What are the antecedents of good practice for successful inclusion of students with ASD?

This study investigates the impact of training on general education teachers’ competency when teaching students with autism spectrum disorder (ASD) in inclusive classrooms. Throughout the research, the paper will focus on several aspects relevant to the topic of inclusion. The introductory chapter begins by covering several preliminary issues, such as the definition of ASD and the prevalence of ASD in the Kingdom of Saudi Arabia (KSA). The introduction then discusses the concept of inclusion, relying on several international definitions and discussing inclusion as a feature of social justice, briefly mentioning the SocialModelofDisabilities. (InclusionLondonWebsite,2020;MentalHealth Organisation, 2016)

The introduction then goes on to summarise some of the main challenges associated with inclusion, including financial challenges that prevent an educational institution delivering appropriate services but also introducing the issue that forms the main subject of this paper, namely, the lack of appropriate teacher training. This leads to an overview of some of the topics associated with teacher readiness for inclusive classrooms and an introduction to the literature that suggests teacher training can improve teacher attitudes towards teaching ASD students. Finally I conclude with a statement of the problem as it exists in the KSA and outline the study’s research questions, as an indication of the objectives that the study intends to achieve.

While the identification of these core features has not changed much since the disorder was first recognised, autism is now regarded as existing on a spectrum (Autism Spectrum Disorder (ASD)) which entails various observable symptoms that range from mild to severe. (Evers et al., 2020; Lord, 2018; Mottron & Bzdok, 2020), . ASD is a developmental disorder and therefore its symptoms develop with the passage of time. Some of the initial symptoms are related to interactive behaviour such as inconsistent eye contact, lack of attention and trouble understanding another person’s point of view. (Almandil et al., 2019; Johnston et al., 2019; Mottron & Bzdok, 2020)

Although ASD is recognised as a product of altered brain development in an individual’s early years (Bauman & Kemper, 2005), there are currently no clear biomarkers of the condition and diagnosis is a question of professional judgement by healthcare professionals. (Almandil et al., 2019; Maynard & Turowetz 2019) It is recognised however that there have been and remain several challenges to successful and uniform diagnosis. (Evers et al., 2020; Weitlauf et al., 2014; Wiggins et al., 2019) In this respect, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (American Psychiatric Association, 2013) sought to clarify the symptoms, in order to aid more consistent diagnosis by healthcare practitioners.

Consequently, the DSM-5 established ASD as a single disorder and consolidated individual subtypes that had previously been identified in the DSM-IV-Text Revised (DSM-IV-TR) (Lord, 2018; Maenner et al., 2014; Mottron & Bzdok, 2020). The individual classifications of Asperger’s Disorder and Pervasive Developmental Disorder not Otherwise Specified (PDD-Nos) for example, were collapsed under the main heading (Wiggins et al., 2019; Maenner et al., 2014; Mottron & Bzdok, 2020). According to the DSM-5, there are now simply two main criteria of symptoms, namely,‘persistent deficits in social communication and social interaction across multiple contexts’ and ‘restricted, repetitive patterns of behaviour, interests, or activities’ (American Psychiatric Association, 2013).

The DSM-5 lists several example characteristic behaviours that may be found in each of these categories. The DSM-5 explains that the symptoms may not be identified during the early stages of a child’s development but may manifest later, when the individual is no longer able to cope with the demands of their social situation. In terms of diagnosis, the symptoms must result in a

“Significant impairment to functioning in important areas of the individual’s life.” (American Psychiatric Association, 2013)

Given the above, the present study will refer to the condition as ASD although it is recognised that the majority of research to date that has been conducted uses the term ‘autism’, as well as the previous sub-classifications. (Eisenhower et al., 2020)

The revisions to the DSM are expected to have several consequences for the diagnostic process. Some have suggested that the different approach could lead to some individuals previously identified as having autism under the DSM-IV-TR or ICD-10 as not being similarly classified under the new regime. (Lord, 2018; Mottron & Bzdok, 2020; Wing et al., 2011)

