ISSN 0827 3383

International Journal
of

Special Education
VOLUME 21

2006

NUMBER 3

Teachers' Attitudes Toward Students With Disabilities In Hati

TheTechnologicallyDependent/MedicallyFragileAtRiskStudent

Time-Out Interventions And Strategies: A Brief Review And Recommendations

Alchemy And Aberrant Behaviour:A Jungian Approach To Working With Boys

With Behaviour Disorders

An Empirical Study On Teachers Perceptions Towards Inclusive Education In

Malaysia

The Effects Of Constant Time Delay And Strategic Instruction On Students With
Learning Disabilities Maintenance And Generalization

Aggressive Behaviour Among Swazi Upper Primary And Junior Secondary

Students: Implications For Ongoing Educational Reforms Concerning Inclusive
Education

EvaluationOfTurkishHearingImpairedStudentsReadingComprehensionWith
TheMiscueAnalysisInventory

TheEffectsOfVisualizingAndVerbalizingMethodsInRemedialSpellingTraining:
IndividualChangesInDyslexicStudentsSpellingTestPerformance

Comorbid Diagnosis And Concomitant Medical Treatment For Children With

EmotionalAndBehavioralDisabilities

Early Identification And Interventions For Children At Risk For Learning

Disabilities

Individual, Family, And School Factors Associated With The Identification Of

FemaleAndMaleStudentsForSpecialEducation

Parents And Special Education Teachers Perspectives Of Implementing

Individualized Instruction In P. R. China-An Empirical And Sociocultural Approach

Parents And Local Education Authority Officers Perceptions Of The Factors

Affecting The Success Of Inclusion Of Pupils With Autistic Spectrum Disorders

Effective Interventions For Individuals With High-Functional Autism

CountingInEgyptianChildrenWithDownSyndrome

International Journal of Special Education

REVISED EDITORIAL POLICY 2006
The International Journal of Special Education publishes original articles concerning special
education. Experimental as well as theoretical articles are sought. Potential contributors are
encouraged to submit reviews of research, historical, and philosophical studies, case studies
and content analyses in addition to experimental correlation studies, surveys and reports of the
effectiveness of innovative programs.
Send your article to marcsapo@interchange.ubc.ca as attachment by e-mail, in MSWORD
for IBM format ONLY.
Articles should be single spaced (including references). Submit one original only. Any tables
must be in MS-WORD for IBM Format. Please include a clear return e-mail address for the
electronic return of any material. Published articles remain the property of the Journal.
E-mailed contributions are reviewed by the Editorial Board. Accepted articles may be
revised for clarity, organisation and length.
Style: The content, organisation and style of articles should follow the Publication
Manual of the American Psychological Association (2001). An article written in an obviously
deviating style will be returned to the author for revision.
Abstracts: All articles will be preceded by an abstract of 100-200 words.
Contributors are referred to the Publication Manual of the American Psychological
Association for assistance in preparing the abstract.
Responsibility of Authors: Authors are solely responsible for the factual accuracy of
their contributions. The author is responsible for obtaining permission to quote lengthy
excerpts from previously published material. All figures submitted must be submitted
within the document.
JOURNAL LISTINGS
Annotated and Indexed by the ERIC Clearinghouse on Handicapped and Gifted
Children for publication in the monthly print index Current Index to Journals of Special
Education (CIJE) and the quarterly index, Exceptional Child Education Resources (ECER).

IJSE is also indexed at Education Index (EDI).

The journal appears at the website: internationaljournalofspecialeducation.com
The editor can be reached at marcsapo@interchange.ubc.ca

VOLUME 21

2006

NUMBER 3

INDEX
Teachers' Attitudes Toward Students With Disabilities In Hati...1
Errol Dupoux, Helen Hammond, Lawrence Ingalls and Clara Wolman
The Technologically Dependent/Medically Fragile At Risk Student......15
Thomas G. Ryan
Time-Out Interventions And Strategies: A Brief Review And Recommendations.22
Tera L. Wolf, T. F. McLaughlin and Randy Lee Williams
Alchemy And Aberrant Behaviour:A Jungian Approach To Working
With Boys With Behaviour Disorders.....30
Robert ODea
An Empirical Study On Teachers Perceptions Towards Inclusive
Education In Malaysia..36
Manisah Mohd Ali, Ramlee Mustapha and Zalizan Mohd Jelas
The Effects Of Constant Time Delay And Strategic Instruction On Students
With Learning Disabilities Maintenance And Generalization .......45
M. Flores, D. Houchins and M. Shippen
Aggressive Behaviour Among Swazi Upper Primary And Junior
Secondary Students: Implications For Ongoing Educational Reforms
Concerning Inclusive Education......58
Lawrence Mundia
Evaluation Of Turkish Hearing Impaired Students Reading Comprehension
With The Miscue Analysis Inventory......68
mit Girgin
The Effects Of Visualizing And Verbalizing Methods In Remedial Spelling
Training: Individual Changes In Dyslexic Students Spelling Test Performance...85
Gnter Faber
Comorbid Diagnosis And Concomitant Medical Treatment
For Children With Emotional And Behavioral Disabilities.....96
Kristina M. Hall, Krista A. Bowman, Katie Ley and William Frankenberger
Early Identification And Interventions For Children At Risk For
Learning Disabilities......108
Stephen M. Lange and Brent Thompson
Individual, Family, And School Factors Associated With The
Identification Of Female And Male Students For Special Education....120
Donald P. Oswald, Al M. Best and Martha J. Coutinho,
Parents And Special Education Teachers Perspectives Of Implementing Individualized
Instruction In P. R. China-An Empirical And Sociocultural Approach.....138
Yi Ding, Kathryn C. Gerken, Don C. VanDyke and Fei Xiao
Parents And Local Education Authority Officers Perceptions Of The Factors
Affecting The Success Of Inclusion Of Pupils With Autistic Spectrum Disorders...151
Emma M. Waddington and Phil Reed
Effective Interventions For Individuals With High-Functional Autism....165
Ann X. Huang and John J. Wheeler
Counting In Egyptian Children With Down Syndrome.....176
Hala Abdelhameed and Jill Porter

TEACHERS' ATTITUDES TOWARD STUDENTS WITH DISABILITIES IN

HATI
Errol Dupoux
Helen Hammond
Lawrence Ingalls
UniversityofTexasatElPaso

and
Clara Wolman
BarryUniversity

After conducting a thorough review of the state of inclusion of students

with disabilities in Hati, the authors present a study that investigates
the attitudes of urban and rural teachers in Hati toward inclusion.
Participants were administered the Opinions Relative to Integration
(ORI) of Students with Disabilities instrument. Reliability of the ORI for
Haitian teachers was .68, as determined by the Spearman-Brown
reliability coefficient. Teachers attitudes toward integration were not
associated with years of teaching experience, education was positively
associated with attitudes, and teachers in rural Hati did not differ from
teachers in urban Hati. Other findings indicated that variables
representing teachers cognitions and beliefs were more important in
predicting attitudes than variables related to the teachers actual
experiences of teaching.
Estimates of global populations indicate that more children with disabilities live in developing
and third world countries than in industrialized countries (UNESCO, 1996). In 1995, the
Ministre de Lducation Nationale of Hati estimated that 11% of the population had a
disability, of which 15% (120 000) were children of school age; this percentage is about 5%
greater than the estimate of the incidence of disabilities in a school age population in the USA
and Canada, for example (Landrum, 1999; Mallory, Charlton, Nicholls, & Marfo, 1993;
Nkabinde, 1993; Scheer & Groce, 1988; Weintraub, 2005). In May 2005, the enrolment of
students with disabilities in school was about 2%, almost double the previous percentage
reported in 1995 by the Ministre de Lducation Nationale (Personal communication with
Dr. Michel Peant, Hatis National Coordinator for the Society of the Blind and National
Secretary for the Integration of the Handicapped People , May 6, 2005). However, since lack
of identification affects prevalence figures, it can be assumed that the percentage of schoolaged children with disabilities is even greater, either because they are not currently attending
school in Hati or are struggling in regular classrooms without the appropriate services. In
1993, of the 54 000 candidates who participated in the final examination for a high school
certificate, only two students with identified disabilities (visual impairments) participated in
that testing (Ministre de Lducation Nationale, 1995).
Presently, Hati is in the unenviable position of being the country with the second highest
proportion of students in private schools, while also carrying the stigma of being one of the
poorest countries in the world (Background Notes on Countries of the World, 2003; Salmi,

2000). The average Haitian family earns $425 in US currency per year (Background Notes on
Countries of the World, 2003). Overall, about 40% and 80% of students of school age do not
attend primary and secondary schools, respectively, which may explain the high illiteracy rate
of 47% in Hati. Education in Hati is essentially a private enterprise with little control from
the government. Seventy-five percent of primary students and 82% of secondary level
students are enrolled in private schools (Salmi, 2000). Less than 10% of the school age
population is enrolled in public schools. At the elementary level, only 65% of those eligible
for primary education are enrolled in schools, although public education is free from first to
sixth grade (Background Notes on Countries of the World, 2003).
In the rural areas, the enrolment rate is about 23%. Overall, across areas, 63% of those
enrolled will complete elementary school (Salmi, 2000). Beyond the primary level, from 15 to
22% of those eligible for secondary education are actually enrolled in schools (Background
Notes on Countries of the World, 2003; Salmi, 2000). Fifty-five percent of those attending
secondary schools live in Port-au Prince, the capital of Hati. Only 38 students will graduate
from high school for every 1000 children who begin first grade (Ministre de Lducation
Nationale, 1995).
Concerning students with disabilities, it was reported that less than 1% (600) of this
population was identified and were receiving special services, and most were enrolled in
private schools (Ministre de Lducation. 1995). One of the structural problems is that low
performing students are not routinely tested; thus, many students who would be classified in
the high incidence categories (i.e. speech and language, intellectual disabilities, learning
disabilities, emotional disorders) in a developed country are an integral part of regular
classrooms in Hati. However, while the regular setting seems to be integrated, it is not so by
design but rather by default. Many teachers indicated that they would welcome a formalized
process of testing to help them target those students who need specialized instruction.
Arbeiter and Hartley (2002) reasoned that a lack of general knowledge about disability, as
well as a lack of access to special programs that exist in the most populated cities in third
world countries, seem to act as barriers to enrolment. Miles (1985) surmised that since many
students with disabilities are not identified, it follows that they are casually integrated in
regular classes. While school systems around the world have spent vast resources in labeling
and classifying students to provide them with a segregated education, Hatis response to low
achievement and poor performance clearly reflects a medical model of disability (i.e. personal
handicap and deficiency). Academic failure is blamed on the student, while remediation of
low achievement is solely the responsibility of the family unit.
Limitations
Hati has been affected by many of the factors confronting developing countries: severe
economic limitations, shortage of trained personnel, and geographic isolation of a large sector
of the population. By and large, these are the results of the incidence of poverty and
unemployment. The main features of schools in Hati are a reliance on a rigid curriculum, rote
learning, and a resistance to experiential and cooperative learning approaches (Ministre de
Lducation. 1998).
There are three categories of schools in Hati: public schools, private schools, and
humanitarian organizations. Only humanitarian schools provide free of charge basic reading
and writing for students with disabilities, especially those with visual and hearing
impairments, as well as those who are taught vocational skills. Across the three category of
schools, a significant number of teachers do not possess teaching credentials. Moreover, there
are no meaningful teacher in-service programs to upgrade teacher methodology and
knowledge of subject matter (Ministre de Lducation. 1998). Special education training is
not part of the courses offered or degree conferred by any of the universities. In terms of

space and infrastructure, schools are chronically overcrowded and lack electricity, water, and
the necessary hygienic facilities.
Overall, students with special needs have not been formally tested and classified. They are left
to fend for themselves within the regular setting. Usually, the main reason is a lack of
funding, since most schools operate on a tuition basis. This relieves the parents from the
shame of failure, and the school from evaluating the delivery of education to all students.
Currently, students with severe disabilities are served in a number of government residential
institutions that house mostly adults with psychiatric disorders, and in private schools. In
general, students institutionalization or placement in special programs depends on the
financial means of the parents.
Readiness and Culture
It has been suggested that integration in developing countries can be facilitated much more
easily and successfully than in North America and Western European countries, because in the
former, students with disabilities are already in the mainstream, unlike in countries with a
dual system of regular and special education (UNESCO, 1997, 1999). Recognizing that
schools in developing countries have large class sizes, untrained teachers, inadequate teaching
techniques, transportation problems, and lack of resources and facilities (Baine, 1993),
Mushoriwa (2001) commented that one of the arguments put forward by policy makers
pertaining to facilitating inclusive education in poor countries is to consider the regular
classroom as the mainstream model. This position takes into consideration the prohibitive
costs associated with implementing the inclusive model, which is expected to meet the needs
of a small number of children, as opposed to additional services provided to the existing
regular classroom for low achievers, regardless of the shortcomings of such a model. There is
an urgency to address the educational needs of students with disabilities; however, there is a
major crisis in general education. Among some policymakers and the educational elite in
Hati, special education is considered a luxury or a benefit that only industrialized nations can
afford. To paraphrase the former Secretary of Education for Hati, an advocate for special
education: When the main house is on fire, who cares about what would become of the guest
house? (Personal communication with E. Buteau, Hatis former Secretary of Education,
September 26, 2003).
The Haitian Constitution sets out that the first six years of education are compulsory. This
statement has never materialized in any other legislative mandates for many reasons, not the
least of which has to do with the role that children of the poor play in providing for the
comfort of middle and upper classes of Haitian society (Gibbons & Garfield, 1999; Janak,
2000). Many parents in the provinces place their children with wealthier families in the cities
in order to ensure that they get food and shelter. In return, these children work from sunrise to
sundown at various household chores. At times, they are sent great distances to buy the
necessities for the household. Usually, they get ready the school uniforms for the wealthier
children their age who attend school, while they stay back to prepare food or clean the house
to facilitate the comfort of the sons and daughters of the house as they return from school and
attend to their homework. These children can be found even in the houses of the framers of
Hatis latest Constitution. Obviously, compulsory education would destroy a source of cheap
labor in Hati (Janak, 2000).
Beginning Steps Toward Integration
Although special education in Hati has a solid history in a few expensive private schools
under the administration of teachers with Masters degrees in special education, obtained
mostly from universities in the United States, public schools lack any formal response to
students failure to learn. However, public educations response to the needs of children with
disabilities is in a state of transition. Based on protocols agreed upon by the countrys
leadership, and a deadline of 2004 imposed by international organizations supporting equality
of education for children (Personal communication with E. Buteau, Hatis former Secretary

of Education, 2003, September 23, 2003; Organization of American States, 1999), there is a
movement in the executive branch to recognize that low-performing students need extra help
through identification, and possibly special services.
While as of 2004 the legislature had shown no urgency in passing legislation to reform
education with regard to quality education for all students. By contrast, the Office of Special
Education has been expanded, with branches located in the two most populated provinces
outside of Port-au-Prince, the capital, in order to pilot an integration program in a few public
schools. In this pilot program, mainstreaming classes largely resemble the current regular
setting, except that students with disabilities may have been identified. This design is
receiving international support in order to ascertain the feasibility of expanding such a model
to other Haitian schools and provinces. Foreign organizations have given extensive start-up
funding for many educational projects related to special needs, in addition to educational
ideas and methods (UNESCO, UNICEF, USAID, World Bank). Such programs rely on
foreign financial assistance and therefore espouse foreign strategies and concepts (e.g.
rehabilitation), without questioning the feasibility of implementing them in the Haitian
context and maintaining them within severely limited local resources. It has been the case in
Hati that foreign donors often do not sustain their efforts over long periods of time.
Inclusion/Integration in the International Context
As Smith, Polloway, Patton and Dowdy (2004) conceptualized the term inclusion, it refers to
students with disabilities becoming part of the general education classroom, receiving a
meaningful curriculum with necessary support, and being taught with effective strategies. In
contrast, integration refers to educating students with disabilities in close proximity to
students in regular classrooms (Arbeiter & Hartley, 2002). Although the term inclusion is
more widely accepted in the USA and the UK, internationally, the term integration is more
preferred (Booth, 1996; Pijl & Dyson, 1998). For the purposes of this paper, inclusion and
integration will be used interchangeably for the following reasons: (1) to encompass the range
of programmatic models in Hati used to integrate students in the general track; and (2)
because participants in the study do not distinguish between the two terms.
Since the mid- to late-1980s, there has been a strong international movement to include
students with disabilities in the general setting (UNESCO, 1994, 1999). This is evident within
the literature for the following continents and geographical areas: Europe (Ainscow & HaileGiorgis, 1999; Didaskalou & Millward, 2001; Flem & Keller, 2000; Pijl & Dyson, 1998;
Senel, 1998), Australia-Oceania (Campbell, Gilmore, & Cuskelly, 2003), Asia (Clarke &
Nomanbhoy, 1998; Kataoka, Van Kraayenoord, & Elkins, 2004; Poon-McBrayer, 2004),
Africa (Arbeiter & Hartley, 2002; Barnartt & Kabzems, 1992; Engelbrecht, Oswald, Swart, &
Eloff, 2003), the Americas (Clark & Artiles, 2000; Hammond & Ingalls, 2003, Scruggs &
Mastropieri, 1996; Woloshyn, Bennett, & Berrill, 2003), the Middle East (Alghazo & Naggar
Gaad, 2004; Gumpel & Awartani, 2003; Heiman, 2001), and the West Indies (Dupoux,
Wolman, & Estrada, 2004; Hall & Dixon, 1995; Lambert, Lyubansky, & Achenbach, 1998;
Newton & Brathwaite, 1987).
Historically, educational researchers have taken varied positions regarding inclusion or
integration as programmatic model. Supporters point to academic and social gains of the
student with the disability, as well as acceptance of diversity among fellow students and
community members, as benefits of inclusion (Lipsky & Gartner, 1996; Whitaker, 2004).
Opponents note concerns about the lack of training, personnel and administrative support and
the uncertainty of academic and social gains through adopting such model (Lewis & Doorlag,
2003; Peterson & Hittie, 2003; Salend, 2001, 2005). Although these issues are important, one
of the critical factors determining the success of the inclusionary program is the attitudes of
the teachers who are involved in the program (Bruneau-Balerrama, 1997; DAlonzo,
Giordano, & Vanleeuwen, 1997; Hammond & Ingalls, 2003; Lanier & Lanier, 1996; Lewis &

Doorlag, 2003; Olson, Chalmers, & Hoover, 1997; Peterson & Hittie, 2003; Salend, 2001,
2005; Smith, et al., 2004; Stoler, 1992; Waldron, McLeskey, & Pacchiano,1999). Issues of
access and integration are strongly related to teachers attitudes toward inclusion (Welch,
1989). The Salamanca Report suggested that attitudinal factors could affect and influence
integration of students in the general classroom (UNESCO, 1994). Cook and Gerber (1999),
Larrivee and Cook (1979), Lewis and Doorlag (2003) and Salend (2005) stated that teachers
attitudes are a prerequisite to successful integration of students with disabilities and the
cooperation and commitment of those directly involved in implementing policies are essential
(Avramidis, Bayliss, & Burden, 2000).
Teachers Attitudes Toward Inclusion or Integration of Students with Disabilities
Research on teachers attitudes has been carried out in most regions of the world and mirrors
the political agendas of these countries in focusing attention on the exclusion of children from
educational opportunities (UNESCO, 1994). Globally, some countries have enacted
legislation pertaining to integration of students with disabilities (Abosi, 2000) and some are
just beginning the process of implementing these programs and/or policies (Meijer, 1998;
UNESCO, 1994). Overall, research seems to support the notion of a general culture of
teaching (Lortie, 1975), in that teachers attitudes toward students with disabilities are
consistent and similar irrespective of the different national cultures in which teaching takes
place (Thematic Group 9, 1996). For example, a cross cultural study conducted on teachers
attitudes in Haiti and the USA revealed that teachers had similar attitudes toward inclusion
(Dupoux et al., 2005).
In many areas of the world, special education is provided as a supplement to or parallel to
general education. In other regions, countries are just meeting the basic learning needs of their
populations with special needs (Ainscow & Haile-Giorgis, 1999). Dissatisfaction with the
integration model has led to the emergence of an inclusive orientation practice that broadens
the range of children to be served in general settings (Meijer, 1998; UNESCO, 1994).
However, professionals continue to debate integration pertaining to placement of pupils in
general settings, since these students require differentiated and individualized teaching
(Kauffman, Landrum, Mock, Sayeski, & Sayeski, 2005; Hornby, 1999; Stainback &
Stainback, 1984). Typically, general educators find it difficult to respond to the mandate to
integrate students with disabilities to the maximum extent appropriate in general settings.
They may perceive this as an additional burden on their already stressed workloads (Meijer,
1998; Scruggs & Mastropieri, 1996).
One of the most important factors affecting teachers attitudes toward integration or inclusion
is the type and severity of disabilities. Research has revealed that, irrespective of teaching
experience, severity of disability shows an inverse relationship with positive attitudes such
that as the perception of severity increases, teachers positive attitudes decrease (Forlin,
Douglas, Hattie, 1996). A cross-cultural study of fourteen nations found that teachers favored
certain types of disabilities for integration in the regular setting (Bowman, 1986). This is
supported by other research showing that teachers are more disposed to accept students with
mild disabilities than students with behavioral-emotional disabilities (Dupoux et al., 2005;
Ward, Center, & Bochner, 1994). Generally, teachers find it difficult to teach students with
more severe disabilities, particularly students with social maladjustments and emotionally
disturbance, due to a lack of training and support and large class sizes (Leyser & Tappendorf,
2001; Scruggs & Mastropieri, 1996).
Other factors that have been studied with regard to how they affect teachers attitudes toward
integration include gender, teachers experiences and contacts with students with disabilities,
level of education, training, administrative support, and class size. With regard to gender,
Alghazo and Naggar Gaad, (2004) report that male teachers attitudes toward integration are
more negative than female teachers, while no gender difference was reported by Berryman

(1989). Studies that examined teachers experiences noted that teachers acceptance of
integration is related to previous experience with children with disabilities (Taylor, Richards,
Goldstein, & Schilit, 1997). According to Leyser, Kapperman, and Keller (1994), overall
teachers contact and interactions with people with disabilities promote positive attitudes
towards integration. While some studies have indicated that individuals with a higher
education level were more negative toward integration (Antonak, Mulick, Kobe, & Fiedler,
1995; Stoler, 1992), other studies found the opposite trend (LeRoy & Simpson, 1996; Villa,
Thousand, Meyers, & Nevin, 1996).
Teachers attitudes also appear to vary based on integration inservice training. Stoler (1992)
and Leyser et al. (1994) reported positive teacher attitudes after inservice training, while other
studies found that staff development failed to improve teachers attitudes (McLesky &
Waldron, 1995; Wilczenski, 1993). Factors related to administrative support have been linked
to teachers commitment to integration. Teachers consider the presence of organizational
support and resources as critical in forming positive attitudes toward integration (Kruger,
Struzziero, & Vacca, 1995). An additional component of positive attitude is related to class
size. General educators reported that reducing class size to 20 students would facilitate their
integration effort (Pollard & Rojewski, 1993; Scruggs & Mastropieri, 1996).
Theoretical Background
Theories and values held by teachers strongly shape their teaching practices and preferences
for students (Kagan, 1992). Pajares (1992) pointed out that all teachers hold beliefs about
their work, their students, and in a broader context, their confidence to affect student
performance. There is potential for conflict as teachers respond to schools expectations that
are different from their beliefs, and in turn try to reconcile them in their classroom practices
(Macnab & Payne, 2003). It is well established that teachers expectations about students will
affect their instructional goals and methods (Mavopoulou & Padeliadu, 2000). Moreover,
teachers instructional tolerance (the range of variance in disabilities a teacher can effectively
accommodate) necessitates the exclusion of some students with disabilities because, since
teachers knowledge is finite, some students fall outside of teachers unique stocks of
pedagogical knowledge and skills. As a result, teachers simplify their instructional tasks to
target the range of students with similar instructional needs that fall within their instructional
tolerance (Gerber, 1988, 1995; Gerber & Semmel, 1985). In view of the many responsibilities
imposed on teachers, Lampert (1985) described teachers as dilemma managers with
ambiguous identities. In such environments, teachers beliefs are situational because they
are consumed with a variety of implicit and explicit mandates that define and limit their
instructional practices (Duffy, 1982). In order to cope with these pedagogical dilemmas as
well as variance in students instructional levels (Gerber, 1988, 1995), teachers seem to agree
with the philosophy that schools should provide benefits for all children, but seem to disagree
that the general classroom is the only avenue (Scruggs & Mastropieri, 1996; Zigmond &
Baker, 1996).
The Present Study
This follow-up study was undertaken to examine the attitudes of urban and rural teachers in
Hati toward integration of students with disabilities. A comparative study of urban teachers in
Hati and the USA revealed that urban teachers in both countries support the philosophy of
integration while recognizing that it is not realistic for all students with disabilities (Dupoux et
al., 2005). The present study investigated teachers attitudes toward inclusion in Hati at a
time when the Haitian government is forging ahead with a new programmatic model to bridge
the gap between the current system and an integrated program. The predictive variables used
in this study included gender, education level, years of teaching experience, number of
students in the classroom, type of teacher (regular or special education), number of students
with disabilities taught, categories of disability served, range of effective accommodation, and
teachers perceptions of other teachers attitudes.

The following hypotheses guided the research:

1. On average, the attitudes of teachers toward integration in Hati will be similar in
urban and rural areas.
2. Attitudes toward integration will be positively associated with the number of
years of teaching experience.
3. Teachers with higher levels of education will have more positive attitudes toward
integration than teachers with lower levels of education.
4. On average, teachers actual teaching experiences will be less powerful predictors
of attitudes toward integration of students with disabilities than teachers
cognitions and beliefs.
Method
Participants
The sample for this study consisted of 183 elementary and secondary urban and rural teachers
in Hati. The sample of teachers was recruited from three public schools, five Catholic
schools, and six nondenominational private schools. One of the two public schools in Hati
included in the study is currently piloting mainstreaming classes.
Instruments
Participants were administered the Opinions Relative to Integration (ORI) of Students with
Disabilities. The instrument is a modified version of a questionnaire originally constructed by
Larrivee and Cook (1979), and revised by Antonak and Larrivee (1995). This rating
instrument measures teachers' attitudes toward the integration of students with disabilities in
regular settings by presenting statements such as Integration of special needs students will
require significant changes in regular classroom procedures, or The integration of special
needs students can be beneficial for regular students. The ORI contains 25 positively and
negatively worded statement options rated on a 6-point Likert scale ranging from disagree
very much (-3) to agree very much (+3).
Reported psychometric characteristics for the ORI have been satisfactory (Antonak & Livneh,
1988); a split-half reliability as determined by the Spearman-Brown reliability coefficient of
0.92 was reported in 1979 and 1982. With the latest revision of this instrument in 1995, the
mean of the Spearman-Brown corrected split-half reliability estimate was 0.87, and a
Cronbachs alpha homogeneity coefficient of 0.83 was reported. The ORI was field-tested in a
previous study with teachers in Hati. The Pilot study indicated that no changes or revisions
were necessary even after translation into the French language and modifications (e.g.
handicap instead of disability) to establish concept equivalence for the Haitian linguistic
context. Reliability of the ORI for Haitian teachers in a previous study was determined to be
0.76 using a split-half procedure (as determined by the Spearman-Brown reliability
coefficient), and a Cronbachs alpha of 0.67 (Dupoux et al., 2005).
In this study, a factor analysis indicated that there is only one dimension of attitudes for this
sample, as opposed to the four factors proposed by the developers of the ORI (Antonak &
Larrivee, 1995). Consequently, only the total score of the scale was used in the analyses. The
sum of responses of the scale ranges from 0 to 150, with a higher score indicating a more
favorable attitude (Antonak & Livneh, 1988).
In addition to the ORI, a background instrument, developed by the first author, requested
information about gender, level of education (bachelors, masters or above), total number of
years of teaching experience, average number of students in the classroom, type of teacher
(regular or special education), number of students with disabilities taught during the past three
years if the teacher was a regular teacher, categories of mild to moderate disability (Learning
Disabilities, Physical Disabilities, Emotional Problem, Deafness or Blindness) that teachers

10

had served over the years, categories of disabilities (Mobility, Visual or Hearing, Learning
Disabilities, Emotional Problem) that teachers thought they could effectively accommodate,
and teachers perceptions of other teachers attitudes toward integration (favorable, neutral, or
unfavorable).
Procedures
Survey packages were distributed to teachers by the school principal or an assigned teacher
during staff meetings. The school principal or the assigned teacher collected the sealed
envelopes at the end of the faculty meeting and mailed them to the first author. The entire
package required about 15 minutes to complete. All responses were anonymous. The survey
packet had three sections. It began with a cover letter describing the purpose of the study and
the rights of the participants. The second section addressed general background information
about teachers. The last section included the ORI (Antonak & Larrivee, 1995).
Results
Description of the Sample
Overall, the return rate was 72%. The number of urban respondents (n = 114) was greater than
the number of rural respondents (n = 70). Of the 184 participants, females represented 52% (n
= 95) of the sample. Only 13% of the respondents (n = 23) reported a graduate degree as the
highest level of education attained. The average years of teaching experience was 13.1 (SD =
6.60) and the average class size was 40.1 (SD = 11.94).
With respect to mild to moderate categories of disability that teachers have dealt with over the
years, teachers were much more likely to have had experience with the learning disability
category (64%) than with any other disability. Teachers reported less experience with physical
disabilities (44%), deafness or blindness (19%), and emotional problem (10%).
The learning disability category was the easiest item endorsed by teachers as a category of
disability they believed they could effectively accommodate (73.9%). Mobility impairment
was the category next most frequently endorsed by teachers (47.3%). Less than a quarter of
the respondents did not believe they could effectively accommodate students with visual or
hearing disabilities (22.8%). Even fewer teachers believed they could effectively
accommodate students with emotional disorders (13.6%). Teachers more commonly perceived
their colleagues attitudes toward integration as neutral (48.9%), while reporting that other
teachers have a favorable attitude (28.3%) slightly more often than an unfavorable attitude
(22.8%) toward integration.
Analysis of Teachers Attitudes
Reliability of the ORI for Haitian teachers was determined to be 0.68 using a splithalf procedure (as determined by the Spearman-Brown reliability coefficient). Twelve items
on the ORI had reverse wording and were recoded so that higher scores represented more
favorable attitudes toward integration. In order to proceed with the scoring, each respondents
responses were summed, and a constant of 75 was added to the total to eliminate negative
scores. As a result, scores could range from 0 to 150.
Teachers in rural Hati (M = 80.19, SD = 16.69) on average had similar attitudes toward
integration to teachers in urban Haiti (M = 77.80, SD = 15.65), t (182) = 1.03, p = .31.
Contrary to predictions, attitudes were uncorrelated with years of teaching experience, r = .07,
p = .33. Results indicated that on average, teachers with Masters degrees have more positive
attitudes toward integration (M = 86.43, SD = 15.37) than teachers with less than a Masters
degree (M = 77.60, SD = 12.47), t (182) = 2.63, p = .009.
A series of four items was used to assess teachers attitudes about their abilities to effectively
accommodate students with mild to moderate disabilities (mobility, visual/hearing, learning,
emotional disabilities). Collectively, these items were statistically significant predictors of

11

teachers attitudes, F (4, 183) = 2.47, p < .05, in a regression equation. An index of teachers
tolerance was created from the predicted value for attitude based on this regression,
combining the four items. The index was used as the dependent variable in the subsequent
multiple regression analysis.
A multiple regression was conducted to assess whether the actual experience of teaching
(years of teaching experience, class size, special education or regular teacher, and number of
special education students a regular teacher has had in class) has less influence on a teachers
attitude than the variables representing teachers cognitions and beliefs (instructional
tolerance, education level, teachers perception of colleagues attitudes). The variables
representing the actual experience of teaching were entered as the first block in the regression
model and they explained only 2.8% of the variance in attitude, F(4,179) = 1.29, p = .28. The
variables representing the teachers cognitions and beliefs were entered as the second block
and they explained an additional 5.3% of the variance in attitude, F(3,176) = 3.40, p = .02.
Therefore, teachers cognitions and beliefs explained almost twice as much of the variance in
attitude as teachers actual experience of teaching.
Discussion
There have been unprecedented efforts by world organizations (UNESCO, 1994) to
encourage governments around the world to provide equal access to education to students
with disabilities, as part of a broad human rights agenda (Chow, Blais, & Hemingway, 1999).
One of the main objectives of this study was to understand how urban and rural teachers in
Hati, a country in the beginning stages of formulating a national policy for integrating
students with disabilities in the regular classroom, respond to the demands of providing the
same educational experience to all students.
Findings indicated that teachers in rural areas did not differ from teachers in urban areas in
their attitudes toward integrating students with disabilities. In fact, both groups of teachers
had a moderate level of acceptance of students with disabilities. Contrary to expectations,
years of experience was not correlated with attitudes toward integration. This finding supports
the regression analysis conducted in this study, which showed that the actual teaching
experiences of teachers were less important in predicting attitudes than the teachers owns
ideas and beliefs.
Although years of teaching experience was not associated with attitudes, having a higher
educational degree was positively correlated with attitudes toward integration. This finding
underscores the importance of education in implementing changes, and in this particular case,
in acceptance and willingness to accommodate students with disabilities.
Predictors of attitudes toward integration of students with disabilities were grouped into the
categories of actual teaching experience and teachers own cognitions and beliefs. Out of
almost 9% of the variance in teachers attitudes, 5% was explained by variables representing
the teachers cognitions and beliefs. Nevertheless, almost 90% of the variance in teachers
attitudes remained unexplained in this study. Teachers thinking is complex as they consider
multiple factors in determining how they should respond to the integration movement. There
might be unobservable personal variations that cannot be captured by administering a survey
of teachers attitudes.
Teachers own cognitions and beliefs, in part, may have their sources in their experiences
while they were students, they may be the product of their teacher training (Pajares, 1992), or
they may be a combination of their training and falling in-line with the prevailing ideas or
beliefs within the context of the school (Acker, 1990; DAndrade, 1981). Greene (1973)
suggests that because teachers are isolated in their classroom, they are estranged from the
importance of school policies over the day-to-day realities of their particular classrooms. In

12

this fragmented reality, grand ideas such as integration seem less of a concern, and therefore
appear as an estranged collective process and added burden.
Recommendations for Further Research
Future research on teachers attitudes should be related to teachers personality characteristics,
such as locus of control, and to behavioral indicators of attitudes, such as pursuing an
advanced degree in special education (Antonak & Larrivee, 1995). Teacher attitude is a
multidimensional construct; for example, introducing the predictor teacher efficacy in the
study design may help generate a teacher profile that aids in selecting teachers who may
successfully carry the educational reform into their classroom, especially in countries in the
beginning stages of integration.
Practical Implications
Two findings in this study, the positive correlation between education and attitudes as well as
the role of teachers beliefs and ideas, indicate the need to educate teachers before acceptance
and accommodation of students with disabilities can really occur. The authors recommend the
development of workshops for teachers in Hati about students with disabilities and
instructional strategies to support these students. Increasing teachers knowledge and
awareness about these students could be an important step in implementing integration in
Hati, and other third world countries. Moreover, developing in the near future a degree
program in special education in one of the universities in Hati could be a fundamental step
toward providing a thorough education to the future teachers of students with disabilities, thus
changing and improving attitudes toward this population of students.
Moreover, there is an assumption that a mandate codifying the rights of students with
disabilities has the potential of affecting teachers attitudes in a positive way. The legislature
in Hati can emulate disability legislation in the USA and Canada by enacting a law that
provides the basis for classroom practices and that relates to the rights of students with
disabilities to be educated in the least restrictive environment.
Additionally, in the Caribbean region, educators uninformed about the integration movement
can be exposed to this educational reform movement. To accomplish this, political leaders in
countries in the area can move in the direction of integrating students with disabilities, as in
Hati, or can adopt supportive policies of countries with a substantial political influence in the
region, such as the USA and Canada. Examples of integration models in the USA and Canada
can be emulated until nations in the region can design a system that fits their culture, and
implement a financing scheme that can be sustained in the midst of severe economic
limitations.
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17

THE TECHNOLOGICALLY DEPENDENT/MEDICALLY FRAGILE AT RISK

STUDENT
Thomas G. Ryan
Nipissing University
This article considers our current technologically sophisticated
educational system as it attempts to meet the needs of a school
population that is more diverse, needy, and exceptional than at any
other point in history. The very nature of the term at risk is based on
the perception that students may dropout due to their living situation
which affects their academic lives. Within this at risk population there
is a further level of need which includes students who are at risk of not
only failure in school but also are identified as medically
fragile/technology dependent (mf/td). It is this mf/td designation that is
illuminated as these students require onsite complex medical care to
manage multiple risks via technologic support, multiple team member
efforts, and coping mechanisms just to complete each day.
The current technologically sophisticated educational system attempts to meet the needs of a
school population that is more diverse, needy, and exceptional than at any other point in
history. Educators quickly realize the special needs of students as children encounter
difficulties academically and socially. The very nature of the term at risk is based on the
perception that students may dropout due to their living situation which affects their academic
lives. Our at-risk population continues to grow daily as an increasing number of young
people live in conditions characterized by extreme stress, chronic poverty, crime, and lack
adult guidance ( Parkay, Hardcastle Stanford, Vaillancourt, Stephens, 2005, p.185). Within
this at risk population there is a further level of need and this level includes students who are
at risk of not only failure in school but also are identified as medically fragile/technology
dependent (mf/td). The mf/td label is most often due to medical conditions requiring complex
care. To meet the needs of these mf/td students who are at multiple risk requires technologic
support, multiple team member efforts, and coping mechanisms just to complete each day
(Rehm, 2002).
Educators have no choice when confronted with the needs of mf/td at risk students. These
students rely on family, school and the community at large to meet both their academic and
health needs. Educators must work within a team as the education of mf/td at risk students
demands a modified environment which is complex yet the use of technology should not drive
the vision. The vision should drive the use of technology (Surgenor, 1992, p. 137). Our
human capacity to take and shape technology is foremost in deciding just how much inclusion
may be possible for each student hence the most meaningful change in schools is that which
comes from within. Education and the educators within undertake a personal journey that is
influenced by many forces that are in some way related to technology which is so deeply
intertwined throughout our lives that it is sometimes hard to recognize, because of its
pervasive nature (Ortega & Ortega, 1995, p. 11). Educators reflect, create and improve
learning for all students so if the mf/td student requires medical devices to aid function, avert
death, and maintain life support during each school day (Winzer, 2002), teachers will work to
meet or exceed these targeted outcomes.

