School inclusion of children with ASD and ADHD

Vol. VI (LXVIII) No. 1B/2016 218-224 School inclusion of children with ASD and ADHD Pîr ean Corina a *, Alina Mirela Trofin a, Simona Marica b a Association Gardienii Terrei, Vintila Mihailescu street, 21, Bucharest, Romania b Spiru Haret University, Fabricii street, 46C, Bucharest, Romania Abstract The main purpose of this research was analysing the way in which teachers perceive children suffering from/ with ASD and ADHD and their open-mindedness towards inclusive teaching, but also identifying the major difficulties the teachers face when encountering a child suffering from [one of the] said disorders. Through the project Social Inclusion of Children with ASD and ADHD we aim at increasing the degree of school inclusion of children suffering from ASD and ADHD through the familiarization of teachers with specific methods and techniques of class intervention and through the improvement of the methods of communication employed between teachers, children and parents. Keywords: autism, ADHD, communication, education, inclusion, preconceptions 1. Introduction Through this project we aim at raising the degree of school inclusion of children suffering from ASD (Autism Spectrum Disorder) and ADHD (Attention Deficit Hyperactivity Disorder) through the familiarization of teachers with specific methods and techniques of class intervention and through the improvement of the methods of communication employed between teachers, children and parents. In the past years, at an international level, the number of cases in which a children suffer from a developmental disorder while growing up has been on the rise. The statistics estimate that in the USA one in every 45 children suffers from a disorder belonging to the autism spectrum ASD (http://www.cdc.gov/nchs/data/nhsr/nhsr087.pdf) and that a percentage ranging between 5.29 and 7.1 % of children suffer from ADHD (http://psych.colorado.edu/~willcutt/prev_body.pdf). Both conditions affect academic abilities and social interaction and manifest themselves in ways that are difficult to manage. In Romania there is no official statistics, but in practice there is a growing number of children suffering from these disorders. The past 10 years have meant for our country an increase in the number of specialists in child psycho-diagnosis and ABA (Applied Behaviour Analysis) and a development of specialized education services. More and more children become the beneficiaries of these services owing to specialized institutions. The children s recovery chances rise considerably. Every child has the right to an inclusive education (Vr ma, 2010). Autism Spectrum Disorder (ASD) is considered to be a neuro-biological disorder which appears during the child s development before the age of 3 and which affects the child s stages of development at all levels (thought, language, social, self-service, psychomotricity). Autism Spectrum Disorder (ASD) is an umbrella term for a variety of symptoms with an impact on the development, learning, processing, and perception abilities of a person. ASD is a disorder which lasts for life and which imposes adaptability both from the affected person and the medium in which he/she lives (school, community, professional domain, sanitary system etc.) * Corresponding author. Tel.: +40724 383 653 E-mail address: pirsean@yahoo.com

Pîr ean, Trofin, Marica/Journal of Educational Sciences and Psychology 219 People affected by ASD encounter difficulties in three broad spheres: language and communication, social interaction, and interests and behaviours. The intensity of these behaviours differs from one person to another hence the name of Spectrum meant to highlight the way in which a person can be affected. Through the educational programmes a person can improve many of the behaviours and reach a certain level of autonomy. Attention Deficit Hyperkinetic Disorder (ADHD) also has a biological basis and is characterised by a disequilibrium at the level of certain neurotransmitters (Green & Chee, 2009). The child affected by this disorder has a behaviour characterized by difficulties in terms of self-monitoring and controlling impulses, and inadequate behaviours. The child is often impulsive, has problems paying attention (gets easily distracted) and has learning difficulties (because of the difficulties regarding focus and short-term memory), but can also manifest a hyperactive behaviour, finding it hard to sit still for a long period of time, feeling the need of being in motion. Both disorders mentioned above affect an increasingly larger number of children. Since they are life-time disorders, the affected person and his/her family are constantly involved in different types of therapy meant to help the person lead an independent life in society. Depending on the degree in which the disorder affects the person and on co-morbidities, people suffering from ASD or ADHD can bridge huge parts of the gap between the chronological age and the development age and reach a high level of personal autonomy. School education is