviewee B, a 31-year-old woman with hearing impairments who stopped her study after completing grade seven also found that the lack of a support system was one of the primary deterrents when trying to continue her education.
The problem was that there was no support in mainstream schools, like sign language or other materials. . . . Most teachers taught by lecture, which, without sign language interpreting, would be almost impossible for us to understand.
Interviewee C, man with hearing impairments, 28-years-old, who had completed seven years of school, had similar views on the problem of providing a support environment in schools. He faced problems with sign language from the start of his education, saying: It was very hard for me to adjust in school from the beginning because I was not taught proper sign language, even though I attended a school that was for persons with hearing impairments.
Along with communication difficulties, he cited a lack of attention to students' individual needs in classrooms as a barrier to progress. In contrast to the participants with hearing impairments, participants with physical impairments cited mostly accessibility issues as problems. Interviewee D, a 35-year-old man with physical impairments cited the impossibility of the school obtaining an elevator or having accessible bathrooms. He also described how the distance of the school from students' homes acted as a barrier; if friends weren't available to assist him, he essentially had to crawl to school. Interviewee E, a 43-yearold male participant with physical impairments had graduated from university with a bachelor's degree. He mentioned facing difficulties with support systems, but said that, due to the support of friends, he did not encounter serious problems during his education, commenting 'although my schools did not have any special support provisions, due to my friends' helpful hands, I successfully continued.' Interviewee F, a 29-year-old woman who also held a bachelor's degree, and had a physical impairment after a bout of polio, has a similar experience. Interviewees with physical impairments emphasized accessibility issues and the need to depend on friends to overcome the barriers.
According to the participants with visual impairments, the lack of support and facilities was also a problem, but like participants with physical impairments they were able to persevere with the help of friends. Interviewee G, a 27-year-old man with visual impairments who had graduated with a bachelor's degree said that although he had studied in an integrated school, once he joined the mainstream class, he had difficulty keeping up, in large part because teachers were not trained in appropriate education techniques and the schools could not provide Braille textbooks. 'Our education was technically integrated,' he commented, 'but in practice there were no proper arrangements for educational materials.' Interviewee H, a 42 year old woman who had graduated with a bachelor's degree also cited schools' lack of support systems as being one of the main barriers faced by students with visual impairments. Although she attended an integrated school considered to have good facilities, she found that in reality the school lacked proper support once she was in the mainstream class, with teachers unfamiliar with appropriate pedagogy and no Braille textbooks. Even in an integrated school which was considered good, students like this interviewee struggled, sometimes relying more on their peers than on school infrastructure.

Unavailability of schools
Unavailability of schools was another factor cited as a limiting the access to education. Similar to the lack of support systems in schools, it was once again found that participants with hearing impairments were the most likely to have been negatively affected by the scarcity of schools. All of the interviewees with hearing impairments mentioned school availability as an issue: educational facilities, not simply resources, were insufficient. For participants with visual impairments, the dearth of placement positions in integrated schools could delay or prohibit a student from continuing.

Parents' financial difficulties
Interviewee A said that although there had been other, serious difficulties as well, his family's weak financial position was a significant barrier. His parents required his assistance in farming and caring for his siblings, and he was ultimately obliged to leave school after grade eight.
Interviewee I, a 30-year-old man with visual impairments gave up his education after finishing seven years of schooling, when his financial support from an NGO ceased. He also said that if his parents, after the support from the NGO disappeared, had particularly wanted to send him school, the cost would have been higher than that of sending his siblings without disabilities to school, since, as there were no schools available in his area, the cost of living in a dormitory would have been added to his other school fees. Faced with this choice, his financially struggling family prioritized his siblings' education over his own. Similar problems were expressed by interviewee J, a 25-year-old woman with physical impairments who gave up her education after completing grade eight. Her parents worked both in farming and in domestic service, and, when she expressed the desire to go to school, they initially discouraged her because of the perceived cost. But, because primary education is free, she was able to attend up through grade five. However, when reached the lower secondary level (grades six to eight), the problem of money arose once again. She recalls her parents saying, 'We are poor. We don't have money to send you all to school. Your brothers have to be given first priority.' She mentions that despite her parents' inability to spend on her, she got a scholarship from an NGO to continue up to the lower secondary level. However, in her case, too, she wasn't able to get further sponsorship after that. Her parents' attitudes became a problem at that point, and she found herself doubly discriminated against. 'Being a woman with disabilities, my parents did not believe that I should get an education, because of their belief that a woman with disabilities cannot be benefitted by it.' Still, she thinks that the financial difficulties that her family faced were the biggest problem: 'If my parents had had enough money, I think they would not have discriminated between me and my nondisabled siblings, and would have sent me to school.'

