Module Review

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Educational Inclusion of Children with Severe Disabilities

Joshua K. Harrower University of California-Santa Barbara

Abstract: The educational inclusion of children with disabilities has long been a topic of con-

troversy. In this article the relevant research literature is reviewed in order to present a ratio-

nale for the educational inclusion of children with disabilities, a summary of the effects of

inclusive placement on the social and academic performance of children with and without dis- abilities, a summary of the research exploring the impact of educators and parents on the

process of inclusion, and an evaluation of recent approaches for facilitating the educational inclusion of children with disabilities.

One of the most fiercely debated issues in education is that of the full inclusion of children with disabilities in regular education classrooms (Havey, 1998). First, definitions of what full inclusion means vary widely (D. Fuchs & Fuchs, 1994; Havey, 1998). Second, the topic of inclusion tends to elicit a variety of emotional responses (see D. Fuchs & Fuchs, 1994; Taylor, 1995). For those who support the tra- ditional &dquo;continuum of services&dquo; model, full inclusion is seen as an elimination of the special education services end of the continuum and a reduction of service options for students with disabilities, specifically for those with mild disabilities (Hallahan, 1998). On the other hand, many full inclusionists view the categorical grouping of students with disabilities, as performed in the continuum of services model, to be problematic for moral reasons (Stainback & Stainback, 1996). Because of the primarily philosophical nature of this debate and the paucity of empirical evidence clearly supporting either side (see Hallahan, 1998; Stainback & Stainback, 1996), it appears that full inclusion will continue to be intensely debated well into the future. The purpose of this paper is to exam- ine the current research literature concerning the educa- tional inclusion of students with severe disabilities. Thus, research concerning the inclusion of students with mild disabilities is discussed only in order to make relevant points that further explain the topic being covered.

Rationale for Inclusion

Historically, children with disabilities have been segregated from their typically developing peers, even from society as a whole (Karagiannis, Stainback, & Stainback, 1996). The rationale for the recent movement toward the increased inclusion of students with disabilities into regular educa- tion classes has been grounded in issues of social devel- opment theory as well as in the civil rights movement. Arguments grounded in social development theory focus on the crucial role of peers in the development of children, specifically in observational learning (Bandura, 1977; Masia & Chase, 1997), the development of social-cognitive skills (Piaget, 1965), and scaffolding and zones of proximal development (Vygotsky, 1978). A guiding principle for the increased social inclusion of persons with disabilities is that of normalization (Wolfensberger, 1972), which asserts that the attainment of socially valued outcomes by socially valued means should be available for all people, and spe- cifically for people with disabilities.

The civil rights movement has also served as a catalyst for inclusive practices for individuals with disabilities. In Brown v. Board of Education (1954), the U.S. Supreme Court overturned the previously long-standing ruling that &dquo;separate is equal&dquo; by declaring the practice of segregating schools on the basis of race to be unconstitutional.

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Following this landmark case, the courts began to apply the &dquo;separate is not equal&dquo; ruling to cases involving indi- viduals with disabilities (e.g., Pennsylvania Association for Retarded Citizens (PARC] v. Commonwealth of Pennsyl- vania, 1972), culminating in the passage of the Education of the Handicapped Act of 1975 (P.L. 94-142). P.L. 94-142 specifically addressed the following six principles:

1. A zero rejection principle in terms of providing a free appropriate public education (FAPE);

2. A provision for nondiscriminatory evaluation prior to qualifying for special education services;

3. A mandate for an individualized education pro- gram (IEP);

4. Placement in the least restrictive environment

(LRE); 5. Protection of rights through due process; and 6. A provision for parent participation in educa-

’

tional decisions (A. Turnbull, Turnbull, Shank, & Leal, 1995).

This act was reauthorized in 1990 as the Individuals with Disabilities Education Act (IDEA) and has continued to be amended and reauthorized, most recently in June 1997 as P.L. 105-17.

Many researchers, wary of the type of educational reform proposed to fully include all students in regular classrooms, argue that IDEA preserves the &dquo;continuum of services&dquo; model in order to provide FAPE (e.g., Gerber, 1995; Hallahan, 1998). Researchers arguing to preserve the continuum, or cascade, of services, have primarily pointed to the paucity of data documenting the successful imple- mentation of FAPE services in inclusive settings for all stu- dents with disabilities and maintain that some children with disabilities, specifically mild disabilities, are better served in more restrictive settings (e.g., Baker & Zigmond, 1995; Gerber, 1995). Many researchers, government offi- cials, and even courts, however, have argued that for stu- dents with severe disabilities, social development is just as important, if not more so, than academic development when it comes to education (e.g., Alper & Ryndak, 1992; Daniel, R. R. v. State Board of Education, 1989; Stainback & Stainback, 1996).

Segregation Versus Integration In recent years, there has been mounting criticism in the research literature regarding the practice of teaching chil- dren with special needs in segregated classrooms. This criticism has been based primarily on (1) efficacy studies evaluating social outcomes of students with disabilities in segregated versus integrated classrooms, (2) efficacy stud- ies evaluating academic/educational outcomes of students with disabilities in segregated versus integrated settings, and (3) the effects of integrated classroom settings on stu- dents without disabilities.

SOCIAL INTERACTIONS

To evaluate the effectiveness of including children with disabilities in general education classrooms, many researchers have directly compared social interactions between children with and without disabilities, as well as between children with disabilities participating in inclu- sive versus segregated settings. Similarities have been found in classroom and playground behavior among ele- mentary students with and without disabilities participat- ing in integrated classrooms (Roberts, Pratt, & Leach, 1991). These individualized contexts were also found to match those in self-contained classrooms for students with severe disabilities. Research focusing on the effects of edu- cational placement has documented higher rates of peer- related social behavior among preschool children with disabilities in inclusive classrooms than in segregated set- tings (Guralnick & Groom, 1988). However, children with developmental disabilities participating in integrated play groups have been found to be less socially integrated into play groups than their normally developing peers (Gural- nick, Connor, Hammond, Gottman, & Kinnish, 1996). Yet, directly comparing the friendship formation of children with developmental disabilities, and communication dis- orders with those of normally developing children has revealed high proportions of friendships established for all groups, with no differences based on the child’s placement in a homogeneous or heterogeneous play group (Gural- nick, Gottman, & Hammond, 1996).