an important pawn in this process. The school represents an environment where the child can transfer the abilities acquired through therapy and at home. School is the first step towards social adaptability and integration. The Romanian educational system comprises specialized educational institutions, but these are not particularly destined to children suffering from ASD and ADHD. These institutions lack both the logistics and the point of view of the differentiated methods of instruction in facing the problems raised by the increase in the incidence of ASD and ADHD. In this types of schools the [educational] level is much lower. Therefore there is an attempt at including children with developmental disorders in the mass education (where the number of students in a group is very large and teachers lack the adequate training). The project School Inclusion of Children with ASD and ADHD run by the Association Gardienii Terrei which we have implemented in a time span of 6 months had as an objective familiarizing teachers with the specifics of ASD and ADHS disorders and the methods and techniques which they can employ when intervening in the classroom in order to offer these children a chance at school inclusion. The main purpose of this research was analysing the way in which teachers perceive children suffering from/ with ASD and ADHD and their open-mindedness towards inclusive teaching, but also identifying the major difficulties the teachers face when encountering a child suffering from [one of the] said disorders. Through this project we aim at increasing the degree of school inclusion of children suffering from ASD and ADHD through the familiarization of teachers with specific methods and techniques of class intervention and through the improvement of the methods of communication employed between teachers, children and parents. Research has shown that the most acute problems are caused by faulty communication between teacher and child, and teacher and parent, but also by a lack of information need for understanding the mechanisms that form the basis for these behaviours, insufficient knowledge regarding the ways to work with such children, and a lack of exercise in working with managing a mixed classroom. The flows in the educational system exert a great amount of pressure on the teacher. A teacher finds himself/herself in a position where he/she has to answer to the solicitations of different school committees which demand reports/assessments, where he/she has to apply differentiated instruction to children with SEN who have the right to an inclusive education, but also to the other children in the classroom, respecting their rights, and, last but not least, providing counselling for parents.

Pîr ean, Trofin, Marica/Journal of Educational Sciences and Psychology 220 The teacher reaches a high level of stress which has an influence on his/her behaviour and health. A teacher under stress cannot perform accordingly nor provide an adequate environment for a harmonious development for the children (Vr ma, T., Vr ma E., 2010, pp. 80-100). 2. Methodology The purpose of this research is identifying the problems that teachers encounter in the process of inclusion in the mass education of children suffering from ASD and ADHD and the opinions that the parents of typical children hold on having a child with ASD or ADHD in the same classroom as their child. The research project is of the exploratory type. The research took place in the counties mentioned in the study the first time. The absence of educational programs for teachers with respect to basic information regarding the two disorders which are at the centre of this research (autism and ADHD) leads to a rise in the stress levels of the teachers and, incidentally, to a negative impact on their behaviour and health. 130 preschool and elementary school teachers from the counties of Tulcea and Constan a took part in the research. The elements comprising this study include the analysis of the way in which teachers perceive children suffering from ASD and ADHD, their predisposition towards inclusive education and the greatest difficulties they encounter when dealing with a child suffering from such a disorder. The lack of information regarding the disorders mentioned above, disorders with which the teachers may come into contact, has a negative effect on the teaching process, but also mares the teachers personal life. The research also included a section focusing on the social perception of the abovementioned disorders with the aim of identifying the potential preconceptions and discriminatory behaviours towards children with ASD and ADHD voiced by the parents with children from the primary form of instruction from Tulcea County. The aim of the research was not that of comprising a generalized statistics analysis, but that through the number of interviewees and the large quantity of collected information to be able to support the theoretic framework of the present thesis. 