Current State of Affairs

18

The current labels technology dependent and medically fragile can best be defined as
circumstances that require technological health intervention(s) to support life functioning. A
medical device or health intervention is required to maintain body function and often life
itself. In the United States, it is estimated that between 11,000 and 68,000 children were
reliant on technology (OTA, 1987, p. 6), and it is plausible that given the requisite supports
each person could attend their community school. Each year there has been a slow
augmentation of these numbers as technologic and medical advances continue to increase the
odds that a td/mf person can live longer and more fully than previously expected. The
American Academy of Pediatrics (1999) has similarly noted that there have been increases in
the population of children who have serious chronic conditions, in part, because of
improvements in survival rates for children with serious and/or life-threatening genetic,
congenital, and postnatally acquired conditions (eg., cystic fibrosis, organ failure, cancer,
human immunodeficiency virus, or severe prematurity) (Rehm, 2000, p. 2).
In Ontario recent data compiled by the Ministry of Health Long Term Care (MoHLTC)
Office of Integrated Services for Children suggests a prevalence rate of .057% within the
Ontario population (Waterloo Region District Health Council, 2001, p. 4). This Health Unit
estimates that approximately 1700 children in Ontario are considered td/mf. Each of these
students may have the opportunity to attend school if the essential supports, team efforts, and
vision are created within the local school and community. However, the Provincial Health
Planning Database (2000) suggests,
the number of children with disabilities living in a geographic area is
influenced by the array of services available in that area. Therefore, more urbanized
parts of the district may have larger numbers of children in need of services than in
rural areas. (p. 14)
Parents are attracted to an area that has expertise, services, and community supports that are
essential for their childs complex health and educational needs. Table 1 shows the number of
children & youth with varying disability levels throughout a district and Ontario, in 1996.
Table one is summative yet lacks details of specific needs of individuals and the medical
circumstances of each person. For instance, Td/mf students include many types of health
exceptionalities such as, arthritis, cerebral palsy, clubfoot, hydrocephalus, limb deficiencies,
multiple sclerosis, muscular dystrophy, scoliosis, and spina bifida. While there are many more
health conditions that may be housed under the umbrella term of td/mf these seem to be most
common in children and youth who attend school. Within our communities as this population
of complex care students grows, they become more visible, known, and newsworthy in
community planning. This leads to activism by people with disabilities, their family
members, and other advocates who have sought equal access to public services and facilities
for all persons regardless of health or mobility status (Rehm, 2000, p. 3).
School and Community Supports
Within the school community and the political make-up of most regions is a complex series of
relationships that allow support agencies to exist in a collaborative manner. For example, in
January of 2000 The Integrated Services for Children Division (ISCD) was put into place to
direct the Long Term Care (LTC) services in Ontario which are provided by Childrens
Treatment Centres (CTC). CTCs in turn are responsible for in home support to children who
are not able to access services outside of the home. In addition, the CTC also includes a
School Health Support Services program. This vital program enables students to attend school
while receiving Long
Term Care (LTC) services. Each Childrens Treatment Centre offers LTC services to children
and youth who are able be moved to attend. Most often childrens LTC services can be
defined as

19

those community-based health and support services that are available for children
with multiple special needs and/or complex care needs (Waterloo Region District
Health Council, 2001, p. 5).
Table 1
The number of children & youth with varying disability levels throughout a
district and Ontario, in 1996.

Geography /
Age
Category
Waterloo
Region
0-4
5-19
Total (0-19)
%
Total Pop.
WellingtonDufferin
0-4
5-19
Total
%
Total Pop.
District
0-4
5-19
Total
%
Total Pop.
Ontario
0-4
5-19
Total
%
Total Pop.

Population

General
Disability
Rate (6.9%)

Multiple
Complex Care Needs Rate
Special
(.057%)
Needs Rate
(2%)

30,433
88,588
119,021
(28.5)
418,334

2,100
6,133
8,212

609
1,772
2,380

17
50
67

16,285
48,323
64,608
(28.9)
223,745

1,124
3,334
4,458

326
967
1,290

9
28
37

46,718
136,911
183,629
(28.6)
642,079

3,224
9,447
12,670

934
2,738
3,673

26
78
104

756,053
2,221,814
2,977,867
(26.8)
11,100,876

52,168
153,305
205,473

15,121
44,436
59,557

431
12,66
1,697

Sources: Provincial Health Planning Database, 2000 (Population Figures);

Statistics Canada (1996).

An example would be a student with cystic fibrosis who requires percussion therapy, to
extricate mucus from their upper body, medication, and a strict diet to compensate for
inadequate (pancreas) organ function. In order to better understand the levels and groups of
required care the The Office of Integrated Services for Children (1999) designed the
following table. (Table 2 next page)
When faced with such complex care it is common for most educators to feel inadequate.
Indeed, Rehm (2002) makes it clear that,
school personnel have regular and increasing contact with children with chronic
conditions and that they often feel inadequately prepared to understand the nature of
children's health concerns or to handle medical emergencies in the classroom (Krier,
1993). School nurses and aides deliver most routine health treatments in the

20

classroom, including medication administration, respiratory treatments, diapering or

catheterization, and tube feeding (Koenning, et al., 1995). Parents and school nurses
provide most of the information educators receive about children's health care needs
(Koenning, et al., 1995). Practicing physicians are not often active participants in
planning for health services and special needs for children with chronic conditions
(Palfrey, Singer, Walker, Butler, 1986). Despite the importance of school nurses as
on-site resources for educators planning services for children with special needs,
nurses are often "shared" by several schools and therefore not necessarily included in
evaluations and planning for special education services. (p. 6)
Table 2
Definition of Children who are MF and/or TD with Complex Care Needs

Group No.

Care Requirements

Group 1

Children dependent at least part of each

day on mechanical ventilation
Children requiring prolonged intravenous
administration
of:
nutritional
substances drugs
Children with daily dependence on other
device-based support for:
Tracheotomy tube care Suctioning
O
xygen support Tube feeding

Group 2
Group 3

Group 4

Group 5

Children with prolonged dependence on

other devices which compensate for vital
body functions who require daily or near
daily nursing care, including:
A
pnea (cardio respiratory) monitors
Renal dialysis due to kidney failure
U
rinary catheters or colostomy bags
plus substantial nursing care
Children with chronic conditions who are
not technologically dependent but who
require as great a level of care as Group 4,
including:
Children who are completely dependent
on others for activities of daily living;
Children
who
require
constant
supervision or monitoring resulting from
the complexity of their condition and/or
the quantity of oral drugs and therapy
they receive.

(The Office of Integrated Services for Children, 1999)

21

In addition to the educators, special educators, nurses, teacher aides, administrators, and
parents there could be several other team members in place to support a Td/mf student.
These include Occupational Therapists, Physiotherapists, Speech-Language Pathologists,
Social Workers, Psychologists, Psychometrists, Augmentative Communication
Technologists, Recreation Therapists, Homemaking services, Personal Support Aides,
Attendant Services, Dietetic services and Respite services for families caring for
medically fragile and technologically dependent children. With larger teams there are
points of tension, errors, and this only heightens the risk for the already at risk td/mf
student.
Locally, a Central Ontario Board of Education has put in print a document entitled: Building
the Future Together: Strategic Planning Toward the Year 2000. The resource suggests
educators must be committed to providing the best possible educational opportunities
through which each student may develop the necessary knowledge, skills and attitudes to
become a responsible, contributing participant in a changing global society (Muskoka Board
of Education, 1999, p. 48).
This inclusive vision is proactive yet when faced with the complex care and educational needs
of a Td/mf at risk student the entire team needs to develop and embrace similar values,
expectations, and outcomes in order for the team strategy to succeed via careful planning,
application and maintenance. As well, there needs to be community support such as the
Parents of Technologically Dependent Children (PTDC) of Ontario Kids Country Club with
organizations in London, Guelph, and Cambridge, Ontario as these vital community supports
strive to create a community where all children are cherished through advocacy, support and
respite services (Parents of Technologically Dependent Children, 2003).
This organization of stakeholders includes parents, advocates, and the community at large
who work closely with the Ministry of Community, Family and Childrens Services and other
professionals who often provide services in a volunteer mode. The vision of this community
support group is to,
value each other and our friendships. Together we can hope and dream. Give us
tomorrow but give us today where people have value and belong and the only label is
their name. Together we will open doors that once were closed. Our needs may be
different we can ensure the building of a caring community. Our children will live
quality lives. But with respect for each other. (Parents of Technologically Dependent
Children, 2003)
To attain some of these goals requires practical and assertive movement from educators who
need to accept several contemporary realities:
Technology is an inseparable part of our daily existence.
Technology is with us from the moment we wake up until the time that we turn in at night.
Technology is even with us while we sleep.
Technology is at the heart of our buildings and structures.
Technology assists us in coping with the environment outside.
Technology is vital in transporting us from place to place.
Technology allows us to solve many of the challenges that face us.
Technology is something that strikes fear in the hearts and minds of people.
Technology intimidates.
Technology is complicated
Technology is advancing at ever-increasing rates.
(Lambton county Board of Education, 1994, p. 2)
Uncertainty can cause educators to put forward thoughts that all educators can and need to
address. For instance, Wadsworth (1993) asks, Help! Is this an Intensive Care Unit or a
classroom? Her paper offers practical suggestions for educators working with Td/mf students.

22

Educators need to manage the physical environment (field trips, classroom layout &
equipment), specialized equipment (modified desk, wheelchair desk, computer, audio, video),
staff training, emergency response team & plans, student/family needs (peer relationships),
counseling liaison, regular meetings (IEP, IPRC) for communication and monitoring
(Wadsworth, 1993). What is implied is that there is a need to go beyond the Individual
Educational Plan (IEP) and develop a written health care plan. The Health plan includes such
items as monitoring and backup systems and schedules that detail frequency and duration of
care at school. As well, the Td/mf students in regular classes (rather than special education
classes) require more time to function, and transition. Health plans explain how nurses, aides,
and caregivers will provide required follow-up activities.
Educators in Canada who work within Special Education attempt to do what is necessary to
fulfill their obligations and comply with such imperative documents as the Canadian Charter
of Rights and Freedoms, the Provincial Human Rights Code, the Provincial Education Act
and regulations made under the act, and other relevant legislation. Most Boards strike
committees such as the Special Education Advisory Committee (Ontario) to oversee the
special education programs however, the hierarchy and number of stakeholders can slow a
process and impinge on its effectiveness. An average Board of School Division would have a
Special Education Superintendent, Manager of a Individual Placement and Review
Committee, Coordinators of Special Education, Supervisors of Special Services, Office
Supervisor/Administrator, Assistant Secretaries, (secretary IPRC/Psych/general secretary
Special Ed), Psycho-educational Consultants, Speech & Language Pathologists, Child and
Youth Counsellors, School Social Workers, Secretaries (MASS, OCTU),
Regional
Coordinator, and finally, the local school with its own stakeholders. What can happen, and
usually does, is that information is mislaid and communication is deficient hence we then
enter into a problem solving process that is often nicely laid out by the Board yet takes a great
deal of time and energy to move through. Meanwhile the needy at risk Td/mf student attends
school daily as stakeholders attempt to untangle themselves. Fortunately, the front line teacher
is on the job each day unencumbered and taking care of the needs of all students.
Conclusion
Students have a right to an education and educators have a legal responsibility to educate all
students including those who may be labeled Td/mf. Most Boards in Ontario have an
integrated services delivery model for professional support services. Most often, the support
is via the Special Education Advisory Committee with extended partnership agreements with
community agencies that aim to enhance and expand the level of professional support services
in its schools. By combining staff from each Board and the community agencies, three levels
of professional support are most often offered throughout a region: clinical, targeted and
universal. For example, universal programs target the student population as a whole while
targeted programs focus on small groups of high-risk students and clinical programs provide
interventions for individual symptomatic children. The complex care required for a Td/mf
student would be considered clinical and as such be addressed on an individual case-by case
basis. With rising numbers in Canada, it is only a matter of time before the training, support
and expertise is more common, mainstream and available in all larger urban areas.
References
American Academy of Pediatrics (1999). Policy statement: care coordination: integrating
health and related systems of care for children with special health care needs (RE9902).
Pediatrics. 1999, 104(4):978-981.
Lambton Board of Education. (1994). Technology: Primary - Junior Education. Sarnia, ON:
Author.
Muskoka Board of Education. (1994). Building the future together.planning toward the year
2000. (1-64). Bracebridge, ON: Author.
Ortega, C.A. & Ortega, R. (1995). Integrated elementary technology education. The
Technology Teacher, 2, 11-16.

23

Parents of Technologically Dependent Children (2003, Fall) Parents of technologically

dependent children of Ontario Newsletter. Chestnut Hill, London, Ontario.
Parkay, F. W., Hardcastle Stanford, B., Vaillancourt, J.P., Stephens, H.C. (2005). Becoming a
teacher. (2nd ed.). Toronto, ON: Pearson.
Rehm, R. S. (2002). Creating a context of safety and achievement at school for children who
are medically fragile/technology dependent. Advances in Nursing Science, 24(3), 71-85.
Statistics Canada. (1996). Health and Activity Limitations Survey, 1991. Ottawa, Ontario:
Government of Canada
Surgenor, E. (1992). Designing Learning Systems. Cambridge, MA: Brookline Books.
The Office of Integrated Services for Children. (1999) Ministry of Health and Long Term
Care Annual Report. Toronto, ON: Queens Printer.
Wadsworth, D. E. (1993, April) Help! Is this an intensive care unit or a classroom? Paper
presented at the Annual International Conference of the Council for Exceptional Children,
San Antonio, TX.
Waterloo Region District Health Council (2001, January). Background Paper: A profile of the
long term care sector Waterloo, Wellington, and Dufferin . Waterloo, ON: Author.
Winzer, M. (2002). Children with exceptionalities in Canadian classrooms. Toronto, ON:
Prentice - Hall.

24

TIME-OUT INTERVENTIONS AND STRATEGIES: A BRIEF REVIEW AND

RECOMMENDATIONS
Tera L. Wolf
T. F. McLaughlin
and
Randy Lee Williams
Gonzaga University
The present paper reviews the literature regarding time-out
interventions employed in home, school, and clinical settings.
Characteristics examined include types of time-out, populations and
settings, legal implications, and research implications.
Policy
recommendations for teachers, parents, and clinicians regarding timeout interventions are included.
The use of time-out as an acceptable therapeutic procedure has gained wide acceptance in
schools, clinics, and hospitals. Time-out is a behavior change technique used to decrease the
frequency of a target behavior, and is most effective for behaviors that are maintained either
by attention or tangible reinforcers and if there is high discriminability between the time-out
environment and the reinforcing environment, often referred to as time-in (Turner & Watson,
1999). The time-out technique involves placing a child in an environment limited in sensory
stimulation contingent upon the emission of deviant behavior (Webster, 1976). Time-out has
been effective in reducing such behaviors as tantrums, inappropriate social behaviors, yelling,
aggression, time spent out-of-seat, and inappropriate verbalizations (Alberto, Heflin, &
Andrews, 2002; Mortimer, Adamsky, & McLaughlin, 1998).
Time-out is a complicated and intricate intervention, involving far more than simply
withdrawing an individual from ongoing activities and then returning him or her after a
predetermined period of time. Effective timeout procedures are likely to vary a great deal,
depending upon such factors as who is administering the intervention, the individual involved,
and the setting (Harris, 1985).
Time-out is frequently misunderstood and even incorrectly defined by both professionals and
lay persons (Harris, 1985). This may be due to such factors as changes in the
conceptualization of time-out over time, the variety of ways to implement time-out, the
multiple definitions which exist in the literature, occasional paradoxical effects, and
difficulties in differentiating between time-out and response cost or extinction (Alberto et al.,
2002). As the use of time-out in both basic research and applied settings increased,
definitions of time-out changed and began to focus on contingent withdrawal from the
opportunity to obtain reinforcement and a meaningful discrepancy between the time-in and
time-out environments (Harris, 1985).

25

Few behavioral management techniques have generated as much controversy as isolation

timeout. Educators and other professionals have used timeout procedures to modify a broad
range of maladaptive behaviors in children and youth. Timeout is a somewhat aversive
procedure on the continuum of behavior-reduction techniques, which also include
environmental modification, differential reinforcement, response cost, overcorrection,
aversive conditioning, and corporal punishment (Costenbader & Reading-Brown, 1995).
The continuum of ascending restrictiveness involved with using time-out includes such
procedures as planned ignoring, during which social attention is removed from the individual;
contingent observation, where a student watches from the periphery but may not participate in
group activities during the timeout period; exclusion timeout, when a student is removed from
the reinforcing environment but may sit facing the corner of the room; and isolation or
seclusion timeout, the most restrictive of these interventions, in which the student is removed
from the classroom and stays alone in a barren room for a specified period of time.
Types of Time-Out
Harris (1985) outlined three major types of time-out: exclusionary, non-exclusionary, and
isolation time-out. Of these three, the first two types seem best suited for classroom use
because the child does not need to be removed from the room (in accordance with the policy
of least restrictive intervention).
Exclusionary. Exclusionary time-out involves removing the child from the reinforcing
situation but not from the room or area of activity (e.g., playground, gym). When a child
displays the inappropriate target behavior, he or she is immediately removed from the activity
for a period of time. Examples of this type of time-out are sending a child to a corner of the
room or a chair positioned away from the ongoing activity. The child is not allowed to view
or be involved in any activity for a specified amount of time (Harris, 1985; Mace & Heller,
1990; Mortimer et al., 1998).
Nonexclusinoary. Nonexclusion time-out is similar to exclusion time-out in that the child is
removed from the reinforcing situation for a certain amount of time but may still observe the
ongoing activity of the class (Harris, 1985). Nonexclusinoary time-out has been further
divided into three subcategories: contingent observation, removal of stimulus conditions, and
ignoring (Costenbader & Reading-Brown, 1995; Harris, 1985). Harris (1985) defines the first
subcategory, contingent observation, as a procedure wherin the individual is required to sit on
the periphery of the ongoing activity and observe the appropriate behaviors of her or his
peers for a brief period of time (p.280).
This type of time-out would be ideal during some activity such as recess or a structured group
academic task in which the child can observe appropriate peer behaviors and see those
behaviors being reinforced. To make contingent observation time-out most effective, the
teacher must reinforce appropriate behaviors and the resulting reinforcement (Turner &
Watson, 1999). After time-out is over, the teacher must then monitor the child to reinforce the
first appropriate behavior demonstrated by the target child to ensure a rich time-in
environment and to increase the discriminability between time-out and the classroom
(Marlow, Tingstrom, Olmi, & Edwards, 1997).
The second subcategory of non exclusionary time-out, removal of stimulus conditions,
imposes the contingent removal of reinforcing stimuli such as work or play materials, food, or
opportunity to gain tokens (Alberto et al., 2002; Harris, 1985) for a certain amount of time
after target behaviors are displayed. The reintroduction of reinforcing stimuli should be
contingent upon demonstrating appropriate behavior to avoid inadvertently reinforcing
inappropriate behavior (Harris, 1985).

26

The third category of nonexclusionary time-out, ignoring, involves withholding social

attention contingent upon inappropriate behavior without removing the child from the
situation (Turner & Watson, 1999). Ignoring is difficult to use in the classroom for three
primary reasons: (a) some behaviors annoy, distract, or interfere with instruction to such an
extent that they are almost impossible to ignore, (b) peer attention may maintain or contribute
to the maintenance of a behavior, and (c) some behaviors are dangerous to the student and
others (Turner & Watson, 1999). However, ignoring a childs misbehavior is a simple
procedure and can be quite effective given the proper circumstances (i.e., for a behavior that
is mildly annoying, maintained solely by teacher attention, does not evoke attention from
peers, and is not dangerous or destructive).
Isolationary. The third broad category of time-out is referred to as isolation. Isolation
involves the removal of the child from the reinforcing environment to an environment where,
at least theoretically, there are no reinforcers available to the child (Tingstrom, 1990).
Isolation typically entails placing the student in a different area such as another room for a
specified amount of time. As effective as this type of time-out can be (Costenbader &
Reading-Brown, 1995), isolation requires extra personnel, (Harris, 1985), has specific federal,
state, and local guidelines for its use (Yell, 1990), and is generally regarded as a more
restrictive form of punishment (Mayerson, 2003). Because of these reasons, it may be
difficult to use isolation in the standard classroom.
Use of isolation time-out should be determined by criteria which include the chronicity and
intensity of the behavior, the danger of the behavior to those in the classroom, and the
effectiveness of other techniques to change the behavior (Tingstrom, 1990). It should be then
implemented only if the specific state and local legal prerequisites have been met (Yell,
1990).
Populations and Settings
Proponents of using time-out with young children extol its virtues, at least for children two or
three years of age and older (Readdick & Chapman, 2000). Numerous studies (Rortvedt &
Miltenberger, 1994; Mace & Heller, 1990; Wilson, Robertson, Herlong, & Haynes, 1979;
Alberto et al., 2002, Reitman & Drabman, 1996; Yeager & McLaughlin, 1995) have shown
various effective uses of time-out with preadolescent children in the home, schools, and
treatment facilities.
A study of Reitman and Drabman (1999) illustrates how the ongoing data-based monitoring
of timeout use by parents enhanced the treatment of an 8-year-old boy, referred because of
noncompliance in the home. Timeout was selected as the primary behavior change strategy
and parents were instructed in implementing and recording each instance of timeout on a
simple data form. In therapy sessions these data were reviewed and used to direct the course
of treatment. Some of the benefits of the timeout record included, enabling rapid refinements
in the timeout procedure by providing a feedback mechanism to the therapist, illustrating the
need for adjunctive treatments and revision of case formulation, and more generally, by
serving as a means of documenting treatment efficacy.
Numerous studies have evaluated the use of time-out in classroom and school environments
in the areas of aggression (Lucas, 2000; Mortimer et al., 1998; Wilson, et al., 1979; Webster,
1976) and disruptive and noncompliant behavior (Mace & Heller, 1990;; Mace, Page, Ivancic
& OBrien, 1986; Rortvedt & Miltenberger, 1994; Reitman & Drabman, 1996; Yeager &
McLaughlin, 1995;). The use of time-out has also been implemented in academic settings of
community-based instruction (CBI) (Alberto et al., 2002), speech and language classrooms
(Marrow et al., 1997), music education (Spradling, 1985), and physical education (Johnson,
1999; White & Bailey, 1990;).

27

Whittington and Moran (1990) evaluated Peace begins with me (Whittington, Crites,
Kreidman, Beck, 1989 cited in Whington & Moran 1990), a published prevention curriculum
for use with kindergarten through sixth-grade children. Time out was viewed as an efficient
means of providing space and time for the young child to mull over wrongdoings, refresh
feelings of guilt, and ponder socially desirable responses in similar circumstances. The
curriculum offers keys to attitude and behavior changes as these relate to self-esteem and self
control. Children lean nonviolence and a foundation for basic coping skills and positive
mental health. They integrate time-out, self-talk, empathy, gender-neutral attitudes, feelings
awareness, assertiveness, conflict resolution, health, parent appreciation, and other concepts
as personal tools for daily survival. Lesson topics must be adapted to the developmental
levels of children. The use of time out appears to be widespread however, preschool teachers
often use time-out frequently throughout the day, but for very short durations, often on or two
minutes (Zabel, 1986).
Incidentally, Betz (1994) believes that there are right and wrong ways to enforce time-outs.
Some ways to make time-out for young children more effective according to Betz is to first
approach the child physically rather than broadcasting displeasure in behavior from across the
room. Second, a teacher should get down on a knee so that eye levels of student and teacher
are level and tell the child exactly what the offense is quietly and calmly. Third, the teacher
should escort the child to the time-out area and keep the time-out duration short; the
suggested limit is about one minute per year of age. Finally, the teacher should not forget
about the child in time-out, otherwise the effectiveness of the time-out could be jeopardized.
Gartrell (2001) believes that time-out, when used as discipline, is one of a group of techniques
that still rely on blame and shame to bring a childs behavior back into line. Referring
especially to toddlers, Gartrell offers five reasons why time-out is an undesirable practice: (1)
the imposed external control of the time-out inhibits a childs ability to build internal controls
and may cause a child last feelings of being ineffectual, (2) the child placed on a time-out
chair does not have personal needs met, including the need to develop alternative strategies,
(3) the time-out diminishes the childs developing self-worth and self-confidence, and may
cause others to view the child as a trouble maker, (4) the young child has difficulty
understanding the relation of actions to consequences and may feel bewildered by the timeout experience, and (5) opportunities for learning valuable lessons in social relationships are
lost during the period of isolation; and humiliation from the time-out may diminish the value
of adult follow-up.
Bezt (1994) emphasizes that time-out fails to teach desirable behavior and should be reserved
for use only when a child is wildly out of control or is a threat to other children. There is
speculation that time-out may be hurtful in a number of ways. Readdick and Chapman (2000)
point out that if the child perceives it as a punishment, time-out can have serious side effects
that are commonly associated with punishment, including increases of other maladaptive
behaviors and withdrawal from or avoidance of the adults administering time-out. In
addition, given their social inexperience, young children ten to internalize negative labels, see
themselves as they are labeled, and react accordingly (Readdick & Chapman, 2000).
Furthermore, Harris (1985) points out that when procedural time-out is experienced as an
aversive consequence by the subject and results in reduction or suppression of the target
behavior, then time-out is properly classified as a punisher. In fact, time-out is typically
defined or classified as a punishment procedure based on the assumption that it will be
experienced as aversive by the subject and reduce the frequency of a behavior. Harris
describes how time-out may function as a negative reinforcer or escape procedure even when
a validated reinforcement procedure exists in the time-in environment.
Hannon (2000), a kindergarten teacher who decided against using time-out after years of
incorporating this technique in her classroom states that, not relying on time out has been both

28

frightening and a reliefbelatedly, I have realized and deeply regret how much time was
wasted in time-out by children misled by my lack of clarity. I see now how important it is that
I discuss and model my expectations for appropriate behavior with children. Many of the
children benefit from well-timed and clear discussions or demonstrations concerning
developmentally appropriate behavior. When we have a bad day, the fault is often due to
inappropriate expectations or insufficient preparation on my part (p. 113).
The use of time-out procedures is a topic of major importance to teachers of behaviorally
disordered students. A survey of special education teachers (Zabel, 1986) identified variables
associated with use of time-out. Among those variables were restrictiveness of placement and
age of child. Teachers or self-contained special educational classrooms reported using timeout more frequently than did teachers of resource rooms. Teachers of younger children
reported using the technique more frequently than did teachers of older children and youth.
Respondents to Zabels survey reported that they used the time-out procedure about five times
per week and that, on average, each child remained in time-out for 12 min. Verbal and
physical aggression were the two behaviors most frequently reported to result in time-out.
About half of respondents reported that they kept a log of their use of time-out, and less than a
quarter of the sample reported that their school districts had written guidelines for the use of
time-out procedures.
Zabel (1986) discusses the use of time-out intervention as appearing to lessen as students get
older, perhaps because teachers have more sophisticated, language-based interventions for use
with older students. Also, as students get older, the question of physical persuasion for those
who might refuse to go to time-out must be considered in light of both possibility and
appropriateness.
However, a study by Costenbader and Reading-Brown (1995) which investigated the use of
isolation time-out in a special education facility administered by a consortium of 26 rural
school districts in upstate New York found that older students comprised the majority of
students in time-out. All students were classified as emotionally disturbed (ED) by their
home school districts, and all students received 100% of their education in special classes.
Students were placed in this facility by their home school districts only after less restrictive
intervention strategies for controlling behaviors had been tried and failed. This facility
represented the most restrictive school-based placement in the six-county area. Students in
this special education facility were divided into a Lower School, consisting of grades K-6, and
an Upper School, consisting of grades 7-12.
Information used in the study was taken from computer data routinely gathered to monitor the
use of isolation time-out rooms in the special education facility over one academic year.
Three infractions-talking, failure to follow directions, and students electing to take a voluntary
time-out period accounted for 70% of all incidents. Only 1% of all time-outs were reportedly
caused by aggressive physical conduct.
In 1986, Zabel found that younger students experienced the time-out procedure more
frequently than did older students. In contrast, Costenbader and Reading-Brown (1995) found
that older students in the more restrictive placement are spending more time in time-out for
more separate behavioral incidents than are younger students. The differential use of
voluntary timeout best accounts for this. Although 22% of the timeouts experienced by older
students were voluntary, less than 1% of those taken by younger students were selfdetermined. Undoubtedly, a number of these behavioral incidents would have escalated from
voluntary to teacher-assigned timeout had the student not chosen to separate himself or
herself from the classroom.
Legal Implications of Time Out