This concern has been highlighted in several studies, including research by Mattila et al. (2011), which reported a 54% reduction in diagnostic sensitivity relative to DSM-IV-TR and McPartland et al. (2012), which found that the new DSM-5 criteria identified only 46% of individuals with PDD and an IQ above 70. The same study also found that sensitivity was low for individuals with Asperger Syndrome and Atypical autism. The McPartland et al. (2012) study recognised the impact that shifting clinical definitions can have on an individual’s self -perception and well-being. (Buxbaum & Baron-Cohen, 2013; Maynard & Turowetz 2019)

Prevalence of ASD in Saudi Arabia

In the KSA, the actual figure for the number of cases of children with ASD is still unknown. (Alnemary, 2017; Alqahtani 2012; Al-Salehi et al., 2009). However, many anecdotal reports suggest an increase in the prevalence of ASD in the country compared with other developed nations. (Al-Salehi et al., 2009; Almandil et al., 2019; Alshaigi et al., 2019) Other evidence concerning the prevalence of ASD from the KSA Ministry of Higher Education (MOH, 2019) suggests that cases of ASD have only just started to emerge and numbers are getting close to one in 160 children being diagnosed every year.
In a study initiated by Alshaigi et al. (2019), findings revealed that parents and families of children with ASD are challenged by stigma that leads to humiliation, social exclusion and isolation. In order to trace the prevalence of ASD in the KSA, the study initiated by Almana et al. (2017) examined the beliefs that people held about ASD in the country. The study surveyed 367 participants and their knowledge of ASD. The results revealed that 59.7% believed ASD is a non-organic disorder whereas 21.5% did not have any information about ASD. This suggests that the majority of Saudis have at least some knowledge of ASD.

Inclusion and Mainstream Education

Definitions

Numerous terms have been used to describe the practice of teaching children with learning difficulties in schools that cater for other children without disabilities. In this respect, ‘inclusion’, ‘mainstreaming’ and ‘integration’ are all terms associated with the provision of learning opportunities for students with special educational needs (SEN) in general classroom settings. (Able, 2015; Cheminais, 2013; Hassanein, 2015)

The term “mainstreaming” describes the practice of placing students with SEN according to their ability into classrooms that predominantly comprise typically developing (TD) students (namely, ‘mainstream classrooms’). (Black-Hawkins, 2010; Cheminais, 2013; Davis, 2013) The term “inclusion” (which developed following the mainstream concept) describes the related, although distinct, notion of organising a mainstream school system and its curriculum to meet the needs of SEN students. (Al-Ghamdi 2020; Hernandez & Fernandez, 2016; Kauliņa et al., 2016) As such, the concept of inclusion has come to reflect both a student’s access to, and opportunity within, educational settings for all children.

The definition of inclusive education has developed and expanded over the last few decades and has been said to refer to

“The presence, participation, acceptance and achievement of all students in school.” (Bradley, 2016, p. 283)

In 2005, the United Nations Educational, Scientific and Cultural Organisation (UNESCO, 2005) defined inclusion as

“a process of addressing and responding to the diversity of needs of all learners through increasing participation in learning, cultures, and communities, and reducing exclusion within and from the full array of educational opportunities available to non-disabled students”.

The concept of inclusion suggests that all students, regardless of their individual characteristics, should be included in the same classroom and curriculum. (Kauliņa et al., 2016; Merry, 2020; Slee, 2013) Including students with SEN has become an essential part of the educational system in both developed and developing countries around the world. (Hannah and Nolan, 2019; Tiwari et al., 2015; Vaz et al., 2015).

This is consistent with, the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD), Article 24, which states that parties must recognise the right of persons with disabilities to education and ensure an inclusive education system at all levels of the educational infrastructure. Article 24(2)(b) of the UNCRPD further goes on to state that

“Persons with disabilities can access an inclusive, quality and free primary education and secondary education on an equal basis with others in the communities in which they live”.

Not only do these provisions establish inclusion as necessary and representative of social justice but also express inclusion as a right (and not merely an ideal). (Della Fina, 2017; Kauliņa et al., 2016; Slee, 2013)

Merry (2020) has sought to understand the trend towards inclusion as reflecting an attempt to

“Redress the almost total historical exclusion of children with disabilities from regular schools.” (Merry, 2020, p. 12)

In the past, exclusion occured almost universally across the world and in this way, the policy of inclusion does not simply reflect a shift in attitude towards inclusion but also a target that schools are aiming and expected to reach. (Al-Ghamdi 2020; Slee, 2013)
Inclusion and Social Justice

According to Polat (2011), inclusion in education can be a step towards improving the mechanism of social justice. In this respect, inclusion and its procedures in education refer to finding new ways to teach and educate all students in a similar way. Inclusive classrooms focus mainly on teachers’ and instructors’ abilities to accept all children into the classroom. (Cheminais, 2013; Davis, 2013; Merry, 2020) Inclusive practices and teaching styles focus on creating a feeling and environment of acceptance.