2.1. Objective The research objectives were: Identifying the need to inform teachers with regard to the specifics of Autistic Spectrum Disorders and ADHD and to raise the competence of teachers and parents to assess such behaviour; Identifying the need to take part in workshops focused on acquiring the required methods to work in a classroom with children suffering from ASD and ADHD; Identifying the need to raise the dialogue between specialists and teachers in order to find and implement the best methods through which the communication and social skills of children with ASD and ADHD can be developed; Identifying the methods of communication through which the teachers can support the inclusion in the classroom of children with development disorders. 2.2. Participants Research has focused on two study groups: 1. First lot of study consisted of 130 subjects - teachers aged 26-59 years. 2. Second lot of study consisted of 26 subjects - parents aged 29-51 years. 2.3. Instruments

Pîr ean, Trofin, Marica/Journal of Educational Sciences and Psychology 221 The research method used to obtain the data that were lately operated was the inquiry based on questionnaires. Both questionnaires had a section with factual data (age, gender, educational level, income level, workplace seniority). 2.4. Procedure The questionnaire for teachers was made up of 33 items out of which 5 were of the closed answer type and 28 of the open answer type. The questions were based on the objectives of the research touching upon subjects such as the social inclusion of the children suffering from ASD and ADHD, the difficulties the teachers encounter in diverse classrooms, the educational needs of the teachers, questions regarding clichés and labelling, preconceptions about children with ASD and ADHD etc. The questionnaire destined for parents had 6 items, 5 with closed answers and an open answer type of question. The items quantified the degree prejudice the parents hold against children with ASD and ADHD, the level of knowledge the parents have about ASD and ADHD and their need to be informed of the two disorders. The questionnaire for teachers was made up of 33 items out of which 5 were of the closed answer type and 28 of the open answer type. The questions were based on the objectives of the research touching upon subjects such as the social inclusion of the children suffering from ASD and ADHD, the difficulties the teachers encounter in diverse classrooms, the educational needs of the teachers, questions regarding clichés and labelling, preconceptions about children with ASD and ADHD etc. The questionnaire destined for parents had 6 items, 5 with closed answers and an open answer type of question. The items quantified the degree prejudice the parents hold against children with ASD and ADHD, the level of knowledge the parents have about ASD and ADHD and their need to be informed of the two disorders. 2.5. Data analysis Our Program School Inclusion of Children with ASD and ADHD was implemented starting December 2015 until May 2016 in Tulcea and Constan a counties. The research focused on two main interest directions: 1. The teachers formed the first main focus point and were given a questionnaire with open and closed questions, with multiple choice types of answers. The study group included 130 subjects (110 from the urban area and 20 from the rural area) teachers with ages ranging from 26 to 59 years old. 2. The second focus point were the parents who had to answer a questionnaire with open and closed questions. The study group included 26 subjects (urban residents) parents with ages ranging between 29 and 51 with a social distance scale with 5 levels regarding children with ASD and ADHD. 3. Results The results of interpreting the data from the questionnaires from both batches are as follows: 1. The correlations made between the research s variables and the issues targeted by the items of the questionnaire handed out to the teachers are the following: 85% of the teachers involved in this study have a work experience of 11 to 20 years or over 20 years [seniority], 15% have under 5 years of experience; the teachers involved in the research project were 12% secondary elementary school teachers, 41% preschool teachers, and 47% primary school teachers; The answers to the questionnaire s 3rd item regarding the inclusion of children with ASD and ADHD included an affirmative answer from 69% of the interviewees, justifying that the presence of the psychologist, the itinerant counsellor and the speech-language psychologist in the respective institutions help the teachers and