29

The use of behavior reduction procedures, such as timeout, with students with BD has been an
area that has spawned a great deal of debate. Although the Individuals with Disabilities
Education Act (IDEA), Section 504 of the Rehabilitation Act of 1973, and regulations
implementing these laws are quite detailed, there are no specific guidelines as to the use of the
behavior reduction procedures (Yell, 1994). Yell points out that the resulting lack of
guidelines has led to uncertainty among special education administrators and teachers as to
the legally sound use of these procedures.
Frequently, when federal laws and regulations do not exist, it falls upon the courts to become
arbiters, acting to balance competing interests through an interpretation of existing laws. The
courts, in interpreting existing laws, fashion a body of law known as case law. The lack of
federal guidelines has resulted in a fair amount of case law regarding behavior reduction
procedures. The procedures that have most frequently been the subject of litigation are the
suspension and expulsion of children with disabilities.
Timeout has also been the subject of litigation. A small body of case law has been developing
regarding the use of timeout procedures with students with behavioral disorders. Yell (1994)
analyzed a number of cases on the use of behavior reduction procedures with students in
special education and concluded that timeout is a controlled intervention. That is, timeout is
legally permissible is used correctly. However, misuse of controlled interventions could
result in rulings against school districts. This is particularly true in cases involving the use of
seclusion/isolation timeout. In such cases school districts may be liable for large attorneys
fees awards. Thus it is extremely important that teachers be aware of legal considerations in
the use of timeout. Four federal court cases have dealt with the use of timeout with students
with BD. These cases involved teachers using timeout procedures with special education
students. In their decisions, the courts discussed guidelines and procedures that should be
followed in using timeout. Three of these cases-Cole v. Greenfield-Central Community
Schools (1986), Dickens v. Johnson County Board of Education (1987), and Hayes v. Unified
School District No. 377 (1989) directly addressed the use of timeout procedures (Yell, 1994).
The fourth case, Honig v. Doe (1988), concerned the use of suspension and expulsion but
briefly mentioned timeout when offering guidelines to school districts using behavior
reduction procedures with students in special education. All of these court cases have
involved law suits brought by parents against teachers, principals, and school districts that
used exclusion and seclusion/isolation timeout or similar procedures to reduce the undesirable
behaviors of students with BD.
Most abuses occur, experts say, when educators dont understand the purpose of timeout, or
overuse it (Lang, 1997). Intended only as a temporary measure, timeout quickly becomes
ineffective and even dangerous when children are placed in small, enclosed places for long
periods of time. In Georgia, the Thomaston case is one of several reported uses of cardboard
boxes for school discipline, said Denise Freeman, a spokesman for Citizens United for Rural
Empowerment, an educational clearinghouse based in Tignall, Ga. (Lang, 1997). Students
have also been placed in broom closets, locked rooms, or plywood boxes designed
specifically for timeout.
Research Implications
Although time-out is frequently used by teachers, researchers and practitioners, it has become
a controversial procedure because of misunderstanding, ineffective use, and ethical
considerations. Regardless of the type of time-out used, it is the discrepancy between the
time-in and time-out environments that provides the conceptual basis for time-out. When
time-out is determined to be the intervention of choice, the least restrictive and aversive
procedure likely to be effective should be designed on an individualized basis.
Constructing such procedures, however, depends a great deal on professional judgment due to
the scarcity of parametric studies. Research comparing time-out and alternative interventions

30

is also scarce, although effective alternatives to time-out have been documented (Harris,
1985; Gartrell, 2001; Betz, 1994; Hannon, 2002; Lang, 1997 Pica & Howard, 1993).
Parametric and comparative research is requisite to the development of a comprehensive
knowledge base concerning time-out interventions (Harris, 1985). Careful documentation of
time-out procedures as well as both positive and negative results is also essential. Since timeout continues to be widely used, these issues must be addressed by researchers and
practitioners.
References
Alberto, P., Heflin, L.J., & Andrews, D. (2002). Use of the timeout ribbon procedure during
community-based instruction. Behavior Modification, 26, 297-11.
Betz, C. (1994). Beyond time-out: Tips from a teacher. Young children, 49, 10.
Costenbader, V.K., & Reading-Brown, M. (1995). Isolation timeout used with students with
emotional disturbance. Exceptional Children, 61, 353-363.
Gartrell, D. (2001). Replacing time-out: part oneUsing guidance to build an encouraging
classroom. Young Children, 56, 8-16.
Hannon, J. (2002). No time for time out. Kappa Delta Pi Record, 38, 112-4.
Harris, K. R. (1985). Definitional, parametric, and procedural considerations in timeout
interventions and research. Exceptional Children, 51, 279-288.
Johnson, R. (1999). Time-out: Can it control misbehavior? Journal of Physical Education,
Recreation and Dance, 70, 32-46.
Lang, L. (1997). Often effective, timeout target in abuse cases. Education Week, 16, 1.
Lang, L. (1997). Too much timeout. Teacher Magazine, 8, 6-7.
Lucas, R.L. (2000). The effects of time-out and DRA on the aggressive behavior of a spirited
two-year-old. Child and Family Behavior Therapy, 22, 51-56.
Mace, F. C., & Heller, M. (1990). A comparison of exclusion time-out and contingent
observation for reducing severe disruptive behavior in a 7-year-old boy. Child & Family
Behavior Therapy, 12, 57-68.
Mace, F. C., Page, T. J., Ivancic, M.T., & OBrien, S. (1986). Effectiveness of brief time-out
with and without contingent delay: A comparative analysis. Journal of Applied Behavior
Analysis, 19, 79-86.
Marlow, A.G., Tingstrom, D.H., Olmi, D.J., & Edwards, R.P. (1997). The effects of
classroom-based time-in/time-out on compliance rates in children with speech/language
disabilities. Child and Family Behavior Therapy, 19, 1-13.
Mayerson, A.B. (2003). Should we eliminate time-out rooms? Educate children, dont
imprison them. American Teacher, 87, 4.
Mortimer, S., Adamsky, S., & McLaughlin, T. F. (1998). Use of isolated time out to reduce
aggression and non-compliance with an elementary school student with severe behavior
disorders: A long term analysis. International Journal of Special Education, 13(1), 34-45.
Pica, L., Jr., & Margolis, H. (1993). What to do when behavior modification is not working.
Preventing School Failure, 37, 29-33.
Readdick, C. A., & Chapman, P. L. (2001). Young childrens perceptions of time out.
Journal of Research in Childhood Education, 15, 81-87.
Reitman, D., & Drabman, R. S. (1996). Read my fingertips: A procedure for enhancing the
effectiveness of time-out with argumentative children. Child & Family Behavior Therapy,
18, 35-40.
Reitman, D., & Drabman, R. S. (1999). Multifaceted uses of a simple timeout record in the
treatment of a noncompliant 8-year-old boy. Education and Treatment of Children Special
Issue: Level 1 research: Improving our education and treatment through simple
accountability procedures, 22, 136-145.
Riley, K. (2003). Should we eliminate time-out rooms? Used wisely, they can help students.
American Teacher, 87, 4.
Rortvedt, A. K., & Miltenberger, R. G. (1994). Analysis of a high-probability instructional
sequence and time-out in the treatment of child noncompliance. Journal of Applied Behavior
Analysis, 27, 327-30.

31

Spradling, R. L. (1985). The effect of timeout from performance on attentiveness and attitude
of university band students. Journal of Research in Music Education, 33, 123-137.
Tingstrom, D.H. (1990). Acceptability of time-out: The influence of problem behavior
severity, interventionist, and reported effectiveness. Journal of School Psychology, 28, 165169.
Turner, H. S., & Watson, T. S. (1999). Consultants guide for the use of time-out in the
preschool and elementary classroom. Psychology in the Schools, 36, 135-148.
Webster, R. E. (1976). A time-out procedure in a public school setting. Psychology in the
Schools, 13, 72-76.
White, A. G., & Bailey, J. S. (1990). Reducing disruptive behaviors of elementary physical
education students with sit and watch. Journal of Applied Behavior Analysis, 23, 353-59.
Whittington, R., & Moran, G. (1990). Teaching nonviolence through time out: A curriculum
for elementary school classrooms. Social Work in Education, 12, 237-248.
Wilson, C.C., Robertson, S.J., Herlong, L.H., & Haynes, S.N. (1979). Vicarious effects of
time-out in the modification of aggression in the classroom. Behavior Modification, 3, 97111.
Yeager, C., & McLaughlin, T.F. (1995). Use of a time-out ribbon and precision requests to
improve child compliance in the classroom: A case study. Child & Family Behavior Therapy,
17, 1-9.
Yell, M.L. (1990). The use of corporal punishment, suspension, expulsion, and timeout with
behaviorally disordered students in public schools: Legal considerations. Behavioral
Disorders, 15, 100-109.
Yell, M.L. (1994). Timeout and students with behavior disorders: A legal analysis.
Education and Treatment of Children, 17, 293-301.
Zabel, M.K. (1986). Timeout use with behaviorally disordered students. Behavioral
Disorders, 12, 15-21.

32

ALCHEMY AND ABERRANT BEHAVIOUR:

A JUNGIAN APPROACH TO WORKING WITH BOYS WITH
BEHAVIOUR DISORDERS
Robert ODea
New South Wales Department Of Education And Training
Alchemy is an ancient philosophy on which the two modern day sciences of
chemistry and analytical psychology are grounded.
In education in New South Wales (NSW) at the present time, the behaviour
of boys is of increasing concern to schools, to teachers, to parents and to
society at large as evidenced by the over-representation of boys in school
suspension figures, detention and intensive learning classes, remedial
reading and behaviour units, special programs and special schools.
This paper outlines an action research study of the aberrant behaviour of
seven boys from Sydney schools who were all clinically diagnosed as
emotionally, conduct or behaviourally disordered. Jungs alchemic process
was employed to assist each boy to understand his inner conflict and how
it contributed to his behaviour. This approach was able to successfully
bring about positive change in the unacceptable, challenging, aberrant
behaviour of each of the boys. One boys process is outlined in more detail.
Terms used in this paper:
Aberrant disturbed behavior that represents a deviation from expected social behaviour.
IST(B) Itinerant Support Teacher for Behaviour.
Behaviour Disorders a generic term for students who display emotional, behavioural and /or
conduct difficulties and disorders.
Over many years of involvement in special education, this author has observed that the
behaviour of boys in schools and in society has deteriorated to a point where boys may be
considered to be in crisis. It is for this reason that the term aberrant has been used in this paper
to describe the behaviour of the boys, because it appears deviant, out of balance and
indicative of a more serious social phenomenon. Furthermore, the inability or unwillingness
of schools to develop and implement effective strategies to adequately cope with this
increasingly aberrant behaviour of boys seems to have left education in crisis. Many different
strategies and approaches to the education of boys have been tried and suggested and have
met with varying degrees of success. Yet, still, many boys continue to struggle academically
and socially and the great majority of students identified and classified as having behaviour
disorders in schools in NSW continue to be over-whelmingly boys. Boys and young men also

33

constitute a high proportion of students in detention classes and detention centres, in remedial
classes and programs, and in units for disturbed behaviour. In light of this, the effectiveness,
implementation and suitability of any strategies and approaches that have been employed so
far have to be questioned. Observations of boys in dropout centers or any Timezone, casualty
wards or in many schools, particularly many secondary schools, across NSW will tell the
same story.
In fact, the behaviour of students in schools has become of such concern in NSW that eleven
special schools for disruptive and unruly students and bullies (Vass, 2001, p1) have been
established. It will be no surprise that many of the students in these schools are, and will be,
boys. Boys are struggling, as shown in an overview of the statistics.
NSW STATISTICS

Boys are nine times more likely to be in detention classes or expelled from schools.

Risk-taking behaviour is more common in males and condoned by peer and societal
pressure from other males and from many females.

Males commit suicide at a significantly higher rate than females and the Australian
male youth suicide rate is reportedly the second highest in the world.

The caseloads of IST(B) teams in the Metropolitan East Region of Sydney are
comprised mostly, and in some areas completely, of boys.

Most of the students with learning difficulties are boys and some research estimates
that up to twenty percent of male children has some form of attention deficit disorder
often displayed as a behaviour disorder or learning difficulty.

Autism Spectrum Disorder, with all its associated problems affects boys four times
more commonly than girls.

Boys are now displaying the symptoms of compulsive disorders such as anorexia
nervosa, anxiety, neurosis and mental illness in much greater numbers than previously.

Boys are over-represented in remedial reading and intensive learning classes, and in
units for behaviour disorders.

This need for schools to be more proactive and introspective about students aberrant
behaviour led to an interest in a more holistic approach to education as provided by the
psychology of Jung and the process of alchemy.
An Overview Of Alchemy
It is not within the scope of this paper to discuss at length the very complicated process of
alchemy and interested readers may refer to this authors PhD thesis or to the excellent
coverage of alchemy by Jung (1951), von Franz (1980), Grossinger (1983), Heinrich (1995)
and Ramsey (1997). This paper will focus on the Jungs work in the area of alchemy.
Jungs interest in Eastern philosophy, medicine and alchemy was instrumental in pioneering,
certainly in the Western academic world, the belief that the alchemists were ... only ostensibly
and secondarily involved in a chemico-physical process (Grossinger, 1983, p.278). Primarily,
the chemical changes in the inanimate substances involved in the alchemic process, were a
means, a vehicle, for the unconscious, introspective human transformation of the alchemists
through their own involvement. Alchemy, in Jungs view, had less to do with the chemical
experiments and more to do with the exploration of the psyche, which was expressed in
pseudo-chemical language. In other words the rituals, symbols, secrecy and complicated

34

processes of The Great Work concealed a psychological course in introspection and selfchange and it is this on which Jung based what he called analytical psychology.
Jungian alchemy is based on the three stages of Ancient alchemy: The Lesser Work, The
Middle Work (a term coined by this author) and The Great Work, as shown in Figure 1.
In Jungs view involvement in this process of alchemy has the potential to bring about
effective, expansive and important change by assisting to make the foundations of the psyche
more secure. Involvement in the process shown in Figure 1 facilitates and allows extremely
difficult, harmful, hurtful or confronting experiences to be perceived as positive experiences,
as a different perception is allowed to flood into consciousness.
Figure 1
An Overview of Jungian Alchemy
The Lesser Work: Nigredo
Symbol: Lead
The Ego State
Projection and transference of the contents of the shadow.
Beliefs: It is somebody elses fault. Life isnt fair.
Question: Whose fault is this? Why is it happening to me?
The Middle Work: Albedo
Symbol: Silver
The Beginning of the Process of Introspection
Introspection and withdrawal of projection and of transference.
Beliefs: I cant understand it. I cant help it.
Questions: What does it mean? Why is it happening?
The Great Work: Rubedo
Symbol: Gold
A State of Higher Consciousness in all Things
Self-awareness and the desire to make the world a better place.
Beliefs: I can help others. I can make a difference.
Questions: What can I learn from this? What is the bigger picture?
Jung identified seven major concepts that facilitate higher consciousness and these are shown
and definitions given in Figure 2.
Figure 2
The Processes of Jungian Alchemy
Concept
Jungian Alchemy
Participation
The reflection of what is happening within, in the
mystique
unconscious, reflecting without, in the conscious world.
The shadow
The darker side of the psyche, where unresolved issues and
repressed feelings lie.
Projection
The unconscious and involuntary attribution of the contents
of ones shadow onto others.
Transference All the exceedingly complex processes that bind people
together in any situation.
Cryptomnesia The unconscious recollection of a thought that one feels is
ones own.
Synchronicit Meaningful coincidence.
y
The recognized triad of space, time, causality.
Individuation The feeling of standing on solid ground within oneself.
Self-understanding.

35

This author took the process and concepts of alchemy as described above and employed them
with a target group of boys as described in the research study.
The Study
The research question that was investigated in the study was to what extent could Jungs
alchemic process and concepts lead boys through the alchemic process and change their
aberrant behaviour? Out of a sample of twenty boys with identified and clinically diagnosed
behaviour disorders, a group of seven boys was selected to be involved in the program, along
with their teachers and parents. Parental and teacher permission for the involvement of the
boys in the research was a prerequisite to inclusion in the study. Figure 3 shows an overview
of the procedures and the research methodology used in the study.
Figure 3
Overview of Procedures and Methodology
The Research Paradigm
= Qualitative Research
through
through
Ethnographic Studies
= The Aberrant Behaviiour of Boys
through
through
The Methodology
= Action Research
through
through
Methodological Triangulation
= Different Methods/Same Study
through
through
The Data Collection Methods
= 1 Participant Observations kept in a
dated Research Journal
2 Narrative and Written Records
3 IST(B) Referrals
4 IST(B) Evaluations
5 In-Depth, Taped Interviews
through
through
The Data Reporting Method
= Discourse Analysis
For the purposes of this paper, one boys program will be overviewed and described, a boy
who was referred to in the research study by the alias of Jimmie.
Jimmies Program
Jimmie was a seven-year-old boy in Year 1 at an inner city school. He was referred to the
IST(B) service because he was a student of above average intelligence who was
underachieving at school, he displayed some bizarre and sometimes dangerous and violent
behaviours, he exhibited a morbid obsession with death and dead things, and it was thought
that he might have suicidal tendencies as he frequently talked about his own death and
threatened to kill himself. He was being seen by a child psychologist and had a history of
violence and aggression towards others both adults and peers.
a) The Intervention
Using the baseline data provided by the school and IST(B) observational baseline data,
Jimmies program became one that addressed his needs, as he perceived them to be. In other
words, the intervention honoured his perception of the problem and established a suitable
intervention. Also, through the free interaction of the alchemic processes described above,
Jimmies program was allowed to unfold and reveal itself on a needs basis. Figure 4 below,
gives an overview of Jimmies alchemic journey.
Figure 4
An Overview of Educational Alchemy for Jimmie
Nigredo
Suicidal tendencies. Morbid obsessions. Violent. Unpredictable.

36

Ego state
Projection of the
shadow

Bizarre Behaviours. Inappropriate social skills.

The recurring nightmare.
Academic failure

Albedo
Withdrawal of
projection

Connectedness to IST(B). Participation mystique.

Involvement in dream therapy. Curriculum modification.
Connection with parents, psychologist. Team approach.
Setting up of whole class behaviour management system.

Rubedo
Moving towards
individuation

Confrontation with dream monster. Unmasking of persona.

Acceptance by teachers and peers. Making and having friends.
Synchronistic events.
Beginning of academic and social success.

b) Behavioural Change
In the research study, baseline data was compared to post-intervention data to evaluate and
measure if the use of alchemy could facilitate observable behavioural change in the case
studies. The results were positive as shown in Figure 5.

Baseline Data
Ego state
Projection of the
shadow

Figure 5
An Overview of Jimmies Behavioural Change
Dangerous, suicidal tendencies and actions. Running into moving
traffic. Hiding under vehicles. Running away from adults.
Bizarre Behaviours. Morbid obsessions with dead things.
Hitting, biting, scratching, fighting with peers. Stealing.
Inability to access the curriculum. Poor writing, motor skills.

Intervention
Withdrawal of
projection

Strong connection with IST(B). Painting, drawing a dream book.

Establishing friendships with peers. Following rules of games.
IST(B) meetings with parents, grandparents and psychologist.
Establishing school/ home approach to behaviour management.
Changing class teachers attitude towards Jimmie and his family.

Post Intervention
Moving towards
individuation

Acceptance by family that Jimmie was being physically abused.

Acceptance by teachers and peers. Making and having friends.
Jimmie displaying a happy, smiling, friendly demeanour.
Working to ability at school. Increase in reading age.

Results and Conclusion

The success of such an approach was clearly demonstrated in Jimmies case, as in all the
interventions in the research. Jung (1951) and von Franz (1975; 1980) would argue that in
each intervention, each team of people constituted an alchemic mixture, and it was this
mixture that brought about the corresponding positive change in behaviour. Furthermore, once
this was achieved, the referred boys were able, some of them for the first time, to experience
social and academic success: to find the inner gold.
One answer to the conundrum of boys aberrant behaviour and their inability to change it may
lie in one of the most interesting findings of this study. With all of the seven boys involved in
the research, it became clear that when these boys were caught in the nigredo state, they were
virtually unable to be helped. For Jimmie, while he was caught in the recurring nightmare of
the nigredo (physical abuse that nobody believed was happening), it was painfully obvious
that he was beyond reach. Jung calls the nigredo the ego-bound state and describes it as an
egocentric state where ones self and ones problems are regarded as the centre of all things.

37

When boys are operating out of this state, changing behaviour is extremely difficult because
everything in the conscious world is seen through, or viewed from behind, each boys
dominant unconscious and problematic issue, which is suppressed and often repressed in the
unconscious of each boy. This author coined the term egocentric issues to describe these
because they seem to dominate the nigredo, the ego state. In fact, it may be that boys are
simply not able to move into the albedo and rubedo states unless their egocentric issues are
resolved. Thus, teaching boys strategies to move out of the nigredo may be a most useful
strategy to employ and doing so may actually allow boys to then access the many different
strategies and approaches to behaviour change and special education available to them.
A new approach to working with boys with aberrant behaviour and behaviour disorders is
urgently required in schools around the world. This paper has outlined one such approach: the
use of Jungs process of alchemy. If schools are to meet the future needs of boys and find
ways to assist them to change their aberrant behaviour and achieve in the education system
and in society, this model of educational alchemy that brings boys out from behind their
egocentric issues, through understanding of their own behaviour to positive behaviour change
and ultimately greater academic and social success, is one way of achieving this aim.
Basically, educational alchemy is, as one student in the study group liked to call it Going for
gold.
Nourishing and caring for the psyche of boys through such programs as educational alchemy,
may ensure that boys have the means to find endless solutions to their own problems, to the
problems of aberrant male behaviour and to that of masculinity itself. Teachers have a huge
role to play in this process and through a change in individual consciousness, could make
enormous changes in education and in society. As catalysts for change teachers could, in fact,
greatly assist boys, schools, the education process, parents and carers and society as a whole.
Coming from the heart and empowering students both educationally and emotionally to lead
fulfilled lives is the challenge for education in the 21st Century, in the Aquarian Age, and
future generations will judge to what extent this challenge was accepted.
Further research with the use of alchemy may provide another avenue of assisting schools and
society to cater for the increasingly problematic behaviour of some boys and young men. The
possibility of this approach being used with girls, young women and adults who display
aberrant behaviour may indicate a wider application of Jungs alchemic theory.
References
Grossinger, R. (Ed.), (1983). The alchemical tradition in the late Twentieth century. Berkeley,
California: North Atlantic Books.
Heinrich, C. (1995). Strange fruit: Alchemy and religion. The hidden truth. London: Butler &
Tanner, Ltd.
Jacobi, J. (1968). The psychology of C.G. Jung: An introduction with illustrations (7 th ed.).
London: The Chaucer Press.
Jung, C.G. (1951). The collected works. London: Routledge & Kegan Paul.
ODea, R. K. (2001). Alchemy and the Aberrant Behaviour of Boys. PhD Thesis. The
University of Sydney. NSW. Australia.
ODea, R. K. (1997). A primary behaviour management system. The Primary Update, 1 (2),
6-7.
Ramsey, J. (1997). Alchemy: The art of transformation. Glasgow: Harper Collins Publishers.
Rabelais, F. (1991). The complete works of Francois Rabelais. Berkeley: University of
California Press.
von Franz, M.L. (1975). C.G. Jung: His myth in our time. New York: G.P. Putnams Sons.
von Franz, M.L. (1980). Alchemy: An introduction to the symbolism and the psychology.
Toronto: Inner City Books.Vass, N. (2001, June). Last chance: Bullies and truants get their
own schools. The Sunday Telegraph. pp.1-2.

38

AN EMPIRICAL STUDY ON TEACHERS PERCEPTIONS TOWARDS

INCLUSIVE EDUCATION IN MALAYSIA
Manisah Mohd Ali
Ramlee Mustapha
and
Zalizan Mohd Jelas
Universiti Kebangsaan Malaysia
The hallmark of inclusive education is the teachers willingness to accept
students with special needs. Their attitudes and knowledge about inclusive
education are important as these are indicators of such willingness. The
purpose of this study was to examine teachers attitudes and their
perceived knowledge towards inclusive education in Malaysia. The
respondents (n=235) were the mainstream and special education teachers
in the public primary and secondary schools. They were given a set of
questionnaire which sought their responses regarding their attitudes and
knowledge towards inclusive education. The data were analysed using
descriptive statistics such as frequency and percentages. The main finding
shows that, in general, teachers have positive attitudes towards inclusive
education.
They agreed that inclusive education enhances social
interaction and inclusion among the students and thus, it minimizes
negative stereotypes on special needs students. The findings also show
that collaboration between the mainstream and the special education
teachers is important and that there should be a clear guideline on the
implementation of inclusive education. The findings of the study have
significant implications to the school administrators, teachers, and other
stakeholders who directly and indirectly involved in implementing
inclusive education.
Inclusive education is a concept that allows students with special needs to be placed and
received instruction in the mainstream classes and being taught by mainstream teachers.
According to the Malaysian Ministry of Education, students with special needs are those who

39

are visually handicapped, or partially or fully deaf or suffer from the disability to learn (Akta
Pendidikan 1996). These are the students that have been identified as suffering from physicalsensory deficiencies and learning disabilities. The Ministry of Education provides special
education programmes for the three types of disabilities, namely, hearing, visual and learning
disabilities.
The learning disabilities programme provides educational service to a heterogeneous group of
students with mild retardation, students with autistic tendencies and students with multiple
disabilities. Such students have been placed in special classes or in special schools.
Placement into special needs programmes is decided based on the special needs
categorizations, namely visual, hearing and/or learning disabilities. For students with visual
or hearing impairments, they are either placed in special schools or in the integration
programme in the mainstream schools. Students with learning disabilities are regularly
placed in the integration programme in the mainstream schools. Table 1 shows the types of
programme and numbers of students with special needs in Malaysia.

Table 1
Types of programme and the number of students with special needs in Malaysia
No of schools (No of students)
Primary
Secondary

Total

Types of programme
1.
a.
b.

Visual impairments
Special schools
Integration programme

6(234)
11(124)

7(338)
26(325)

2.
a.
b.

Hearing impairments
Special schools
Integration programme

23(1,713)
41(448)

1(104)
15(201)
2(523)
39(965)

25(2,236)
80(1,413)

3. Learning disabilities
a.
Special schools
b.
Integration programme
402(7,437)
160(2,786)
562(10,223)
______________________________________________________________________________
Total

483(9,956)

217(4,579)

700(14,535)

(Source: Jabatan Pendidikan Khas [Department of Special Education], 2002)

The initiatives to implement inclusive education in Malaysia by the Ministry of Education

were conducted through seminars (Zalizan, 1995a; 1995b; 1997), workshops and field works
(Kementerian Pendidikan Malaysia, 1995). The inclusive programme in Malaysia has been
conducted in regular classes as a part of a service continuum for students with special needs.
Trailed from the UNESCOs declaration of Education for All, this programme aimed at
encouraging interaction between students with special needs and the mainstream students.
Students with special needs are placed in regular classes and are taught by a class teacher who
is also assisted by a special education teacher. In the following section, this paper discusses
briefly on inclusive education in Malaysia. This is followed by the discussion on an empirical
study about the teachers perceptions and knowledge towards inclusive education.
Overview of inclusive education in Malaysia
Inclusive education in Malaysia began through the Malaysians involvement at the
international level in seminars and workshops hosted by the United Nations particularly under
the UNESCO activities. The Worlds Declaration on Education for All in Jomtien, Thailand in

40

1990 has been focusing on integration initiatives and equity issues for all including those with
special needs. Further commitment on education for all was emphasised in the UNESCOs
Sub-regional Seminar on Policy, Planning and Organisation of Education for Children with
Special Needs in Harbin, China in 1993. The outcomes of the seminars and workshops on
special education and Education for All have made way for the change of emphasis from
integration to inclusion. The concept of inclusion assumes that the mainstream classes can be
restructured and adapted so that the needs of children with special needs can be met. This
orientation towards inclusion was part of the important agenda in the seminar in Spain in
1994 which brought forward the Salamanca Statement on Principles, Policy and Practice in
Special Needs Education (Zalizan, 1997). This seminar was represented by 92 countries
including Malaysia, and 25 international organisations.
In Malaysia, inclusive education was first introduced in the mid-1990s as part of a reform
initiative that was focused on students with special needs. However, the term inclusive
education is loosely defined and understood by the policymakers and practitioners. Akta
Pendidikan 1996 (Education Act 1996) explains that the national context towards special
education is based on the principle to integrate and to make inclusive special education
students who have the right to be alienated as and when necessary (Akta Pendidikan 1996).
Acknowledging the obstacles to full inclusion, the students are either partly or fully included
based on their level of ability to follow instructions in the mainstream classes. In Malaysia,
inclusion is carried out in schools at primary and secondary levels where there are also
integration programmes for students with special needs.
Theoretical Framework
The inclusion of individuals with disabilities in mainstream educational, occupational and
societal frameworks has become an accepted concept in western countries in the last two
decades (Heiman, 2004). The inclusion policy specified attendance at mainstreamed schools
and also dealt with different models of implementing the inclusion and with teachers' needs in
terms of practical and theoretical training. Research has shown the many positive effects of
placement in inclusive classes and the different benefits for students with disabilities.
According to Heiman (2004), there are four different models of inclusion: (a) in-and-out, (b)
two-teachers, (c) full inclusion and (d) rejection of inclusion. In her study of inclusive
education in United Kingdom and Israel, Heiman (2004) found that most of the teachers in
United Kingdom and Israel thought that an in-and-out model would be more effective for the
students with learning disabilities. These teachers believe that this approach would enable
students with disabilities to benefit from two worlds: the special instruction they needed
together with regular lessons and interactions with their peers in regular settings. The twoteacher model was somewhat popular in Israel and less so in Britain. According to this model,
two teachers teach simultaneously in the classroom with one of them, who has had training in
special education, concentrating on the students with disabilities. Small percentages of
teachers in both countries thought that full inclusion is the right model to apply within the
regular classroom. They thought that with additional support and cooperation between
teachers and with the services of the educational system, full inclusion could succeed and be
the most beneficial for all. Some teachers in both countries rejected inclusion completely. The
teachers in this group thought that it would be better for students with disabilities to study in
separate classes, according to special programs, so they could progress at their own pace.
They felt that such model is more effective since special needs students in inclusive class
would never be able to reach the academic level of the mainstream students. Similar models
were observed in Malaysia. Form our observation, full inclusion is the least method used.
Most teachers would apply hybrid models such as two-teachers and in-and-out approaches.

Review of Literature

41

During the past two decades, the inclusion movements have made significant progress in (a)
supporting the rights of children to have their special educational needs identified and met
through education legislation and the right of individuals with disabilities to equal
opportunities, (b) minimizing unjustified discrimination, and (c) developing support facilities
and services for individuals with special needs (Disability Rights Task Force Final Report,
2004; Ministry of Education, 2004).
According to Heiman (2004), students can be included in mainstream classes based on a
multidimensional diagnosis including psychological and educational tests. The students
usually receive additional academic support from a special education teacher in their regular
classrooms or in a resource room. To provide flexible inclusion in the least restrictive
environment, the schools need to train more mainstream teachers to handle and cope with
special needs students in their classes.
Despite the apparent benefits of inclusion, and regardless of the teachers' commitment and
positive attitudes; and notwithstanding their having the knowledge and skills necessary to
meet the educational needs of diverse students with disabilities, teachers were concerned
about the academic, social, and behavioral adjustment of the students with disabilities in
inclusive classes. Some teachers felt that inclusion would bring little benefit to students with
disabilities and, consequently, they questioned the advantages of inclusion (Heiman, 2002;
Priestley & Rabiee, 2002).
Other teachers stressed their concern that as more students are included, teachers would need
additional tools and skills for coping with the social and emotional problems that accompany
inclusive schooling (Idol, 1997). Vaughn, Schumm, Jallad, Slusher & Samuell (1996)
mentioned several aspects which might cause teachers to raise objections to inclusion, such as
the large number of students in the class, budget shortages, the teachers' work load,
difficulties in standardized evaluation. Still, others pointed to the lack of teamwork, or asked
for guidance in dealing with students with special needs (Danne & Beirne-Smith, 2000).
Some of the mainstream teachers claimed that they had chosen to teach a specific discipline
and not special education, and the inclusion policy forced them to enter areas they were
unsure about or not interested in it (Vaughn, et al., 1996). Mock and Kauffman (2002)
described the catch in which teachers were trapped: on one hand, teachers cannot be prepared
to answer the unique educational needs of every student with special needs, and, on the other
hand, teachers in inclusive classes teaching students with special needs, might function
beyond their training and their specialization.
Perception and knowledge of teachers towards inclusive education in Malaysia
In order to determine the outcome of the implementation of inclusive education in Malaysia, a
survey on the attitudes and knowledge of school teachers regarding inclusive education was
conducted. This descriptive study involved regular and special education teachers in public
primary and secondary schools. A sample (n=300) was randomly selected from a nation-wide
directory of Malaysian teachers using a stratified sampling method. The population was
stratified into 5 zones northern, western, central, eastern, and southern zones. The
respondents were given self-rated questionnaire to identify their attitudes and knowledge
towards inclusive education. Data were analysed using descriptive statistics in the form of
percentages based on the three categories: Agree, Uncertain, and Disagree. A total number of
235 of the questionnaires were returned which constituted 78% return rate. The findings were
synthesised according to the aspects of teachers perception and knowledge towards inclusive
education, collaboration with special education teachers and other related matters concerning
with the implementation of inclusive education.

42

Table 2 depicts the teachers perceptions regarding inclusion education in Malaysia. Overall,
the majority of respondents agreed that inclusive education is appropriate for special needs
students, at least in theory. For Item 1, only half of the respondents (50.6%) agreed that
students with special needs are academically better in inclusive classrooms. Nevertheless,
approximately two-thirds (66%) of the respondents were in favor of the notions that special
needs students should be integrated into the mainstream classes/community and that the
students would be benefited from inclusive classes (Items 2, 3, and 6). Items 4 and 5 show
mixed feelings of the respondents regarding academic performance of special needs and
mainstream students in an inclusive setting. In Item 4, about one-thirds (32.4%) of the
respondents agreed that the placement of students with special needs in regular classes
negatively affects the academic performance of normal students while the rest (25.5%) were
uncertain and (42.1%) disagreed. A similar pattern was seen in Item 5 where 42.1% of the
teachers disagreed that the academically-talented students would be isolated in the inclusive
classrooms while 27.2% of the teachers agreed and 30.6% were uncertain. With regard to
Item 7, approximately two-thirds (62.5%) of the respondents believe that students with special
needs have the right to receive an education in mainstream classes. Most importantly, more
than half (57.1%) of the respondents believe that the negative stereotype of special needs
students can be minimized in inclusive classroom. In particular, labeling of the students with
special needs can be reduced (Item 8).
Table 2
Teachers perception towards inclusive education
ITEM

AGREE
(%)

UNCERTAIN
(%)

DISAGREE
(%)

Students with special needs are academically better

in inclusive classrooms

50.6

32.3

17.0

Students with special needs must be integrated into

the regular community

62.1

8.1

29.8

In order to achieve the highest level of inclusion, it is

necessary for students with special needs to be
placed in regular classes with back up support
The placement of students with special needs in
regular classes negatively affects the academic
performance of mainstream students

67.7

12.3

20.0

32.4

25.5

42.1

The academically-talented students will be isolated

in the inclusive classrooms

27.2

30.6

42.1

Students with special needs will benefit from the

inclusive program in regular classrooms

66.8

20.4

12.8

Students with special needs have the right to receive

an education in mainstream classes

62.5

15.3

22.1

Students with special needs will not be labeled as

stupid, weird or hopeless when placed in regular
classrooms

57.1

22.6

20.4

Collaborative efforts between mainstream and special education teachers in inclusive

classrooms
Table 3 illustrates the perceptions of Malaysian teachers regarding the collaborative efforts
between mainstream and special education teachers in an inclusive classroom. Data for Item 1
shows that the majority of respondents (80%) agreed that the collaboration between the
special education teachers and regular teachers is vital in the implementation of the inclusive

43

program (Item 1). However, almost half (49.8%) of them stated the implementation of
inclusive education is ineffective (Item 2). In terms of who is taking charge of inclusive
classroom (Item 3), 49.3% of the respondents agreed that the mainstream classroom teacher
is the one who is in-charge while 34.4% of the respondents disagreed. In addition, most of
the respondents (43.5%) agreed that the presence of a special education teacher in the regular
classrooms could raise difficulties in determining who really is responsible for the special
students (Item 4). Finally, majority of the teachers (63%) concurred that the role of special
education teacher is to assist the students with disabilities (Item 5). The success of the
inclusive program depends among others, on the attitudes of the classroom teachers towards
the children with special needs (Anotonak & Larrivee, 1995 & Wilczenski, 1992 in Zalizan,
2000). This includes the teachers perception towards the learning abilities and the
willingness of the teachers to change in order to fulfill the needs of different individuals. The
collaboration between the mainstream and the special needs teachers is a critical factor in
determining the successful implementation of inclusive program. Zalizan (2000) suggested
that in order to ensure the success of an inclusive program, a collaboration or co-operation
form or mode between the particular teachers should be introduced within the programme as
soon as possible.
Table 3
Collaboration between mainstream and special education teachers
ITEM

AGREE
(%)

UNCERTAIN
(%)

DISAGREE
(%)

Special needs teachers and regular teachers need to

work together in order to teach students with special
needs in inclusive classrooms
Although the inclusive education in a good concept,
its implementation is ineffective due to objections
from the mainstream classroom teachers

80.0

6.0

14.1

49.8

28.9

21.3

3.