Furthermore, children with severe developmental dis- abilities in inclusive classrooms were found, over a 2-year period, to progress on a measure of social competence, whereas matched counterparts in segregated settings regressed (D. Cole & Meyer, 1991). No differences have been found in developmental progress between toddler- age children with mild, moderate, or severe disabilities in inclusive settings and those in segregated classrooms (Bruder & Staff, 1998; K. Cole, Mills, Dale, & Jenkins, 1991). Similarities in language ability and significantly higher scores on measures of social play have also been found among children with disabilities in inclusive versus

segregated settings (Jenkins, Speltz, & Odom, 1985). Elementary school students with severe disabilities

participating in inclusive settings have also been found to spend more time participating in activities with nondis- abled peers and to receive higher proportions of social interactions than their peers in segregated settings (Hunt, Staub, Alwell, & Goetz, 1994). Similarly, students with severe disabilities in inclusive elementary classrooms have been found to have greater levels of sustained contact with nondisabled peers, as well as richer friendship networks, than do students in special education classrooms (Fryxell & Kennedy, 1995). Furthermore, intermediate school students with disabilities in full inclusion settings were found to have more frequent interactions with nondis-

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abled peers, to provide and receive higher proportions of social support, and to have larger, more durable networks of nondisabled peers than did their peers with disabilities in special education classrooms (Kennedy, Shukla, & Fryxell, 1997). This is an important finding, because in intermediate school a student’s classmates frequently change from one period to another, and greater emphasis is placed on academics in these settings than in preschools and elementary schools.

ACADEMIC AND EDUCATIONAL OUTCOMES

There is considerable controversy regarding the concept that grouping students by disability enhances learning. In fact, research has shown few differences between teacher communication patterns, learner involvement, and instructional methods across special classes for students with different categorical classifications (Algozzine, Mor- sink, & Algozzine, 1988). And there continues to be a growing body of literature that points out evidence demonstrating that equal amounts of teacher attention (Sontag, 1997), and even greater amounts of one-on-one instruction and instruction time devoted to academic activities (Logan & Keefe, 1997), are being given to chil- dren with special needs in integrated versus segregated set- tings.

Although positive effects have been documented for students with disabilities participating in full inclusion classrooms (Kennedy et al., 1997; Waldron & McLeskey, 1998), many researchers have concluded that proximity alone is insufficient in ensuring successful outcomes (Kohler, Strain, & Shearer, 1996). Further supporting this conclusion are a number of studies directly evaluating children with disabilities who are merely placed in inclu- sive classrooms without support. For example, Hilton and Liberty (1992) found that children with severe disabilities merely placed in inclusive classrooms were not provided with opportunities that would have facilitated social inter- actions or friendship, nor were they found to be making progress toward skill acquisition that would lead to greater independent adult functioning. In five case studies of schools where children with learning disabilities were placed in general classrooms, Baker and Zigmond (1995) found little evidence of &dquo;special&dquo; educational services being delivered to these children, specifically with regard to IEPs. Yet, the conclusions reached by various researchers based on these findings vary widely, with some concluding that full inclusion is ineffective for certain students with disabilities (e.g., Gerber, 1995; Zigmond & Baker, 1995) and others concluding that the failures noted were a result of appropriate supports not being provided to these stu- dents (e.g., McLaughlin, 1995), contrary to &dquo;best practices&dquo; for inclusive education (Sailor, 1991, 1996). The discrep- ant views on inclusion seem to differ, in general, between groups of researchers concerned with children with mild

versus severe disabilities (see Downing, 1997). When the focus is on including children with severe disabilities, the lit-

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erature indicates that successful inclusive education requires individualized educational support services in addition to the physical proximity provided by general education place- ment (Hunt & Goetz, 1997).

EFFECTS OF INCLUSION ON CHILDREN

WITHOUT DISABILITIES

Researchers have also focused on social and academic vari- .

ables affecting children without disabilities who partici- pate in settings where children with disabilities are being included. Sociometric ratings taken over a 3-month period from a group of nondisabled children in integrated and nonintegrated classroom settings revealed a significant increase in positive attitudes toward children with severe learning disabilities among the children in the integrated classroom (Maras & Brown, 1996). An earlier case study focusing on the classmates of a student named Peter, who was described as having moderate mental retardation and was receiving pull-out special education services, found that when asked about Peter, the typical students consis- tently reported that he was not a member of the class (Schnorr, 1990). The author concluded that mainstream- ing students with severe disabilities into regular class- rooms was not enough to reduce the negative stigma of receiving special education services. Recent studies have documented positive effects of inclusive classrooms on peers without disabilities. First, preschool children in inclusive classrooms were found to have more knowledge about long-term consequences of disabilities and gave higher acceptance ratings to children with and without disabilities than did children in traditional preschool classes (Diamond, Hestenes, Carpenter, & Innes, 1997). Middle and high school students were found to be willing to form friendships with peers with severe disabilities and felt that the regular classroom was the best setting for friendships to develop (Hendrickson, Shokoohi-Yekta, Hamre-Nietupski, & Gable, 1996). Yet, these same students also felt that they might not know what to say or do when in the company of a peer with a severe disability, and they did not think that the peer with the disability would be able to do the things they did or liked to do. Furthermore, secondary-level students tended to put the responsibility of taking the initiative on the &dquo;new&dquo; student, whether that student had a disability or not (Schnorr, 1997). These find- ings lend support to the idea that educators must design classroom environments and social interventions that maximize learning for all students (Evans, Salisbury, Palombaro, Berryman, & Hollowood, 1992).

One area of concern when including children with disabilities in regular classrooms is the possibility that they may require excessive attention from classroom personnel, thus drawing attention and support away from students

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without disabilities (Hollowood, Salisbury, Rainforth, & Palombaro, 1994). Yet, when amount of allocated teacher time and observations of classroom instructional sessions were documented, the results indicated that the presence of students with severe disabilities in general education classrooms did not significantly affect the level of engaged time for classmates without disabilities (Hollowood et al.). Furthermore, when losses of instructional time were doc- umented, they were found to be unrelated to the presence of students with severe disabilities. In a recent review of the literature, Manset and Semmel (1997) found relatively greater positive gains in measures of basic skills for nondisabled students who were in inclusive environments than for comparison students in noninclusive classrooms.

Educators and Parents

EDUCATORS’ ATTITUDES TOWARD INCLUSION

The attitudes of general education teachers toward the inclusion of children with disabilities is frequently dis- cussed as a critical variable in the practice of includ- ing children with disabilities in general classrooms (e.g., Greenwood, 1998; Richardson & Anders, 1998).