In order to establish inclusion as part of a social justice system, systems of social justice must be initiated at the level of school management, which must be able to rely on a well-structured Education Development Programme (EDP). (Qvortrup & Qvortrup, 2018) An EDP’s role is to increase the provision of teaching and learning materials and teacher training, as per the needs of inclusive students. Inclusion in education can be successful from a social justice perspective where the philosophical stances of inclusion are focused on maximising the participation of all children and reducing the impact and influence of discriminatory practices. (Crowson & Brandes, 2013; Lupu, 2019; Slee, 2013)

As suggested, there can be several challenges when seeking to implement the policy of inclusion in practice. It has been recognised, for example, that children with disabilities require an educational model that is different to that of their TD peers. (Able, 2015; Black-Hawkins, 2010; Merry, 2020) This means a typical school will need to provide additional educational services for children that have more challenging academic needs. Inclusion will not be able to work if, despite good intentions, general schools fail to meet the additional demands that SEN students require in practice. (Able, 2015; Bossaert et al., 2013; Finke et al., 2009)

The Social Model of Disabilities

The Social Model of Disabilities (also known as the Social Model of Disability) was developed in the 1960s and 1970s by people with disabilities and explores the inclusive experience of such persons. The model reflects the various hurdles and hardships that socially incapacitated people go through and addresses the exclusion, lack of opportunity and lack of control over their own decisions that they experience. The model mainly supports disabled people’s ability to adapt to life’s opportunities and make necessary, if not radical adjustments, where appropriate.

The model does not take a charitable or medical approach; rather, it posits that impairment stems from societies’ discrimination and consequent exclusion of disabled people, rather from the person’s disabilty itself. (Kauliņa et al., 2016; Levitt, 2017; Maynard & Turowetz, 2019) The model does not only explore the causes of disability but also strives to understand the responses of society. It explores barriers that people with disabilities face through the ‘barriers-approach’, as well as ways in which such barriers may be overcome.

The model reveals there are several relevant barriers to inclusion. Attitudinal barriers, for example, reflect the fact that some people may form assumptions about certain impairments, such as believing that people with disabilities cannot work and cannot be independent. (Gibson, 2019; Taylor, 2018) Physical barriers include problems such as lack of facilities in public spaces, (narrow corridors and doorways, inaccessible street curbs, toilets and housing as well as poor lighting). The final type of barrier is the information and communication barrier, which reflects a wider responsibility held by the community as a whole. For example, this may include a lack of signage for deaf people or a lack of provision of hearing induction loops. (Wood, 2017)

Apart from these three barriers, Figure 1 below reflects an overview of the problems faced by disabled people. The model suggests there is a significant difference between impairment and disability. Impairment refers to an individual’s physical, sensory or cognitive differences, for instance blindness or a learning disability (LD). On the other hand, disability is seen as a social consequence resulting from the responses of society. According to this perspective, it is arguable that a social construct which results in a person experiencing disability should theoretically be removed or modified so that it no longer serves as a source of disability. The social model states that to improve the social survival of disabled people, social constructs such as discrimination, poor job prospects and inaccessible amenities should be addressed. (Milligan & Thomas, 2016; Taylor, 2018)

Figure 1: Social Model of Disability
(Adapted from Inclusion London Website (2020).