Mainstream classrooms teachers have a main

responsibility towards the students with special
needs placed in their classrooms

49.4

16.2

34.4

4.

The presence of a special education teacher in the

regular classrooms could raise difficulties in
determining who really is responsible for the special
students

43.5

23.0

33.7

The special education teacher only helps the

students with special needs

63.0

11.5

25.6

1
2

Strategies to improve inclusive education

There are several strategies that can be employed in order to enhance the effectiveness of an
inclusive programme. Table 4 highlights some of the issues that need the attention of the
parties involved in implementing this program. Over half of the respondents (56.6%) stated
that the mainstream classroom teachers lack the exposure and the skills to deal with students
with special needs (Item 1). This response contradicts Rogers (1987)s opinion which stated
that exposure to the population of students with special needs does not influence a teachers
perception. Within the context of the study, it is felt that the exposure to inclusive education is
important in order for the teachers to understand the form of the education programme as well
as to understand their role in implementing inclusive education.

44

The majority of the respondents (78.3%) agreed that special needs students need extra
attention and help in the classroom (Item 2) and that these students were seen as having more
disciplinary problems when compared to the regular students (Item 3). The lack of guidance
and cooperation from the special education teachers and the limited resources in the teaching
and learning of students with special needs (Items 4 and 5) were the critical aspects that need
to be improved. Thus, the findings show that when dealing with the students with special
needs, teachers willingness to adapt and change is necessary to ensure that the teaching and
learning process is carried out according to the abilities of those students (Zalizan, 2000;
Madden & Slavin, 1983).

The way forward with the current implementation

Based on the results of the study, in general, the efforts to implement the inclusive programme
received a positive response from the teachers. In relation to this, the implications and
suggestions for the parties involved in the implementation of inclusive education are
discussed, following Table 4.
Table 4
Strategies to improve inclusive education
ITEM

AGREE
(%)

UNCERTAIN
(%)

DISAGREE
(%)

Mainstream classroom teachers have the training and

skills to teach special needs students

29.4

14

56.6

Special needs students need extra help and attention

78.3

14.5

7.2

Students with special needs committed more

disciplinary problems compared to the regular
students

50.7

13.2

36.2

Mainstream classroom teachers received little help

from the special needs teachers

47.7

26.4

26.0

Although inclusive education is important, the

resources for the students with special needs in a
mainstream classroom are limited.

70.2

15.7

14.1

Schools administrators
The active involvement and support of the schools administrators in the implementation of
inclusive education programme is critical. Schools with the administrative support for
inclusive education demonstrate a significant increase of awareness regarding the concept of
inclusion. A recent study (Salisbury & McGregor, 2002) suggests that the school principals
have an essential role in improving the school environment and in implementing educational
policy. The researchers demonstrate the complex relationships between the school staff and
the school climate, and emphasize the importance of the principals awareness of the role of
the staff in implementing the inclusion successfully. When most of the teachers share in an
open dynamic discussion group regarding their beliefs, difficulties, different aspects of
teaching and ways of coping with dilemmas, this encourages them to find better coping
solutions and support in their difficulties with the inclusion process. In addition, when the
school principal shares the decision making process with the school staff, this contributes to
more educational accountability and responsibility.

45

Teachers
This study found that the inclusive education programme could be successfully implemented
if the level of the teachers competency is increased. Thus, the opportunities to attend courses
that are related to the inclusive education program have to be created, especially for those
who lack of exposure and training in special education. Adjustments towards the pedagogical
aspects can be trained internally by experienced teachers to the new teachers. The effort
towards a collaborative teaching between mainstream and special education teachers should
be put in place. Indirectly, this effort could help to reinforce a cooperative spirit in
implementing inclusive education. Literature has shown that the success of the inclusive
education depends, to a large extent, on the willingness and the ability of teachers to make
accommodations for individuals with special needs (Bender, Vail, & Scott, 1995). In addition,
research also shows that teachers who are aware of the inclusion policy and therefore can
define the pragmatic meaning of inclusion is more willing to be part of the inclusion team.
However, numerous studies found that teachers agree that the inclusive education is
important, but many find it difficult to apply.
Teacher Training Institutes
Specifically, the role of teacher training institutes is very important. Teacher training
institutes should incorporate the concept of inclusion as part of the curriculum. For example,
The Faculty of Education, Universiti Kebangsaan Malaysia offers education courses with
honours (special education), which trains future special education teachers. Many important
aspects in relation to special education and special needs are stressed throughout the duration
of the courses. This includes the aspects of inclusive education. There are also courses which
are open to students from other programmes as well which indirectly help to prepare the
trainee teachers to gain knowledge in relation to students with special needs. As part of the
teacher training programme, it is therefore recommended that education courses make room
for critical discussion regarding issues and concepts of inclusion and teaching effectiveness.
It is also recommended that the trainee teachers be given structured opportunities to
experience inclusive education in practice. Exposure to observing teaching children with
special needs in inclusive setting is one of the essential components in the process of breaking
down barriers and building positive attitude (Garner, 1996).
Conclusion
Results of the study discussed in this paper revealed that teachers may form perceptions based
on a number of discrete factors, that is, how these teachers perceived inclusive education
programme, their opinion on the team effort or collaboration between teachers and how they
viewed the possible ways of improving the related aspects of inclusive education. The
discussion in this paper also indicated that teachers have a positive perception towards the
implementation of the inclusive education programme. However, there are some aspects that
can be improved such as the collaboration between the mainstream and special education
teachers and the preparation to train regular teachers in handling and teaching students with
special needs. The need to provide adequate resources to inclusive classes is never been more
critical. In addition, there should be an increasing effort in promoting inclusive education
programme to the public as well as to the stakeholders.
References
Akta Pendidikan 1996 (Akta 550) & Peraturan-Peraturan Terpilih. Susunan oleh Lembaga
Penyelidikan Undang-Undang. Kuala Lumpur: International Law Books Services.
Anotonak, R. F. & Larrivee, B. (1995). Psychometric Analysis and Revision of the Opinions
Relative to Mainstreaming Scale. Exceptional Children. 62: 139-49.
Bender, W. N., Vail, C. O., & Scott, K. (1995). Teacher attitudes toward increased
mainstreaming: Implementing effective instruction for students with learning disabilities.
Journal of Learning Disabilities, 28, 8794.
Danne, C. J., & Beirne-Smith M. (2000). Administrators and teachers perceptions of the
collaborative efforts of inclusion in the elementary grades. Education, 121, 2.

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Disability Rights Task Force Final Report (2004). From Exclusion to Inclusion. Retrieved
from: http://www.disability.gov.uk/drtf/full_report/index.html.
Garner, P. (1996). A Special education? The experience of newly qualified teachers during
initial teacher training. British Journal of Special Education, 23(4): 176-179.
Heiman, T. (2002). Inclusive schooling: Middle school teachers perceptions. School
Psychology International, 23 (1), 174-186.
Heiman, T. (2004). Teachers coping with changes: Including students with disabilities in
mainstream classes: An international view. International Journal of Special Education,
19(2).
Idol, L. (1997). Key Questions related to building collaborative and inclusive schools.
Journal of Learning Disabilities, 30, 384-394.
Jabatan Pendidikan Khas (2002). Maklumat Pendidikan Khas. Kuala Lumpur: Jabatan
Pendidikan Khas.
Kementerian Pendidikan Malaysia (1995). Perancangan Strategik Pendidikan Khas 2020.
Kuala Lumpur: Jabatan Pendidikan Khas.
Madden, N. & Slavin, R. (1983). Mainstreaming student with mild handicaps. Academic and
social outcomes. Review of Educational Research, 53: 519-570.
Ministry of Education (2004). Mainstreaming Students with Special Needs. Retrieved from:
http://www.education.gov.il/special/english6.htm.
Mock R. D., & Kauffman M. J. (2002). Preparing teachers for full inclusion: Is it possible?
The Teacher Educator, 37, 3, 202-217.
Priestley, M., & Rabiee, P. (2002). Hopes and fears: stakeholder views on the transfer of
special school resources towards inclusion. International Journal of Inclusive Education, 6
(4), 371-390.
Rogers, B.G. (1987). A comparative study of the attitudes of regular education personnel
toward mainstreaming handicapped students and variables affecting these attitudes. Paper
presented at the Fourth Pan American Conference on Rehabilitation and Special Education,
Acapulco, Mexico. (ERIC Document Reproduction Service No. ED 182 465).
Salisbury, C. L., & McGregor, G. (2002). The administrative climate and context of inclusive
elementary schools. Exceptional Children, 68, 2, 265-274.
Vaughn, S., Schumm, J. S., Jallad, B., Slusher, J., & Samuell, L. (1996). Teachers views of
inclusion. Learning Disabilities Research & Practice, 11, 96-106.
Zalizan Mohd Jelas (1995a). Strategi bagi pelaksanaan pendidikan inklusif. Paper presented
at Seminar Pendidikan Inklusif. Kuala Lumpur: Jabatan Pendidikan Wilayah.
Zalizan Mohd Jelas (1995b). Perkembangan kini dan peningkatan pelaksanaan pendidikan
khas. Paper presented at Seminar Kebangsaan Pendidikan Khas. Kuala Terengganu:
Kementerian Pendidikan Malaysia
Zalizan Mohd Jelas (1997). Ke-arah pendidikan inklusif di Malaysia melalui kerjasama
antarabangsa. Paper presented at Seminar Kebangsaan Pendidikan Guru. Serdang: Universiti
Pertanian Malaysia.
Zalizan Mohd Jelas (2000). Perception of inclusive practices: The Malaysian perspectives.
Educational Review, 52 (2): 187-196.
Zalizan M. Jelas, Ramlee Mustapha & Manisah Mohd Ali (2002). Persepsi dan pengetahuan
guru terhadap pendidikan murid dengan keperluan khas : Perkembangan profesional guru ke
arah pendidikan inklusif. Laporan Laluan Pantas G2/2000. Bangi : Fakulti Pendidikan,
UKM (tidak diterbitkan).

47

THE EFFECTS OF CONSTANT TIME DELAY AND STRATEGIC INSTRUCTION

ON STUDENTS WITH LEARNING DISABILITIES MAINTENANCE AND
GENERALIZATION
Margaret M. Flores
University of Texas at San Antonio
David E. Houchins
Georgia State University
Margaret E. Shippen
Auburn University
The purpose of this series of case studies was to compare the impact of
Constant Time Delay and Strategic Instruction on the maintenance and
generalization of learning. Four middle school students with learning
disabilities were effectively taught two different groups of multiplication facts
using Constant Time Delay and Strategic instruction. The researchers
measured students levels of maintenance and generalization after receiving
each type of instruction. Maintenance data were collected using 1-minute
fluency probes. Generalization data were collected using timed (1-minute)
and untimed probes. Strategic Instruction appeared to have a greater impact
on the students maintenance and generalization of multiplication skills. The
students performance and perceptions are discussed in terms of potential
implications for the classroom.
According to the National Council of Teachers of Mathematics (2000), mathematics
instruction should result in successful problem solving and logical thinking. However, in
order to advance to higher levels and solve mathematical problems, it is critical that students
be fluent with basic operations (Miller & Mercer, 1993a). Fluency in math computation
allows students to allocate their attention to the purpose of the problem instead of
computation (Case, 1992; Fleischner & Manheimer, 1997). According to Houchins, Shippen,
and Flores (2006), mathematical fluency is the effortless and automatic ability to perform
math operations (p. 331). Unfortunately, many students with learning disabilities are not
fluent in basic mathematical operations, particularly in multiplication (Cawley, Parmar, Yan,,
& Miller, 1996).

48

Two typical instructional methods have been used to teach multiplication fluency to students
with learning disabilities. The instructional methods are Constant Time Delay (CTD), a
behavioral strategy, (Cybriwsky, & Schuster, 1990; Koscinski, & Gast, 1993; Mattingly &
Bott, 1990; Morton & Flynt, 1997) and Strategic Instructional Model (SIM), a cognitive
strategy (Mercer, Jordan, & Miller, 1996). Both CTD and SIM have been effective in teaching
multiplication facts to students with learning disabilities. Each method is briefly described
below.
Constant Time Delay
CTD provides teachers with a systematic, data-based method of using flashcards to teach
multiplication facts. The method transfers stimulus control from a controlling prompt (e.g.,
teachers verbal prompt) to a natural cue (e.g., multiplication fact). Mattingly and Bott (1990)
used CTD to teach multiplication facts to elementary students with learning disabilities, mild
intellectual disabilities, and emotional behavioral disorders. As a result of the intervention, all
of the students demonstrated a high rate of correct verbal responding (98.3%). The students
maintained their performance up to four weeks after training and generalized their oral
performance to pencil-paper tasks consisting of multiplication facts that were written
vertically rather than horizontally as presented on time delay cards.
Cybriwsky and Schuster (1990) used CTD to teach fifteen multiplication facts to a ten-yearold student with learning and behavior disabilities. The student demonstrated mastery across
teachers, settings, and materials with different orientations, appearance and color. CTD
resulted in nearly errorless learning. Koscinski and Gast (1993) replicated Cybriwsky and
Schusters (1990) findings with five elementary students with learning disabilities. The
researchers measured generalization using vertical orientation rather than horizontal,
reversing factors, and presenting paper-pencil tasks. The procedure was near errorless with a
student-error rate of only 4%. The students transferred their multiplication skills to
independent paper-pencil tasks, demonstrating generalization to typical classroom tasks.
Strategic Instruction Model
SIM differs from CTD in that there is an emphasis on the students cognitive processing. The
purpose of the SIM is to build independent strategy use and self-regulation through explicit
instruction (Lenz, Ellis & Scanlon, 1996). This model has been used to teach math problem
solving and computation (Harris, Miller, & Mercer, 1995; Maccini & Ruhl, 2000; Mercer &
Miller, 1992b; Miller & Mercer, 1993a; Miller & Mercer, 1993b;). Mercer and Miller (1992a)
developed a SIM program based on this model for basic mathematical concepts. In addition to
the principles of SIM, one of the main instructional methods used in this program is the
concrete-representational-abstract (C-R-A) learning sequence. The C-R-A methodology
fosters conceptual understanding of mathematical operations before memorization of facts.
The concrete instructional phase involves the use of manipulatives to demonstrate the
meaning of multiplication. During the second phase, the teacher and students illustrate the
multiplication process by drawing lines to represent the numbers. The third instructional
phase is the abstract phase that involves computing facts to automaticity.
Mercer and Miller (1992b) found that the combination of SIM and the C-R-A sequence
resulted in accuracy and fluency over time for students with learning disabilities. The results
from field studies indicated that students with learning disabilities were able to acquire
computational skills across facts, solve word problems, and generalize skills across
examiners, settings, and tasks. The students performance improved from an average of 5
correct facts per minute to 14 correct facts per minute after instruction. The students
maintained the same level of accuracy ten days after instruction. Harris, Mercer, and Miller
(1995) replicated previous findings with second grade students with learning disabilities in
inclusive settings. The students rate and accuracy in computing multiplication facts increased
from a range of 1-4 digits correct per minute during baseline to a range of 11-14 digits per
minute. With regard to fluency, the increase for students with disabilities was similar to that of

49

students without disabilities. These students acquired multiplication skills at a

developmentally appropriate time.
Research has demonstrated that methods based on behavioral principles such as CTD, and
those based on cognitive behavioral principles, such as SIM, are effective in teaching math
facts. However, there is no literature regarding a comparison of the two methods. Therefore,
the purpose of this series of case studies was to compare CTD and SIM. Specifically,
maintenance and generalization of multiplication facts of students with learning disabilities
were examined.
Method
Research Design
The purpose of this article is to present a series of case studies which examined the influence
of two methods of multiplication fact instruction, CTD and SIM, with regard to maintenance
and generalization. Maintenance was defined the number of correct digits per minute written
when presented with previously taught multiplication facts. Maintenance was measured 1
week after instruction and 5 weeks after instruction. Generalization was defined as
computation of unknown multiplication facts. Generalization was measured in two ways: (a)
through a timed (1-minute) probe that included a set of unknown multiplication facts, and (b)
through an untimed probe that included a different set of unknown multiplication facts. This
article focuses on application of CTD and SIM instruction and their effects on the
performance of students with specific learning disabilities in the area of mathematics.
Setting and Participation Requirements
Participants were students with specific learning disabilities attending sixth grade in a major
southeastern city. The school was chosen based a recommendation by the district
administration. Students were selected based on their area of disability eligibility, the presence
of prerequisite math skills, and their knowledge of multiplication. Students whose area of
eligibility was listening comprehension were not considered since this would interfere with
probe administration and parts of instruction that were presented verbally. In order to
participate in the study, students met the following criteria as indicated by Mercer and Miller
(1992a) in the Strategic Math Series: (a) count to 81, (b) compute addition facts to 18, (c) add
single column sums to 81 without regrouping, and (d) copy 40 digits in 1 minute. Students
were also selected based on their lack of skill mastery with regard to multiplication facts. That
is, students needed a pool of at least thirty unknown multiplication facts. The range of
unknown multiplication facts was 30 to 50 multiplication facts. All of the students performed
at least three grade levels below their grade placement in reading, math, and writing. The
interventions took place during a thirty-minute period designated for remedial instruction.
This period was school-wide, not a special education initiative. The primary researcher
provided one-on-one instruction with each student for 15-20 minutes per session. The primary
researcher was a white female certified in special education, with 7 years of experience. The
instructor received professional development in both CTD and SIM through her teacher
preparation program and professional development workshops. She implemented both
instructional methods successfully with students with disabilities in her previous position as a
middle school resource teacher.
Instructional Procedures
SIM was implemented according to Mercer and Millers (1992a) Strategic math series:
Multiplication facts 0-8. CTD was conducted according to a modified version of procedures
outlined by Wolery, Ault, and Doyle (1992). All procedures were identical to Wolery et al.,
with the exception that students were told to write their answer instead of simply providing a
verbal response. Since SIM requires writing, this was an attempt to equalize time issues
across both methods.
Instructional Materials

50

Prior to instruction, students completed a multiplication test that included 100 multiplication
facts, factors 0-9. The multiplication facts that were missed were grouped into four
independent (no duplicated facts such as 6x8 and 8x6) and balanced groups of facts. To ensure
that CTD did not influence SIM, groups used within each type of instruction consisted of
facts that were less likely to influence the learning of other facts (for example, knowing 9x5
might lead to solving 9x6 by solving 45+9.). No strategies were taught within either method
that might have encouraged such problem solving, but efforts were made to minimize the
chance incidental learning. The four groups of facts were used for the two intervention phases
(ten facts for each condition) and the two sets of generalization probes (five facts for each
probe). Students writing fluency was also measured to ensure adequate motor skills to reach
criterion of writing 40 digits per minute with no more than two errors. Given 1 minute, the
students copied numbers written on a page.
The materials for CTD consisted of multiplication facts printed vertically in black ink on a 4by-6 inch index card with print that was approximately 2 inches in height. The order of the
flashcards was changed between each trial so that the order of presentation was not
predictable. In addition to the flashcards, instructional materials included a multiplication
sheet that corresponded to the flashcards. After verbally responding to the flashcards, the
students wrote the answer on the multiplication sheet. This modification of CTD materials
was to prepare the students for the written probes. The materials for fluency instruction
consisted of a sheet containing the target facts, written multiple times in a random order.
During SIM, the materials included a contract in which the teacher and student agreed to work
rigorously using strategies to master multiplication facts. The materials for lessons 1-3 were
paper plates, three- dimensional objects, and a worksheet with target multiplication facts
written vertically and horizontally. The materials for representational phase involved drawings
that were pre-printed on the lesson sheet and target multiplication facts written vertically and
horizontally. After instruction at the representational level, the DRAW (Discover the sign,
Read the problem, Answer, or draw tallies and/or circles and check your answer, Write the
answer) was introduced where the materials consisted of a sheet printed with the strategy. The
last phase of instruction involved fluency activities and the materials included facts written
repeatedly and in a random order. The materials also included a chart used to record student
progress after each activity. The probes for CTD and SIM consisted of multiplication facts
written repeatedly in random order.
Inter-rater Reliability
Treatment integrity was conducted during 25% of the lessons (Poling, Methot, & LeSage,
1995). Live observations were used to evaluate the instructors behaviors. A treatment
checklist for each intervention was used in order to ensure that procedures were carried out
correctly. A teacher was trained in using the treatment integrity checklists through
demonstration and practice. When the teacher completed a checklist with 100% accuracy,
treatment integrity checks began. Treatment integrity was calculated at 100% for the study.
Treatment Fidelity
Inter-rater reliability was conducted for 25% of all of the multiplication probes administered.
A teacher was trained through demonstration and practice in the scoring procedures and
reliability checks began after the teacher had scored a probe with 100% accuracy. The primary
researcher collected data on a daily basis and scored fluency probes. The trained teacher
scored the same multiplication probes. To calculate inter-rater reliability, the total number of
agreements between the teacher and the primary researcher were divided by the total number
of observations and this answer was multiplied by one hundred (Poling et al., 1995). Interrater reliability was calculated for CTD responses, independent written work during SIM,
fluency, and mastery probes. Inter-rater reliability was 100% for the study.

51

Case Study 1: Sam

Sams background
Sam was a 12 year-old African American male in the 6 th grade who qualified for special
education services with specific learning disabilities in the areas of mathematics computation,
reading decoding, and written expression. Sam also qualified for services through other health
impairments with a medical diagnosis of sickle cell anemia which interfered with his
educational performance due to frequent illness and fatigue. Sams cognitive ability was
within the average range (WISC-III, FS=89). Sam performed below grade level in the areas of
math computation (2:0), reading decoding (K:1), and written expression (2:0). Sam was an
outgoing middle school student who verbalized excitement about participating in instruction.
Sam reported that remembering his math facts was a problem and this caused difficulties
when completing math assignments.
CTD Instruction with Sam
Sam learned the first group of 10 multiplication facts through CTD instruction. Sam
expressed enthusiasm for learning multiplication facts. He reported being very pleased with
himself when he answered correctly. When Sam was unsure of an answer, he waited for the
instructors prompt. This resulted in repeated practice with correct responses. He reported that
he like CTD because instruction was fast-paced. Sam was absent on 4 occasions during
instruction and this was not unusual given his medical condition and as reported by his
resource teacher. Sam reached the criterion for proficiency (40 correct digits written on a oneminute multiplication probe over three consecutive trials). He reached criterion after 14
probes, ranging from 4 to 46 correct digits per minute. His mean performance for CTD
instruction was 26.07 correct digits per minute.
SIM Instruction with Sam
Five weeks after CTD instruction, Sam learned the second group of multiplication facts
through SIM instruction. Sam appeared to understand multiplication throughout each phase of
instruction, moving to each successive phase without re-teaching. Sam quickly learned and
used the DRAW strategy appropriately. Two facts were particularly difficult for Sam, 6x8 and
8x9. During the representational phase of instruction, when given the problem 6x8, Sam
solved the problem by adding the product of 5x8 to the product of 1x8 to arrive at the answer
48. He used the same procedures to solve 8x9. Instruction did not include explanation of the
distributive property. Despite his progress during SIM, Sam reported that he did not like this
kind of instruction because it took too long. He reported that he would rather learn using CTD
because it was faster. During SIM, Sam reached criterion after 19 probes ranging from 8-48
digits per minute. His mean performance for this condition was 29.63 correct digits per
minute.
Sams Performance
Table 1 presents a summary of Sams and other students performance. One week after
instruction in CTD, a multiplication probe was administered to check maintenance of his
skills. Sam wrote 22 correct digits per minute (dpm). Sam reported that he was disappointed
that he did not remember more of his facts after taking the first maintenance probe. Another
maintenance probe was administered five weeks after CTD instruction ended. Sam wrote 8
correct dpm. Sam remembered 2 of the 10 math facts and wrote correct digits for the same
fact and half of the correct digits for another fact. The instructor administered Generalization
probes including 5 unknown facts, one timed probe (1-minute) and a probe with no time limit.
Sam wrote 0 correct dpm when given the timed probe and 0 dpm when given the probe with
no time limit. Sam reported that he was finished with the untimed probe at 2 minutes. Sam
reported that he did not know those facts because he had not learned them previously. Next,
Sam learned the second group of 10 multiplication facts through SIM instruction. Sam
reached the criterion for proficiency (40 correct digits written on a one-minute multiplication
probe over three consecutive trials). One week after instruction in SIM, a multiplication probe
was administered to check maintenance of his skills. Sam wrote 38 correct digits per minute

52

(dpm). Sam reported that he was pleased with his performance. Another maintenance probe
was administered five weeks after SIM instruction ended. Sam wrote 20 correct dpm. Sam
wrote most of the digits automatically, without hesitation. He began using the strategy that he
had learned during SIM instruction, but ran out of time for this strategy to be useful within the
1-minute time limit The instructor administered Generalization probes including 5 unknown
facts, one timed probe (1-minute) and a probe with no time limit. Sam wrote 0 correct dpm
when given the timed probe and 42 dpm when given the probe with no time limit. Sam
reported that he was finished with the untimed probe at 5 minutes, 20 seconds. Sam used the
strategy that he had learned in SIM instruction to complete the unknown fact problems.

Table 1
Performance Summary

CTD
Sam
Kate
Jerry
Cindy
SIM
Sam
Kate
Jerry
Cindy

Maintenance
1-week
dpm
22
32
16
36
Maintenance
1-week
dpm
38
40
40
36

Maintenance
5-week
dpm
8
16
18
6
Maintenance
5-week
dpm
20
19
33
20

Generalization
1-minute
dpm
0
9
4
0
Generalization
1-minute
dpm
0
40
40
4

Generalization
Untimed
Digits/min:sec
0 / 2:00
7 / 2:54
44 / 2:30
0 / 1:15
Generalization
Untimed
Digits / min:sec
42 / 5:20
50 / 1:45
50 / 2:25
50 / 5:20

Comparison of Sams CTD and SIM Performance

Sam learned 2 groups of multiplication facts (10 in each) and reached proficiency with both
instructional methods. However, there was a difference in how those groups were maintained
over time. Sams 1-week maintenance performance decreased with both methods, the
decrease was significantly lower after CTD (52% lower) than after SIM (21% lower). Sams
5-week performance decreased again for both methods, but the decrease was lower after CTD
(83% lower) than after SIM (58% lower). The difference between Sams performance on the
generalization probes favored SIM instruction. Sams learning during the CTD condition did
not generalize to the unknown facts. Sam did not write any digits correctly for either of the
probes. However, Sams knowledge of the strategy appeared to be useful in generalizing skills
to the unknown facts. Sam did not write any correct digits with the timed probe. However,
when given unlimited time, Sam wrote 42 dpm. Sam demonstrated his use of the strategy
learned in SIM instruction by drawing the problems and solving them correctly.
Case Study 2: Kate
Kates background
Kate was an 11 year-old African American female in the 6 th grade who qualified for special
education services with specific learning disabilities in the areas of mathematics reasoning.
Kates cognitive ability was below the average range (C-TONI comp=83). She performed

53

below grade level in the areas of math computation (3:1), reading decoding (3:1), and written
expression (2:1). Although Kate qualified for services in the area of mathematics reasoning,
current assessment data were not available in that area. Kate appeared friendly and was
cooperative throughout the study. She reported that math was her most difficult subject and
remembering math facts was difficult. Kate was interested in learning new ways to learn and
remember math facts and reported that she was happy to participate.
CTD Instruction with Kate
Kate learned the first group of 10 multiplication facts through CTD instruction. She was
present for every scheduled session. Kates mastery of facts increased steadily over sessions.
She demonstrated patience, waiting for the instructors prompt when she was unsure of an
answer. Kate appeared engaged and eager to participate throughout each of the sessions. Kate
reached the criterion for proficiency (40 correct digits written on a one-minute multiplication
probe over three consecutive trials). Kate reached criterion after 10 probes, ranging from 10 to
49 correct dpm. Her mean performance for this condition was 29.8 correct dpm.
SIM Instruction with Kate
Five weeks after CTD instruction, Kate learned the second group of multiplication facts
through SIM instruction. Each instructional phased was completed without the need for rereaching. Kate appeared to like SIM instruction as evidenced by reports that she thought it
was easier to remember her facts. She liked using the DRAW strategy for facts that she could
not quite remember. She also reported that she needed more time to remember some of the
math facts and that she liked that there was no time limit during instruction as in CTD
instruction. Similar to Sam, Kate discovered an alternate way to solve facts problems that she
did not remember. Her grouping of facts also included 8x6 and 8x9. She had mastered 8x5 and
8x8 earlier in SIM instruction. Rather than using the DRAW strategy, she added the product of
5x8 to the product of 1x8 to arrive at the answer 48. She used the same procedures to solve
8x9. This was not a part of the strategic instruction program. During SIM instruction, Kate
reached criterion after six probes, ranging from 26 to 46 dpm. Her mean performance for this
condition was 36.83 correct dpm.
Kates Performance
Table 1 (above) presents a summary of Kates and other students performance. One week
after instruction in CTD, a multiplication probe was administered to check maintenance of her
skills. Kate wrote 32 correct dpm. Kate appeared pleased with her performance. Another
maintenance probe was administered five weeks after CTD instruction ended. Kate wrote 18
correct dpm. The instructor administered Generalization probes including 5 unknown facts,
one timed probe (1-minute) and a probe with no time limit. Kate wrote 9 correct dpm when
given the timed probe and 7 dpm when given the probe with no time limit. Kate reported that
she was finished with the untimed probe at 2 minutes and 54 seconds. Next, Kate learned the
second group of 10 multiplication facts through SIM instruction. She reached the criterion for
proficiency (40 correct digits written on a one-minute multiplication probe over three
consecutive trials). One week after instruction in SIM, a multiplication probe was
administered to check maintenance of her skills. Kate wrote 40 correct dpm. Kate appeared to
be satisfied with her performance. Another maintenance probe was administered five weeks
after SIM instruction ended. Kate wrote 19 correct dpm. The instructor administered
Generalization probes including 5 unknown facts, one timed probe (1-minute) and a probe
with no time limit. Kate wrote 40 correct dpm when given the timed probe and 50 dpm when
given the probe with no time limit. She reported that he was finished with the untimed probe
at 1 minute, 45 seconds. Kate used the strategy that she had learned in SIM instruction to
complete the unknown fact problems.
Comparison of Kates CTD and SIM Performance
Kate learned 2 groups of multiplication facts (10 in each) and reached proficiency with both
instructional methods. However, there was a difference in how those groups were maintained

54

over time. Kates 1-week maintenance performance decreased with both methods, the
decrease was significantly lower after CTD (45% lower) than after SIM (13% lower). Her 5week performance decreased again for both methods, but the decrease was lower after CTD
(67% lower) than after SIM (59% lower). The difference between Kates performance on the
generalization probes favored SIM instruction. Her learning during the CTD appeared to
generalize to unknown facts to some degree. She wrote 9 correct dpm during the timed probe
and 7 correct dpm during the untimed probe. However, Kates knowledge of the strategy
appeared to be more useful in generalizing skills to the unknown facts. She wrote 40 correct
dpm with the timed probe and , when given unlimited time, wrote 50 correct digits. Kate
demonstrated her use of the strategy learned in SIM instruction by drawing the problems and
solving them correctly.
Case Study 3: Jerry
Jerrys background
Jerry was an 11 year-old African American male in the 6 th grade who qualified for special
education services with specific learning disabilities in the areas of mathematics computation
and reading decoding. Jerrys cognitive ability was within the average range (Stanford-Binet,
Comp=85). Jerry performed below grade level in the areas of math computation (3:5) and
reading decoding (2:5). Jerry was a quiet and reserved middle school student who reported
interest in participating in instruction. Jerry reported having difficulty completing math
problems because he did not know all of his multiplication facts.
CTD Instruction with Jerry
Jerry learned the first group of 10 multiplication facts through CTD instruction. Jerry was
present for every scheduled session. He began mastering facts immediately after presentation
using a zero-second delay. There were only two instances of teacher prompts during
presentation with the 4-second delay. Although Jerry mastered facts quickly, he reported that
is was hard to remember and that he didnt like that the answers were hidden on the back of
the flashcard. Jerry reached the criterion for proficiency (40 correct digits written on a oneminute multiplication probe over three consecutive trials). Jerry reached criterion after five
probes, ranging from 16 to 40 correct dpm. His mean performance for this condition was 31.6
correct dpm.
SIM Instruction with Jerry
After 5 weeks of CTD instruction, Jerry began SIM instruction with the second group of facts.
He completed each instructional phase and there was no need for re-teaching. Jerry mastered
facts quickly and used the DRAW strategy on several probes when he did not automatically
remember facts. Jerry reported that he like SIM instruction because it was easier to remember
facts. Jerry reached criterion after nine probes, ranging from 18 to 50 dpm. His mean
performance for this condition was 30.89 correct dpm.
Jerrys Performance
Table 1 (above) presents a summary of Jerrys and other students performance. One week
after instruction in CTD, a multiplication probe was administered to check maintenance of his
skills. Jerry wrote 16 correct dpm. Jerry appeared frustrated with his performance after the
probe and reported that he wished he could remember more of his facts after taking the first
maintenance probe. Another maintenance probe was administered five weeks after CTD
instruction ended. Jerry wrote 18 correct dpm. The instructor administered Generalization
probes including 5 unknown facts, one timed probe (1-minute) and a probe with no time limit.
Jerry wrote 4 correct dpm when given the timed probe and 44 dpm when given the probe with
no time limit. Jerry reported that he was finished with the untimed probe at 2 minutes and 30
seconds. Next, Jerry learned the second group of 10 multiplication facts through SIM
instruction. Jerry reached the criterion for proficiency (40 correct digits written on a oneminute multiplication probe over three consecutive trials). One week after instruction in SIM,
a multiplication probe was administered to check maintenance of his skills. Jerry wrote 40

55

correct digits per dpm. Another maintenance probe was administered five weeks after SIM
instruction ended. Jerry wrote 33 correct dpm. The instructor administered Generalization
probes including 5 unknown facts, one timed probe (1-minute) and a probe with no time limit.
Jerry wrote 40 correct dpm when given the timed probe and 50 dpm when given the probe
with no time limit. Jerry reported that he was finished with the untimed probe at 2 minutes, 25
seconds. Jerry used the strategy that he had learned in SIM instruction to complete the
unknown fact problems.
Comparison of Jerrys CTD and SIM Performance
Jerry learned 2 groups of multiplication facts (10 in each) and reached proficiency with both
instructional methods. However, there was a difference in how those groups were maintained
over time. Jerrys 1-week maintenance performance decreased with facts learned during CTD
(60% decrease), but not after SIM (20% decrease). Jerrys 5-week performance decreased for
both methods, but the decrease was lower after CTD (55% lower) than after SIM (34%
lower). The difference between Jerrys performance on the generalization probes favored SIM
instruction. Jerry wrote 4 correct dpm on the first generalization probe. However, when given
the untime probe, Jerrys performance was surprisingly higher with 44 correct digits written in
about 2 minutes. Jerrys knowledge of the strategy appeared to be useful in generalizing skills
to the unknown facts. Jerry wrote 40 correct dpm with the timed probe. His performance
increased to 50 correct digits written in about 2 minutes.
Case Study 4: Cindy
Cindys background
Cindy was an 11 year-old African American female in the 6 th grade who qualified for special
education services with specific learning disabilities in the area of mathematics reasoning.
Cindys cognitive ability was below the average range (WISC-III FS=76). She performed
below grade level in the areas of math computation (3:2), reading decoding (3:2), and written
expression (3:2). There were current data regarding math reasoning although this was her area
of eligibility. The resource teachers reported being most concerned about her performance in
math. They reported that she had a particularly difficult time learning, demonstrating memory
problems to a greater extent than other peers with specific learning disabilities.
CTD Instruction with Cindy
Cindy learned the first group of 10 multiplication facts through CTD instruction. Cindy was
present for every scheduled session. Cindy made slow progress at the beginning of
instruction. She mastered 2 facts and maintained that level of performance for 7 sessions.
Cindy was impatient during instruction as evidenced by quick incorrect responses rather than
waiting for the instructors prompt. Her progress was more sporadic than the other students in
that one say she would appear to have mastered a fact one day but not the next. During the
last 5 probes before the criterion, there was a large increase in her performance and this
increase continued until the criterion was reached. Cindy reached the criterion for proficiency
(40 correct digits written on a one-minute multiplication probe over three consecutive trials).
Cindy reached criterion after 16 probes ranging from 2 to 44 correct dpm. Her mean
performance for this condition was 17.5 correct dpm.
SIM Instruction with Cindy
Five weeks after CTD instruction, Cindy learned the second group of multiplication facts
through SIM instruction. Each instructional phased was completed without the need for rereaching. Cindy did not appear to like SIM instruction. She learned the DRAW strategy
without difficulty and used it appropriately when she could not remember a fact. Cindy
reported that she liked SIM instruction better than CTD because the DRAW strategy provided
her with a plan that she could use to remember facts. Cindy reached criterion after 13 probes,
ranging from 0 to 42 dpm. Her mean performance for this condition was 23.69 correct dpm.