Parents' attitudes
Interviewee C described his parents' tacit discouragement as a factor in his eventual decision to leave school. On the other hand, interviewee K, a 34-year-old woman with hearing impairments who graduated with a bachelor's degree, said that her parents had had a very positive attitude towards her education, and that she did not feel any serious discrimination from them.
Other interviewees felt that parents' education or awareness levels were a key factor in determining their attitudes toward their children with disabilities. Interviewee H, says that her parents' attitudes changed markedly once they learned that it was actually possible to help their daughter live an independent life as a contributing member of society: My parents were very sad having a female child with visual impairments. They often blamed their fate and used to tell me that our family was unlucky to have a child like me. Our neighbours also used to discourage them, saying that my parents must have done something wrong in a previous life in order to have been cursed with a child like me. But, once my educated relatives told my parents that it was possible to send me to school, they totally changed.
After that, she says, she was strongly encouraged to study. Similarly, interviewee E said that his parents worried about his future until a neighbour told them about an organization for people with disabilities which provided education and rehabilitation. After they learned about this organization, the respondent's parents sent him there to study there for one year. Interviewee L, a 29-year-old woman with physical impairments, said that her own parents never said anything negative directly to her, but rather often encouraged her to study hard. However, her 'experience says that parents who have had little or no education themselves are more likely to think negatively about their children with disabilities.' Interviewee J said that her parents were under the impression that, even if she were to be educated, she would not be able to utilize that education. She also noted her parents' own lack of awareness as a contributing factor to their attitudes. Similarly, interviewee I indicated that his parents worried about his ability to take care of himself without their support. He says that his parents often used to blame themselves for having a child with visual impairments, and wondered things like 'Who will care for you after we die?' Clearly, an awareness of disability issues, even down to the awareness that their children can be educated, is a key factor in parents' attitudes toward encouraging their children to study.