There are various factors included in the Social Model of Disability and these play a key role in placing limitations on people with disabilities within the community. As suggested, these factors include poor job prospects, isolated accomodation and facilities, discrimination and a lack of appropriate design in buildings, including special schools and transport. Amongst these, the most recurring determinants for the Social Model of Dsability are poor job prospects and isolated accomodation. Moreover, this model does not simply recognise inaccessible mainstream society as one of the reasons for the experience of disability; but also provides insight into how society deals with a person with impairments, which is also known as the barriers-approach. (Inclusion London Website, 2020)

The Social Model of Disability therefore suggests that what makes an individual disabled is not their condition but rather the structure, behaviour and attitudes of society. Further, it may be seen as a civil rights approach since, if contemporary life was designed in a way that facilitated participation by such individuals, they would no longer be so restricted or debarred. (Black-Hawkins, 2010: Levitt, 2017; Taylor, 2018)

On the other hand, some impairments inhibit individuals with disabilities from performing certain activities. Thus, an additional disadvantage conferred by society is where it views these impairments as abnormal. This results in needless exclusion from full participation in a society that ends up incapacitating impaired individuals. The Social Model of Disability depicts that it is society that incapacitates impaired individuals through the predominant influence of the TD population over society. (Mental Health Organisation, 2016; Taylor, 2018)

Challenges Associated with Inclusion

Where inclusion is implemented, children with ASD are sometimes educated in mainstream education schools with peers who do not have disabilities. (Able, 2015; Bossaert, 2013; Davis, 2013) It is recognised however, that outcomes for students with ASD both at school and after leaving it are poor when compared with both the typical population and other disability groups. (Ashburner et al., 2010; Howlin et al., 2014; Leach & Duffy, 2009; Roberts & Simpson, 2016) Moreover, as will be discussed later in Chapter 2, while schools may agree with the principle of inclusion, they may not in fact possess the appropriate resources necessary to carry it out. (Black-Hawkins, 2010; Qu, 2019; Slee, 2013)

First, there could be financial challenges that prevent a school from possessing the appropriate resources to support inclusion, be that either equipment or adequately trained support staff. (Able, 2015; Black-Hawkins, 2010; Gubbels et al., 2017) Indeed, inclusion in mainstream schools has sometimes been viewed as preferable for financial reasons since it means schools do not have to pay for additional and individualised resources, as non-profit organisations provide the finances. (Cenci & Fuhro, 2016; Davis, 2013; Ferraioli & Harris, 2011) As suggested by Leach and Duffy (2009), despite good intentions, where mainstream school staff do not have the resources necessary to deal with students with ASD, such students may perform more poorly within the inclusive classroom rather than a specialised environment. As Merry, (2002, p. 14) has stated,

“As a general rule many schools – even when there are strong legal protections … are unable to do much more than provide the bare minimum. Indeed, children with autism, like many other children with disabilities, often receive little more than a warehousing experience, where schools – not unlike psychiatric wards – are but places of confinement and seclusion”.

Secondly, another main challenge to inclusion is the lack of teacher readiness to deal with such students. This issue will be discussed briefly in the following section and in depth in Chapter 3.

Teacher Readiness for Inclusion of Students with ASD

Many students with ASD need individualised strategies and academic supports to cope with everyday demands to improve their social competencies, academic achievement and behaviours. The academic and professional training of general education teachers therefore is vital for these students’ success in the general classroom. Support and guidance for students with ASD can positively help to improve the state of their condition and help the policy of inclusion to work successfully in mainstream class settings. (Able, 2015; Slee, 2013; Vaz et al., 2015)

It is recognised therefore that teachers of SEN students, and ASD in particular, require additional skills training to support inclusion. General education teachers may lack awareness of ASD as a disorder and its characteristics, as well as training in the skills and techniques necessary to cope with the behavioural demands that the disorder presents in inclusive settings. Lack of training can lead to teachers’ exasperation with students, which can in turn lead to more exclusion in practice. (Crowson & Brandes, 2013; Kauliņa et al., 2016; Merry, 2020)

Early work by Stone and Rosenbaum (1988) for example, found that general education teachers were more likely to misjudge the cognitions of students with ASD; while Cascella and Colella (2004) found that teachers were less likely to use successful inclusion strategies. As will be discussed further in Chapter 3, there is currently a lack of teacher training programmes across the world and this is affecting both the way in which teachers are taught and the skills they are being taught to use. (Able, 2015; Alquraini & Rao 2018; Hsieh & Hsieh, 2012; Lee et al., 2015).