Effects of Experience on Teacher ’

Attitude Toward Inclusion

Teacher experience has been identified in the literature as a variable influencing attitudes toward teaching in inclu- sive classes. Surveys of 11 general educators, 7 special edu- cators, and 181 classmates without disabilities taken at the end of the first year that students with severe disabilities were integrated into general education middle schools revealed positive perceptions of the integration experience for all three groups (York, Vandercook, MacDonald, Heise- Neff, & Caughey, 1992). Interviews of a small sample of general educators in inclusive classrooms revealed strong positive feelings toward integration and their own experi- ences (Janzen, Wilgosh, & McDonald, 1995). Also, inter- views of general education teachers who have had a student with a severe disability in their class revealed that initial negative reactions to the placement of the child in their classroom transformed over time into positive expe- riences for these teachers (Giangreco, Dennis, Cloninger, Edelman, & Schattman, 1993). Special education teachers and general education teachers in inclusive classrooms have been found to have similar, positive views of inclu- sion and high perceptions of self-efficacy, competency, and satisfaction, whereas general education teachers in tradi- tional classrooms were found to hold less positive views in these areas (Minke, Baer, Deemer, & Griffin, 1996). According to teacher and family ratings, teacher advocacy for integration is the variable most strongly related to inte- grated placement (Hunt et al., 1993). However, research

has shown that although many novice teachers do express beliefs favoring the inclusion of children of diverse educa- tional needs in their classrooms, two impediments to this goal have been documented: (a) lack of training, and (b) lack of models of successful inclusive education (Tom- linson et al., 1997).

Effects of Degree of Disabilitv on Teacher ... &dquo;,

Attitude Toward Inclusion

The contrast in the attitudes of teachers toward inclusion of students with disabilities may also be explained by research indicating that teacher perceptions toward inclu- sion vary by type of disability. For example, teachers have indicated more hostile responses to including students with mental retardation, learning disabilities, and behav- ioral disorders than to including those with social or phys- ical disabilities or hearing impairments (Soodak, Podell, & Lehman, 1998; Wilczenski, 1992). Research has docu- mented teacher perceptions of responsibility for learning as being determined by the learner as opposed to the cur- ricular material, despite extensive research demonstrating the powerful effects of well-designed instructional materi- als for students with disabilities (Simmons, Kameenui, & Chard, 1998). Olson, Chalmers, and Hoover (1997) inter- viewed general education teachers who had been identified as effective inclusionists by principals and special educa- tors. These teachers

1. Described themselves as tolerant, reflective, and flexible;

2. Accepted responsibility for all students; 3. Described a positive working relationship with

special educators; 4. Reported adjusting expectations for integrated

students; 5. Indicated that their primary inclusionary atti-

tude was showing personal warmth and accep- tance in their interactions with students;

6. Felt that there was insufficient time available for collaboration; and yet

7. Had reservations about fully including all stu- dents-specifically those with severe behavior problems, as they might disrupt the class.

In an extensive research synthesis of articles on teacher perceptions of mainstreaming/inclusion published from 1958 to 1995, Scruggs and Mastropieri (1996) found that approximately two thirds of general classroom teachers reported supporting the concept of inclusion, with a slight majority indicating that they would be willing to imple- ment such practices in their own classes. An interesting, yet troubling, finding was the lack of a systematic relation- ship between teacher attitude and year of publication, indi- cating that teacher attitudes have changed little over time and that recent programs to effect positive attitudes have

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been as ineffective in preparing teachers for inclusion as they were over two decades ago (Scruggs & Mastropieri, 1996).

Resources Available to Educators

To better understand teacher effectiveness in inclusive

classrooms, many studies have focused on principals’ knowledge of and attitudes toward inclusion (Barnett & Monda-Amaya, 1998). Stanovich and Jordan (1998) per- formed statistical analyses based on questionnaire data and found that principals’ attitudes and beliefs about het- erogeneous classrooms and teachers’ interventionist atti- tudes as developed through staff training were the two strongest predictors of effective teaching behaviors in inclusive classrooms. Structured interviews of principals, general educators, and special educators have documented similarities in reported barriers to inclusive practices, with negative attitudes being the most frequently cited barrier (Downing, Eichinger, & Williams, 1997).

Further attempts to explain conflicting teacher atti- tudes toward inclusive practices have focused on the extent of collaboration exhibited between regular and general educators in facilitating inclusion. Villa, Thousand, Meyers, and Nevin (1996) found that when collaboration between general and special educators was an option, general edu- cators clearly indicated a preference for including children with disabilities in their classrooms. Also, educators have

specifically argued for collaboration, indicating it to be an &dquo;absolute necessity&dquo; in order for inclusion to work (e.g., Jewett et al., 1998). In fact, implementing a collaborative instruction model in an experimental sample of four inclusive secondary classes has been shown to increase time spent by teachers in instructional activities (Boudah, Schumacher, & Deshler, 1997). Although there is some evi- dence indicating that the blurring of boundaries between programs and people’s roles may occur in instances of col- laboration, thus presenting significant challenges to the collaborative process (Fink & Fowler, 1997), specificity in articulating roles and needs by key personnel has been found to increase with experience (Gallagher, 1997). Unfor- tunately, research has indicated a lack of collaboration between general and special educators when including children with special needs in regular classes (Janko, Schwartz, Sandall, Anderson, & Cottam, 1997), suggesting that collaboration may be occurring infrequently. For example, results of questionnaires obtained from a mailing to a random sample of educators in the state of New York revealed that less than half of the educators who had a child with a disability in their general classroom were currently working with a special educator (McDonnell, Brownell, & Wolery, 1997). Lack of time has often been cited as a constraint to the development of collaboration (Olson et al., 1997); implementing a specific time and framework for collaboration has been demonstrated to have a positive impact on the performance of collaborative

roles between resource and general education teachers (Voltz, Elliott, & Harris, 1995).