56

Cindys Performance
Table 1 (above) presents a summary of Cindys and other students performance. One week
after instruction in CTD, a multiplication probe was administered to check maintenance of her
skills. Cindy wrote 36 correct dpm. Cindy appeared pleased with her performance. Another
maintenance probe was administered five weeks after CTD instruction ended. Cindy wrote 6
correct dpm. The instructor administered Generalization probes including 5 unknown facts,
one timed probe (1-minute) and a probe with no time limit. Cindy wrote 0 correct dpm when
given the timed probe and 0 correct digits when given the probe with no time limit. Cindy
reported that she was finished with the untimed probe at 1 minutes and 15 seconds. Next,
Cindy learned the second group of 10 multiplication facts through SIM instruction. She
reached the criterion for proficiency (40 correct digits written on a one-minute multiplication
probe over three consecutive trials). One week after instruction in SIM, a multiplication probe
was administered to check maintenance of her skills. Cindy wrote 36 correct dpm. Another
maintenance probe was administered five weeks after SIM instruction ended. Cindy wrote 20
correct dpm. The instructor administered Generalization probes including 5 unknown facts,
one timed probe (1-minute) and a probe with no time limit. Cindy wrote 4 correct dpm when
given the timed probe and 50 correct digits when given the probe with no time limit. She
reported that he was finished with the untimed probe at 5 minute, 20 seconds. Cindy used the
strategy that she had learned in SIM instruction to complete the unknown fact problems.
Comparison of Cindys CTD and SIM Performance
Cindy learned 2 groups of multiplication facts (10 in each) and reached proficiency with both
instructional methods. Although her performance decreased with both methods, her
performance was slightly lower with the CTD condition (18% lower) than with the SIM
condition (14% lower). Her 5-week performance decreased again for both methods, but the
decrease was lower after CTD (86% lower) than after SIM (52% lower). The difference
between Cindys performance on the generalization probes favored SIM instruction. Her
learning during the CTD did not appear to generalize to unknown facts, writing 0 correct
digits on both timed and untimed probes. However, Cindys knowledge of the strategy
appeared to be more useful in generalizing skills to the unknown facts. She wrote 4 correct
dpm with the timed probe and , when given unlimited time, wrote 50 correct digits. Cindy
demonstrated her use of the strategy learned in SIM instruction by drawing the problems and
solving them correctly.
Discussion
Instruction and Performance
This investigation was designed to examine the differences between CTD and SIM with
regard to maintenance and generalization of multiplication facts. Consistent with previous
studies, the students maintained their learning (Mattingly & Bott, 1990). However, this study
measured maintenance both one and five weeks after instruction rather than three weeks in
other studies. This study extended previous SIM and CTD findings with regard to
generalization, defining it as computation of untaught multiplication facts. Mattingly and Bott
(1990) and Cybrinsky and Schuster (1990) defined generalization as the transfer of verbal
identification to written tasks. Koscinski and Gast (1993) defined it as the ability to identify
the same previously taught facts using a different orientation and through completion of
written multiplication facts. Mercer and Miller (1992b) defined generalization as the ability to
use previously taught facts in other mathematical algorithms, across settings, and with
different examiners.
This study demonstrated a difference between CTD and SIM with regard to generalization
and maintenance. After SIM, two students wrote more correct digits during the timed
generalization probe and all of the students wrote more digits during the untimed probe.
These increases were significantly higher with increases of 39 and 43 more digits. Three of
the four students maintained a higher level of fluency one week after the SIM condition with

57

increases as high as 16 and 24 more dpm. All of the students maintained a higher level of
fluency five weeks after the SIM condition, with increases as high as 15 dpm.
Student Background, Behavior, and Perceptions
The students all had similar backgrounds with regard to age, grade, ethnicity, achievement,
special education eligibility, and amount of special education services. The students
behaviors were consistent with their performance in that engagement and ease of following
procedures was consistent with the number of probes completed before mastery. For example,
Cindy had great difficulty during CTD, frequently impulsively responding with incorrect
answers rather than waiting for the teachers prompt. This frequent practice with incorrect
responses may have contributed to her rate of progress. There was a surprising finding in the
students perceptions of the CTD and SIM. All of the students but Sam perceived SIM
instruction as the better instructional method. This was surprising because Sam performed
much better during SIM instruction. He discovered an alternate way to solve unknown
multiplication facts through the distributive property. He also used the DRAW strategy during
generalization which led to a significant increase in his performance on the untimed probe.
Despite his increased performance and demonstration of understanding of multiplication, he
perceived CTD as better way to learn because it was fast-paced. This did not appear to affect
his performance and it is not known how the perceptions of the other students influenced their
performance.
Implications of Findings
The students in this study were older than the students involved in most of the previous
research (Mattingly & Bott, 1990; Cybrinsky & Schuster, 1990; Koscinski & Gast, 1993;
Harris et al., 1995) and had a history of failure. A concern regarding the students age might
be the amount of instructional time devoted to learning basic multiplication facts rather than
other mathematical skills (Cawley, Parmar, Yan, & Miller, 1996). However, ten to fifteen
minutes outside of regularly scheduled math instruction for as few as five days produced an
increase in proficiency and fluency. It is realistic that middle school teachers could devote this
amount of time to instruction (Zigmond & Baker, 1990). Although both interventions were
implemented individually, CTD can be used in a group format (Keel & Gast, 1992; Keel,
Slaton, & Blackhurst, 2001; Koscinski & Hoy, 1993) and SIM was designed for group
instruction (Mercer & Miller, 1992a). Group implementation would be a more efficient use of
time.
The most significant implication for the results of this study was the effects of SIM on
maintenance and generalization. The students maintained greater levels of fluency on the 5week maintenance measures. According to cognitive theory, learning occurs through a process
involving attention, perception, encoding information for storage, and retrieving previously
learned information (Case, 1992; Pressley, 1995). Perhaps manipulating objects and using
visual representations increased students attention and built a more elaborate mental
framework for multiplication, leading to more efficient storage and retrieval of information.
Other evidence that the students demonstrated greater understanding of multiplication was
that they discovered other strategies for solving multiplication problems. During SIM, when
given the problem 6x8, two students added the product of 5x8 to the product of 1x8 to arrive
at the answer 48. Two other students solved 8x9 using the same procedure. Perhaps the
manipulation of objects and use of visual representations led to increased understanding and
use of the distributive property.
The increased generalization performance might have been due to the students strategy-use
during the SIM condition. It was evident that the students used this strategy during the
generalization probes because they translated the numerical problems into pictures on the
timed generalization and untimed generalization probes. In addition to maintaining their
knowledge of multiplication facts, the students applied their strategic knowledge to another
task. The use of the DRAW strategy for unknown multiplication facts took more time, but led

58

to greater accuracy. This may explain the students increase in accuracy when there was no
time limit for completion.
Limitations
The limitations of this study are in the area of external validity, the degree to which the results
can be generalized beyond the experimental conditions (Kazdin, 1982). First, the students
who participated in this study were similar with respect to grade level, ethnicity, disability,
amount of time served in special education, and level of achievement. It is not known whether
the same results would be obtained with characteristically different students. A further
limitation of this study is the generality of the behavior change agent (Kazdin, 1982). The
primary researcher delivered instruction rather than the students math teacher. This may have
increased the treatment integrity, but the results may be less practical or applicable. Also, the
likelihood that this type of instruction will continue to be implemented by the students
teacher is probably small since she did not experience the students progress firsthand.
Implementation of these methods by a teacher in a typical classroom situation would
strengthen the results. In order to bridge the gap between research and practice, appropriately
trained teachers should implement research procedures in a typical classroom situation.
Finally, the amount of time employed for the maintenance condition is a limitation. The study
was conducted during the second semester of the school year and maintenance measures up to
5 weeks ensured that students finished both conditions by the end of the school year. A longer
maintenance condition would have increased validity and in practice, maintenance would be
expected to be much longer than five weeks.
Future Research and Conclusion
Further research is needed to investigate how long the treatment effects are maintained.
Measurement of maintenance each week for several weeks might provide more practical
maintenance information. Also, further research may be needed in order to investigate
whether and/or how much practice is needed to maintain the treatment effects over time.
Further investigation of generalization is also needed. Although generalization of
multiplication skills to untaught facts was measured, this study did not involve programmed
instruction for generalization. This is a component of other programs following SIM (Deshler,
Schumaker, Harris, & Graham, 1999; Schmidt, Deshler, Schumaker, & Alley, 1989). The
generalization measures in this study did not extend to problem solving and real world
application of skills as called for by the National Teacher of Mathematics Standards (2000).
Future research should involve instruction and measurement in this area.
CTD and SIM have demonstrated improvements in the mathematical performance of students
with LD (Cybrinsky & Schuster, 1990; Koscinski & Gast, 1993; Harris et al., 1995; Mattingly
& Bott, 1990; Mercer & Miller, 1992b ; Miller & Mercer, 1993a; Miller & Mercer, 1993b).
Both teaching strategies are effective, but SIM may have a greater impact on the maintenance
and generalization of skills. It is important that teachers know which strategies improve the
retention of math skills for students with LD, so that these students have a greater likelihood
of academic success.
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AGGRESSIVE BEHAVIOUR AMONG SWAZI UPPER PRIMARY AND JUNIOR

SECONDARY STUDENTS: IMPLICATIONS FOR ONGOING EDUCATIONAL
REFORMS CONCERNING INCLUSIVE EDUCATION
Lawrence Mundia,
University of Brunei Darussalam
Swaziland is planning to introduce inclusive education as part of
education for all. The innovation may benefit learners with emotional
and behavioural disorders (EBD). A purposive teacher sample (N =
47) was used to generate and identify behavioural problems that are
prevalent in Swazi schools. Aggression was one of the many conduct
disorders cited. Using a purposive sample of 300 students, the study
found aggression to be indeed a problem among upper primary and
junior high school students. The type of school attended was found to
be correlated with aggression. Students with moderate to severe
aggressive behaviours were found on all categories of learners used in
the study. However a significant difference in the number of aggressive
students was obtained on only two variables, the type of school students
attended and the kind of guardians students lived with at home. There
were more students with aggressive tendencies in government schools
than other types of schools. Furthermore, aggressive students lived
mainly with both biological parents. Teachers rely mainly on
punishment to deal with aggressive students. The findings have
implications for the ongoing educational reforms concerning inclusive
education in Swaziland. Three major recommendations were made to

61

address them. Teacher skills in handling aggressive cases need to be

enhanced by both preservice and inservice courses. School counselors
need to be appointed to provide suitable psychological intervention.
Finally, a more detailed investigation using qualitative procedures was
recommended to gain in-depth insights into the problem and its
solutions.
The need to study students behavioural disorders is increasing in the world these days as
more psychotic incidents of students fatally wounding or killing teachers and fellow pupils in
schools for various reasons are being reported by the news media. Such reports portray
teaching as an unsafe, dangerous and security-risk profession. Students with emotional and
behavioural disorders (EBD), learning disabilities (LD), and those who live under at-risk or
difficult circumstances constitute newer categories of exceptional learners in Swaziland.
Although these students tend to be the majority in exceptional populations of learners in
Swaziland and other developing countries, their education is usually accorded a low status
along with the education of those who are gifted / talented. For example there are no special
schools and centres for EBD, LD, the at-risk, and gifted students in Swaziland and many
developing countries. On the contrary top priority is often accorded to the education of
students in the older traditional categories of disabilities (blind, deaf, physical, intellectual,
and communication) and there are many special schools and centres for learners with such
special needs in most developing countries. Consequently as a result of these problems there
are few or no incidence statistics about people with EBD, LD, or those living in unusual
conditions in some developing countries such as Swaziland. The objectives of the present
study were to:

Determine the student behavioural problems prevalent in Swazi upper primary and
junior secondary schools.
Measure the relationship between aggression and selected demographic variables.
Assess the nature and extent of student aggression.
Find out if there are differences in aggression between various categories of students.
Identify the strategies teachers frequently use to manage student behaviour problems.

Types of Aggressive Behaviour

There are many different kinds of behavioural disorders. Aggression is just one of the several
known categories of conduct problems. The behavioural disabilities that are related to
aggression can be divided into two main groups: verbal and physical. Verbal aggression
includes acts such as using insulting language, displaying anger, threatening, swearing, and
being sarcastic, all in order to cause emotional or psychological pain. On the other hand
physical aggression aims to cause bodily damage and includes bullying, destructing,
vandalism, gangsterism and fighting. According to Shaffer (2002) an aggressive act is any
form of behaviour designed to harm or injure a living being. In aggression, the desire to harm
is intentional rather than accidental (Sdorow, 1995; Matlin, 1998). Longitudinal research on
the long-term stability of aggression shows that the trait is a reasonably stable attribute.
However research also indicates that the rate of physical aggression (fighting) tends to decline
from middle childhood through adolescence (Shaffer, 2002). Aggression is different from and
should not be confused with rough-and-tumble play that does not have any harmful intent
(Humphrey and Smith, 1984; Shaffer, 2002). The following are some of the numerous types
of aggression commonly found in the literature.
Relational aggression (also known as social aggression). This occurs where a person,
usually a female, behaves maliciously with the intention of damaging an adversarys selfesteem, friendship, or social status (Shaffer, 2002). Other forms of relational aggression
include: snubbing or ignoring another person to make him / her feel bad; not talking with a
person following an argument; and spreading malicious gossip / lies about others (Shaffer,

62

2002). An example of relational aggression happened in Brunei Darussalam when a teenage

girl gave a false story accusing a man of raping her (Ezam, 2003). Relational aggression is
most common among females.

Verbal abuse (nonphysical aggression). The examples of this form of emotional or

expressive aggression include name-calling, teasing, quarreling, extortion, intimidating,
vicious gossiping, and cruel rumour campaigns (Christie and Christie, 1999; Nicholson &
Ayer, 1997). The intention here is to harm or injure another persons feelings indirectly.

Physical aggression. There are many examples of this form of hostile aggression that
include, but are not limited to bullying, kicking, molesting, harassing, biting, hitting, pushing,
and torturing. Other examples of hostile aggressives are street gangsters, school bullies, and
children who repeatedly attack their peers (Shaffer, 2002). Shaffer adds that the incidence of
bullying by school age girls occurs just as frequently as is true for boys. Habitual bullies
however aggress mainly those who are provocative, passive, weak, and socially isolated /
withdrawn (Olweus, 1993). Violence is used to cause destruction and the aggression is both
direct and overt.

Retaliatory (reactive) aggression: making an attack in return for a similar attack

occurs where a person behaves aggressively when there is a real or imagined provocation
from another or other people (Shaffer, 2002). This is often done in form of self-defense or
revenge.

Instrumental (proactive) aggression: occurs when a person behaves aggressively, not

necessarily, to revenge, but to get a reward to satisfy specific personal goals such as gaining
access to a certain object, space, or privilege and the aggressor is quite confident that
aggression will pay off (Shaffer, 2002; Mussen, Conger, Kagan, & Huston, 1984). An
example of this type of aggression are bullies who beat up other kids because they get payoffs
of various types from their actions.
Causes of Aggressive Behaviour
There are many possible causes of aggression in humans. The causes can, however, be
divided into two broad categories: biological (chromosomal, genetic and hormonal), and
environmental (classical and operant conditioning, social learning or modeling, child-rearing
practices, parental / teacher leadership style, and reinforcements). The following are examples
of some casual factors from this wide range of sources.

Biological factors. Although biology is implicated in the causation of human

aggression, many studies on this issue have had either inconclusive or inconsistent results
(Pinel, 1990). For instance the inconsistent evidence that testosterone affects the aggressive
behaviour of humans is, according to Pinel (1990), attributable to two factors. First, hormones
have less of an effect on human aggression than they do on aggression in other species.
Second, the tests of aggression that have been used to study human aggression are markedly
different from those that have proven successful in the study of aggression in other species
such as rats. Despite this limitation a few points can be noted from sources such as Pinel
(1990) about the role of biological factors in human aggression. First, studies of human
patients in clinical settings indicate that brain stimulation can elicit aggressive affect. Second,
the stimulation of the lateral hypothalamus has been shown to elicit predatory, defensive and
social aggression in all species. Third, the fact that social aggression in many species occurs
more frequently between male than between females is often attributed to the organizational
and activation effects of testosterone. Biologically, males are more aggressive physically and
verbally than females (Carlson,1987; Mussen, Conger, Kagan, & Huston, 1987). However the
tendency for boys to act more aggressively than girls is least in toddlers (Shaffer, 2002).
Females use more social (relational) aggression than overt aggression. Fourth, those who

63

advocate psychosurgery for the treatment of human aggression usually recommend lesions to
the amygdala. Fifth, it is possible that violent criminal behavior is hereditary because it tends
to run in families (Matlin, 1998).

Individual characteristics. The main possible contributing factors to aggression here

include having a difficult temperament, inappropriate social skills, misinterpreting other
peoples behaviour as hostile, and inability to find nonaggressive solutions to conflicts
(Salvin, 1994).

Home and school environments. The possible source or cause of aggressive

tendencies here is the negative influence of parents and teachers whose parenting and
leadership styles are dictatorial, coercive, or oppressive (Mwamwenda, 1995). Children
model these undesirable aggressive behaviours. Out-of-control children are typically reared in
coercive home environments (Shaffer, 2002). In addition, factors such as being cold and
rejecting, ignoring aggression among children, constant or erratic use of physical punishment
to control aggression, nuturing aggressive tendencies, high permissiveness toward aggressive
acts, and low punitiveness to aggressive behaviours can all facilitate the development of
aggression among children (Shaffer, 2002). Shaffer further says that child rearing in low
income families encourages violence in three ways: encouraging children to respond forcibly
to provocations; applying physical punishment such as spanking; and lack of parental
monitoring of children.

Peer influence. Making friendship with antisocial peers or belonging to deviantoriented peer groups whose members have antisocial attitudes and behaviours can lead to the
development of aggressive tendencies through modeling violent peers.

Exposure to media violence. A lot has been researched and written on this matter.
Many studies have confirmed the contribution of the electronic media (television, video and
internet) to the development of aggression and violence among young people from infancy to
adolescence (Shaffer, 2002). Young people love watching too much action packed violent
programs on television, video and internet. They also like playing violent television, video
and internet include Meeky Mouse, Akira, Spyderman, Mutant Ninja Turtles, Counter Strike,
Mortal Kombat, Batman, Karate, boxing, and wrestling. Many young people see aggressive
figures in these brutal programs as their heroes. They model their aggressive behaviours and
get reinforced vicariously while watching or playing the program / game on the television,
video, or internet.

Community and social factors. Tolerance and acceptance of aggression and violence
in the community or society increase the likelihood that children brought up in these contexts
will become aggressive and violent. This is because aggressive behaviour is largely learned
and maintained in a manner similar to the other learned behaviours (Craig, 1980). According
to Shaffer (2002) aggression is socialised in three main ways. First, parents play rougher with
sons than with girls. Second, parents discourage daughters aggression more than sons
aggression. Third, physically rough play is part of the androgynous gender role.
Prevention of Aggressive Behaviour
Aggression has many psychological effects and social costs on both the perpetrator and
victim. For instance the aggressor may be isolated due to peer rejection, have no long term
friend(s), and be expelled from school. The victim looses freedom, forfeits self assertion,
becomes submissive and lives under fear. Aggression can disrupt the schools educational
processes and disturb group and intergroup relationships in the school community. Because
of its many adverse impacts, aggression should be prevented or minimized in all social
contexts (home, school, and work). The best programs to reduce aggressive behaviours are
those which are preventative and family-focused. Parents and teachers can reduce aggression

64

by removing aggressive toys, videos, and games from the playrooms thereby creating non
aggressive environments (Shaffer, 2002). Aggression can be reduced by addressing most of
the non biological factors that cause it. Parents and teachers can, for example, also control the
type of programs and games children watch and play on television, video and internet at home
and school. Unfortunately most parents and teachers in developing countries are still not very
computer literate and can not effectively use programs or applications such as Stop Pop Up
that can block access to unwanted internet sites with aggression, violence, sex or pornography
(Lefrencois, 2001). Although aggression can not be reduced to zero, there are many
procedures that can decrease it significantly. These include the cognitive behaviour
modification scheme, schedules of reinforcement and behaviour shaping under operant
conditioning, the aggression replacement training, ART model (Glick, 1996), and the whole
school approach to bullying (Olweus, 1993). Anti-violence intervention programs in schools
have been shown to be effective as early as kindergarten (Shaffer, 2002).
Method
Design
The study adopted the field survey approach to investigate the problem. Field survey research
has many limitations which are known by both researchers and users of research results. For
instance, the presence of the researcher during data collection (by interview, observation or
questionnaire) may have effects that can sensitise the research participants to give socially
desirable responses to research items. In addition, the outcomes of a survey study might not
show cause-and-effect relationship among the variables probed. Several ethical measures and
precautions were taken during the conduct of the study to reduce researcher effects. Despite
the weakness, the rationale for using the field research method was three-fold: first, to involve
as many students as possible in exploring the problem; second, to give on-the-spot assistance
to research participants who needed help about completing the research instrument; and third,
to generate research questions or hypotheses for further detailed investigation.
Samples
The study used two nonprobability samples: teachers and students. The purposive teacher
sample consisted of 47 serving and highly experienced teachers. The purpose of this sample
was to generate and identify behavioural problems that were deemed to be prevalent in Swazi
primary and secondary schools. The teacher sample consisted of 20 males and 27 females.
Most of them taught in primary schools (28) while the rest (19) were secondary school
teachers. They represented both rural schools (26) and urban schools (21). All taught at
coeducation schools. Each had a diploma qualification in education. The teachers age ranged
from 25 to 54 (mean = 34.86; SD = 6.93). Their teaching experience ranged from 5 to 20
years (Mean = 11.50; SD = 4.76).
According to the last education census statistics, Swaziland has about 539 primary schools
with 213,041 students and 51 junior high schools with 4,943 students (Central Statistics
Office, 2000). The study could not use all these schools and students due to lack of time and
other constraints. Instead, a sample of 300 students was selected purposively from 15 schools
for use in the study. There were only three criteria for inclusion of schools and students in the
study sample. First, research participants were drawn from schools with ease of access in
terms of transport. Second, students were recruited from a variety of schools (upper primary,
junior secondary , urban and rural schools, and government, mission and private schools) to
have a wide range of opinions on the research problem. Third, both genders were represented
in the study. The student sample consisted of an equal number of males (150) and females
(150). They were in both rural schools (170) and urban schools (130). The students
represented three types of schools: government (165); church / mission (86); and private (49).
Of the 300 students, 141 were in upper primary school while 159 were in junior secondary
school.They originally came from all parts of Swaziland: Hhohho (119); Manzini (96);
Shiselweni (10); and Lubombo (75). The age range of the students was 10-20 years (Mean =
15.42; SD = 2.17).

65

Instruments
Two instruments were used to collect the data for the study. The first self-report instrument
administered to the teacher sample was constructed by the researcher. This instrument was a
checklist. The checklist had three sections collected teachers biodata, their ratings of
aggressive behaviours prevalent in schools, and strategies teachers use to solve them.
Although the instrument did not lend itself calculable to quantitative evidence of reliability,
five former colleagues of the researcher at the University of Swaziland judged it to have had
adequate content validity.
The second self-report instrument administered to the student sample was adapted from
Townend (1994). The instrument had a demographical section which collected students
biodata using eight items. The rest of the instrument consisted of 80 mixed items measuring
passiveness, manipulativeness, assertiveness, and aggressiveness (20 items for each
behavioural trait). A linguist at the University of Swaziland was used to adapt 11 of the 80
items to suit the education level and language skills of the students. This modification was
done without altering the original meaning of the effected items. Of the 80 items, only 20
measuring aggression were relevant for this study. The other 60 items were allowed to remain
in the instrument to control classical measurement errors, social desirability and to prevent
students from developing a response set. The instrument was pretested using a class of 41
Grade 7 students at one of the upper primary schools. The Cronbach alpha reliabilities ranged
from .77 for aggressiveness to .83 for assertiveness items (passiveness .79 and
manipulativeness .80). The instrument was also rated to have had high content validity by
five former colleagues of the researcher at the University of Swaziland. In addition, interscale
correlations were all negative and mostly low (aggression vs. assertiveness: rho (41) = - .111,
p > .05; aggression / passiveness = - .356, p > .05; aggression / manipulativeness = - .044, p
> .05). Aggression was thus different from assertion, passivity and manipulativeness.
Data Analysis
Data were analysed in a variety of ways to meet the objectives of the study stated earlier. To
describe the two samples adequately biodaata were analysed by descriptive statistics
(frequencies, percentages, means and standard deviations. The teachers checklist of
behavioural problems thought to be prevalent in Swazi schools was scored by frequencies and
percentages to determine the major problems. Spearmans rank-order correlation (rho) was
used to assess the relationship between the students demographic characteristics and
aggression. This analysis was performed to identify variables that could be investigated in
future in-depth studies for possible causal connections with aggression. Descriptive statistics
(Mean, Mode, Median and standard deviation) were used to analyse the students aggression
data. This analysis was conducted to give insights into the extent of aggression among the
students as one whole group. After this, aggression data were put into three score intervals
recommended by Townend (19944). Using cross tabulation, frequencies in each score
interval were obtained per subsample or category of each demographic variable. This
information enabled the researcher to compute chi-squares to find out if there were any
significant differences in aggression between subsamples of students based on demographic
variables. The justification for using the descriptive and nonparametric statistics (rho and x)
was based on three reasons. First, both samples were nonprobability. Second, nonprobability
samples provide data sets that are distribution-free in terms of the statistical assumptions of
normality and random errors. Third, only non-inferential statistics can be used to analyse nonrandom data.
Results
Aggressive behaviour in schools
According to the teachers surveyed, there seems to be a considerable number of behaviour
problems in Swazi primary and junior secondary schools (Table 1). Of the fourteen conduct
disorders presented in the checklist, three (fighting, destructiveness, and bullying) are highly

66

related to aggression. Among these three, fighting and bullying feature prominently as major
problems.
Table 1
Behavioral problems common in schools (N = 47)
Behaviour
Frequency*
Jealous
22
Stealing
45
Fighting
43
Disruptive / hyperactive
37
Attention-seeking
37
Cheating / lying
47
Drug abuse
27
Destructive
17
Sex offences
29
Truant
30
Complainants
24
Bullying
44
Smoking
29
Gambling
14

Percentage*
46
96
89
79
79
100
57
36
61
64
51
93
61
29

* Non-additive frequencies and percentages.

Relationship between aggression and demographic variables

The literature reviewed in this study revealed that behaviour problems are caused by many
factors. In some cases, factors interact to cause a single or multiplicity of behaviour
disorders. From eight biographical variables used in this study, only one (type of school
attended) was found to be significantly associated with aggression (Table 2). The connection
is however inverse and being a correlation no cause and effect are implied at this stage. Only
one variable (guardians) neared significance at the .05 level.
Table 2
Relationship between aggression and selected demographic characteristics (N = 300)
Variable

rho

Gender
Age
Location of school attended
Type of school attended
Region of origin
Guardians
Practicing religion
Level of education enrolled

.112
.087
.014

196. **
.076
.045
.060
.027

** P < .01 (two tailed)

Amount and extent of student aggression

The study did not find much evidence of severe aggression in the students surveyed contrary
to the views of the teacher sample. For instance there were only few students in the 14-20
(severe aggression) score interval and the largest aggression score was only 16 rather than 20,
the highest possible maximum (Table 3). The distribution of aggression scores was
approximately normal as indicated by central tendency measures. Despite this there was a
large number of students in the mild-to-moderate range of the scale (7-13 score band) who
were potentially aggressive. The commonest score (mode) fell in this range.
Table 3
Analysis of Student Aggression scores (N = 300)
Attribute

Score

Frequency*

Lowest aggression score

Highest aggression score
Mean
Mode

1.00
16.00
9.00
8.00

1
2
23
37

Percentage*
0.30
0.70
8.00
12.30

67

Median
Little or no aggression
Mild to moderate aggression
Severe to profound aggression

8.00
0-6
7-13
14-20

37
80
202
18

12.30
26.70
67.30
6.00

* Non-additive frequencies and percentages

Differences in aggression between various subsamples

In terms of the aggression categories recommended by Townend (1994) two points were
noted. First, there were a few students with severe aggressive behaviours (1420 score range) in all the subgroups (see Table 4). Second, there were more
students with moderate aggressive behaviours (7-13 score range) among the
males, in 16-20 year-olds, in urban schools, in government schools, at junior
secondary school level, in students who stay with both parents, and among
those who claimed to be practicing religion. Significant differences in
aggression between various categories of students were, however, obtained
on only two variables: location of the schools attended and the students
guardians (Table 4).
Table 4
Differences in aggression between various groups (N = 300)
Variable

Group

(n)

Gender

Males
Females
10-15 years
16-20 years

(150)
(150)
(140)
(160)

Location of School

Rural
Urban

(170)
(130)

46
34

110
94

14
4

3.69
(2)

Type of School

Government
Church / Mission
Private

(165)
(86)
(49)

32
33
15

117
51
34

16
2
10

18.16**

Upper Primary
Junior secondary
Hhohho
Manzini
Shiselweni
Lubombo

(123)
(177)
(119)
(96)
(10)
(75)

38
42
39
19
2
20

77
125
77
69
7
49

8
10
3
8
1
6

2.18
(2)
8.04

Both parents
Father
Mother
Grand parent(s)
Other people
Yes
No

(135)
(27)
(90)
(36)
(12)
(237)
(63)

41
3
27
6
3
65
15

86
19
61
27
9
159
43

8
5
2
3
0
13
5

15.85*

Age

Level of education
Region of origin

Guardian(s)

Practicing religion

Frequencies in Score Categories

0-6
7-13
14-20
37
103
10
43
99
8
41
88
11
39
114
7

Chisquare
(df)
0.75
(2)
2.97
(2)

(4)

(6)

(8)
0.75
(2)

* p < .05
** P < .01

Control of student behaviour problems in schools

Swazi teachers appear to use a variety of techniques to address behaviour problems in
schools. A representative list of some of the strategies employed is presented in Table 5.

