Every year disability is determined for almost 50 classrooms consisting of children under the age of 16. In about half of the cases the disability is severe. These figures show that there are many children who need special attention during the education process due to their medical condition. According to the Basic Schools and Upper Secondary Schools Act, passed in 2010, these children are students with special educational needs. They are not released from the duty to to attend school and the state has to provide them all opportunities for the acquisition of basic education.

The analysis of the organisation of the general education for the children with special medical needs gives a short overview of the children who potentially need a sanatorium school, the situation of those schools, practices in the rest of Europe when giving general education to children with special needs, the parties’ viewpoints and the main problems connected to sanatorium schools.

During the last phase of the project a special morning brainstorm session (mõttehommik) was held, where the topic of sanatorium schools was discussed with doctors, teachers, education administrators, school employees, parents and other parties. The discussion focused on the possible roles of sanatorium schools and the alternatives for the children with special needs to acquire a good basic education in so-called mainstream schools.

Following conclusions arose from the discussions:

  • At the moment, regular schools are not prepared to teach children with special medical needs.
  • The sanatorium schools do not function efficiently in Estonia. To solve the problem, the role of sanatorium schools in the educational system has to be defined and then the Ministry of Education and Research and the Ministry of Social Affairs have to agree on the responsibility.
  • Sanatorium schools have a bad reputation and there is little information about these schools.
  • Estonia should create centers of competence to help develop new methods for teaching children with special needs, help coordinate their education and counsel parents and teachers.
  • Involving children with special medical needs in regular schools needs prior analysis of investment needs and ensuring the necessary money for investments.

Sanatorium schools

Arguments against:

  • Society’s negative attitude towards special schools (including sanatorium schools).
  • Parents overestimate the mental skills of their children.
  • Relations with friends from regular school are interrupted.
  • Possibility for the children to develop the behavior of a special school student.
  • The danger of over-caring in schools and residential schools.
  • Puts a label on children and families.
  • Residential schools are far from home.

Arguments in favor:

  • Necessary provision of special needs education and psychological and, if needed, medical supervision
  • Using specific methodology, appropriate techniques and study materials when teaching subjects, thereby ensuring better results.
  • Chance to give individual help (smaller classrooms).
  • Economically more beneficial for the state.
  • Communication in special needs schools is usually more tolerant.
  • For children with special educational needs it is easier to get a positive evaluation, develop a motivation for studying and they do not interrupt the work of a regular classroom.

Regular schools

Arguments against:

  • Parents have a big workload to help their child stay in a regular school.
  • If the prerequisites for being included in the regular school are not fulfilled, the child may feel more inadequate than others.
  • The conditions in regular schools are lacking: the physical environment, a lot of students, lack of necessary personnel.
  • Lack of appropriate teaching devices.
  • Incomplete preparation of teachers. The child is not fully involved in the learning process due to inadequate attention and a weak special needs education preparation .
  • A teacher in a regular school has less chances to take the child’s special needs into account.

Arguments in favor:

  • Chance to go to the school of the place of residence, contact with parents remains.
  • Chance to see the other side of their disability or disease in a so-called regular environment.
  • Lower risk for the children to be stigmatized because of their disability or disease.
  • Having friends in regular classrooms makes children with special needs identify themselves with the same group.
  • With the same prerequisites the child at the regular school is significantly more successful in their studies than those at special schools.
  • More frequent chances to experience the discomforts of everyday life than in the controlled environment of special schools.
  • Classmates get the experience of interacting with a child who has a disability or disease.