Further information regarding the level of supports and resources available to general educators in inclusive classrooms is available in the literature. The three most

important supports/resources for general education teach- ers, as identified by a questionnaire answered by 1,430 teachers with experience in including a child with a dis- ability in their classroom, were (a) training; (b) support from a team of professionals; and (c) help in the classroom (Werts, Wolery, Snyder, & Caldwell, 1996). Although teachers indicated these supports/resources as extremely important, they have also reported that these resources are not sufficiently available to them (Werts, Wolery, Snyder, Caldwell, & Salisbury, 1996). Similarly, results have been obtained in which teachers indicate time pressure and

proper training in managing challenging behaviors as their primary concerns (Pearman, Huang, & Mellblom, 1997). Overall, these findings regarding general educators’ atti- tudes toward, and resources available for, implementing successful inclusion programs clearly call for innovative and effective teacher training programs addressing specif- ic collaborative strategies documented to be effective in facilitating the successful educational inclusion of students with disabilities.

Sophistication of the Support Staff

Another important variable in facilitating the educational inclusion of children with disabilities is the level of sophis- tication of the support staff (Wood, 1995). Specific aca- demic variables have been observed among teachers found to be more effective inclusionists, including (a) fast-paced teaching; (b) use of a variety of instructional formats; (c) deliberate and accurate planning of instructional activ- ities ; and (d) incorporation of motivational statements and incentives (Phillips, Fuchs, Fuchs, & Hamlett, 1996).

Quality of teacher feedback has also been identified as a statistically notable predictor of reports of reading satis- faction and global measures of self-worth for children with and without disabilities in inclusive classrooms (Baer, Minke, Griffin, & Deemer, 1998). General educators who have been successful in including students with moder- ate or severe developmental disabilities have been docu- mented to provide sophisticated support by modifying the classroom routines in order to keep the target student situated near peers and by modifying the instructional activities through academic adaptations and social partic- ipation strategies (Janney & Snell, 1997).

Researchers have also investigated how teachers use peers in including children with moderate and severe dis- abilities. Teachers have been observed to teach peers to consider age appropriateness, to determine how to help, and to treat the child to be included as &dquo;just another stu- dent.&dquo; Some have also been observed to &dquo;back off&dquo; in order to let peers interact on their own (Janney & Snell, 1996).

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Giangreco, Edelman, Luiselli, and MacFarland (1997) investigated the effects of the proximity of instructional assistants on students with multiple disabilities participat- ing in 16 different general education classrooms through interviews and observations. Their findings indicated sev- eral negative effects of the physical proximity of these primarily untrained instructional assistants, including (a) interference with responsibility by the regular educa- tors, (b) separation from classmates, (c) dependence on adults, (d) negative impact on peer interactions, (e) limi- tations on receiving competent instruction, (f) loss of personal control, (g) loss of gender identity (e.g., most commonly observed in reference to bathroom use when with an aide of the opposite gender), and (h) interference with instruction of other students (Giangreco et al.,1997). Thus, support staff may need specific training in methods designed to fade assistance and encourage students to respond to natural cues (e.g., Alberto & Troutman, 1995). To increase the sophistication of support staff in inclusive settings, strategies for providing curriculum, social and learning support (Ferguson, Meyer, Jeanchild, Juniper, & Zingo, 1992), behavioral consulting support (O’Neill, Williams, Sprague, Horner, & Albin, 1992), and instruc- tional training packages (Wolery, Anthony, Snyder, Werts, & Katzenmeyer, 1997) have been developed to facilitate the delivery of such supports.

PARENTAL VIEWS AND INVOLVEMENT

Parental views and involvement are important in the educational inclusion of children with severe disabilities

(L. Koegel, Koegel, Kellegrew, & Mullen, 1996). Research- ers have found that parents of children with severe mental retardation are more interested in their child’s develop- ing social relationships than in acquiring academic skills (Hamre-Nietupski, Nietupski, & Strathe, 1992). Parents’ perceptions of integration have been found to increase in a positive direction when their children are placed in such settings, with this increase in positive attitude depending largely on the quality of the program being implemented (Collins, 1995). Furthermore, parents of children with severe disabilities have consistently been shown to prefer that their child be educated with same-age peers without disabilities in general education classrooms that provide opportunities for learning and provide appropriate chal- lenges (Ryndak, Downing, Jacqueline, & Morrison, 1995).

Unfortunately, parents have reported overall unhappi- ness and frustration regarding the process used to decide the location in which their child would receive services, suggesting that parents are not valued members of their child’s education team, or that school districts are not suf-

ficiently open to discussing the pros and cons of services in various types of settings (Ryndak, Downing, Morrison, & Williams, 1996). This is an interesting finding in light of research documenting that increased parent involvement

has been identified by parents and teachers as a priority for facilitating successful inclusion (York & Tundidor, 1995). Factors related to increased participation by parents of children with disabilities include family resources such as time and support and information and such family beliefs as perceptions of parental roles and expectations for schooling (Coots, 1998). The quality of parental involve- ment necessary for successful inclusion has received little attention in the literature. In one study, a majority of 48 parents surveyed reported positive experiences with both inclusion and relationships with other team members (Bennett, Deluca, & Bruns, 1997). However, as advocacy efforts among parents increased, positive relationships with team members decreased. Although a majority of the 84 teachers surveyed noted that parental involvement in regularly scheduled meetings facilitated inclusion, they believed that parental involvement was intrusive when parents questioned teachers’ expertise, had unreasonable expectations for their children, or became overactive advo- cates (Bennett et al., 1997).

Views on inclusion among parents of typical children have revealed generally positive attitudes (Giangreco, Edel- man, Cloninger, & Dennis, 1993), with more-positive atti- tudes being reported by parents whose typical child participated in a classroom that included a student with a disability, as opposed to parents of children in classes not including a child with a disability (Miller et al., 1992). Fur- ther research investigating parental views on the educa- tional placement of their child (Miller et al., 1992; Ryndak et al., 1995, 1996), parental involvement and membership in their child’s educational team (Bennett et al., 1997), and other issues in home-school collaboration, such as family characteristics (L. Koegel, Koegel, Kellegrew, & Mullen, 1996), is needed to increase the current knowledge base on educational inclusion.

Again, while there do seem to be positive effects of placing children with disabilities in proximity with their typically developing peers in general education class- rooms, most researchers agree that more-desirable results will be obtained through comprehensive and systematic interventions specifically designed to facilitate the educa- tional inclusion of children with disabilities (e. g., Kelle- grew, 1995).