68

Unfortunately punishment, an aversive or negative reinforcement that is supposed to be used

sparingly and as a last resort, is overused. The more desirable procedures of discussing the
problem with the student, parents, and school counsellor (in form of counselling and
guidance) are underutilised. One of the factors contributing to this problem is that schools
lack trained and experienced counsellors / school psychologists to help with the management
of behavioural cases especially aggressives.
Table 5
Teacher strategies to behaviour management (N = 47)
Action(Percentage*)
Frequency*
Ignore the problematic student (25)
12
Refer the student to the headteacher (71)
33
Discuss the problem with the student (43)
20
Punish the student (93)
44
Discuss the problem with the parent(s) (54)
25
Discuss with the school counsellor (7)
3
*Non-additive frequencies and percentages.

Discussion
The list of behavioural problems used in the checklist for this study represented mainly
physical conduct disorders. Only two (cheating / lying and complaining) were nonphysical.
There are probably more different types and categories of behaviour problems in Swazi
schools (both physical and nonverbal). Future research can identify additional behavioural
disabilities particularly the nonverbal and nonphysical types.
A significant relationship between aggression and the demographic variables used was
obtained by correlation on the type of school attended. Apart from age, the rest of the
variables were categorical. It is possible the variables might be related to aggression
interactively. Further research could use more sophisticated statistical procedures such as
multiple regression analysis to probe the joint relationship of two or more of these variables to
aggression. Variables such as the type of school attended that are identified to be highly
related to aggression should be investigated for both statistical and practical significance. The
latter would be insightful in determining the causes of aggression and the effects of such
aggression in schools. More in-depth qualitative research should investigate the reasons why
there are more students with moderate to severe aggressive tendencies in government schools
(X (df = 4) = 18.16, p < .01) and in families with both biological parents (X (df = 8) = 15.85,
p <. 05).
The number of students with moderate to severe aggressive inclinations should also be a
source of concern to both Swazi teachers and school authorities because of the disruptive
effects that aggression can have on educational processes. This finding calls for teacher
education (both inservice and preservice) to address aggression with a long-term solution.
Current teacher reliance on punishment to solve behavioural problems in schools is
unsatisfactory for two main reasons. First, previous research in the literature indicates that
punishment does not have a durable or long- lasting effect. Second, punishment is only
effective if administered soon after the misconduct / offense and when the reasons for its
application are properly explained to the recipient at the time of using it. Third, punishment
may aggravate the aggression problem due to the effects of conditioning.
Conclusion
According to evidence emerging from this study there are student behaviour problems of
many kinds in Swazi schools. Aggression is one of the potential major problems. The study
recommends that more detailed investigations, both quantitative and qualitative, be conducted
to gain deeper perceptions into the nature of the problem, its possible causes, and solutions
that are likely to be most effective in addressing it. An enhancement of teacher skills in

69

handling behaviourally aggressive cases needs to be given high consideration and priority by
relevant authorities in the present circumstance. Teachers ought to use approved forms of
punishment sparingly as a last resort. Research indicates that punishment does not have a
long-term effect and it tends to worsen the undesirable behaviour rather than reduce or
eliminate it.
References
Ary, D. V., Duncan, T. E., Biglan, A., Metzler, C. W., Noell, J.W. & Smolkowski, K. (1999)
Development of adolescent problem behaviour, Journal of Abnormal Child Psychology, 27
(92), 141-153.
Carlson, N. R. (1987) Psychology: science of behaviour (Boston, Allyn & Bacon).
Central Statistical Office. (2000) 1997 Census statistics (Mbabane, Government Printer).
Christie, G. & Christie, C. (1999). Reducing and preventing violence in schools. Paper
presented at the Australian Institute of Criminology Conference. Available online at:
http://www.peacebuilderoz.com/papers/june99.html. (accessed 12 September 2003).
Conger, R.D., Neppl, T., Kim, K. J. & Scaramella, C. (2003) Angry and aggressive behaviour
across three generations: a prospective longitudinal study of parents and children, Journal of
Abnormal Child Psychology, 31(2), 143-162.
Craig, G. J. (1980) Human development (London, Prentice-Hall).
Ezam, R. (2003) Teen girl jailed for false testimony. Borneo Bulletin, page 4, May 22.
Glick, B. (1996) Aggression replacement training in children and adolescents, in:
Hatherleigh guide to child and adolescent therapy (New York, Hatherleigh Press).
Humphreys, A.P. & Smith, P.K. (1984) Rough-and tumble in preschool and playground, in:
P. K Smith (Ed.) Play in animals and humans (Oxford, Basil Blackwell).
James, O. (1995) Juvenile violence in a winner-looser culture (London, Free Association
Books).
Lefrancois, G.R. (2001) Of children - an introduction to child and adolescent development
(Wadsworth, Thomson Learning).
Matlin, M.W. (1998) Psychology (New York, Wadsworth).
Mussen, P. H., Conger, J.J., Kagan, J. & Huston, A.C. (1984) Child development and
personality (New York, Harper & Row).
Nicolson, D. & Ayers, H. (1987) Adolescent problems (London, David Fulton Publisher).
Olweus, D. (1993) Bullying at school (Oxford: Blackwell).
Salvin, R. E. 91994) Educational psychology: theory and practice (London, Allyn and
Bacon).
Sdorow, L. M. (1995) Psychology (New York, Brown and Benchmark).
Shaffer, D. R. (2002) Developmental psychology: childhood and adolescence (Wadsworth,
Thomson Learning).
Townend, A. (1994) Developing Assertiveness (London, Routledge).

70

EVALUATION OF TURKISH HEARING IMPAIRED STUDENTS READING

COMPREHENSION WITH THE MISCUE ANALYSIS INVENTORY
mit Girgin
Anadolu University.
The purpose of the current study is to evaluate the reading comprehension
of hearing impaired 8th graders who are being trained through an
auditory-oral approach. The evaluation is conducted through miscue
analysis using complex stories. To realize this aim, the following research
questions are formulated. (1) To what extent do hearing impaired K-8
students use the language cue systems (i.e. syntax, semantics and
graphophnonics) during reading. (2) What is their reading comprehension
level? (3) Is there a consistency between the mistakes they make and their
reading comprehension levels?
Ten severe to profoundly hearing impaired secondary students who are at
the Research and Education Center for Children with Hearing Impairment
(i.e. EM) at Anadolu University participated in the current descriptive
study. Since there is not any ready reading inventory in Turkey, stories with
different levels along with retelling, question-answer and fill-in-the-blanks
forms regarding those stories were prepared. Results suggest that when
hearing impaired students read a story at their instructional level, they do
use their knowledge of syntax, semantics and graphophnonics, they
understand what they read and there is a consistency between the mistakes
they make and their reading comprehension.
In reading education, the expertise of teachers of the reading process is as important as
students background knowledge and proficiency in reading. Readers comprehend what they
read using their background knowledge and reading skills. They need to decipher and

71

understand the written materials using these skills and knowledge. It is necessary for teachers
to evaluate the texts that are deciphered and comprehended by the readers so that they can
develop students insufficient strategies in reading comprehension.
Reading can be defined in several ways. Among those definitions, different aspects of reading
are listed such as speaking out all words given on a page or interacting with the text to
construct meaning. Reading comprehension is the process of combining the cue systems of
the language, namely, syntax, semantics, pragmatics and graphophnonics with the prior
knowledge and experiences. If readers have a purpose to read and if the material interests
them, they involve their background knowledge in the process, too, which facilitates reading
comprehension. Previous research particularly emphasizes that reading comprehension is an
active and interactive process between the readers and the written materials in which readers
attribute meanings to the text through their background knowledge (Goodman, 1995; Lewis &
Wray, 2000; Rasinski & Padak, 2004; Zwiers, 2004).
Goodman, Watson and Burke (1987), define reading as the process of problem solving and
meaning construction. Readers construct meaning while they are thinking about what the
author tries to tell. During this construction, they use their language, their thoughts and their
background knowledge. In order to develop the crucial elements of reading comprehension,
namely decoding and understanding, reading strategies should be taught in a specific
sequence and these strategies should later be combined so that the comprehension process is
realized. Within time, the notion of literacy has changed, that is, simultaneous development of
reading strategies and the gains readers get through interacting with the texts are given more
importance. In order to get a clearer picture of this new literacy concept in both general and
special education, which focuses not only decoding the text but also comprehending it, the
necessity to revise the education and evaluation in classes arose (Chaleff & Ritler, 2001;
Ewoldt, 1981; Schirmer, 2000).
In teaching and developing reading, it is important to evaluate every single student constantly
in order to assist them during their meaning construction process more effectively (Miller,
2001). This application has an additional importance for teachers working with hearing
impaired children because of the difference in the language development process of the
hearing impaired students, hearing loss and poor academic achievement they demonstrate
(Paul, 1998).
Research revealed that hearing impaired childrens knowledge of language is not same as
their hearing peers. Thus, students who have serious hearing problems or who have impaired
hearing at the pre-acquisition stage of language confront with problems while they are
learning to read (Girgin, 1999; Paul, 1997; Quigley & Paul, 1985). However, previous
research revealed that hearing impaired children employ the same reading skills and strategies
as their hearing peers (Moog & Geers, 1985; Schirmer, 2000). In reading evaluation, miscue
analysis is used to evaluate students oral reading mistakes. Using miscue analysis plays a
crucial role in determining and developing reading strategies regarding reading
comprehension. Informal reading inventories which contain different levels of texts are used
in order to conduct the miscue analysis.
Miscue Analysis
In the United States, Kenneth Goodman, Yetta M. Goodman and Carolyn Burke investigated
childrens first years of literacy in the 1970s and developed the miscue analysis for reading
evaluation. In miscue analysis, the idea is to observe children interacting with the text and
evaluate what they do (Goodman et al., 1987; Goodman, 1995).
Miscue is the word read differently from its original from during oral reading including
reading words that are not in the text, not reading words that are in the text, skipping words,
replacing the words in the text with other words. It is emphasized that miscues done during

72

oral reading are done during silent reading as well (Goodman, 1995). No matter how
proficient they are, all readers can make mistakes. There are two basic principles in miscue
analysis. First, all readers make mistakes and these differences in reading are not always
wrong. Second, miscues give us information about readers prior knowledge, past
experiences, undertakings to construct meaning from the text and active reading strategies
they use (Davenport, 2002; Rasinski, 2003).
Miscues made during oral reading give important information about readers thinking and use
of the languages cue systems. These systems help readers understand how reading is realized
and control the meaning construction process through asking questions while reading
(Goodman, 1995). The cue systems of the language employed by readers are explained below.
Syntax: is a system regarding the structure of the language and involves the grammatical
rules along with the information about sequencing words in order to construct meaningful
sentences. When readers read a sentence, they think whether that sentence carries the
characteristics of a sentence concordant with the rules peculiar to the language (Davenport,
2002; Goodman et al., 1987).
Semantics: is the meaning system of the language and provides information about the
meanings of words, phrases and sentences along with the ways those meanings can change in
different situations. When readers read a sentence, they think whether the sentence carry a
meaning (Davenport, 2002; Goodman et al., 1987).
Pragmatics: This system involves the language which is accepted and expected in specific
situations, or the language that should be used in line with the social rules. When readers read
a sentence, they think about what to say in that specific situation or environment (Davenport,
2002; Goodman et al., 1987)
Graphophnonics: This system involves information about the relationship between the letters,
sounds of those letters and the form of the letter sequences in words. Readers think how
letters and sounds of letters help in choosing the meaningful word to construct a meaningful
speech unit. (Davenport, 2002; Goodman et al., 1987)
It is necessary and crucial that readers focus on the meaning of the text. In order to realize
this, all cue systems should process in harmony and provide readers with information in a
balanced way. The harmonious processing of those systems can be explained with the
following example. In a story called Yasemin is at the Pastry-Shop, the events of Yasemins
going to the pastry shop, buying some pastry, and having an accident are reported. In such a
story, when the readers do not understand the word package in a statement in the story, Uncle
Hakk helped the little girl package the pastries, they involve in the following processes:
(1) When the readers confront with a word they do not know such as package they work out
the necessary information from the text and make guesses using the graphophnonics system.
(2) Readers syntax helps them guess which words can be suitable for this particular sentence.
Readers think that there is a noun after the word they do not know, so it can be a verb.
However, this operation is not done consciously. Readers, as natural and proficient speakers,
make improvisations without saying anything about these operations using their information
on grammatical rules.
(3) Semantics help readers select words by checking other words within the statement and
relating them to the subject of the story. Thus, the word to be used before the pastries is
guessed. Guesses could be like eat; sell or package.
(4) Pragmatics narrows down the choices made by the reader in accordance with the content
of the story along with the social status of the characters. What can Uncle Hakk do to help
the little girl? Put the pastries in a basket; package them,; cut them, etc.
(5) The graphophonics system is used again and the first letter of the word is checked, then
the visual information is controlled again. Among the selections that are narrowed down, the
most appropriate one is chosen. Readers can use everything they know from the beginning of

73

the story, check the letters and can understand that the word is not eat or sell but package. All
decisions are made simultaneously within a short span of time. Readers use the strategies of
confirmation, inference and guessing along with the cue systems of the language. The
decision comes out itself and appears all of a sudden (Davenport, 2002).
Evaluation of miscues made during oral reading helps researchers observe all these operations
occurring in readers minds and understand the strategies readers employ to construct the
meaning. These miscues are generally an internal part of meaning construction process from
the text. In miscue analysis, children are observed while they are interacting with the text and
an inventory of their mistakes is prepared. Through observation of these mistakes, childrens
syntax, semantics, pragmatics and graphophonics knowledge is determined. Besides, their
skills and strategies regarding their comprehension of what they read are determined through
the procedure of retelling, question-and-answers and fill-in-the-blanks activities.
Standardized tests concentrate on the products of reading whilst miscue analysis examines the
active meaning construction process employed by readers to work out the meaning
(Goodman, 1995). Thus, the reading needs of learners at any age can be determined.
Important oral reading miscues are as follows: Replacing a word with something else
(substitution), adding a new word (addition), skipping a word or phrase (omission), correcting
a mistake while reading (correction), repeating the word or phrase (repetition) (Goodman,
1995; Goodman et al., 1987).
Informal Reading Inventory
Miscue analysis can be used in all types of reading methods. Students development at all
levels from beginners to advance can be observed and determined (Shanker & Ekwall, 2000).
In order to observe students development, it is important to choose reading materials suitable
for their levels. Previous research suggests that in miscue analysis, students strategies are
mostly determined using reading materials at their instructional levels (Chaleff & Ritter,
2001; Paul, 1998; Wilhelm, 2001). In order to evaluate students in terms of the reading
materials in line with their instructional levels, ready informal reading inventories can be used
or a new reading inventory can be developed by the teacher.
In the informal reading inventory, students reading comprehension knowledge is scrutinized
through registering qualitative and quantitative data whilst they are retelling what they read,
answering the questions and filling in the blanks in the reading material. Evaluations are
diagnostic since reading inventories are generated in order to meet the needs of each student.
Thus observations cannot be compared with each other. The most important characteristic of
the informal reading inventory is that they are based on observations and they provide
information about the cognitive characteristics of the readers. Therefore, collected data is
valid for a single student whilst it is not useful to comment on the performance of other
students. Another reason to use reading inventories is to document the reading developments
of students. These inventories are teacher-controlled and child-centered. They provide useful
information to teachers about students developments and give parents information about the
students achievement levels and necessary skills to develop them (Gillet & Temple, 1990;
Miller, 2001). Many informal reading inventories provide ready word lists, questions and
answers to control reading comprehension, forms for student stories based on reading and fillin-the blanks forms that are suitable for different levels from pre-school to 8 th grade.
Preparation of Informal Reading Inventories
Development of informal reading inventories involves two phases. First, the material in the
inventory is developed. In this phase, reading materials are selected, reading comprehension
questions and answers are developed, the evaluation form for the retelling procedure is
generated and fill-in-the-blanks papers for each text are prepared. In the second phase, the
material is piloted and applied.

74

In teacher-made informal reading inventories, texts can be selected from story books or texts
similar to those used in the school. Texts in published inventories are either selected from
story books or prepared particularly for the tests. Selecting and using the same stories or texts
used in the classroom can interfere with the evaluation of students and mislead teachers in
understanding students development of reading strategies (Gillet & Temple, 1990).
While conducting the miscue analysis, what is criticized most is the selection of the texts. The
purpose of selecting texts is to use a reading material which is suitable for students
instructional level so that students can read them fluently and understand it using self-guiding
and correction strategies (Jensama, 1980; LaSasso & Swaiko, 1983; Paris, 2002). For
instance, a reading material which is assumed to be easy for a student can be difficult to him
when the subject matter is fishing. This is because a student who is not living by the sea or
who does not have experience in fishing can have problems in understanding the terminology
in an unfamiliar subject. Informal reading inventories should contain interesting, authentic,
correct dialogs, descriptions and subjects students can recognize and understand. The text
should constitute a whole in itself. It should not be an extract taken from the middle of a story.
Since instructors working with hearing impaired students cannot get sufficient information
regarding the evaluation of students reading comprehension based on standardized normreferenced tests (Jensema, 1980), they can acquire more information through the application
of this child-centered evaluation approach to hearing impaired children. When the studies
involving miscue analysis are examined, it is seen that there are few studies conducted with
hearing impaired students. Ewoldt (1981) examined the reading process of four hearing
impaired students with serious hearing loss aged between 7 and 17 who are being trained
through the total communication approach. Students read 25 stories and were asked to tell the
stories with American Sign Language (ASL). Besides, reading comprehension and fill-in-theblanks exercises were conducted. It was found that hearing impaired students can understand
what they read, have similar reading behaviors as their hearing peers and can use language
cue systems (i.e. syntax, pragmatics, graphophonics) when they are given materials suitable
for their current levels.
Chaleff and Ritter (2001) studied with hearing impaired students with serious hearing loss
aged 5, 7 and 12 who were trained with the total communication approach. After determining
students miscues, those miscues were reviewed working individually with each student and
focusing on the reasons behind the miscues. It was found that hearing impaired students used
language cue systems; however, their reading comprehension skills were worse than their
peers. Reading process of hearing impaired students who were trained through auditory-oral
approach was not evaluated through the miscue analysis.
In Turkey, reading evaluation of hearing and hearing impaired students through miscue
analysis was not conducted yet. Besides, there is not any informal reading inventory
generated for either intact or hearing impaired students. However, reading comprehension has
been examined through the retelling procedure (Girgin, 1999) and question-answer method
(Akamete, 1999; Girgin, 1987; den, 2003; Tfekiolu, 1992).
This study is conducted in order to meet the need for the development of a reading evaluation
material, selection of the type and basic characteristics of stories for inclusion in the material,
application of those stories and interpretation of the results. Reading development and
strategies of 8th graders are determined through the miscue analysis involving reading
comprehension, question-and-answer and fill-in-the-blanks using complex stories organized
in accordance with students reading levels. The reason to choose 8 th graders is to evaluate the
reading comprehension strategies of students who have been trained with auditory-oral
approach since 3 year-old, to determine their reading development levels, to understand the
contribution of the education they receive and to determine what should be done in further

75

Turkish courses they are going to take. Besides, it is hoped that sharing the findings with the
families will enlighten their parents for their further educational decisions.
The purpose of the current study is to evaluate the reading comprehension of 8 th graders, who
are being trained through auditory-oral approach, by using complex stories and the miscue
analysis. The research questions are as follows
1- To what extent do hearing impaired 8 th graders use the language cue systems (i.e.
syntax, semantics and graphophnonics)?
2- What is their reading comprehension level?
3- Is there a consistency between the miscues they make and their reading
comprehension?
Method and Procedures
Participants
The current descriptive study is conducted with 10 students studying in the Research and
Preschool Education Center for Children with Hearing Impairment at Anadolu University (i.e.
EM). EM is an educational institution, where hearing impaired children are diagnosed at
an early age and trained during daytime through auditory-oral. Data were collected in May
2005. The demographic information regarding participants is provided in Table 1.
Table 1
Demographic information of the participants
Participant ID
Date of Birth*
Gender
Hearing Loss (dB)
1
February 21, 1990
Female
108
2
April 1, 1990
Female
96
3
May 28, 1990
Male
103
4
June 8, 1990
Male
114
5
September 9, 1990
Male
89
6
October 5, 1990
Female
100
7
October 24, 1990
Male
89
8
November 29, 1990
Male
100
9
December 1, 1990
Male
107
10
June 28, 1991
Male
90
*Participants dates of birth are chronologically ordered.

Except for the 2nd participant, all students were diagnosed at the EM audiology clinics and
fitted with proper hearing aids. Their families had got parent guidance three years. They
started the nursery school of EM at the age of four and received education for there years
through EM and at the same time their parents went on parent guidance program. When
they are 6, they started elementary school at EM and finished K-8 in 2005. The 2 nd student
in Table 1 was diagnosed at EM and her/his parent had got parent guidance to; however,
she did not get training at EMs nursery school. She/he got her/his education in the
integration classes till the 5th grade. She/he went on her/his education 6th through 8th grades at
EM. Besides, the 1st student received cochlear implant after the 6 th grade. None of the
students had a second physical handicap and none of their parents was hearing impaired.
Data Collection
Determining the Stories and their Levels
Since there is not any ready informal reading inventory in Turkey, texts at different levels
used in the study, reading comprehension, question-answer and fill-in-the-blanks forms used
were prepared by the researcher. It is emphasized that texts used in the miscue analysis should
be prepared in terms of three levels namely, independence, instruction and frustration.
Besides, it is important that texts should contain interesting and authentic dialogues, correct
descriptions and subject-matters, and characters that are understandable and familiar to

76

children (LaSasso & Swaiko, 1983; Paris & Carpenter, 2003; Woods & Moe, 1989).
Therefore, texts that are familiar, appropriate, interesting and likeable were selected through
screening elementary school Turkish course-books and through asking elementary school
Turkish teachers to get expert opinion. According to teachers, students read complex stories.
Complex grammatical structures, words, idioms and concepts were reviewed, and unfamiliar
items, statements and words were revised. During these revisions, it was considered that short
texts reduce the chance of working out the meaning from the clues whilst long texts place a
burden on students memories (LaSasso & Swaiko, 1983). The titles of the stories were as
follows: At the Zoo, The Child and the Tree, The Lost Bag, and The Heron.
Complex stories have different characters experiencing a couple of problems, a large number
of solutions for the problems, and a large number of suggestions made as solutions (Gillet &
Temple, 1990; Hughes, Mc Gillivary, & Schmidek, 1997). The integrity of the selected stories
was determined in accordance with the grammars of the stories. Thus, contexts of the stories
(i.e. time, place, and characters), problems, reactions, scenarios, interferences, the results of
the interferences, and results statements were determined (Gillet & Temple, 1990). After
determining these statements, a consensus between independent raters was reached in order to
increase reliability. The reliability was calculated through dividing the number of identical
ideas to the sum of identical and different ideas and multiplying the result by 100 (Tekin &
Krcaali-ftar, 2001). All reliability indices in this study were calculated through this formula.
The reliability indices of the consensus between the raters for four stories, namely, At the Zoo,
The Child and the Tree, The Lost Bag and The Heron were 82 %, 80, 82 % and 92 %
successively.
In order to determine the difficulty level of the stories, the average lengths of the T-units are
examined. T-unit refers to every single main clause and all other subordinate clauses related to
that main clause (Hughes et al., 1997). The T-units in the stories were determined first. Then,
the reliability indices for the consensus between the raters were calculated, which were, 82 %
for At the Zoo, 80 % for The Child and the Tree, 82 % for The Lost Bag and 84 % for The
Heron. The average lengths of the T-units were calculated through dividing the total number
of words in a story to the number of T-units. If the average lengths of the T-units increase, the
complexity of the story increases as well (Hughes et al., 1997). Table 2 provides the average
lengths of the T-units.
Table 2
The average lengths of T-units in the stories
Name of the Story
Total Number of
Total Number of Twords
units
At the Zoo
227
31
The Child and the
253
35
Tree
The Lost Bag
324
38
The Heron
265
26

Average lengths of
T-units
7
7
8,5
10

When Table 2 is examined, it is observed that At the Zoo and The Child and the Tree are at
the simple level, The Lost Bag is at the instructional level and The Heron is at the frustration
level. In order to determine the difficulty of the stories, subordinate clause index was
calculated as well. The subordinate clause index was found through dividing the total number
of clauses to the total number of t-units. The result of the division is always higher than 1.0
since every T-unit has at least one clause. If the result digresses from 1.0, the difficulty of the
statements increases as well (Hughes et al., 1997). Table 3 provides the subordinate clause
indices of the stories.
Table 3

77

Name of the Story

At the Zoo
The Child and the
Tree
The Lost Bag
The Heron

Subordinate clause indices of the stories

Total Number of
Total Number of TClauses
units
70
31
82
35
85
79

38
26

Subordinate Clause
Index
2,25
2,34
2,23*
3,10

When the subordinate clause indices are examined, it can be observed that the subordinate
clause index of The Lost Bag is smaller than that of The Child and the Tree. However, in
order to determine the difficulty of a story, it is important to conduct further analyses. One of
those analyses is to concentrate on different words. Stories that do not repeat the same words
and use different words are more difficult. To determine the word difference, all words are
counted within a story. When a word occurs again, it is not counted as a different word. To
count a word as different, it should occur in the text for the first time. To find the words
difference index, the total number of different words in the story is divided by the square root
of twice the total number of words (Type-token ratio). (Woods & Moe, 1989; 13). Table 4
provides the difference indices of the stories.

Name of the Story

At the Zoo
The Child and the
Tree
The Lost Bag
The Heron

Table 4
Difference indices of the stories
Total Number of
Total Number of
Words
Different Words
227
165
253
171
324
265

228
223

Words Difference
Index
7,7
7,6
8,9
9,6

According to Table 4, the first two stories are at the independent level, the third one is at the
instructional level and the last one is at the frustration level. After examining the text
difficulty of the stories, retelling forms for each story were developed. The retelling form was
developed in accordance with that of Ewoldt (in Thackwell, 1992). This form was comprised
of three sections. In the first section, characters in the story were written and graded in
accordance with their importance total score being 25 points. In the second section, important
events were written, each event was graded and a total of 50 points was given. In the third
section, details in the story were written, each detail was graded and a total of 25 points was
given. After the retelling forms were prepared by the researcher, a consensus between
independent raters was reached for reliability. The reliability indices were 80 % for At the
Zoo, 81 % for The Child and the Tree, 81 % for The Lost Bag and 84 % for The Heron.
While preparing the questions and answers, three types of questions were asked. Questions
that had an identical answer within the text, questions that did not have an identical answer
but could be inferred from what is within the text, and finally questions that required children
to integrate their experiences with the information provided in the text to answer the questions
(Miller, 2001). A total of 10 questions were asked four of them having identical answers, four
being inference questions and two requiring children to use their background knowledge
along with the information provided in the text. Each question was worth 10 points. The
reliability indices of all stories in terms of the questions and answers were 100 %.
While preparing the fill-in-the-blanks papers, every 5 th word were deleted from the text
(LaSasso, 1980). The first two sentences in the first paragraph and the last two sentences in
the last paragraph were left intact so that they could provide clues to students. While deleting

78

every 5th word, the next or the previous words was chosen whenever the same word occurred
as the 5th word. Students were expected to fill in the blanks with the exact words occurred in
the story. However, when they wrote a meaningful and suitable word which did not change
the meaning of the sentence, the response was accepted (Thackwell, 1992). This procedure
measures the readers skills to work out the meaning regarding the whole story and to guess
the statement structure (Miller, 2001; Thackwell, 1992). Before the stories were developed
and the data were collected, the stories were piloted with four 6 th, 7th and 8th graders who did
not have a hearing impairment along with five hearing impaired 7 th graders who did not
participate in the study. This process elaborated the process of application.
Application
Applications are conducted through working with each student individually. Data were
collected by experienced researcher in terms of working with the hearing impaired in a
soundproof room. While collecting data, according to students reading proficiency levels, 40
to 60 minutes were given to students for reading, filling in the blanks, reading comprehension
and answering the questions. Students who asked for extra time were given an additional 10
minutes. In order to make the application more effective, the followings were taken into
account:
(1) While determining the story to be read by students, they were asked to start from the story
which was supposed to be at their instructional levels. In order not to give clues to the
students, the fill-in-the-blanks forms were given before they were exposed to oral reading and
they were asked to read the story silently and fill in the blanks. When students asked for help
while filling in the blanks, they were not supported but encouraged to reread and review the
story from the very beginning to the end (Thackwell, 1992).
(2) After the fill-in-the-blanks part was over, oral reading started. A copy of the story was
used by the researcher to follow the reading of students so that she could check the miscues
(Davenport, 2002).
(3) After the oral reading, students were asked to retell what they had read. Students were not
asked questions while reading; however, they were encouraged with statements such as What
happened next?; Good for you!; Proceed, please! If students could not retell what they read, a
lower level of story was selected supposing that the level of the story was hard for them.
(4) After retelling procedure, question-and-answer section was applied. Students answers
were taken down by the researcher. Whenever students did not understand a question, the
question was repeated and every single thing student said was documented. The whole
procedure was video-recorded to sustain the objectivity of the data. For each student, a dataset
was generated containing miscues during oral reading, reading comprehension, question-andanswer and fill-in-the blanks. The analysis of this dataset is explained below.
Data Analysis
In order to answer the first research question, that is, to determine the extent to which students
use syntax, semantics and graphophnonics, an inventory of their miscues was prepared.
Statements within the story were numbered (i.e. 1 st sentence, 2nd sentence) and doublechecked through watching the video-recordings. After determining the miscues, they were
examined to see whether they violate the syntax, semantics, and intended meaning of the
statement. Besides it was also checked whether there was a similarity in terms of
graphophnonics between the words students produced and the actual words occurring in the
text. Percentages were calculated for above indices.
Before calculating the percentages;
(a) it was checked whether each miscue violated the syntactic correctness of the statement or
not. If it did not change the syntax for the worse, or if the syntactic structure of the statement
was still all right after the miscue, the statement correctness column was marked with yes.
(b) It was checked whether the statement carried a meaning after the miscue. If it carried a
meaning, the semantic correctness column was marked with yes. For instance, while reading

79

the 7th sentence of The Heron, u glde nesilleri kuruyacak (i.e. their generation will become
extinct in this lake), the 7th student read the word nesilleri (i.e. their generation) as nesleri.
Even though he said a pseudo word rather than nesilleri the rules of syntax were not violated.
However, the sentence was turned into u glde nesleri kuruyacak (i.e. their nesleri will
become extinct in this lake). When the sentence was examined to see whether it still had a
meaning, it was observed that it had a meaning even thought a nonsense word was used.
However, what would become extinct was uncertain. Thus, the column labeled does it have a
meaning was marked with yes.
(c) It was checked whether the miscue, the word nesleri, violated the actual intended meaning
of the author. The author tries to explain that the heron generation will become extinct. With
the miscue, the intended meaning was replaced with a defective meaning. Thus, the cell
regarding whether the miscue changed the actual intended meaning of the statement was
marked with yes with a comment partially changed the intended meaning.
(d) The similarity of graphophonics between the uttered word and the actual word was
checked. If there were differences involving just one or two letters, the words were considered
highly similar. If the differences involved two or three letters, the words were considered
moderately similar. Finally, if there were more differences, there were no similarities column
was marked (Davenport, 2002).
After asking above questions and marking relevant columns with either yes or no, the
percentages of syntactic acceptability, semantic acceptability, and the possibility of changing
the authors intended meaning was calculated. In this calculation, the number of syntactically
correct statements was divided by the number of total statements and multiplied by 100 to
find the syntactic correctness percentage. Similarly, the number of semantically correct
statements was divided by the number of total statements and multiplied by 100 to find the
semantic correctness percentage. Finally, the number of statements whose meanings were
changed was divided by the number of total statements and multiplied by 100 to find the
meaning change percentage (Davenport, 2002).
While finding the percentages of graphophnonics similarities, deletions, additions, selfcorrections and repetitions were not considered (Davenport, 2002). Letter and sound
similarities were examined in cases of substitutions. In order to find the percentages, the
number of letter-sound similarities in the miscues was calculated first. Within these miscues
high letter-sound similarities were determined. The total number of high letter-sound
similarities was divided by the total number of similarities and multiplied by 100 to determine
high letter-sound similarity. Similarly, the total number of moderate letter-sound similarities
was divided by the total number of similarities and multiplied by 100 to determine moderate
letter-sound similarity.
In order to answer the second research question (i.e. what is their reading comprehension
level?), students scores on reading comprehension, question-and-answer and fill-in-theblanks sections were calculated. To calculate the reading comprehension scores, video
recordings were watched again. Expressed characters, basic events and details were marked
and the scores were calculated on the reading comprehension evaluation from.
For the fill-in-the-blanks scores, words written in the blanks were examined under three
headings.
(1) Correct responses were determined to calculate fill-in-the-blanks point. When the students
wrote the very same word in the story, this was accepted as a correct response and the total of
those responses were written to the correct responses column.
(2) If students did not write the very same word while filling in the blanks, but wrote
something that did not change the meaning of the statement, this response was accepted as

80

correct as well. The total of these responses were written to the different but does not change
the meaning column.
(3) Words that changed the meaning and that were wrong were determined, and the total of
those words were written to the not correct, changes the meaning column. The number of
correct responses was divided by the number of blanks and multiplied by 100 to find the
correct response percentage. The percentages of the second and the third group were found
via this method as well (Thackwell, 1992). The dataset belonging to 30 % of the students
participated in the study was controlled by another expert in the field and the reliability
between the raters was found as 100 %.
Results
Each student participated in the study read the stories at an instructional level in which they
could read fluently, correct their miscues, self-guide during reading and work out the intended
meaning (Table 5)

Table 5
Stories read by the participants
Order
Participant
Name of the Story
1
1st participant
The Lost Bag
2
2nd
At the Zoo
rd
3
3
The Heron
4
4th
At the Zoo
5
5th
The Lost Bag
th
6
6
The Heron
7
7th
The Heron
8
8th
The Child and the Tree
9
9th
At the Zoo
th
10
10
At the Zoo
When the stories read by the students are examined, it can be seen that that four students read
At the Zoo, two students read The Lost Bag, three students read The Heron, and one
student read The Child and the Tree.
The first question focusing on the extent to which hearing impaired 8 th graders use language
cue systems (i.e. syntax, semantics and graphophonics) during reading was answered with
percentages in Table 6.
Table 6
Percentages of students use of syntax, semantics and graphophonics
Participant

7th participant
3rd participant
6th participant
5th participant
1st participant
2nd participant
9th participant

Name of
the Story

Number
of Tunits

The Heron

26

The Lost
Bag
At the Zoo

28
31

Syntactic
Correctness
(%)

Semantic
Correctness
(%)

Meaning
Change
(%)

Letter-sound
similarity (similarity
of graphophonics)
(%)

100
96
100
100
100
100
96

96
96
100
100
100
90
96

96
96
88
94
94
87
90

100 high
75 high / 25 moderate
100 high
100 high
100 high
85 high / 15 moderate
50 high / 50 moderate

81

4th participant
10th participant
8th participant

The Child
and the
Tree

96
100

96
100

96
87

100 high
80 high / 20 moderate

97

97

94

100 high

35

When Table 6 is examined, it can be seen that all students participated in this study could use
the language cue systems (i.e. syntax, semantics and graphophonics) during instructional level
story readings. The amount of miscues students made during reading changed the syntactic
structure and meaning correctness at an extent between 96 % and 100 %.
In order to answer the second research question, in other words, to determine students
reading comprehension levels, reading comprehension, question-and-answer and fill-in-theblanks scores were examined. Reading comprehension scores of the students are provided in
Table 7.