Pîr ean, Trofin, Marica/Journal of Educational Sciences and Psychology 222 facilitate the child s inclusion, while 31% of the teachers answered negatively, justifying their answer through the existence of a large number of children in a classroom (over 25), the insufficient equipment provided by schools, a curricula specially adapted to children with ASD and ADHD, the parents reticence in acknowledging the children s diagnosis, and the refusal of certain teachers to instruct classes with children suffering from ASD and ADHD. As for item 6 regarding the way a child with ASD or ADHD as a member of the classroom is perceived, 81% of the teachers answered affirmatively justifying their answer through the condition of respecting the special needs of children with ASD or ADHD and creating the ideal conditions for interaction with the other classmates under the strict coordination and surveillance of teachers. With children in preschool, due to the absence of prejudice, there are better results regarding class inclusion. 19% of the teacher answered negatively arguing the atypical social behaviour of the child suffering from ASD and ADHD which decisively influences his acceptance in the collective and the need for teachers to pay extra attention. The child is labelled as a problem in the collective. Item 11 regarding the need for support teachers instructing classes with children suffering from ASD and ADHD, 100% of the teachers answered affirmatively arguing that the presence of support teachers is a real help, but their small number is evident in comparison with the number need in schools. The answers quantified for item 12 regarding the interaction with the teacher/ support teacher (itinerant) for ADHD and ASD suffering children, 56% of the teachers answered affirmatively justifying their answer with having the same approach in most cases, 28% answered negatively arguing that up to this point no standard procedure has been issued with regard to interacting with children with ASD and ADHD which generates different types of approaches, while 16% did not answer because they have not had the opportunity to interact with specialists in the domain of behavioural disorders in children. Item 13 regarding the school admission of children with ASD and ADHD in the same way a typical children showed 53% of the teachers answering affirmatively justifying their answer through arguing that in educational institutions where there is a team (counsellor teacher, speech-language pathologist, itinerant teacher, child, specially qualified instructor) supporting the teachers in their activities, the children with ASD and ADHD are well received, 35% answering negatively reasoning that the current school environment is no ready for children with ASD and ADHD, while 12 % of the teachers did not answer or did not make the distinction between school (institution, teachers) and collective (classmates). In item 15 regarding the degree of instruction of the teachers for facing the negative opinions of the pupils who do not see eye to eye with their classmate with special educational needs 63% of the teachers answered affirmatively justifying their answer through the special training - teachers are able to avert negative opinions of the pupils about their classmate with special educational needs, but through workshops, and can develop the necessary abilities to maintain a grounded discussion/ recommendation/ advice for avoiding a conflict generated by this situation, 26% answered negatively evoking the lack of empathy, emotional generosity and superficial involvement of certain teachers which leads to the perpetuation of the negative opinions the pupils hold of their classmate with special educational needs instead of eradicating the violent outbursts of certain pupils, and 11 % of the teachers did not answer or were undecided. In item 18 regarding pupil diversity (typical and suffering from ASD and ADHD) in the classroom seen as a resource for instruction or an impediment in the process of instruction 23% of the teachers answered RESOURCE arguing that pupil diversity can be perceived as a resource and the course they have attended about the School Inclusion of children with ASD and ADHD opened up a new and innovative perspective on the child with SEN as a determinant in sustaining learning (the game can be a link in determining the typical and atypical child to develop his/her way of

Pîr ean, Trofin, Marica/Journal of Educational Sciences and Psychology 223 learning). Implementing the courses at the level of all teachers in Romania can change an entire mentality towards regarding the child with SEN as a resource. 58% of the teachers answered PROBLEM, arguing that the presence of children with ASD and ADHD is an additional stress factor for the teacher because of the busy educational curricula and the exponential rise of the expectations to be met by teachers, because of the demands of the superior [educational] institutions, and last but not least because of the demands of the parent of all children. The lack of support in the educational institutions is big problem. 19% of the teachers did not answer or were not sure. As for item 31 which refers to the need for programs bringing additional information about difficult behaviours and disorders among pupils, 100% of the teachers answered affirmatively justifying their answer through the fact that the programme School Inclusion of children with ASD and ADHD holds valuable content for teachers and can become a necessary course, relevant among the various subjects for the continuous training of teachers. The confusion or lack of information regarding the disorders the teachers face in class only adds up to the existing tensions and prejudices. At item 32 referring to the need for programmes for improving teachers, their ability to communicate with the pupils and their parents, 98% of the teachers answered affirmatively justifying their answer through the fact that such programmes are necessary because one of the basic abilities of a teacher is communication. 