Approaches to Intervention

FUNCTIONAL ASSESSMENT

Functional assessment-based intervention strategies have been successfully implemented for children in inclusive classrooms (Daly, Witt, Martens, & Dool, 1997). Umbreit (1995) confirmed, through functional assessment proce- dures, that disruptive behavior of a boy with attention- deficit/hyperactivity disorder (ADHD) in an inclusive

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classroom was being maintained by the boy’s escaping from an activity and receiving peer attention. An interven- tionist taught the child to request breaks and instructed the teacher to implement independent working activities and ignore disruptions, which resulted in an elimination of disruptive behavior.

The process of conducting functional assessments, making hypotheses regarding the variables maintaining problem behavior, experimentally testing hypotheses, and implementing intervention packages based on the hypoth- eses has been successfully conducted completely within a general education classroom environment for an elemen- tary student with emotional/behavioral challenges (Kern, Childs, Dunlap, Clarke, & Falk, 1994). The interventions were developed collaboratively by the researchers and the classroom personnel and implemented completely by the school personnel. They were successful in increasing on-task behavior, which was maintained for the remainder of the school year (Kern et al., 1994). These procedures have been further replicated for children with ADHD and comorbid oppositional defiant disorder (ODD) and found to produce substantial reduction in problem behavior. They have received high satisfaction ratings from both teachers and students, indicating the feasibility and effec- tiveness of functional assessment-based interventions in the classroom (Ervin, DuPaul, Kern, & Friman, 1998).

Furthermore, studies utilizing functional assessment strategies have documented evidence that peer attention serves as a function for disruptive behavior among chil- dren with disabilities in general classrooms (Broussard & Northup, 1995). Broussard and Northup ( 1997) also demon- strated the effectiveness of utilizing peer attention as a Differential Reinforcement of Other behavior (DRO) pro- cedure in reducing classroom disruptive behavior to levels of zero for four children, two of whom were diagnosed with ADHD and were taking regular doses of Ritalin. Intervention procedures were based on prior classwide functional assessment information revealing that disrup- tive behavior was being maintained by peer attention. Thus, typical peers were taught to ignore disruptive behav- ior and to systematically fade their responses to appropri- ate behavior from 1- to 10-minute intervals. Functional assessment is a particularly promising line of research because it can so readily be directly combined with a vari- ety of effective interventions (Daly et al., 1997). Setting events and their specific intervention procedures are likely to be a focus of future research on modern behavior sup- port plans (Carr, Reeve, & Magito-McLaughlin, 1996).

INSTRUCTIONAL ADAPTATIONS

Researchers investigating instructional adaptation have identified a variety of strategies for facilitating the inclu- sive education of children with disabilities. For example, incorporating choice by allowing students to choose their

language arts assignment revealed dramatically decreased levels in undesirable behavior (disruptive and off task) in the choice conditions (Powell & Nelson, 1997). Further- more, allowing students to choose the order in which they complete academic tasks has been shown to result in improved levels of desirable classroom behavior (Dunlap et al., 1994). Priming, or pre-practice, has also been docu- mented as an effective classroom intervention for children with disabilities. Priming consists of previewing informa- tion or activities that a child is likely to have difficulties with before actually engaging in that activity (Wilde, Koegel, & Koegel, 1992). This strategy has been shown to be effective for children with autism in reducing disruptive behavior and increasing on-task behavior during class storybook reading activities (see Wilde et al., 1992) and in increasing initiations of social interaction with typical peers (Zanolli, Daggett, & Adams, 1996). Partial participa- tion (Baumgart et al., 1982) is another strategy for adjust- ing curriculum to facilitate the educational inclusion of students with severe disabilities (e.g., Nickels, 1996). Par- tial participation, also known as multilevel instruction (Falvey, Givner, & Kimm, 1996), consists of allowing the child with the disability to participate in the same projects and instructional activities as the rest of the class, with spe- cific modifications to the activity so that it suits the child’s specific abilities and needs (Baumgart et al., 1982; Falvey et al., 1996; Nickels, 1996). Testing modifications (e.g., extended time, separate location, oral exams) and instruc- tional aids (e.g., use of a calculator, spell checker, or dictionary) have also been suggested in the literature as additional strategies for implementing instructional mod- ifications (Hay, Courson, & Cipolla, 1997).

Adaptations to the curriculum have been the focus of much research in facilitating the inclusion of children with disabilities in the general education classroom (see Wolery, & Schuster, 1997, for review). Researchers investigating the effectiveness of adaptations to instructional arrangements found that one-on-one, small group, and independent work arrangements were associated with higher engaged behavior than whole-class instruction for 29 elementary students with moderate, severe, or profound intellectual disabilities who were included in full-time general educa- tion classrooms (Logan, Bakeman, & Keefe, 1997). How- ever, researchers have documented a lack of individual curriculum adaptations for children with disabilities in general classrooms, even when the students responded to group instruction with repeated failure (D. Fuchs, Roberts, Fuchs, & Bowers, 1996). These researchers have identified an apparent tension between instructional routines and instructional adaptation in inclusive classrooms (L. Fuchs & Fuchs, 1998). In fact, in a recent review of the literature, Scott, Vitale, and Masten (1998) found that even when general classroom teachers had been shown to be very pos- itive about making and implementing instructional adap- tations for students with disabilities, they were unlikely to at UTSA Libraries on August 10, 2015pbi.sagepub.comDownloaded from

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actually implement adaptations. Yet, in studies in which teachers were trained how to implement such adaptations, positive results were observed in their implementation of curricular adaptations (Scott et al., 1998). For example, teachers have been taught to successfully implement instructional adaptations found to be effective for students with disabilities, including clear directions, appropriate, immediate feedback, and mnemonic recall strategies and have reported high levels of satisfaction with these adapta- tions (Bulgren, Deshler, & Schumaker, 1997; Rademacher, Schumaker, & Deshler, 1996). General educators have been taught to effectively implement instructional adaptations in mathematics (Woodward & Baxter, 1997) and reading and writing (Vaughn, Hughes, Schumm, & Klingner, 1998). Teaching problem-solving methods for implement- ing curricular adaptations to educators in inclusive class- rooms has also been demonstrated to be an effective

strategy for facilitating successful inclusion outcomes (e. g., Giangreco, 1993). Each of these strategies merits fur- ther investigation, specifically in terms of teacher accept- ability and willingness and ability to implement such adaptations in inclusive classrooms.

