Where do we start in preparing a child for inclusive education

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Where do we start in preparing a child for
inclusive education?

• Dr Alta Kritzinger
• CHRIB (Centre for Early Intervention in
  Communication Pathology
• University of Pretoria)

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As a speech-language therapist ..

• Inclusive education is a catalyst for
  reconceptualizing our intervention efforts (Klein
  Gilkerson, 2000)
• We need to open the doors of our therapy rooms
• For our clients and their families
• Inclusion is about belonging to a community a
  group of friends, a school community, a
  neighbourhood (Allen Schwartz, 1996)

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Where do we start?

• Inclusion
• Early Communication Intervention (ECI)
• From birth onwards
• Communication-based
• Together with parents and caregivers
• Ultimate goal School readiness

• Presentation
• Aims
• Early identification
• Case study
• Assessment
• Areas
• Justification
• Intervention
• Strategies

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Early identification

• Case study
• He is now 19 years old
• His mother contacted me in May 2004
• Request Please write a letter to the provincial
  DoE to
• justify the assistance of a scribe (reading the
  questions to him and writing his answers)
• extra time
• during his senior certificate examinations

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He is a Learner with SEN

• He loves the movies and dreams about the scripts
  of the movies he is going to make one day
• He is busy training for his drivers license
• He is in a regular high school with 2000 children
• He fits in fairly well
• It is going well with him but difficult
• He has unbelievable persistence

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He is diagnosed with ASD

• He is a perfectionist and adds stress to himself
  (stereotypical behaviour patterns)
• He has 5 days a week extra classes in almost all
  his subjects, but never complains
• He usually does not lack the knowledge, he has
  trouble with language
• Receptive and expressive language
• Communication impairment
• Symbolic use of language
• Frustration Cannot go on with another task if he
  tries to retrieve information
• Social interaction Exposed to mocking

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How do you relate to the case?

• What are the issues for
• Identification of LSEN?
• Assessment?
• Intervention?
• What are the theoretical resources that we can
  use?
• What are you going to do?

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How did he make it so far?

• Who first noticed there was a problem?
• His parents
• What did they do?
• Saw medical specialists
• 17 years ago they persisted until they found
  professionals to help them
• Medical assessments did not initiate therapy
• When was he identified?
• Early, at 2 years

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Early predictors for inclusion from case study

• The parents drove the process of identification,
  and continue till today
• Parents always wanted to include him
• He was identified early
• The parents had knowledge and financial resources
  and knew how to use it
• They developed a majestic support network of
  therapists, teachers, caregivers
• They handled their stress Resilient

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Risks for inclusive education

• Too much depended on the parents
• No inclusive educational policy at that time
• Only pioneers make it happen
• Potential stressors (Guralnick, 1997)
• Parental information needs
• Interpersonal and family distress
• Resource needs
• Confidence threats
• Chain of emotional reactions to diagnosis of
  childs disability

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Importance of early identification of child for
inclusive education

• EI is regarded as one of the most important
  predictors for successful ECI
• Outcome of ECI is school readiness
• Who are the infants and toddlers who may be L
  with SEN?
• It is well known that all children with language
  learning difficulties are at risk for academic
  failure (not school failure)
• Majority of the slts preschool client base is
  therefore at risk for learning difficulties

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Reconceptualize intervention goals for all
preschool clients

• Prevent academic failure
• If you consider inclusive education seriously,
  you should have a sense of urgency in your
  intervention
• Infants grow up and disappear
• make the most of critical learning periods
• Child must be as ready as possible for school

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What are the goals we work towards in inclusive
education?

• To develop the childs full potential
• Focus areas
• Language skills ? academic skills
• Social skills
• Self-help skills
• To make friends and mix with peers
• To be as independent as possible
• To be part of the learning community, in typical
  schools and communities

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If these are the goals of inclusive education,
how do I assess?

• What are the parents needs? (CHRIB, 2000)
• What is the cause of my childs problem?
• What is my childs level of functioning?
• What progress can I expect in my child?
• What can I do to help my child?
• Which step in inclusive education?
• Moms and Tots
• Playgroup
• Nursery school
• Successive levels of skills required for each
  step until school readiness

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Functional and comprehensive early communication
assessment

• Goals (Olswang Bain, 1991)
• To be able to tell what the infant can do
• To identify what is missing in the infants
  developmental profile
• To identify what behaviours occur infrequently
• To identify what
• can be changed
• must be compensated for
• in order to succeed in the next step of inclusive
  education

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Focus areas for assessment

• Inner circle Physical features and sensory
  integrity
• May lead you to the contributing factors or
  causes of the disability
• To provide a complete as possible description of
  the childs problem
• Parents need this information
• often to alleviate guilt
• Interdisciplinary assessments required

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2nd level Language and communication skills

• Language learning contexts
• Dyadic parent-child interactions
• Parent talks to single child
• Polyadic teacher-child interactions
• Caregiver/teacher talks to a group of children
• Multi-lingual
• At home
• At educational setting
• Diverse interaction styles

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2nd level Assessing language and communication
skills

• How does he/she listen when people talk?
• Record the variety and frequency of communication
  functions observed
• Intentional communication skills provide basis
  for developing speech and language skills
• Speech production and feeding difficulties may be
  a predictor to augment or use alternative means
  of communication
• Do not delay AAC We want the toddler to
  communicate
• Analyze receptive vocabulary categories
• Record the variety of semantic relationships

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3rd level Assessing general skills

• Level of play will determine childs readiness
  for participating in a group
• Describe levels of awareness and cognitive skills
• Self-help skills attained What are the
  requirements for assistance with self-care?
• Early literacy skills
• Knowledge of conventions of book reading
• Enjoyment of books
• Level of engagement Pictures ? text

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3rd level Assessing general skills

• Early computer skills
• Gross fine motor functioning determines access
  to and participation in activities
• Describe emotional responses and behaviour
  patterns adaptive abilities in strange
  situations
• Analyze parental interaction styles What do
  parents do to enhance inclusion?
• Describe personal social skills Confidence and
  self-esteem

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Assessment is an art ...

