AMERICAN ACADEMY OF DEVELOPMENTAL MEDICINE & DENTISTRY
BY H. BARRY WALDMAN DDS, MPH, PHD, STEVEN P. PERLMAN DDS, MSCD, DHL (HON), AND MISHA GAREY, DDS
“Inclusive education is a worldwide phenomenon widely advocated in the recent past. It is a philosophy as well as a principle and/or practice that is based on human rights and social justice. It advocates that children with special needs have to be educated along their normal peers in the regular classrooms. In order to achieve this direction, teachers in inclusive classrooms play a major part through their attitudes and actions both in Papua New Guinea and elsewhere… Inclusive education policies also play a major part to influence the way teachers form their attitudes toward inclusion.”1
“…female teachers (in Nigeria) have a more positive attitude towards the inclusion of special needs students than their male counterparts. Furthermore, married (teachers are more positive) than single teachers in their attitude towards special need students.” 2
“It appears the senior educators (in one area in New York State) are not too keen (on inclusion), whereas the new teachers, just beginning their careers only know what they have learned through their schooling. It should be noted that the underlying problem of inclusion is that there is no formal or state mandated way to carry it out.” 3
Teachers in general education are expected to cope with students with diverse needs. They might not always be ready or sufficiently supported to meet these challenges. This is not a U.S. problem, but one which faces educators throughout the world as efforts are made to mainstream children with a wide range of disabilities.
The ability of teachers to provide the needed support for these youngsters is associated with the teachers’ personal characteristics, such as age, experience, education and personal contact with individuals with special needs. Teacher’s requirements for accommodations also highly correlated with environmental working conditions (e.g. working hours and number of children in a class setting).4
In the past 30 years, the number of students with disabilities served in a general education classroom has increased. Historically, most students with disabilities were served in segregated special education classes. More recently, the majority of students with disabilities receive a portion of their education in a general education classroom. Nationally, as much as 80% of students with disabilities are served through inclusion (i.e. mainstreaming). One reason for the increase in the number of students being served in an inclusion setting can be contributed to legislation, including the passage of the American with Disabilities Act (ADA) and the reauthorization of the Individuals with Disabilities Education Act (IDEA). IDEA mandates students with disabilities receive a Free and Appropriate Education in the Least Restrictive Environment.5 Although legislation can set guidelines for the placement and services of students with disabilities, it cannot force acceptance of those involved. “Numerous (initial) research studies have focused on the attitude of teachers toward the inclusion of students with disabilities. Since the early days of mainstreaming, teachers have been shown to have generally negative attitudes toward inclusion. More recent research, however, has indicated a shift in teacher attitudes toward a more favorable view of inclusion… (Nevertheless,) research has documented that general education teachers are largely against having students with disabilities in the classroom. General education teachers may also believe including students with disabilities would have an adverse effect on the learning atmosphere of their classrooms.” 5 By contrast, special education teachers appear to have more positive attitudes toward inclusion. Both general education and special education teachers believe students with disabilities will not receive effective instruction in an inclusion classroom. 5
It is important to consider different background variables and the effect on teacher attitudes.
• Contrary to what would be expected, there are reports that previous experience and contact with persons with disabilities did not influence teacher attitudes toward inclusion.6
• Elementary school teachers tend to have more positive attitudes toward inclusion than secondary teachers. This may be attributed to the amount of time primary teachers have with their students or the less strenuous curricular expectations. 7
• Although years of teaching experience has not been shown to influence teacher attitudes, the level of education a teacher achieves does appear to have an influence.7 “The higher the education level achieved by a teacher, the more negative the attitude towards inclusion.” 8
• One factor associated with negative attitudes relates to academic concerns and the impact having students with disabilities in the classroom will have on students without disabilities.9
• Research has shown that teachers’ attitudes depend on the type and severity of disability of the student.10 Teachers had more negative attitudes toward including students with more severe or obvious disabilities Students with intellectual disabilities, emotional or behavioral disabilities, or multiple disabilities caused the most concern for teachers. Teachers were more accepting of those students with physical or medical disabilities. 11
“You don’t get the chance to say no. You’re told this is what you’re going to have and these are the kids in your grade next year and very often the job situation the way it is at the moment is often that you’re not ongoing or any of those things. Often, you’re on contract. If you are seen to be difficult or things like that, obviously, it can affect your job, so, a lot of people just…!