’

SELF-MANAGEMENT

Self-management is an intervention procedure that has been described as a viable technique for promoting inde- pendence in the classroom because it shifts behavior man- agement responsibility from the teacher to the student (L. Dunlap, Dunlap, Koegel, & Koegel, 1991), thus freeing teachers to concentrate on academics. Teaching a child self-management in the classroom allows that child to function independently without relying on the teacher or on a one-on-one aid (L. Koegel, Harrower, & Koegel, 1999). Self-management allows individuals with disabili- ties to become actively involved in the intervention process and more involved in their classroom environments. This more active involvement has the potential to improve autonomy by reducing dependence on adult intervention, which in turn gives the child more opportunities to inter- act with classmates without the stigma of having a one-on- one aid. Self-management has also been suggested as an ideal intervention for children with disabilities participat- ing in full inclusion classroom settings (Reid, 1996).

Although documentation of the use of self-management in inclusive classrooms has been surprisingly scarce (Reid, 1996), the few studies of self-management interventions implemented in these settings have reported favorable results (DuPaul & Eckert, 1997). For example, self- management has been successfully utilized for improving off-task and inattentive behaviors among children with ADHD who were receiving a pharmacological (Ritalin) intervention (Mathes & Bender, 1997). Successful use of self-management techniques also have been described for improving the following: _

~ on-task behavior and academic productivity of children with learning disabilities (Maag, Rutherford, & DiGangi, 1992),

~

peer interactions of children with behavioral

problems (Falk, Dunlap, & Kern, 1996), ~ social skills and disruptive behavior of children with autism (L. Koegel , Koegel, Hurley, & Frea, 1992),

~ appropriate academic engagement of children with developmental disabilities (L. Koegel et al., 1999),

. math fluency and engaged time of students with mild disabilities (McDougall & Brady, 1998), and

. on-task behavior of adolescents with learning dis- abilities (Prater, Joy, Chilman, Temple, & Miller, 1991) participating in integrated academic set- tings.

Additionally, researchers have begun to combine self- management strategies and functional analyses. In one such study, functional analyses were conducted for two high school students with mental retardation in order to determine a functionally equivalent response for inappro- priate responding and were then taught to successfully self-manage the use of the appropriate social skills (Frea & Hughes, 1997). Similarly, functional assessment proce- dures have been utilized to select more functional rein- forcers (e. g., attention) for use in a self-management package, resulting in a successful reduction of disruptive behavior displayed by a typically developing first-grade boy (Grandy & Peck, 1997). This combination of tech- niques appears to be quite promising in successfully guid- ing the selection of target behaviors and more natural reinforcers for use in a self-management treatment pack- age.

PEER-MEDIATED INTERVENTIONS

Because of the documented deficiency in the quality of peer relationships for children with disabilities, peer- mediated interventions have long been advocated for facil- itating the inclusion of children with disabilities in general education classrooms.

Cooperative Learning A number of studies have demonstrated that teaching social skills to children with disabilities and their non-

handicapped peers in cooperative groups in integrated set- tings results in increased frequency, duration, and quality of social interactions (e.g., Kamps et al., 1992; Kohler et al., 1995). However, cooperative learning groups have primar- ily been used in inclusive classroom settings as an instruc- tional activity for increasing academic success (see Put- nam, 1993). For example, cooperative learning groups have been used during fourth-grade social studies activi-

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ties and have been found to improve test scores, academic engagement, and duration of student interaction between children with autism and their nondisabled classmates

(Dugan et al., 1995). There is some indication, however, that certain students with disabilities may not fully partic- ipate in cooperative groups (Pomplun, 1996). In fact, it has been suggested through indirect statistical analyses that children with behavioral disorders participate less in the group processes of cooperative groups than other children with and without disabilities (Pomplun, 1997). Additional research needs to be conducted for this population of stu- dents using direct measures of participation in order to corroborate these findings and to identify the relevant variables contributing to a possible lack of participation.

Peer Tutoring Peer tutoring consists of any instructional strategy where two students work together on an academic activity, with one student providing assistance, instruction, and feed- back to the other (DuPaul & Eckert, 1998). Peer tutoring strategies and its variants have been demonstrated to be effective in producing increases in on-task behavior and math performance (DuPaul & Henningson, 1993) and on-task behavior and social interactions (Locke & Fuchs, 1995) of children with disabilities in inclusive classrooms. In classwide peer tutoring (CWPT), all children in the class are paired and work simultaneously. The purpose of CWPT is to increase the amount of instructional time that all students engage in academics and to provide pacing, feedback, immediate error correction, high mastery levels, and content coverage (D. Fuchs, Fuchs, Mathes, & Sim- mons, 1997). Students with autism and their nondisabled peers participating in CWPT in regular classrooms have made gains in reading fluency and correct responses to reading comprehension questions (Kamps, Barbetta, Leo- nard, & Delquadri, 1994). Furthermore, in unstructured free-time activities, increases in the duration of social interactions have been observed after the implementation of CWPT (Kamps et al., 1994). However, there is some evidence suggesting that increasing the rate of social inter- action among children with disabilities by implementing classwide peer-mediation programs may be insufficient in producing enduring changes across unprogrammed set- tings (Hundert & Houghton, 1992). Thus, even though this strategy appears ideal for use in inclusive classroom

settings, more research needs to be done to assess the generality of findings as well as to verify the effects on aca- demic achievement of children of different ages with dif- ferent needs in their regular classrooms.

Effects of Multiple Peer Supports

Many peer-mediated interventions have focused on teach- ing interaction skills to both students with and without disabilities utilizing a rotating system of peer buddies across a variety of school activities. For example, a

comprehensive individualized intervention consisting of (a) ongoing information to classmates about various aspects of the disability experienced by the target student, disseminated during naturally occurring interactions or in weekly &dquo;club&dquo; meetings, (b) various media for commu- nicative interactions, and (c) a rotating &dquo;buddy&dquo; system was found to dramatically increase reciprocal interactions and target student-initiated interactions for students with

significant physical and intellectual challenges and sensory impairments (Hunt, Alwell, Farron-Davis, & Goetz, 1996). These findings have been replicated for students with autism and further validated in that, through the record- ing of interactions among typical students, the quality of interactions for students with disabilities was found to increase to normative levels (Hunt, Farron-Davis, Wrenn, Hirose-Hatae, & Goetz, 1997). Pivotal Response Training (PRT), which focuses on increasing children with autism’s motivation to learn by incorporating choices, reinforcing attempts, using adequate modeling, and providing natural consequences (R. Koegel, O’Dell, & Koegel, 1987), has been utilized within sociodramatic play-training groups to successfully increase language and social skills (Thorp, Stahmer, & Schreibman, 1995). Although this approach appears more effective than sociodramatic script training -by promoting generalization of skills across toys and settings (Thorp et al., 1995)-studies utilizing PRT tech- niques with only one peer trainer have documented limi- tations with the generalization of social skills across untrained peers (Pierce & Schreibman, 1995). Yet, when multiple peers have been utilized to implement PRT, gen- eralization across untrained peers has been enhanced

(Pierce & Schreibman, 1997).