• Assessment for inclusive education is the art of
  identifying strong points and features of
  resilience in a child and a family, and making
  the most of it

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Outcome of assessment

• 1. Report to parents (copies to team)
• Developmental profile of child and family
• Strong points
• Abilities and skills
• Skills to be expanded
• New skills to be learned
• Skills to be compensated for
• 2. Intervention planning
• What must now be done to enhance functioning on
  the next level of inclusion?

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Reconceptualize intervention goals?

• Not good enough to change ECI goals
• We have to implement those goals
• Work towards inclusion in every therapy session
• Track developmental changes
• Assist parents to keep track of the goals
• Give information, support, train them
• Solve problems together

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Intervention strategies for inclusive education

• Train parents and caregivers in the responsive
  interactional approach of communication
  development (Hanen 1992)
• Infants become initiators of communication
  interaction
• They gain confidence in communicating because
  parents are interested in their communication
  efforts
• They may survive better group contexts as they
  have communication skills

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Intervention techniques

• Adults (parents and caregivers) learn best when
  (Cohen et al., 1996)
• New ideas or behaviours are introduced in small
  steps
• Goals are set along the way
• Someone models how to do the new behaviour
• Positive behaviours are praised
• Therapists, team, family and friends support them
  in the changes they wish to make

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Predictors for success of inclusion Case study

• Intensive therapy necessary for ASD
• slt and ot every day
• play therapy
• Started with therapies within a month after slt
  assessment
• Regular serial assessment by team of experts to
  guide intervention steps
• Interdisciplinary work
• Active parental involvement

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Predictors continued ...

• Maintained a support system
• Adaptability
• parents
• teachers
• therapists
• Many resilient factors, above all my clients
  wonderful personality that shone through all the
  difficulties of his behaviour and communication

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Immeasurables

• Young man has always belonged to a secure home
  environment
• Balance between dreams and common sense
• Hallo Alta, Its good to make contact with you
  again. I would have loved to give you news that H
  won 10 Oscars for his movies, that he is happily
  married, and that I am a grandmother. This is the
  summary of my prayers for him, but we are not
  there yet!

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ECI resources

• Buckley, S. Bird, G. 2001. Speech and language
  development for infants with Down syndrome. Down
  syndrome issues and information. UK The Down
  Syndrome Education Trust.
• Buckley, S., Emslie, M., Haslegrave, G.,
  LePrevost, P. Bird, G. 1993. The development of
  language and reading skills in children with Down
  syndrome. 2nd Ed. UK University of Portsmouth.
• Fewell, R. R. Vadasy, P. F. 1983. Learning
  Through Play. New York Teaching Resources, Inc.
• Furono, S. (Ed.) 1997. Hawaii Early Learning
  Profile HELP. HELP Activity Guide. Revised
  Edition. Palo Alto Vort Corporation.

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Resources continued ...

• Hong, C.H., Gabriel, H. St John, C. 1996.
  Sensory Motor Activities for Early Development.
  Oxon Winslow Press.
• Hussey-Gardner, B. 1999. Best Beginnings. Helping
  Parents Make a Difference through Individualised
  Anticipatory Guidance. Handouts for Parents. Palo
  Alto Vort Corporation.
• Klein, M. 1990. Parent Articles for Early
  Intervention. Tucson Communication Skill
  Builders.
• Kritzinger, A. Louw, B. 2002. A Comprehensive
  Assessment Protocol for Infants and Toddlers at
  Risk for Communication Disorders. Part II.
  Assessment Protocol. Clinica Monograph 6. UP.

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Resources continued ...

• Kritzinger, A. Louw, B. 1997. A Description of
  Joint Book-Reading Practices of Mothers and their
  Young Children, 0 - 2 years. Clinica,
  Applications in Clinical Practice of
  Communication Pathology. Monograph 2. University
  of Pretoria.
• Kumin, L. 2003. Communication Skills in Children
  with Down Syndrome. A Guide for Parents. 2nd
  Ed.Rockville Woodbine House.
• Lynch, C. Kidd, J. 1999. Early Communication
  Skills. Oxon Winslow Press.
• Manolson, A. 1992. It takes Two to Talk. Toronto
  The Hanen Centre.

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Resources continued ...

• McCurtin, A. 1997. The Manual of Paediatric
  feeding Practice. Oxon Winslow Press.
• Parks, S. 1999. Revised Edition. HELP When the
  Parent has Disabilities. Palo Alto Vort
  Corporation.
• Parks, S. 1998. HELP At Home. Activity Sheets
  for Parents. Palo Alto Vort Corporation.
• Rondal, J. A. Buckley. S. 2003. Speech and
  language intervention in Down syndrome. London
  Whurr.
• Rossetti, L. M. 2001. Communication Intervention.
  Birth to Three. Australia Singular Thomson
  Learning
• Weitzman, E. 1992. Learning Language and Loving
  it. Toronto The Hanen Centre.

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Conclusion

• The early years are learning years make them
  count
• Its never too early for intervention