I think it’s fine for a lot of these politicians (in Australia) who are up there in their ivory tower who aren’t in those classrooms.” 12
Nevertheless the report implies that the “… Victoria (Melbourne, Australia) teachers are in the main positively inclined towards the philosophy of inclusive education, perceiving the process as beneficial to all participants within the inclusive setting. However, they remain cautious about the inclusion of students with more severe disabilities.”12
Given the relationship between attitude and exposure or training, the significantly more positive attitude measured in younger teachers may be attributed to their having more exposure to teaching children with special needs than their older counterparts. “… it would likely be very beneficial for university level teacher training programs to ensure that coursework in teaching children with special needs be provided to their trainees, particularly because inclusion will likely become more prevalent in the classrooms over the next ten years as a result of the increasingly more stringent federal and state mandates promoting inclusive education.” 13
“Teacher training programs tend to follow a model that prepares regular education teachers to expect to teach regular education students and special education teachers to teach special education students. Regular education teachers then, may feel ill equipped and overwhelmed by the prospect of teaching children with special needs. Teaching programs need to prepare teachers to work with all children.”13
Nevertheless, as one parent comments:
“As a parent of a premature, under developed and physicallychallenged child with special needs, I was extremely nervous to transition her into our school district of the excellent pre-school services and support my daughter was receiving from our County. Lauren was receiving a tremendous amount of in-home support and case management, from speech and physical therapy to nutrition and feeding support. I admit I was pleasantly surprised of how smooth it went when the district took over.”
– Holly Koenig, mother of Lauren, Jericho Union-Free School
District, Jericho, New York
“Nationwide, about 60% of students with disabilities spend at least 80% of their instructional time in regular classrooms. Many parents of other children in public schools understand that when teachers focus on students who need more attention, their kids may get shortchanged. Yet most parents opt out of any discussion and don’t complain.” 14
“Special education is expensive. Estimates of its cost nationwide range between $80 billion and $110 billion per year, and the spending continues to rise faster than regular-education spending.” 14
Today, six million students with disabilities (about 14% of all students) have the right to a free appropriate public education and an individualized education program. Between 70% and 80% of these students have mild or moderate disabilities, including learning disabilities, speech or language impairments, social and emotional disabilities, and other conditions, such as ADHD. Only 20% to 30% have more severe disabilities, such as cognitive impairments, physical disabling conditions, deafness or blindness.14
Most parents, once their children receive special education services, tend to give the programs good ratings, and most believe that mainstreaming helps special needs children academically. Two thirds (67%) rate their schools good or excellent in providing their children with the help they need. Almost two-thirds (64%) said that once their child was identified as having special needs, it was easy to get the services they needed, versus 35 percent who expressed frustration. 15
However, one special educator comments, “… research also shows that students with disabilities, whether mild or severe, often have poorer social skills and are less accepted by their non-disabled peers. So we have to ask ourselves—who are we really thinking of when we talk about inclusion? Are we thinking of the student with a mild learning disability who may easily blend in and be accepted by their abled peers, or the student with cerebral palsy who uses a wheelchair and must be fed by a feeding tube, who just may stick out in a mainstream crowd? Speaking from experience, I’ve seen that the best communication skills, motor skills, and social skills are developed when students work alongside peers who are like themselves—peers who share their struggles, who know what it feels like to make huge gains in small steps.”16
There is no single or simple answer to the complex realities of the educational needs of children with disabilities. “The purpose is to focus on fairness and equity for all students in the nation’s classrooms. That goal can only be achieved by encouraging many more people, especially parents and educators, to come forward with their views and experiences. The time for that robust, inclusive and frank national discussion is now.” 14
ABOUT THE AUTHORS:
H. Barry Waldman, DDS, MPH, PhD – Distinguished Teaching Professor, Department of General Dentistry at Stony Brook University, NY; E-mail:email@example.com
Steven P. Perlman, DDS, MScD, DHL (Hon) – Global Clinical Director, Special Olympics, Special Smiles and Clinical Professor of Pediatric Dentistry, The Boston University Goldman School of Dental Medicine, Private pediatric dentistry practice – Lynn MA.
Misha Garey, DDS is Director of Dental Services at the Orange Grove Center.
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14. Freedman MK. ‘Mainstreaming’ Special-Ed students need debate: What has been the law’s impact on students who are not disabled? The matter at least merits discussion. Wall Street Journal, August 4, 2013. Web site: http://www.wsj.com/articles/SB10001424127887323309404578613532497541300 Accessed January 27, 2015.
15. Public Agenda. When it’s your own child: some surprising views from parents about special-ed Web site: http://www.publicagenda.org/press-releases/when-its-your-own-child-some-surprising-viewsparents-about-special-ed Accessed January 27, 2015.
16. Smith N. Takepart. Op-Ed: An argument against mainstreaming kids with disabilities. A special education teacher shares why she believes students with special needs thrive in schools solely for kids with disabilities. Web site: http://www.takepart.com/article/2012/10/26/op-ed-inclusion-best-idea-childrendisabilities Accessed January 27, 2015.