Friendship

Many empirical studies have been conducted demonstrat- ing the importance of friendships for typical children (see Hurley-Geffner, 1995), but research exploring the benefits and importance of friendships for children with develop- mental disabilities is extremely limited (Guralnick, 1990). However, recently researchers have been calling for a more direct evaluation of the variables affecting friendship for children with developmental disabilities (Hurley-Geffner, 1995). Because typical children become friends with other children who attend their schools and share their classrooms (Strully & Strully, 1985), inclusive classrooms appear to be an excellent setting to evaluate and design interventions to promote friendships for children with dis- abilities ; at the least, they provide these children with the opportunity to interact socially (Hurley-Geffner, 1995; Meyer et al., 1998). In a recent study, Kennedy, Cushing, and Itkonen (1997) utilized peer-mediated interventions to facilitate the inclusion of two students with severe dis- abilities in a regular junior high and high school class- room. Participation in general education classes was the independent variable in determining the effects of such

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placements on measures of social contacts and friendship networks in a multiple baseline design across classrooms. These inclusive classrooms consisted of the following

~

components: (a) placement of a child with a disability in a general classroom, (b) collaboration between general and special education personnel, (c) additional personnel in the general education classroom, (d) recruitment and training of peer supports, (e) a monitoring and feedback system, and (f) ongoing curricular adaptations. Findings indicated that participation in these classrooms resulted in increases in the (a) frequency of social contact with peers without disabilities, (b) number of peers participating in a social contact, (c) number of new peers met, (d) number of peers regularly nominated as friends, and (e) cumula- tive number of peers nominated as friends (Kennedy, Cushing, & Itkonen, 1997).

Meyer et al. (1998) identified six &dquo;frames&dquo; of friend- ship, through observational and qualitative research meth- ods conducted with individuals with severe disabilities

participating in inclusive classrooms, that seem to charac- terize the social relationships between students with and without disabilities. The first, entitled &dquo;ghosts and guests,&dquo; is the situation where the child with the disability is viewed as &dquo;invisible&dquo; or as an outsider to the group. Second, the frame &dquo;inclusion kid/different friend&dquo; is different treat- ment that appears more appropriate for a younger child than for a same-age peer. Third, the &dquo;I’ll help&dquo; frame is when children engage in a variety of helping behaviors for the child with the disability. This frame characterized the majority of social interactions observed. Fourth, the &dquo;just another kid&dquo; frame is when children with disabilities are viewed the same as the other kids in the class, with the disability being &dquo;no big deal&dquo; and the children thus not receiving any differential treatment. The main distinction between the fifth frame, &dquo;regular friends,&dquo; and the sixth, &dquo;best friends,&dquo; is that in addition to being friends in school, &dquo;best friends&dquo; tended to spend time together away from the school setting.

Further research into the variables affecting friend- ships between students with and without disabilities is likely to focus on naturalistic strategies for supporting the development of relationships with characteristics found in the more desirable frames of friendship.

Effects of Peer-Mediated Interventions on Typical Peers

Some concern has been raised regarding possible negative effects of peer-mediated interventions on students without disabilities (Kauffman & Hallahan, 1995). Yet, a recent study investigating the academic effects of serving as a peer support for children with moderate to severe disabilities found that academic engagement, assignment completion, grades and perceived classroom participation actually improved for typical children serving as peer supports (Cushing & Kennedy, 1997). Pomplun (1996), describing

results for students with mild disabilities who participated in a state science assessment with cooperative groups, found that participation by students with disabilities did not negatively affect group scores. Furthermore, children without disabilities who participated in cooperative learn- ing groups during reading and writing instruction with their peers with and without disabilities in fully inclusive schools were found to make significantly higher improve- ments in reading vocabulary, reading comprehension, and language expression than typical children served in tradi- tional classrooms (Stevens & Slavin, 1995). Researchers have also looked at some of the more social effects of peer- mediated interventions on typical peers. Favazza and Odom (1997) examined the effects of contact, books, and discussion on the attitudes of kindergarten-age children toward others with disabilities. Children in the high- contact group made significant pretest to posttest gains on a scale measuring level of acceptance, but children who had incidental or no contact made no gains.

Research on Inclusion Model Programs Although studies have long documented strategies for suc- cessfully including students with severe disabilities in gen- eral education classrooms (e.g., Russo & Koegel, 1977), some researchers have pointed out potential problems with including such students who participate at schools that operate under the continuum of services model. For

example, although specialized curricular adaptations have been demonstrated as effective interventions in the inclu- sion process (see Wolery & Schuster, 1997, for review), there is evidence that without specific prompting and sup- port, general educators do not make these important adaptations (L. Fuchs, Fuchs, Hamlett, Phillips, & Karns, 1995). This appears to be due to the documented lack of support and resources that general educators with children with disabilities in their classrooms receive under the con- tinuum of services model (McDonnell et al., 1997). There- fore, many researchers and policymakers have argued for educational reform through the reallocation of special education services from a dual systems approach to a coordination of support services in order to successfully include all children with disabilities (Sailor, 1991, 1996; Stainback & Stainback, 1996).

Yet, conflicting results have been obtained when these model programs for inclusive schools have been directly compared with segregated programs (Mansett & Semmel, 1997). Studies comparing different models of special edu- cation service delivery have demonstrated nonsignificant differences between children with special needs being served in segregated versus integrated settings for such dependent variables as reading and language arts (Jenkins, Jewell, Leicester, Jenkins, & Troutner, 1991). This same study did, however, reveal an outperformance in math among target students in noninclusive settings (Jenkins

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et al., 1991). Some authors have obtained significant dif- ferences in favor of inclusive settings when comparing inclusive and segregated service models for children with special needs (see Manset & Semmel, 1997). For example, significant differences in favor of students with special needs served in integrated as compared with segregated settings have been documented for a variety of dependent variables, including reading and language arts (Jenkins, Jewell, Leicester, O’Conner, & Troutner, 1994), as well as in combined analyses of reading, writing, and math (Schulte, Osborne, & McKinney, 1990).