When teachers are equipped with appropriate information, their expectations of students with ASD in inclusive settings may change. (Kauliņa et al., 2016; Segall, 2008; Vaz et al., 2015) Many studies have indicated that teachers often have negative attitudes toward the inclusion of students with ASD. (Crowson & Brandes, 2013; Kauliņa et al., 2016; Vaz et al., 2015) However, this may be less to do with the students themselves and more to do with the complexity of the disorder, accompanied by limited available training. In a recent study, Gavish (2017), discussed the importance of preparing the whole school for inclusion; not only for the staff who work directly with the students but also in making preparations for assessment and teaching, designing the curriculum and implementing evidence-based strategies such as cooperative learning, responses to interventions (RTI), peer tutoring and assistive technology. (Able, 2015; Kauliņa et al., 2016; Steinbrenner et al., 2020)

According to Segall and Campbell (2012), teachers engaging in certain practices can improve the ability of children with ASD to successfully interact in a classroom environment. As will be discussed in Chapter 3, there is a growing body of literature concerning the identification of best or evidence-based practices (EBPs) and teachers are increasingly being encouraged to rely on these tried and tested techniques. (Guldberg 2016; Rakap, 2017; Steinbrenner et al., 2020)

It is mentioned however, that despite knowledge of the characteristics of ASD being helpful for teachers, it is still insufficient to fully guarantee the success of such students in school, or for increasing teachers’ acceptance of them. (Able, 2015; Crowson & Brandes, 2013; Goodall, 2014) These findings raise questions as to the applicability of the inclusion principle and leads to the recognition that inclusion may need to be interpreted on a more individual basis. (Kauliņa et al., 2016)

Statement of the Problem

This study focused on the impact of training on the competencies of teachers who teach students with ASD. According to Brown and McIntosh (2012), training for teachers can improve their interaction in inclusive classrooms and contribute to the learning of preventive and supportive teaching strategies. (Alothaim, 2017; Florian, 2017; Goddard & Evans, 2018) There is however, a lack of conclusive evidence on the impact of training on teachers’ interactions with students with ASD.

As discussed above, in terms of the prevalence of ASD in Saudi Arabia, teachers can expect to see more students with ASD in their general education classrooms and will need to be ready and able to employ effective strategies to accommodate the unique and special needs of these students. (Al-Ghamdi, 2020; Alnemary, 2017; Alquraini, 2012) Despite the idealism of the inclusion principle, educational institutions and staff continue to struggle with implementing the policy in practice. (Able, 2015; Black-Hawkins, 2010; Crowson & Brandes, 2013) This suggests there will be a significant amount of new territory to be forged in the coming years, as teachers continue to adapt their classrooms to the inclusive approach.

The rise in the number of children diagnosed with ASD will mean that Saudi Arabia will have to continue to increase provision and ensure there are both mainstream and specialised schools available that are equipped to teach these children effectively. As discussed, the findings of many studies have indicated that teachers usually hold negative attitudes toward the inclusion of students with ASD and this is mainly due to the complexity of the disorder, as well as a lack of training. (Lee et al. 2015; Wong & Cumming, 2010)

In Saudi Arabia, there are significant changes in the types of special education services being provided for students with disabilities, including ASD. (Al-Ghamdi, 2020; Alnemary, 2017; Al-Nadhi, 2014) The academic and professional training of general education teachers is essential to increase teachers’ teaching competency and students’ success in the general classroom. Additionally, as ASD cases are increasing, so is the knowledge of people in Saudi Arabia about the disorder although not many studies have reflected on this. (Alshaigi et al., 2019) The present study, therefore, wanted to analyse the impact of training on general education teachers’ competency in teaching students with ASD within inclusive classrooms.

Purpose of the Study

The purpose of this study was to identify the impact of teacher training on teaching competency when teachers were trained to teach children with ASD in an inclusive setting. A qualitative research design was used to examine the research questions, listed below. A qualitative research design was also used to understand the prevalence of ASD within society. The academic performance of students with ASD was considered and examined with the aim of examining the benefits of teacher training on the performance of children with ASD in a holistic way.

Research Questions

The research aimed to explore:

What are the appropriate teacher training strategies that should be included in teacher training programmes when preparing teachers to educate students with ASD in inclusive classrooms?
What are the benefits of inclusion for students with ASD?
What are the relevant elements necessary for teacher training to be successful?
What are the antecedents of good practice for successful inclusion of students with ASD?

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