Table 7
Reading comprehension scores of the students
Participant
7th participant
3rd participant
6th participant
5th participant
1st participant
2nd participant
9th participant
4th participant
10th participant
8th participant

Name of the Story

Characters
(25 points)

Basic Events
(50 points)

Details (25
points)

Total

25
25
25
25
25
21
24
21
24

43
38
35
30
45
31
34
34
41

20
8
10
15
18
3
3
16
13

88
71
70
70
88
55
61
71
78

25

30

15

70

The Heron
The Lost Bag
At the Zoo
The Child and the
Tree

As the Table 7 indicates, except for the 2 nd student, all students mentioned characters and
received either 24 or 25 points on this part. While talking about the characters, the 2 nd student
did not mention the turtle, the bird, the monkey, the rabbit, and Atatrk Forest and received
21. When the basic events are examined, it is observed that the 2 nd student got the lowest
score (31 out of 50) again whilst the 7 th student got the highest score (43 out of 50). When
students points on details are examined, it is observed that the highest score was received by
the 7th student whilst the lowest scores were received by the 2 nd and 9th students. When the
total scores are examined, it is observed that all scores were above 50, highest score
belonging to the 7th student whilst the lowest one belonging to the 2 nd student. Students
question-and-answer scores are given in Table 8.
Table 8
Students question-and-answer scores
Participant

Name of
the Story

QUESTIONS
1

10 Total

82

7th participant
3rd participant
6th participant
5th participant
1st participant
2nd participant
9th participant
4th participant
10th participant
8th participant

The
Heron
The Lost
Bag
At
Zoo

the

The Child
and the
Tree

10
10
5
10
10
0
10
10
10

0
10
10
10
10
0
10
5
10

10 10 5 5 10
5 10 5 5 5
0 10 5 10 10
10 5
5 10 0
10 7,5 5 10 0
7,5 10 0,5 5 5
7,5 5 10 10 5
7,5 10 7,5 5 10
7,5 5
5 10 7,5

10
10
5
10
7,5
5
5
0
5

10
10
10
10
10
10
7,5
10
10

10
5
10
10
10
10
10
10
10

80
75
75
80
80
60
80
75
80

10

10

7,5

10

70

10

When Table 8 is examined, it is seen that students answered the questions with direct and
clear answers. However, the 7th student who read The Heron did not understand the 2 nd
question, Why did the heron make a plan?, and could not give the answer He was too old to
go fishing and understood that he would die, so he made a plan which was directly provided
within the text. The 6th student did not understand the 3 rd question, Why did the crab tell
herons about the danger? Moreover, she did not understand the meaning of the statement u
glde nesilleri kuruyacak (i.e. their generation will become extinct in this lake). Even though
she read the statement correctly, she inferred the meaning that the lake itself will become
extinct. Thus she gave an answer like the lake is going to dry, fish must go somewhere, they
should not disappear. However, the right answer was He understood that he would be hunted
with the fish by the hunters.
All students understood the inference questions and answered them right except for a few of
them. For instance, the 5th question in The Heron What was the herons plan should be
answered like To cause fish to move and eat them while they are moving. The 7th student
answered this question as He tells them to hide in a larger river; however, the fish does not
know how to go there. So, he tells that he can carry them there in his mouth. However, he tells
a lie, goes to the forest and eats them with pleasure. Since the student mentioned eating fish,
he was given half a point. The 5 th student answered the same question as To eat the fish, to eat
the crab, eat them all and deceive them. Since he did not mention to cause the fish to move
but just eating fish, he was given half a point as well.
The 5th student who read The Lost Bag had problems in answering the 7 th inference question
Why did not Berk get upset about not finding his bag?, which should be answered as He was
not upset, because he thought that the bag was in the class or he thought that he would find
the bag in the class the next day. The 5th student answered this question as He was not aware
that he forgot the bag in the class, so he did not get upset. The 1st student answered the very
same question as Because Berk has another old bag. The answer was not correct.
All students correctly answered the questions that required children to integrate their
experiences with the information provided in the text. When their scores are examined, it is
observed that they got scores between 70 and 80. The fill-in-the-blanks scores of the students
are provided in Table 9.
Table 9
Students fill-in-the blanks scores
Different
Different but
Correct Response +
Correct
and change
Name of
N of
do not change
Differences that do
Participant
Responses
the
the Story blanks
the meaning
not change the
(%)
meaning
(%)
meaning (%)
(%)
7th participant The Heron
43
20
47
18
42
5
11
38
89

83

3rd participant
6th participant
5th participant The Lost
Bag
1st participant
2nd participant
9th participant
At the Zoo
4th participant
10th participant
The Child
8th participant and the
Tree

45
36

12
13
18
21
3
5
12
9

28
30
40
47
8
14
33
25

15
14
20
17
16
19
14
12

35
32
44
37
44
52
39
33

16
16
7
7
17
12
10
15

37
37
15
15
47
33
27
41

27
27
38
38
19
24
26
21

63
62
84
84
52
66
72
58

24

14

48

28

21

72

29

When students correct responses are examined, it is observed that the 7 th student got the
highest score whilst the 2nd student got the lowest score. However, when the words that did
not change the meaning were considered as correct, students all had percentile scores
exceeding 50 %. For instance, the 9 th student who read At the Zoo replaced the word first
with the word all and the meaning slightly shifted from They first visited the nests to They
visited all the animal nests. This did not violate the syntactic correctness and the meaning of
the statement, so this response was considered correct. Moreover, he replaced the word
monkeys with squirrels and the meaning shifted from.. they saw colorful birds, turtles,
monkeys, to .. they saw colorful birds, turtles, squirrels, which did not violate the syntactic
and semantic correctness of the statement, either. However, the same student replaced the
word visited with blue which violated the meaningfulness of the statement and that statement
was considered wrong.
To examine the last research question of the study (i.e. is there a consistency between the
miscues they make and their reading comprehension?), their syntax, semantics, and
graphophonics percentages were provided along with their reading comprehension, questionand-answer, and fill-in-the-blanks scores (Table 10)
Table 10
Percentages of students use of syntax, semantics and graphophonics along with their
reading comprehension, question-answer and fill-in-the-blanks scores

When Table 10 is examined, it is seen that when students read a story at the instructional
level, there occurred a consistency between their use of language cue systems (i.e. syntax,
pragmatics, and graphophonics) and their reading comprehension, question-and-answer and
fill-in-the-blanks scores.

84

Discussion and Suggestions

Determining the miscues students make while reading do not completely explain their reading
process (Hempenstall, 1999). However, it gives opportunities to evaluate their oral reading
and meaning construction knowledge. This information is used to determine the objectives of
reading education and to support students. Besides, it helps learners to evaluate themselves
and have self-esteem (Chaleff ve Ritter, 2001).
Findings of the current study revealed that hearing impaired students trained through the
auditory-aural approach could use the language cue systems (i.e. syntax, semantics, and
graphophonics) when they read a story at the instructional level. This finding is in line with
the findings of studies conducted with hearing impaired students (Ewoldt; 1981; Yurkowski &
Ewoldt, 1986; Chaleff & Ritter, 2001). Similar to the current study, those studies emphasized
that students should read stories at their current level that they can read fluently, correct and
self-guide themselves while reading.
When students retelling scores were examined, it was observed that their scores on retelling
were higher than 50 out of 100. Using Ewoldts retelling evaluation tool (in Thackwell, 1992),
it can be stated that students use reading strategies efficiently, retell important events,
understand the gist of the stories most of the time, retell the important figures along with the
changes in those figures. When students question-answer scores were examined, it was seen
that they could answer questions, which had direct and identical answers within the text
whilst they were having problems with some of the inference questions. Based on their
answers on the third type of question, it can be said that they can integrate their prior
experiences with the information given in the text (den, 2003). When students responses in
the fill-in-the-blanks activities were examined, which evaluated students knowledge on
sentence structure, grammar and comprehension; it was seen that the percentage of writing the
identical word in the story was quite low. Students could not remember some of the words in
the story; however, they wrote different words that did not change the meaning of the
statements, which were accepted correct (Thackwell, 1992). Students scores were 50 or
higher. Thus, it can be stated that students remember important events and details in the story
and they can use their knowledge regarding the sentence structure and grammar.
There was a consistency between the mistakes students made and their reading
comprehension. They usually repeated the reading mistakes during retelling and answering
the questions as well (Davenport, 2002).
Further research with these students who can use syntax, semantics and graphophonics should
concentrate on their use of graphophonics knowledge, because most of the mistakes they
made resulted from using suffixes. For example they said kan rather than kanz,
bekliyorlar rather than bekliyorlarm. It should be emphasized in Turkish and grammar
courses along with other courses where necessary that the whole word should be taken into
account rather than the beginning of the words, since the suffixes can change the meaning of
words or statements. Besides, students language use and reading comprehension should be
further examined through individual and group studies evaluating their written and oral
language. Because, students are likely to confront with difficulties in reading the structures of
a language, whose written and oral forms are understood and used with difficulty.
When students reading scores were examined, it is observed that the 2 nd student had lower
scores. This reveals that the story she read (i.e. At the Zoo) was not at her instructional level.
Including easier stories within the reading inventories is important to determine students
exact reading proficiency levels and to sustain ideal instruction within the class. The fact that
the 2nd student had lower scores in reading comprehension might be because of the training
she has received, because she had training in the immersion class till the 6 th grade. Since the
classes are too large at the elementary level in Turkey, it is quite difficulty to arrange the

85

curriculum in line with the individual characteristics of the children. Thus, it can be said that
students with serious hearing loss cannot attain experiences and skills necessary to improve
their reading strategies. The reading curriculum should be developed and implemented based
on the observations regarding students individual characteristics and achievement levels.
Even though the miscue analysis is an evaluation method requiring a lot of time, it profoundly
investigates students reading comprehension and reveals each students strengths and
weaknesses. Thus, it accelerates the process of teaching reading strategies along with the
development of language cue systems.
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87

THE EFFECTS OF VISUALIZING AND VERBALIZING METHODS IN

REMEDIAL SPELLING TRAINING: INDIVIDUAL CHANGES IN
DYSLEXIC STUDENTS SPELLING TEST PERFORMANCE
Gnter Faber
Arbeitsstelle fr pdagogische Entwicklung und Frderung
in Goslar (Germany)
A remedial spelling training approach is presented which systematically
combines certain visualizing and verbalizing methods to foster dyslexic
students' orthographic knowledge and strategy use. It essentially
depends upon an integrative application of algorithmic graphs and
verbal self-instructions: Visualization and verbalization are intended to
focus the students attention, cognitions, and behaviors on the
algorithmic rule components for enhancing their task orientation and
self-regulation skills. To that degree, the intervention must provide an
intensive and consistent cognitive modeling phase as well as a broad
range of special training materials which, in particular, are comprised
of various algorithmic and self-instructional task formats. In the present
replication study the temporal training effects on the spelling test
performance of 9 students with severe spelling difficulties were evaluated. Achievement-related pre-test and follow-up data were analyzed
after a treatment time of 40 hours. Empirical results could demonstrate
individually and statistically significant gains in students general and
error-specific spelling test performance in both systematically trained
and, to a somewhat lower degree, only incidentally considered spelling
skill areas.
Many dyslexic students have no or only scarce knowledge of the important orthographic rules
and are not familiar with their implications and thus they do not follow structurally adequate

88

criteria as much as those seeming subjectively plausible to them. Often they resort to their
existing phonological spelling skills, and they try in vain to master the critical word items in
terms of phonological correctness (Bailet, 1990; Carlisle, 1987; Darch, Kim, Johnson &
James, 2000; Manis & Morrison, 1985; Steffler, 2004). Due to their errors, these students then
seem irritated and disappointed over their unsuccessful spelling efforts as they have, from
their viewpoint, genuinely pondered over the words and could even come up with an
explanation for their decision to choose the spelling they used.
Therefore, the task in remedial spelling training is to enhance, round off, or catch up on the
orthographic skills of the students concerned, the acquirement of which had been unsuccessful for them so far so as to avoid, last but not least, the motivational and so cioemotional long-term effects of failure experiences accumulated in the individual (Faber,
2002a,b; Humphrey, 2002; Licht & Kistner, 1986; Tobias, 1992). The development and persistence of these learning difficulties can be traced back essentially to fundamental knowledge
and strategy deficiencies: the students concerned are lacking relevant knowledge with regard
to the critical demands; in addition, they do not possess suitable metacognitive planning and
control concepts for the acquirement of appropriate learning strategies or they are unable to
adequately apply solution approaches formally known to them (Borkowski, Johnston & Reid,
1987). Therefore, adequate remedial interventions have to teach students the knowledge of
relevant rules in an understandable way, and useful behavioral patterns with regard to the instruction strategy have to be worked out so as to bring this knowledge to application (Larkin
& Ellis, 2004; Mki, Vauras & Vainio, 2002; Scheerer-Neumann, 1993; Zimmerman, 2000).

89

In particular, learning theories from the view of action psychology point up the necessity of
an instructional approach which enables the students to understand the underlying logic of a
certain spelling rule and to form a cognitive concept or tool for further problem solving in that
given spelling domain (Arievitch & Haenen, 2005; Galperin, 1989). In this sense, the
training must include systematic orientation guides for the presentation of the object of
learning in a way suitable to the students, as well as effective structuring remedies for a
proper acquirement of the skills on the part of the students. Accordingly, the task of gradually
developing relevant skills requires, first of all, finding suitable ways of conveying
orthographic rules which guarantee that the issues at hand can actually be followed and
understood by the students. Most of all, this requires considerations in the direction of
resolving the verbal, abstract complexity of orthographic rules by subdividing them into
single information chunks of a concrete nature which, when looking at them from the students
view, seem logically consistent, reliable, and mentally controllable. To that degree, an
orientation basis significantly enhancing the learning process can be achieved by
implementing visualization and verbalization methods subdividing the orthographic
regulations into their characteristic sub-operations, thus presenting them in a methodical
sequence of relevant decision criteria in symbolic-graphic form and as descriptive as possible (Clarke, 1991). In this way, the students receive materialized, quasi prototypic patterns of
orthographic problem-solving which are supposed to enable them to acquire knowledge and
certainty of the relevant rules in clearly structured steps. If these conditions are fulfilled the
next task is to implement adequate strategies making it possible for the students to carry over
their acquired knowledge of the orthographic rules to corresponding spelling routines, and to
apply it autonomously in order to meet orthographic
demands. Therefore, their orthographic knowledge
has to be relocated from the physical activity level
into their consciousness, habitualizing it there as a
behaviorally active pattern of thinking. Thus, the
acquirement of skills and strategies is supposed to
take place by educationally initiated and monitored
internalization processes. In order to achieve this, it is
absolutely essential, in the view of action psychology,
to carry over the action from the exterior to the
interior speech by putting the orthographic rule
processing completely into language (Bodrova &
Leong, 1998; Galperin, 1989), having the students
commenting their rule application aloud until they
master it so well that they gradually need less and less
time for the operation and are finally able to do without verbal teacher assistance. Now the students approach the orthographic solution without materialized
structuring or overt self-instructions, and they have
successfully automatized it as a continuous spelling
strategy.
In that sense, the successful acquirement and
application of orthographic rules may be facilitated
significantly if one can successfully manage to
subdivide the complex meaning of the rules into
clearly structured intermediate algorithmic steps
which can easily be visualized and if one can also
successfully manage to support the acquirement of
these intermediate algorithmic steps with consistent
verbalizing methods. In doing so, the acquirement of
orthographic spelling skills may predominantly
dependent upon the implementation of suitable visua-

Figure 1. Algorithmic flow chart in

the spelling skill area bp
(concerning the German spelling of
explosive consonant sounds)

90

lizing methods, the development of relevant solution strategies, and most of all, the use of effective verbalizing methods (Thackwray, Meyers, Schleser & Cohen, 1985). For the success
of the remedial process it may be crucial to combine both instruction approaches (and thus the
implementation of visualizing and verbalizing methods as well) as closely as possible.
For the beginning stages of the translating experience of the intermediate algorithmic steps
into language and their subsequent consolidation with regard to the learning strategy, it seems
methodically self-evident to utilize and adjust the principles of cognitive modeling and selfinstructional learning (Meichenbaum & Asarnow, 1979) as their efficiency in the
development of strategic skills on the part of the students has been proven sufficiently long
since, across a wide range of educational problems and school grades (Ellis, Deshler, Lens,
Schumaker & Clark, 1991; Harris, 1990; Montague, 1997; Schunk, 1986).
From a methodical viewpoint, the systematic use of visualizing and verbalizing methods in
remedial spelling training requires an algorithmic problem-solving plan which is capable of
both structuring the acquirement of orthographic knowledge and facilitating the development
of orthographic strategies simultaneously by providing the specific problem-solving steps as
well as the self-instruction steps at the same time. In this regard, an algorithmic flow chart
(Figure 1 above) has proven to be a suitable method
that focuses the students attention on the target word, first of all, introducing a reflexive
problem-solving action,
that determines the relevant orthographic problem as a concrete issue in question,
that introduces an algorithmically structured problem-solving approach to clear the issue
in question with definite decision criteria in clearly structured intermediate steps,
that presents the algorithmically founded spelling of the target word as a reliable solution,
and that eventually carries over this solution to an orthographically adequate spelling of
the target word.
The application of this problem-solving plan has to be demonstrated by the teacher first by
thinking aloud. In the course of this, the teacher also informs the students in de tail of the
meaning of the problem-solving algorithm and the benefits of the thinking aloud technique for
one's own enhancement of orthographic skills (Pressley, 1986; Schunk & Rice, 1987). Under
these circumstances, the students can test and practice the problem-solving plan with the
teacher's guidance. At first, they apply the plan by thinking aloud, without exception. In doing
so, they follow the algorithmic plan determined by them on a respective worksheet step by
step with a colored pencil. In the case of errors or uncertainties, the teacher discontinues the
ongoing solution attempt and starts to determine the correct solution approach together with
the students, repetitively modeling the correct step if needed. In this way, each target word is
analyzed by itself before a decision is made. Both the self-instructions and the colored
marking of the solution approach should contribute to the students slowing down in their
solution behavior, thus replacing impulsive guessing with reflexive action patterns. At the
same time, they should be able to perceive their proceeding more consciously and control it
more precisely, as the combination of visualized algorithms and verbal self-instruction renders
the own success/failure experience more comprehensible. The flow chart helps to precisely
locate and promptly eliminate any difficulties in executing a certain problem-solving step.
For the systematic work with algorithmic flow charts of this nature, methodically adequate
practice materials in particular play a central role (Faber, 2006). They have to de pict the orthographic demands using algorithmically formatted exercise types consistently enabling the
students to convert the orthographic skills acquired by them into a strategically adequate
behavior (Figure 2).

91

 comes from
"ge-ben"
-e -en -er

so I write "b"

git
Figure 2. Algorithmic and self-instructional task format: An example

Previous empirical evaluation results

The results of evaluation studies so far conducted in the field of systematic remedial training
with graphic problem-solving algorithms and verbal self-instructions could establish and
prove significant gains in performance on the part of four training cohorts whose intervention
was completed after nearly two years in each case. In the mean time, the relevant analyses
encompass an intervention period of about eight years, and they are based on data compiled
from overall N = 100 dyslexic children and adolescents not taking the ongoing study (with
the fifth training cohort) into consideration. Overall, it was possible to replicate and to
gradually specify the pertinent results and findings (Faber, 2006):
On the basis of relevant norm test scores, the students trained over a longer period of time
were able, interindividually as well as intraindividually, to achieve highly significant gains in
spelling performance. This result is maintained even when empirically taking into
consideration regression-related gains in performance prior to the treatment. At the same time,
the students trained over a longer period of time were able to achieve, particularly in
statistical and practical terms, significant gains in the systematically trained spelling skill
areas. To a slightly lesser but still significant extent, this also holds good for the spelling skill
areas only incidentally considered. In this respect, strategic transfer effects must have taken
place in the course of the intervention. The analyses could establish significant improvements
in the untrained spelling skill areas as well, which also indicates the possibility of strategic
transfer effects. The gains in performance achieved in each case and cohort were not
significantly correlated to gender, age, or regular school training conditions. Finally, some
first empirical evidences suggest that advances in the students performance with the
proviso of conceptually adequate approaches, procedures, and training conditions can be
achieved largely independent of any teacher effects. These preliminary findings, however,
have to be replicated again, by all means, with additional evaluation studies and they have
to be specified further with regard to a comprehensive series of conceptual and/or methodical
questions of detail.
Evaluation study
Evaluation goals. With another evaluation setting, the objective of the study was to replicate
and to differentiate the results of previous evaluation findings. In this sense, the performance
data of the present training cohort were supposed to be analyzed in detail, considering the following questions: (1) Does the students general spelling test performance significantly
increase? (2) Do their individual error-rates in three systematically trained spelling skill areas
significantly decrease, and, to a somewhat lower extent, (3) do their individual error-rates in
two incidentally considered spelling skill areas significantly decrease as well?

92

Subjects. The training cohort was comprised of 9 (4 female and 5 male) students from
different grade levels (Figure 3) who displayed normal cognitive abilities but had extensive
orthographic difficulties which, in most cases, had already been accumulated over a longer
period of time. Descriptive spelling error analyses revealed clear evidence, that the students
orthographic difficulties could be traced back to a lack of rule-dependent competencies and
strategies in most cases violations of the phonologically based spelling of words were
relatively rare overall (Figure 3). In the majority of cases, the performance problems were associated with inadequate (mostly impulsive, inactive and unfocused) learning styles,
motivational orientations mainly characterized by test anxiety and avoidant behaviors, as well
as socio-emotional conspicuities in a large number of cases.
Basic training conditions. In all cases studied, the spelling training consisted of an individually compiled sequence of area-specific training steps addressing different orthographic
problems with extensive use of visualized problem-solving algorithms and verbal selfinstructions. This concerned the spelling skill areas explosive consonant graphemes
(gk/dt/bp), i-graphemes (i/ie/ih), as well as doubling of consonants (II+). In contrast, the
incidentally considered spelling skill area capitalization was only picked out as a central
theme in cases of individual uncertainties or errors; the students were then supposed to show
the critical front part of the word with the aid of a corresponding signal card and by thinking
aloud (Faber, 2006). Similarly, the incidentally considered skill area of phonologically based
spelling was picked out as a central theme as required, by also focusing the students attention
on the critical work part with signal cards (Blackwell & McLaughlin, 2005), and getting them
to think aloud about their spelling activities. Often this concerned problems around the
subjects of differentiating phoneme sounds and, in particular, structuring or segmenting words
the mastery of which is, with elaborate syllablization exercises, already a central component
part of the spelling strategies imparted in the training units dealing with explosive sounds and
doubling of consonants. The intervention took place once a week for 60 minutes each with
single individuals or groups of two. It was carried out by the author and another teacher who
received regular consultation with regard to questions as to the diagnostic and methodical implementation of the approach.
Measurements and statistical analyses. The students spelling achievement were first assessed
in pre-test 1 six months prior, on an average, to the beginning of the training, again in pre-test
2 directly at the beginning of the training, and in subsequent follow-up tests after 40 hours
into the training. According to grade level, this took place with standardized, norm-referenced
spelling tests (Faber, 2006). In pre-test 2, it was possible to use parallel forms of the
instruments employed in pre-test 1. As follow-up measures instruments with norms for the
next higher grade level were administered in each case. Evaluation of test results was carried
out quantitatively on the basis of grade-related T score norms, as well as qualitatively with the
proviso of descriptive error categories. For this purpose, individual error rates were generated
from an especially developed word list (Faber, 2004). It promises, as to content and psychometry, more adequate results with regard to the students individual error ratio, as these are
not any longer directly depending upon the item pool of a certain spelling test. The internal
consistency of the word list amounted to = .93 (Cronbachs Alpha). The sum total of list
words correctly written correlated with the T score norms of the spelling test procedures by r
= .56 (p = .005) and turned out to be significantly influenced by the grade level (r = .55, p = .
007) but not by gender (r = .01, p > .05). Due to the previous course of the training, the
corresponding error percentage scores in the learning skill areas explosive consonant
graphemes, i-graphemes and doubling of consonants were used, for the study at hand, as
error-specific performance criteria for the systematically trained spelling competences and
the error percentage scores in capitalization and phonologically based spelling were used as
error-specific performance criteria in the incidentally considered skill areas. As children and
adolescents with severe spelling difficulties in particular tend to several misspellings in one
single word often, the ordinary test sum scores can, foreseeably, only roughly reflect the
extent of their individual problems. Therefore, their individual error frequency was recorded
as an additional performance criterion, relativizing the sum total of individual errors in the

93

spelling test with the total item sum of the corresponding procedure. With the test norm
scores, the error frequency of all students at measurement time 2 correlated to r = -.73 (p = .
000).
Students individual changes in spelling performance were, at first, documented for each
single case and subjected to a conventional visual data inspection. Data from pre-test 1 and 2
respectively were the base rate to control for positive changes in unaddressed problems.
Follow-up data (from measurement time 3) served as indicator for intervention-related
improvements. This was done to explore particular intra-individually marked student
development, also with regard to subject-specific effects of the intervention. Furthermore,
summarizing statistical examination of total performance effects in the entire cohort was
carried out using nonparametric Wilcoxon tests with an (one-tailed) alpha error probability of
p < .05 (Siegel & Castellan, 1988). This procedure should clarify to what extent individual
improvements are so similar that interindividually reliable replication of certain intervention
effects for all students can be assumed.
Results.
The visual inspection of single-case data shows that most students have clearly improved
standardized test results (Figure 3). The extent of the improvements, however, varies
significantly. While some test results are remarkable, and almost instantaneous, other cases
developed in a much slower manner. In addition, the comparisons between pre-test and
follow-up data concerning the error-specific results show that all students have reduced their
initial error ratio in the systematically trained areas to a greater or lesser extent: All students
have decreased their individual error rates, which was, in some cases, extremely high before
the training and some have made remarkable progress.

94

Figure 3. Individual changes in total spelling

test performance (spTest: T-scores) and in
different spelling skill areas (error rates). The
numbers indicate the various measurement
times (1= before the beginning of the training,
2= at the beginning of the training, 3= followup after 40 training hours).
After 40 hours of remedial training, at measurement time 3, all students make significantly
less multiple spelling errors per word than at
the beginning of the training at measurement
time 2 (Table 1).
While summarizing this individual case data
into group-statistically analyzable achievement parameter, the average test scores of all
tested students, which differed significantly
before the intervention, had increased during
the follow-up test by an average of 10 T-scorepoints (Figure 4). The extent of the intraindividually achieved changes can be verified from
an inference-statistical perspective for the entire group (Wilcoxon test: Z = -2.68, p = .007).
There is no noteworthy correlation between
the extent of the achievements so far, e.g. the
difference between the second and third measurement time, and the grade the student is in
(r = .-16, p = .712). The students age do not
influence the improved test results. This is also

Figure 4. Changes of spelling test performance in the

training cohort: Norm-referenced spelling test scores 6
months prior to the training (pre-test 1), at the
beginning of the training (pre-test 2), and after 40
hours of training time (follow-up)

95

true for the gender variable, which does not correlate with the improvement in spelling test
performance (r = -04, p = .910).
The group-statistical analyses regarding error-specific student improvements in the systematically trained spelling skill areas have similar results (Table 1). The errors regarding the skill
area of explosive consonant graphemes (gk+) as well as the skill area of i-graphemes (ieih)
and doubling of consonants
(II+) decreased after 40 hours
Table 1. Error rates in various spelling skill areas: Preof training to an extent that
test and follow-up data (gk+ = explosive consonant gracannot be attributed to chanphemes, ieih = i-graphemes, ll+ = doubling of consoce, as evidenced by inferencenants, grokl = capitalization, lautg = phonologically bastatistical analysis. But there
sed spelling)
are also substantial changes
Spelling skill area gk+ (systematically trained)
with regard to the incidentally
Pre-test 2
Follow-up
Wilcoxon
p
considered spelling skill
Median
=
27
Median
=
10
Z
=
-2.55
.011
areas. As could be expected,
changes in this area are less
Spelling skill area ieih (systematically trained)
significant, but are also statisPre-test 2
Follow-up
Wilcoxon
p
tically more significant than
Median = 20
Median = 8
Z = -2.49
.013
could be explained by chance.
Spelling skill area II+ (systematically trained)
The average error ratio for caPre-test 2
Follow-up
Wilcoxon
p
pitalization
(grokl)
and
Median = 50
Median = 16
Z = -2.67
.008
phonologically based spelling
Spelling skill area grokl (incidentally considered)
(lautg) has notably decreased.
Pre-test 2
Follow-up
Wicoxon
p
Altogether, for the entire
Median = 12
Median = 5
Z = -2.10
.036
training cohort spelling perSpelling skill area lautg (incidentally considered)
formance has improved in a
Pre-test 2
Follow-up
Wilcoxon
p
statistically significant manMedian
=
16
Median
=
5
Z
=
-2.43
.015
ner.
Total error rate
Discussion.
Pre-test 2
Follow-up
Wilcoxon
p
The results of the present evaMedian = 102
Median = 42
Z = -2.67
.008
luation study show noted
performance gains in the students spelling after 40 hours of remedial training both for individual cases, which show intra-subjectively noteworthy student changes, and for the entire group, whose competence increase is more significant than can be attributed to chance and thus prove inter-subjective replicability of the case-related achieved results. As expected, the students improved most in the
systematically trained spelling skill areas and less in the only incidentally considered spelling
skill areas. Students performance gains in the incidentally considered area of phonologically
based spelling, unless they arrived at syllabizing solution strategies by transfer, which had
been systematically studied in connection with the explosive consonant and double consonant
skill area. If the improvements in the capitalization skill area, which was also trained
implicitly, are the result of the respective signal card and/or strategic transfer effects, remains
to be seen. Possibly, the algorithmic and self-instructive process has lead to a more conscious
awareness of language-structural word markers.
Considering the small size of the sample, these interim results should only be seen as a first
impression and thus only allow for preliminary conclusions about the possible effects of the
intervention. We are waiting for finalizing analyses, since the results for each individual case
need to be stabilized and improved upon with further training. With this caveat, these results
confirm the findings from previous research on the group level and point to the positive
effects of systematic work with algorithmic and self-instructive learning in remedial spelling
training: The students improvements are much more significant between test points 2 and 3
than between 1 to 2, which is proof for the effects of the intervention. The heterogenous
composition of the training cohort has not influenced these results on the contrary, changes

96

can be noted across gender and grade levels. This may also be an indication for appropriate
individual adaptation of the training.
Concerning the individual data, these results also provide important information about a
educationally helpful assessment of the training to date: The progress, evaluated by spelling
tests, seems quite marginal, even though the respective students have significantly improved
in various areas. The results of the norm-referenced spelling tests can (so far) only somewhat
reflect this progress e.g. the intra-subjectively achieved competency increase is not
sufficient in a social comparison. Due to the often massive amount of errors in several areas at
the beginning, these relative discrepancies between intra- and inter-individual evaluations of
training effects are to be expected. For an evaluation of the students improvement, the casespecific before and after differences in the systematically trained areas should be used, and
looked at within the context of all case-specific problem aspects particularly the extent to
which certain critical characteristics concerning cognitive-motivational, behavioral, and
knowledge-based learning conditions of the respective students make learning more difficult
or could even block learning.
Independent from practical and conceptual perspectives of this nature, it might be in teresting
as well, eventually, to examine whether the visualizing and verbalizing methods developed
can be systematically transferred to rule-specific spelling trainings in the orthographies of
other languages, and whether they can be integrated into other training approaches phonologically oriented (Faber, 2006; Lovett, Lacerenza, Borden, Frijters, Steinbach & De Palma,
2000; Mki, Vauras & Vainio, 2002).
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99

COMORBID DIAGNOSIS AND CONCOMITANT MEDICAL TREATMENT

FOR CHILDREN WITH EMOTIONAL AND BEHAVIORAL DISABILITIES
Kristina M. Hall
Krista A. Bowman
Katie Ley
&
William Frankenberger,
University of Wisconsin-Eau Claire
The purpose of the current study was to determine the types of
psychiatric disorders and the corresponding medications prescribed to
children enrolled in elementary Emotional Behavioral Disability (EBD)
programs. The project employed a questionnaire that was distributed to
elementary level teachers (EBD) to: (a) determine the proportion of
children identified with single and multiple psychiatric disorders; (b)
determine the proportion of children treated with single and multiple
psychiatric medications; (c) investigate possible adverse drug
interactions for children receiving combinations of medications for their
psychiatric disorders; and (d) assess the attitudes of teachers (EBD)
concerning the use of psychiatric medication to treat elementary level
children. Results revealed 76.8% of the 617 students were identified as
having one or more psychiatric disorder(s) and 21.2% of students were
identified as having been diagnosed with multiple psychiatric disorders.
Approximately 65% of the elementary students in EBD programs were
identified as receiving psychiatric medication for the treatment of one or
more psychiatric disorders. Fifteen percent of students were identified as
receiving combinations of medications, and 6.2% were identified as
receiving three or more medications concurrently. Implications of the
rates of pharmacological treatment of children and potential concomitant
target and adverse effects were discussed.
According to the American Academy of Child and Adolescent Psychiatry an estimated 7-12
million Americans under 18 years of age suffer from emotional, behavioral, developmental
and mental disorders that are often treated with psychiatric medication (aacap.org). A metaanalysis of the current literature indicates that 9-13% of children in the United States suffer
from mental disorders that warrant treatment with medication (Weisz & Jensen 1999).
Research indicates that the diagnosis of psychiatric disorders among school-age children with
emotional and behavioral disabilities (EBD) and concomitant treatment of such disorders with
psychotropic medications has increased dramatically in the last 15 years. In 1987 Cullinen,
Gadow, and Epstein (1987) reported 9.3% of children in EBD programs received psychiatric
medication. In 1996, Runnheim, Frankenberger, and Hazelkorn (1996) reported 40% of
children in EBD programs were treated with stimulant medication. The increasing rate of
diagnosis and treatment of children with psychiatric disorders has raised many questions. The
questions raised are especially important because data concerning the prevalence of
psychiatric disorders among children and the prevalence of child treatment is fragmented and
inconclusive (Weisz & Jensen, 1999). In addition, the validity and reliability of the diagnosis