Discussion
People with disabilities in Nepal face various barriers to education. Some of these barriers were found to be impairment-specific, while some others were common irrespective of the type of impairments. People with visual and hearing impairments largely cited the inadequacy of support systems in schools such as sign language facilities and books in Braille, whereas participants with physical impairments primarily faced difficulties caused by physical barriers, such as inaccessible school infra-structures, distance, and the lack of safe and accessible roads by which to commute. The issue of distance was a problem for both participants with hearing and visual impairments for a different reason: namely, that the available schools nearby their residences generally did not have any provisions or facilities for their education.
In school environments where individual needs cannot be effectively addressed, the results indicate that people with hearing impairments seem to be the most vulnerable to being deprived of education. The large number of respondents with hearing impairments who noted this as a problem makes it clear that there are significant institutional barriers undermining their education in Nepal. Support systems are such things as sign language facilities, appropriate teaching methods, an understanding of the challenges faced by students with hearing impairments on the part of the schools' administrators and teachers, and various other adjustments which address students' educational needs. As Vlachou argued in the case of the Greek situation, children with disabilities, 'with very little or no support at all, confront an educational system that is unable to adjust to their differences' (Vlachou 2006). The same can be said of Nepal's system of supporting students with hearing impairments in schools, as such individuals are often required to attend classroom education without any real, suitable special education facilities.
Despite the inadequate support to participants, the respondents with visual and physical impairments were able to find more ways to work around these problems. Support issues for participants with physical impairments, although potentially weighty in individual cases, often were a less serious deterrent. As a result, participants with physical impairments had often reached a much higher level of education than their counterparts with hearing impairments. Ultimately, the dominance of spoken language in mainstream teaching may be the root of the problem for students with hearing impairments. Unless the problem of this language barrier is addressed, people with hearing impairments, even if they are lucky enough to find a place in a school, cannot fully participate in classroom study. There are still not any specific legal provisions (such as providing sign language interpreters) for helping mainstream schools adjust to the possible arrival of a student with hearing impairments, yet it is clear that, without any system of support, people with hearing impairments face severe obstacles in the path of their education. Clearly, if schools cannot offer sign language interpretation, even on a temporary basis, not even those students with hearing impairments who wish to attend will be able to participate in regular classroom teaching.
The findings that those studying in special schools had comparatively fewer years of schooling than those studying either in integrated or mainstream schools was consistent with the scarcity of special schools for people with hearing impairments as there were mainly 16 schools nationwide. Also, these special schools used to provide basic education for them. This clearly indicates that there are insufficient educational options for people with hearing impairments, and that their generally low rate of access to education has been caused by a lack of facilities and other required support. The choice of some students with disabilities to get their education from mainstream schools cannot be used to justify politicized claims of supporting inclusion Á a conclusion also drawn by Vlachou (2006) in her study of support teachers in Greek primary schools. Rather, it might be mainly due to consequences of circumstance, for example the unavailability of seats in integrated schools, or schools being located far from students' homes. Thus, it would appear that students are joining mainstream schools, in many cases, because even an education that is not fully appropriate to the student's need is better than none.
Without financial certainty, families cannot send their children to school, even when they know well the potential benefits of doing so. In Nepal, a large percentage of the population lives below the poverty line. This creates financial constraints which prevent many children, with and without disabilities alike, from receiving education. Poverty based discrimination, consequently, makes people with disabilities most vulnerable to being left out. Discriminatory attitudes, such as those described in the data about families, contribute to a pattern of children without disabilities being favoured when a family is so disadvantaged that they are obliged to choose which of their children get an education, and which must give up that privilege in order to help the family stay financially afloat. Thus parents' financial difficulties can be considered one of the major barriers making people with disabilities discontinue their education.
If parents understand their children's disabilities Á that is, if they believe that having a disability doesn't mean that a person has no abilities Á they are likely to have a positive impact on their children's education. On the other hand, if parents are not convinced that their children can become productive members of society, despite having a disability, they may not be willing to invest in education, regardless of their financial situation.
Despite the clear relationships between perceived attitudes and years of schooling, it is difficult to say from interviews and surveys whether our respondents' perceptions of their parents' attitudes are entirely accurate, and whether or not their perceptions have even been influenced by the difficulties that they had continuously faced. It seems prudent to emphasize that a lack of understanding and awareness is likely the strongest determining factor in parents' attitudes, and to acknowledge that negative attitudes were likely due to the influence of wider society, i.e. as one of the above interviewees suggested in the case of her own family, it is also plausible that, while parents may not have necessarily perceived their children or their children's abilities negatively, they were probably concerned about others' negative attitudes.

Conclusion
Nepal cannot reach its full social, economic and political potential by ignoring or marginalizing people with disabilities. Overall, it seems that raising awareness, in families, communities, and at the government level alike, is potentially the strongest tool for working toward better education and more opportunities for people with disabilities. Hegarty suggests that educational policies that disregard social and cultural realities are 'likely to be ineffectual and indeed to waste resources' (Hegarty 1998). Therefore, first and foremost, raising awareness is key. Neither policy interventions nor community-based solutions can work to their full potential without the cooperation of the other. Our findings Á that the average schooling of children whose parents had a positive view and understanding of the issues of disability was significantly longer than that of those whose parents had a negative view Á suggests that further programmes on awareness-raising among parents of those with disabilities are in order. This could foster more positive understandings of disability, which, in turn, might encourage parents to invest more heavily in the education of their children with disabilities.
The results of this research suggest a number of possible strategies and areas of focus. First and foremost, the government of Nepal should broaden the educational opportunities for people with disabilities, by increasing funding for education and mobilizing the necessary educational resources to assist people with disabilities. New programs should be implemented, targeting all school-going people so that every individual with disabilities can benefit from the potential for high returns. Similarly, efforts should be made to dismantle any social and institutional, as well as financial barriers that diminish opportunities or prevent people with disabilities from enjoying their right to education.
The government should provide adequate scholarships and educational materials to people with disabilities and to schools where they are educated. Since people with hearing impairments appeared to be at the greatest disadvantage in this study, the government should significantly increase the number of schools for students with hearing impairments, focusing on sign language instruction. Similarly, more integrated educational programs should be offered to people with visual impairments, whereas, to address accessibility issues, school infrastructure should be built up to facilitate accessible buildings and adequate transport.
Understanding a problem is the first step toward solving it; in this sense, awareness at all levels is the first step towards implementing strategies and policies to Scandinavian Journal of Disability Research 323 combat other barriers like poverty and the lack of resources. Through understanding and awareness persons with disabilities will be able to enjoy economic independence and social inclusion to the benefit of all.