A common form of school restructuring to facilitate the inclusion of students with disabilities is to bring the services to the child in the general education classroom as opposed to bringing the child to the services in a pull-out setting. Thus, a second teacher would be spending por- tions of the day in the regular classroom assisting the stu- dents with disabilities and also serving as a resource for the general educator. There is, however, some recent prelimi- nary evidence that a simple reallocation of services in inclusive classrooms may result in an inverse relationship between the academic achievement of students with and without mild disabilities (Cook, Gerber, & Semmel, 1997). As a result, researchers and policymakers have looked into more comprehensive approaches to developing effective models for educational reform.

One such framework for addressing educational reform is the Positive Behavioral Support (PBS) model (L. Koegel, Koegel, & Dunlap, 1996; Weigle, 1997). An example of the PBS model for educational reform is the Comprehensive Local School (CLS) approach (Sailor, 1991). In this model, the school serves as a coordinating vehicle for all children’s services and functions with all cat-

egorical programs reconfigured and coordinated at the school site under a site-based management system charac- terized by a shared decision-making process (Sailor, 1991). Now known as the New Community Schools (Sailor, 1996), the updated conceptual approach includes three components: (a) school-linked &dquo;wrap around&dquo; service integration, (b) school restructuring (i.e., coordinating special resources so that all children can benefit), and (c) inclusive education for all students. Due to successful results obtained through the implementation of PBS approaches to facilitate the educational inclusion of stu- dents with severe disabilities (Todd, Horner, Vanater, & Schneider, 1997), many researchers are now calling for the implementation and further validation of such systemic approaches (Weigle, 1997).

Another approach to facilitating the inclusion of all children in the regular classroom is through collaborative problem solving or &dquo;action research&dquo; (Salisbury, Evans, & Palombaro, 1997; Salisbury, Wilson, Swartz, Palombaro, & Wassel, 1997). This approach utilizes inservice training to teach educators to collaboratively design and imple- ment their own interventions to address issues related to

the inclusion of students with disabilities in general class- rooms. Educators use a five-step process to solve problems in a situation where a child is not being meaningfully included in a classroom activity. They seek to (a) identify the issue, (b) generate all possible solutions, (c) screen solutions for feasibility, (d) choose a solution to imple- ment, and (e) evaluate the solution (Salisbury, Evans, & Palombaro, 1997). Collaborative problem-solving and action research groups have been shown to successfully facilitate the inclusion of students with disabilities through highly socially valid means, but there remain important questions regarding the ability of these groups to effec- tively and efficiently implement best-practice interven- tions on their own (Salisbury, Wilson, et al., 1997). _

Another problem-solving approach, choosing options and accommodations for children (COACH), outlines a planning process specifically designed to assist teams in identifying the content of IEPs for students with signifi- cant disabilities in general education settings (Giangreco, 1996). COACH is organized into three major parts: conduct- ing a family prioritization interview, defining the educa- tional program components, and addressing the education program components in inclusive settings. The use of the COACH model in including students with severe disabili- ties in general education classrooms has been documented to change IEP goals by making them more specific and

.-

reducing the overall number of goals written, positively affect relationships between families and professionals, shift control of educational decisions to parents, and facil- itate changes in valued life outcomes as reflected in new program and social opportunities (Giangreco, 1996).

Conclusion

Although the educational inclusion of children with severe disabilities continues to be a topic of controversy, specifi- cally among research dealing with children with mild dis- abilities (see Kauffman & Hallahan, 1995), many highly effective strategies for facilitating the inclusion of all chil- dren have been documented (see Stainback & Stainback, 1996). Yet, an important aspect of implementing any inter- vention in the general education classroom is that it be socially valid to those implementing and receiving the ser- vices (see Wolf, 1978). Fortunately, many interventions, such as curriculum modification, peer-mediated interven- tions, and group goal setting and contingencies, have been documented to be socially valid by teachers who have been documented to perceive them as highly effective (Abelson, 1997). However, the most effective practices may not be the best practices if the most effective practices are not used by those who are designed to implement them (Kennedy, 1997). Thus, researchers must continue to investigate the extent to which service providers utilize and subjectively rate effective interventions designed to facili- tate the inclusion of students with severe disabilities.

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Because of the highly philosophical nature of push for increased educational inclusion of students with disabili- ties (Hallahan, 1998; Stainback & Stainback, 1996), educa- tors involved in this process must continue to let their decisions be guided by empirical evidence, keeping the appropriate education of the child as a top priority. The focus on placement should not take precedence over the appropriate education of students with disabilities, lest students’ basic FAPE provisions be denied through the practice of &dquo;dumping&dquo; (i.e., placing students with dis- abilities in general education classrooms without support). Instead, empirically validated strategies guided by the principle of normalization (Wolfensberger, 1972) continue to be the best-practice strategies for providing the most appropriate education for children with disabilities. Thus, many researchers are refraining the inclusion question, turning from a focus on the most effective settings for spe- cial education services toward a focus on identifying and developing the most effective strategies and determining how they can be best delivered in more inclusive settings (Schulte, Osborne, & Erchul, 1998). Research in this area should continue along these lines, taking also into account factors such as the cost (see Hunt & Goetz, 1997) and method of delivery (see Giangreco, 1996; Weigle, 1997) of providing such services in general education classrooms. Thus, the transition from segregated to fully integrated classroom placements for students with disabilities requires the implementation of best-practice techniques that ensure the delivery of an appropriate education in fully inclusive classroom settings.

-

z

ABOUT THE AUTHOR

Joshua K. Harrower, PhD, is currently a postdoctoral fellow at the University Affiliated Center for Developmental Disabilities (UACDD), West Virginia University. Address: Joshua K. Harrower, University Affiliate Center for Devel- opmental Disabilities (UACDD), West Virginia University, Morgantown, WV 26505.

AUTHOR’S NOTES °’

1. This research was supported in part by Public Health Service Research Grant No. MH28210 from the National Institute of Mental Health and by U.S. Department of Education Grant No. H133B980005.

2. 1 would like to thank Melinda Young Harrower, Robert L. Koegel, George H. S. Singer, Michael Furlong, Lynn Kern Koegel, and Cynthia M. Carter for their helpful comments and feedback during the preparation of this article.

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