2% of the teachers answered negatively, arguing that there are communication courses in the educational system, but not on this particular subject. The correlations between the variables of the study and the issues targeted by the items of the questionnaire handed out to the parents are the following: there were no significant differences identified with respect to prejudices dependent on the age of the parent, but the parents of children aged 9 and 10 are far less perceptive than those with children aged 6 or 7; there were no significant differences identified with respect to prejudices dependent on the level of instruction or the social milieu they come from; there were significant differences identified dependent on the family income with an income of over 3500/ month/ family parents are unaffected by prejudice; on items 4 and 5 it we notice that out of the 85% of the subjects who already have a certain amount of knowledge regarding ASD and ADHD 35% wish to know more; Out of the 26 parents taking part in this study only one had a child diagnosed with ADHD. As for the set objectives of the present thesis we mention the following: As the quantification of the answers in item 31 shows that all the teachers involved are aware of the need for information/ training we consider it to be met the objective regarding identifying the need for informing the teachers in terms of the specificity of Autistic Spectrum Disorder and ADHD and of rising the competence of evaluating such behaviours by teachers and parents. As the need for training/ information is obvious and can only be realised through an increase in the opportunities of dialogue between teachers and specialists, we suggest multiplying the actions of the round table type, conferences, debars etc. in order to realise such a dialogue. Taking into consideration the data quantified in item 32, namely that 98% of the teachers involved claim that yes, they need information/training courses for acquiring the communication abilities through which the teachers can support the inclusion of children with disorders in class. 4. Discussions Out of processing the date from the two questionnaires, one designed for teachers and one designed for parents, the following conclusions emerged:

Pîr ean, Trofin, Marica/Journal of Educational Sciences and Psychology 224 The need to implement in educational institutions studies/ workshops of presenting the development disorders that can occur in children, ways of behaving towards them both for classmates and teachers, involvement of children with ASD or ADHD in all school projects and eliminating the prejudice and labelling that exist towards them. The approach on a national level of inclusive education in schools, in conjunction with the implementation programmes suited to children with ASD and ADHD. The correct informing of children and their parents about ASD and ADHD disorders with the aim of creating an equilibrated and conflict-free environment in educational institutions, through accepting diversity and interacting with everyone without any social/ medical/ etc. discrepancies. Paying special attention to specialists in the domain through their permanent presence in school, through organizing sessions of introducing both specific and general elements of certain disorders with an eye to developing interpersonal relations between typical children, atypical children, teachers, parents, and specialists. Realizing an instrument of screening/ evaluation and developing the competence of evaluating the said disorders which the teachers and parents can use to identify behavioural disorders in children. References 1. American Psychiatric Association, (2013). DSM V, Washington.D.C. 2. Dobrescu, Iuliana, coord., (2010). Manual de psihiatrie a copilului i adolescentului, Editura Infomedica, Bucure ti 3. Green, C. & Chee. K (2009). S în elegem ADHD deficitul de aten ie înso it de tulburare hiperkinetic, Editura Aramis Print, Bucure ti 4. Exkorn, Karen Siff, (2010). S în elegem autismul, Editura Aramis, Bucure ti 5. Manu B, Marica S, Banica L, (2014). Myths, Biases and Stereotypes over the Autism, in Communication Context and Interdisciplinarity, 3/2014, Alpha Institute for Multicultural Studies, Petru Maior University Press, Târgu Mure, pp 25-33 6. Marcelli, D., (2003). Tratat de psihopatologie a copilului, Editura Funda iei Genera ia, Bucure ti 7. Vr ma, T., Vr ma, E. et all., (2010). Incluziunea colar a copiilor cu cerin e educa ionale speciale. Aspira ii i realit i. Editura Vanemonde, Bucure ti 8. http://psych.colorado.edu/~willcutt/prev_body.pdf 9. http://www.cdc.gov/nchs/data/nhsr/nhsr087.pdf