100

of disorders such as ADHD, mood disorders, and schizophrenia in young children are
controversial (Coyle, 2000).
Incidence of Psychiatric Disorders
There is a dearth of information related to the prevalence of psychiatric conditions in the
school-aged population. Although the following study did not provide data for actual
prevalence, an extensive review of existing literature conducted by Weisz and Jensen (1999)
reported ADHD, depression, bipolar disorder, anxiety disorder, autism and obsessivecompulsive disorder to be among the most commonly treated psychiatric disorders occurring
in childhood. Attention-Deficit/Hyperactivity Disorder (ADHD) has been estimated to occur
in approximately 3-7% of school-aged children according to the Diagnostic and Statistical
Manual of the American Psychiatric Association (American Psychiatric Association, 2000).
However, estimates as high as 10% have been proposed more recently (Rowland, Umbach,
Stallone, Naftel, Bohlig & Sandler, 2002).
Incidence of Treatment with Psychiatric Medications
Some of the most commonly prescribed types of psychiatric medications for children include
stimulant, antidepressant, antianxiety, antipsychotic, and antiseizure medications (Weisz &
Jensen, 1999). The incidence of stimulant treatment in the school-age population has
increased dramatically in the past few years as the acceptance of pharmacotherapy for ADHD
increased. Currently, estimates as high as six million children being treated with stimulant
medication for treatment of ADHD appear in the literature (Hearn, 2004). The large increase
in the treatment of ADHD with stimulant medication since 1990 is evidenced by the
following research. In a national survey of 19 school districts, Frankenberger, Lozar, and
Dallas (1990) reported fewer than 1.5% of the students surveyed were diagnosed with ADHD
and were receiving treatment with stimulants. More recently, Rowland, Umbach, Stallone,
Naftel, Bohlig, and Sandler (2002) completed a school-based survey that revealed 10% of the
6099 children included in the study were identified as having ADHD and were treated with
stimulant medication. The increase in stimulant use is also evinced by data from the United
States Drug Enforcement Administration (DEA, 2002). According to DEA data, there was
nearly a 900% increase in methylphenidate (Ritalin) production from 1990 to 2001. With the
introduction of Concerta and Metadate, the production of methylphenidate has increased by
40% from 2000 to 2002. Furthermore, from 1993 to 2006 the production of amphetamines
(Dexedrine and Adderall) increased by 7143% (DEA, 2006).
Researchers have also investigated use of antidepressant medication to treat children. Zito,
Safer, dosReis, Gardner, Soeken, Boles, et al. (2002) found a three to five fold increase in
antidepressant treatment among children between 1988 and 1994. Antidepressant use in
children increased by 9.2% each year from 1998 to 2000 (Delate, Gelenberg, Simmons,
Motheral, 2004). Selective serotonin reuptake inhibitors (SSRIs) were most frequently
prescribed by pediatricians and family physicians (Delate, 2004; Zito, et al, 2002; Rushton,
Clark, & Freed, 2000). However, recent research has questioned the efficacy of antidepressant
medication for the treatment of children (Keller, Ryan, Strober, Klein, Kutcher, Stan, et al.,
2001; Zito & Safer, 2001; Emslie, Rush & Weinberg, 1997). Furthermore, there is concern
over the potential risks of antidepressant use in the pediatric population. The FDA issued a
public health advisory regarding a potential increased risk of suicidality (suicide ideation and
attempts) and worsening of depressive symptoms associated with pediatric use of SSRIs to
treat major depressive disorder (FDA, 2004).
Researchers have generally not addressed the use of combinations of medications to treat
psychiatric disorders in children. The use of multiple psychotropic medications substantially
increased throughout the 1990s. A national sample of physician office visits revealed the rate
of combined antidepressant and stimulant use increased 25% from 1994 to 1997 (Safer, Zito,
dosReis, 2003). Children with more emotional, social, or educational difficulties were more
likely to receive multiple medications (Safer, Zito, dosReis, 2003). Bussing, Zima, and Belin

101

(1998) found 20% of children in an elementary special education program were receiving
multiple psychotropic medications. One of the most common psychotropic medication
combinations was that of an antidepressant and a stimulant (Bussing, Zima & Belin, 1998).
Rushton and Whitmore (1998) reported 30% of children in North Carolina were receiving an
SSRI concurrently with a stimulant. Despite the recent increase in use of multiple
psychotropic medications, there is a lack of research supporting its use and exploring potential
risks. In the adult literature, consistent findings reveal that as the number of concomitant
medications increases, the risk of adverse drug effects increases as well (Safer, Zito, dosReis,
2003). Such adverse effects include an increased possibility of unfavorable drug interactions
that can lead to serious physical and/or behavioral complications (Ambrosini & Sheikh,
1998).
Issues related to use of Psychiatric medication with children
Many studies have demonstrated the positive impact of psychiatric medication on symptoms
of psychiatric disorders in children. For example, the MTA Cooperative Group (MTA, 2004)
revealed stimulant medication appeared to successfully treat symptoms of ADHD as long as
the treatment continued. However, fewer data are available for other types of medications and
potential risks associated with these medications have recently been identified. The period
from early childhood to late adolescence is characterized by rapid physical, psychological and
social change, and though children are being treated with the same psychiatric medications as
are adults, their options for drug treatment are different due to pharmacokinetic and
pharmacodynamic effects that change with age (Weisz & Jensen, 1999; Wiznitzer & Findling,
2003). The brain of a child is an evolving organ with myelination, pruning, and the maturation
of synaptic connections continuing throughout adulthood (Wiznitzer & Findling, 2003).
While the short-term effects of multiple psychotropic medications have been documented, the
long-term effects of such drugs are not known (Wiznitzer & Findling, 2003). Recent research
may shed light on this issue. The MTA Cooperative Group revealed that the group treated
with medication showed a significantly reduced growth rate and continued growth
suppression (MTA, 2004). Until recently, experimental animal studies examining the effects
of psychotropic agents on brain maturation during critical periods of development were absent
from literature (Weisz & Jensen, 1999). However, recent research indicates that
methylphenidate may have long term effects on the brain and behavior due to changes
discovered in the brains of young animals that persisted into adulthood (Brandon, Marinelli,
Baker & White, 2001; Carlezon, Mague & Andersen, 2003; Bolanos, Barrot, Berton, WallaceBlack & Nestler, 2003).
The issue of psychopharmacological treatment in the child population is difficult to address
due to the fact that supporting data comes predominantly from small scale, non-blind
assessments, case reports, and a few regional surveys rarely involving systematic study (Safer,
Zito & dosReis 2003; Weisz & Jensen, 1999). Unfortunately, studies assessing the
effectiveness of psychopharmacological treatment in children are absent from the existing
research literature (Weisz & Jensen, 1999). Several important issues concerning the use of
antianxiety, antipsychotic, antiseizure and combinations of medications in the childhood
population currently remain unaddressed.
The purpose of the current study was to determine the types of psychiatric disorders and the
corresponding medication prescribed to children enrolled in elementary Emotional Behavioral
Disability (EBD) programs. Additionally, the study was designed to determine the most
common psychiatric diagnoses in the elementary EBD population, along with the most
common multiple diagnoses and corresponding single and multiple prescribed combinations
of medication. More specifically, the study was designed to determine the proportion of
children enrolled in the elementary Emotional Behavioral Disability (EBD) programs who
were currently prescribed medication for psychiatric disorders. Through a comprehensive
literature review and analysis of data, the current study also aims to address issues concerning

102

possible adverse drug interactions of single and multiple combinations of psychiatric

medication. Finally, the study examined the attitudes of EBD teachers toward diagnosis of
psychiatric disorders and use of psychiatric medication to treat children.
Method
Participants
The participants were elementary teachers of students with emotional and behavioral
disabilities in the state of Wisconsin for the 2003-04 school year. A list of elementary EBD
teachers was obtained from the Wisconsin Department of Public Instruction. Of the 3,562
teachers, 500 (14%) were randomly selected to receive the questionnaire. A cover letter
(explaining the purpose of the study and assuring anonymity), questionnaire, magnet
incentive and return envelope were mailed to each participant. Two weeks after the initial
mailing, reminder postcards were mailed, asking teachers to complete and return the
questionnaire if they had not already done so.
Instrument
A four page questionnaire was designed based on the survey employed in the Runnheim
(1996) et al. study to collect the data. The questionnaire was designed to gather information
through a series of Likert-type questions that assessed the teachers attitudes about the
incidence of childhood psychiatric disorders, and the use of psychiatric medication to treat
children in the teachers classroom. In addition, the teachers were asked to provide
demographic data and information regarding the grade level(s) they taught, their class size or
size of caseload, and the number of students receiving medication for a psychiatric
disorder(s). For each reported student receiving medication, the teachers were asked to
supply the following information: (a) grade level, (b) type of psychiatric disorder(s), and (c)
the particular psychiatric medication(s) administered to treat the corresponding disorder(s).
Results
Of the 500 questionnaires distributed, 146 teachers (29%) returned a questionnaire. Of the
questionnaires, 39 were returned as unusable due to not reaching the appropriate individuals
and five were returned after data analysis was completed. A total of 102 teachers provided
information on 617 elementary-aged children in Wisconsin placed in programs for students
with emotional and behavioral disabilities.
Information About the Students in EBD programs
Approximately 77% (474) of the 617 students were identified as having one or more
psychiatric disorder(s) and 21.2% (131) of students were identified as being diagnosed with
multiple psychiatric disorders. Approximately 65% (400) of the elementary students in EBD
programs were identified as receiving psychiatric medications for the treatment of one or
more psychiatric disorders. Fifteen percent (94) of students were identified as receiving
combinations of medications, and 6.2% (38) were identified as receiving three or more
medications.
Most Common Single or Multiple Psychiatric Diagnoses
Table 1 reveals percentages of children diagnosed with single or multiple psychiatric
disorders. Approximately 52% (322) of elementary students in EBD programs were identified
as having ADHD. The next most common disorder reported was anxiety disorder, with 12%
(74) of students identified, and bipolar disorder was identified for 10.4% (64) of the students.

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Table 1
Percent of Children With Single or Multiple Psychiatric Disorders
Disorder
Number
Percentage
ADHD
322
52.2
Anxiety
74
12.0
Bipolar
64
10.4
Depression
56
9.1
Autism
18
2.9
Seizure Disorder
14
2.3
Other
57
9.2
* percentages include all children that were diagnosed with either a single or multiple disorders

Most Common Multiple Psychiatric Diagnoses

Table 2 reveals that the most common multiple disorders were included in the category of
other due to the extent of multiple unique combinations of two or more diagnoses which
occurred very infrequently. The next most common multiple psychiatric diagnosis was
ADHD and anxiety disorder identified for 3.7% (23) of the students. Of children
diagnosed with more than two disorders, ADHD, anxiety disorder and bipolar disorder
occurred most frequently accounting for 1% (8) of the students.
Table 2
Percent of Children With (most common) Multiple Psychiatric Disorders
Disorders
ADHD + anxiety
ADHD + bipolar
ADHD + depression
ADHD + anxiety + bipolar
ADHD + bipolar + depression
ADHD + OCD
Other
Total

Number
23
14
13
8
7
7
59
131

Percentage
3.7
2.3
2.1
1.3
1.1
1.1
9.6
21.2

Most Commonly Prescribed Psychiatric Medications (Medication Specific)

In order to more clearly identify patterns of pharmacological treatment of psychiatric
disorders, specific medications were collapsed into classes specified in Table 3 and Table 4
that included stimulant, antidepressant, antianxiety, antiseizure or mood stabilizers,
antipsychotic and other medications. Table 3 reveals that 49.3% (304) of the students were
identified as receiving stimulant medication (Strattera was included in the stimulant category).
Of those receiving stimulants, 46.4% (141) of the students were identified as receiving
amphetamine (Dexedrine & Adderall), 36.5% (111) of the students were identified as
receiving methlyphenidate (Ritalin, Concerta, Metadate & generic methylphenidate), and
17.1% (52) of the students were identified as receiving Strattera.
The next most commonly prescribed psychiatric medications were antidepressants that
accounted for 10% (62) of the students. Of the students treated with antidepressants, 67.7%
(42) were receiving treatment with SSRIs (Zoloft, Paxil, Prozac & Celexa). Other newer nonSSRIs (Wellbutrin, Effexor & Remeron) accounted for 29% (18) of the students.

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Table 3
Percent of Children Receiving Single or Multiple Psychiatric Medications (by drug class )

Drug Class
Stimulant
Antidepressant
Antipsychotic
Antiseizure/Mood Stabalizers
Antianxiety
Other

Number
304
62
55
29
18
2

Percentage
49.3
10.0
8.9
3.9
2.9
1.1

* percentages include all children that are receiving either single or multiple medications

Approximately 8% (50) of the students were identified as receiving antipsychotic medication,

with 70% (35) of those treated with antipsychotics receiving Risperdal and 20% (10) of the
students were receiving Zyprexa. Approximately 3% (18) of the students were identified as
receiving antianxiety medication. It should be noted that 77.8% (14) of those treated with
antianxiety medication received Clonidine. Finally, 3.9% (24) of the students were identified
as receiving antiseizure or mood stabilizing medication, with 58.3% (14) identified as
receiving Depakote and 20.8% (5) receiving lithium.
Most Common Combinations of Psychiatric Medications (by Drug Class)
Table 4 reveals that the most common combinations of multiple psychiatric medications were
identified by the category of other due to the extent of multiple unique combinations of two
or more medications which occurred infrequently (4.1%, 24). The two most common
medication combinations were a stimulant plus an antidepressant and a stimulant plus and
antipsychotic, both of which occurred for 2.4% (15) of the students. The most common three
medication combination was a stimulant, an antidepressant and an antipsychotic medication
accounting for 1% (6) of the students.
Table 4
Percent of Children on Multiple Psychiatric Medications (by drug class)
Drug Class
Number
Percentage
Antidepressant + Stimulant
15
Antipsychotic + Stimulant
15
Stimulant + Stimulant
11
Antianxiety + Stimulant
7
Antidepressant + Stimulant + Antipsychotic
6
Antipsychotic + Stimulant +Stimulant
5
Antipsychotic + Stimulant + Antiseizure
5
Stimulant + Stimulant + Antidepressant
4
Antidepressant + Antidepressant + Antipsychotic + Stimulant
2
Other
24
Total

94

2.4
2.4
1.8
1.1
1.0
0.8
0.8
0.6
0.3
4.1
15.2

* 6.2% (38 students) were identified as receiving three or more medications.

Teachers Attitudes of Childhood Psychiatric Disorders and Use of Medication

The elementary EBD teachers were asked a series of questions regarding their views on the
incidence of childhood psychiatric disorders and the use of psychiatric medication in the EBD
classroom. The teachers' responses were based on a scale of 1 to 5 as specified in Table 5. A
mean response between 4.00 and 5.00 was labeled agree or greatly increase. A mean for a
particular statement between 3.50 and 3.99 was labeled a tendency to agree or increase. A
mean located between 2.50 and 3.49 was labeled neutral or remained the same. A mean

105

falling between 2.01 and 2.49 was labeled a tendency to disagree or decrease. A mean of
2.00 or below was labeled disagree or decrease greatly.
Table 5
Survey Questions With Means and Standard Deviations
Teachers Attitudes of Childhood Psychiatric Disorders and Use of Medication
THEFOLLOWINGSCALEWASUSEDTORESPONDTOTHEQUESTIONSBELOW:
1=Decreasedgreatly2=Decreased3=Remainedsame4=Increased5=Increasedgreatly

Question
SD
1. In your experience in the last five years the incidence of anxiety
disorder in the EBD population has
2. In your experience in the last five years the incidence of AttentionDeficit/Hyperactivity Disorder in the EBD population has
3. In your experience in the last five years the incidence of depression in
the EBD population has
4. Iamawarewhenachildhasnottakenhis/hermedication.
5. Medication significantly benefits students in terms of controlling their
own behavior.
6. Medication significantly improves academic performance of children
with EBD.
7. In my experience, medication has been a benefit to maintaining
classroom control.
8.ChildrenwithEBDreceivingmedicationbehavemoreappropriatelyin
socialsituationsthantheywouldwithoutthemedication.
9. Classroom behavior control would be much more difficult for me if
children were not treated with prescription medication.
10.Behavioralinterventionscanbeaseffectiveasmedicationfor
maintainingclassroomcontrol.
11. Iamconcernedwiththelongtermimpactofmedicationonchildren.
12.Ibelievethatstimulantmedication(e.g.Adderall)hasfewsideeffects.
13.Ibelievethatantidepressantmedication(e.g.Paxil)hasfewside
effects.
14.Ibelievethatantianxietymedication(e.g.Zoloft)hasfewsideeffects.
15.Ibelievethatantipsychoticmedication(e.g.Geodon)hasfewside
effects.
16. Most children with EBD are more teachable as a result of treatment
with medication.
17.Medicationtendstoimproveachildssocialadjustment.
18.MostchildrenwithEBDaremorelikeableasaresultoftreatmentwith
medication.
19.Medicationtendstochangeachildsnaturalpersonality.

100

3.82

.626

100

3.71

.715

98

3.66

.555

102
102

4.63
4.01

.525
.724

101

3.98

.735

102

3.92

.841

101

3.88

.864

101

3.68

.916

102

3.24

.925

101
97
99

4.02
2.95
2.93

.883
.795
.732

2.90
2.77

.703
.648

101

4.08

.744

102
101

3.71
3.33

.839
1.04

102

2.74

.984

96
92

Statements 1-3 addressed opinions regarding recent trends of psychiatric disorders. Teachers
tended to agree that the incidence of anxiety disorder, Attention Deficit/Hyperactivity
Disorder and depression in the EBD population had increased within the last five years.
Statements 4-10 assessed teachers attitudes concerning the effects of psychiatric medication
on classroom behavior of students in EBD classrooms. In response to questions 4 and 5 the
teachers agreed with the statements, I am aware when a child has not taken his/her
medication, and Medication significantly benefits students in terms of controlling their own
behavior. The teachers had a tendency to agree with question 6, Medication significantly
improves academic performance of children with EBD and question 7, In my experience,
medication has been a benefit to maintaining classroom control. On question 10, Behavioral

106

interventions can be as effective as medication for maintaining classroom control, the

teachers responses were in the neutral range.
Statements 11-15 addressed opinions regarding the effects of psychiatric medications. The
teachers agreed with question 11, I am concerned with the long-term impact of medication on
children. However, teachers responses were in the neutral range to questions 12-15
concerning whether they believed stimulant medication, antidepressant medication,
antianxiety medication, or antipsychotic medication, have few side effects.
Finally, questions 16-19 assessed teachers opinions regarding the social effects of psychiatric
medication on their students. They agreed with question 16, Most children with EBD are
more teachable as a result of treatment with medication.
Discussion
Incidence of Psychiatric Disorders
Few studies have looked specifically at the prevalence of psychiatric diagnoses among
children. An extensive review of existing literature conducted by Weisz and Jensen (1999)
reported ADHD, depression, bipolar disorder, anxiety disorder, autism and obsessivecompulsive disorder to be among the most commonly treated psychiatric disorders occurring
in childhood, even though the study did not specify actual prevalence rates. Similarly, results
of the current study indicate that ADHD, anxiety disorder, bipolar disorder, and depression
were the most prevalent psychiatric disorders occurring in children in EBD programs, with
the exception of obsessive-compulsive disorder, which appeared very infrequently.
Incidence of Treatment with Psychiatric Medications
Cullinan, Gadow, and Epstein (1987) reported that of the 11% of children in EBD programs
receiving pharmacological treatment, 71% were receiving stimulant medication. Children
were treated with other types of psychiatric medications in only 3% of the EBD population at
that time (Cullinan, Gadow, & Epstein, 1987). The current study revealed that of the 65% of
children in EBD programs were receiving pharmacological treatment, 76% received stimulant
medication alone or combined with other medications. In the current study children were
treated with medications other than stimulants in 27% of the cases. In fact, almost 9% were
being treated with antipsychotic medication and more than 15% of the children in EBD
programs were receiving multiple psychiatric medications.
Changes in Rates of Psychiatric Medication Over Time
Cullinen, Gadow, and Epstein (1987) reported that approximately 14% of children in EBD
programs were receiving medication to treat all categories of psychiatric disorders including
seizure disorder. In 1996 Runnheim et al. reported 40% of elementary school children in EBD
classrooms in Wisconsin were receiving medication to treat ADHD. To date, only the current
study has investigated the use of psychotropic medication in EBD classrooms since 1996.
Results of the current study reveal that 65% of children in elementary EBD programs were
receiving medication for treatment of psychiatric disorders, with 49.3% receiving
psychopharmacological treatment for ADHD. In addition, the current study revealed 21.2% of
children in elementary EBD programs were diagnosed with multiple psychiatric disorders and
15.2% of those diagnosed with multiple disorders were receiving concomitant multiple
psychopharmacological treatment. Currently the proportion of children being treated for
multiple disorders with multiple medications exceeds the proportion of children receiving any
type of psychiatric medication in 1987.
Possible Adverse Effects and Drug Interactions
An issue of concern related to side effects of medication is the use of antipsychotic
medications with children. Data from the current study revealed an increasing number of
children were receiving antipsychotic medication alone and in combination with other
psychiatric medications. Risperdal was the antipsychotic medication used most frequently

107

with children in this study. The pharmaceutical company that produces Risperdal recently
received a warning letter from the FDA stating the company had minimized the risks
associated with Risperdal and made misleading claims regarding efficacy of the medication
(FDA, 2004). The long-term effect this medication may have on children is generally
unknown but drowsiness caused by the medication may hinder educational goals in the
classroom.
The results of the current study highlight the need to address the issue of possible adverse
drug interactions related to the use of multiple psychiatric medications in young children.
Data from the study revealed that 15.2% of the children were receiving multiple psychiatric
medications (two or more) and 6% of the sample was being treated with three or more
medications. In the current study, the most common combination of medications was a
stimulant taken concurrently with an antidepressant (SSRI). The combination of stimulants
and SSRIs may enhance the risk of serious side effects in adults, but the type of interaction
that may occur in children is unknown. Though existing research addresses interaction effects
for pairs of medications, there is little research investigating the effects of three or more
medications given in combination.
Teachers Attitudes of Childhood Psychiatric Disorders and Use of Medication
Questionnaire data from the current study revealed teachers believe medication improves the
behavior and learning ability of children in EBD classrooms. Teachers attitudes related to the
target effects of psychiatric medication were generally positive while their attitudes related to
side effects were generally in the neutral range. Other research indicates that teachers have not
been aware of relevant information related to side effects of psychiatric medications ( Snider,
Busch & Arrowood, 2003). Research has shown that some medications, such as
antipsychotics and antiseizure medications, may result in a number of cognitive or memory
impairments that could interfere with learning (Forness & Kavale, 1988). Also, findings from
a study conducted in 1984 suggest that antidepressant medication may have had adverse
effects on childrens classroom performance (Forness & Kavale, 1988).
Implications
First, the current study reveals that the rate of treatment of psychiatric disorders of children in
EBD programs has increased dramatically over the past 15 years. Research is needed to
determine whether children in EBD programs have intensive and individualized behavioral,
social, and educational interventions that are aimed at controlling and helping the child
control the behaviors for which they are receiving medication. Medication can help to control
symptoms while children are being treated, but children cannot learn from medication.
Historically, EBD teachers employed behavioral, social and academic interventions to address
the issues evinced by the children in their program. Results of the current study indicate that
there is an increasing trend towards using pharmacological interventions in educational
settings.
The increase in the use of medication for the treatment of psychiatric disorders and school
related issues in the absence of research supporting long-term efficacy of such treatment may
be attributed to the increased acceptability by society, professionals and teachers. Results of
the current study revealed that teachers were aware of the positive impact medication had on
controlling the behavior of children in their classroom. Teachers were less aware of the side
effects and lack of long-term efficacy data related to the use of medication.
Secondly, results of the current study revealed that children in EBD programs were treated
with antipsychotic medication more frequently than in the past. This trend raises questions
based on the known side effects associated with such medications. Teachers should be made
aware of the documented long-term effects of antipsychotic medication in the population of
institutionalized children with mental retardation, and the possibility that these medications
may interfere with a childs ability to learn. (Gualtieri, Schroeder, Hicks, & Quade, 1986).

108

Finally, a significant proportion of students in EBD programs received multiple medications

for multiple disorders. This finding is important because the impact of single medications on
developing children is often unclear, and the impact of multiple medications is unknown.
Research reveals that the potential side effects of single and multiple medications ranges from
a negative effect on growth rate to impaired development and learning in young children
(MTA, 2004; Forness & Kavale, 1988). The treatment of children with multiple psychiatric
medications is a nascent trend and positive as well as negative long-term effects of such
treatment are unknown.
Limitations
Approximately 30% of the questionnaires were returned which raises the question of whether
the returned sample is representative of the original random sample. One reason the return
rate was not higher may be that the questionnaire did ask teachers to provide a great deal of
information that may have required them to do some research. However, the obtained data
was very much in line with the results reported by Runheim, et al. (1996). In fact, the
increased rate of stimulant use from the time of the Runheim et al. (1996) study to the time of
the current study agreed with other data indicating similar increases in rates of stimulant
treatment with children (Lefever & Dawson, 1999). The same consistency was also found in
relation to the use of multiple medications (Moline and Frankenberger, 2001). The internal
validity of the study was assessed via two different methods used to identify the percent of
children receiving medication. Teachers were asked to specify the number of children in their
EBD program and the number of children who were being treated with medication. They
were also asked to provide detailed information on each child receiving medication. Both the
initial number identified as receiving medication and the actual number of children for which
detailed information was provided correlated exactly.
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EARLY IDENTIFICATION AND INTERVENTIONS FOR CHILDREN

AT RISK FOR LEARNING DISABILITIES
Stephen M. Lange
&
Brent Thompson
West Chester University of Pennsylvania
We propose that a model for early screening of children aged 3-5 years
for vulnerability for learning disabilities risk can result in preventive
interventions, including collaborative interventions planned through
parent-professional partnership. The goals of screening and preventive
services would be to mitigate increased risk of learning disabilities in
elementary school years. The present article describes the rationale for
early screening, dimensions that should comprise brief screening tools
for use from ages 3-5 years, and potential preventive interventions that
have empirical support.
The diagnosis of learning disabilities is often determined when children begin to exhibit
academic difficulties in school, and the average age when children receive learning
disabilities assessments is 9years (Shaywitz, 1998). Delayed intervention can result in adverse
and persistent consequences for academic skill acquisition. In contrast, early identification of
children at risk for learning disabilities may offer the potential to mitigate the negative effects
of delayed intervention by directing children to preventive services at an earlier age. This is
persuasively argued by a National Institutes of Health consensus report, Emergent Literacy
Workshop: Current Status and Research Directions, which asserted that diagnosis at
kindergarten or first grade is too late (National Institutes of Health [NIH], 2000).
A Developmental Model of Learning Disabilities
A complicating issue in learning disabilities intervention generally, with implications for
prevention, is the ongoing debate surrounding definition of learning disabilities and how or
whether -- they may be appropriately diagnosed. We assume that learning disabilities can be
defined as an adverse developmental outcome (Geary, 2004; Gersten, Jordan & Flojo, 2005)
resulting in unexpected and significant (Fletcher, Coulter, Reschley & Vaughn 2004)
difficulty with basic academics. We assume that learning disabilities result from multiple
vulnerabilities that arise from biological, psychological, and social systems and their complex
interactions (Rueda, 2005). Specifically, children who demonstrate learning disabilities during
their elementary school years demonstrate early biological vulnerabilities including a genetic
liability for mild cognitive delays or low birth weight. Once biologically vulnerable children
begin to lag behind peers, their interaction with their social world and with modes of
instruction systematically differ from their peers.
The interaction between an earlier vulnerability and response to intervention has been
specifically studied for children who demonstrate reading disorders: Once children who have
greater difficulty than peers developing reading fluency they begin to lose opportunities to
practice reading connected discourse as they spend increased time learning foundation skills
such as phonetic decoding. This places initially struggling readers at a continuing
disadvantage as they progress through public education. Further, children who initially
struggle to read passages lose access to the language experiences and content information
available in print (Torgesen, 2000). Consequently, we propose a cross-theoretical, evidencebased standard for identifying vulnerabilities to target for prevention. In other words, early
developmental factors that consistently predict learning disability diagnosis merit
consideration as targets for preventive services, and are presumed to confer vulnerability.

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Differing theoretical positions regarding the etiology of the learning disability construct may
lead to preventive services that emphasize different vulnerabilities, and approaches which
target different vulnerabilities are not presumed to be mutually exclusive. For example, Head
Start is an example of a very comprehensive preventive intervention for academic failure that
simultaneously intervenes with multiple, interacting, and dynamic systems including familial,
community, economic, psychological, and biological systems. The purpose of our paper is to
focus attention on the development of prevention strategies that identify young children who
demonstrate a set of intrinsic, presumably organically determined vulnerabilities, particularly
those that are associated with mild cognitive impairment and more specifically language
delays.
The importance of developing prevention strategies that mitigate risk for learning disabilities
is suggested by the consensus criteria used to determine how to invest prevention resources:
Priority is assigned to disorders that have a high prevalence, and those which are associated
with developmental trajectories that can result adverse behavioral, social, and psychological
outcomes (Biglan, Mrazek, Carnine & Flay, 2003). Learning disabilities are indeed prevalent,
and as many as 17 percent of the population may have learning disabilities (Lyon, 2005). The
importance of early intervention for children at risk for learning disabilities is further
illustrated by their potentially pervasive effects on development. While those with learning
disabilities constitute a heterogeneous and diverse population with varied outcomes, adverse
consequences of learning disabilities can persist across the lifespan and extend beyond
academic skill acquisition to more complex developmental tasks (National Research Center
on Learning Disabilities [NRCLD], 2002). During childhood, individuals with learning
disabilities face a complicated and challenging task of integrating their disability into an
emerging self-concept. Children who have difficulty with this task and employ immature
strategies such as denial or disavowal can become harsh self-critics. These children thus have
an increased lifetime risk for a broad range of psychiatric disorders (Esser, Schmidt, &
Woerner, 1990), and particularly depressive disorders and Posttraumatic Stress Disorder
(McNulty, 2003). For example, when compared to other pupils, college students with learning
disabilities were found to be nearly three times more likely to have depressive illness, and
have more problems with their grades and quality of their coping skills (Arnold, 2000). Even
when the consequences of learning disabilities such as harsh self-appraisal do not merit
psychiatric diagnoses, children and adults with learning disabilities can still experience
diminished confidence in the efficacy of their own academic, cognitive, and occupational
efforts, having internalized repeated exposure to frustration (Cummings, Maddux, & Casey,
2000). As members of the adult workforce, those with learning disabilities are more likely to
experience unemployment, or underemployment, and to earn less than non-disabled adults
(Cummings et al., 2000). Even among adults who possess college degrees, routine workplace
demands can prove more difficult for employees with learning disabilities than for their
coworkers, diminishing their productivity and value to employers (Dickenson & Verbeek,
2002).
During early childhood, the term vulnerability aptly describes risk for learning disabilities. By
itself, assessment that identifies biological risk factors for learning disabilities are neither
sensitive nor specific enough for learning disability diagnosis (Jenkins & OConnor, 2002;
OConnor & Jenkins, 1999; Schatschneider & Torgenson, 2004). The responsibility for
surveillance is shared among multiple social systems including families and the medical care,
daycare and educational systems. In particular, physicians and other professionals who
interact with young children and who have training in child development are encouraged to
provide surveillance for early signs of language and learning disorders (AAP, 2001).
Biological Predictors Vulnerabilities for Learning Disabilities
Organic factors are indeed associated with increased risk of learning disabilities
(Scarborough, 1990). These include genetic liability for mild cognitive disorders, low birth

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weight, and previous evidence of comorbid mild cognitive disorders. With respect to genetic
liability, studies of heritability of learning disabilities indicate that the parent-child and sibling
concordance rates for learning disabilities are 25-60% and 40% respectively. Multi-gene
transmission of learning disabilities is the suggested mechanism (Olsen, Wise, Conners, Rack,
& Fulker, 1989; Plomin & Walker, 2003). Because genes implicated in transmission of
learning disabilities may also be implicated in other cognitive disorders, siblings and children
of individuals with Attention Deficit Hyperactivity Disorder (ADHD) and Autistic Spectrum
Disorders need to be considered at risk as well (Faraone & Biederman, 1993; Williams,
Oliver, Allard, & Sears, 2003). Low birth weight (birth weight less than 2500 grams or
approximately 5 pounds- 6 ounces) predisposes children to delays in development of visuospatial and language skills, especially for children with socio-familial stressors such as
poverty, or who need more intensive medical intervention following birth (Breslau, Johnson,
& Lucia 2001; Kanzawa, Shimizu, Kamada, Tanabe, & Itoigawa, 1997; Ross, Lipper, & Auld,
1996; Stanton-Chapman, Chapman, & Scott, 2001). Finally, with respect to prior diagnosis of
mild cognitive disorders, a previous ADHD diagnosis indicates learning disabilities
vulnerability. ADHD has a high rate of co-morbidity with learning disabilities with as many
as 66% and 27% of children with ADHD experiencing either written language or reading
disabilities, respectively (Mayes, Calhoun, & Crowell, 2000). Because of the high rate of comorbidity as well as common cognitive features of the two disorders, Mayes and her
colleagues, along with others (e.g., Marshall & Hynd, 1997), propose that ADHD and
learning disabilities represent overlapping spectrum disorders.
Language Development and Learning Disabilities
Academic achievement across the curriculum is inherently dependent on language, and from a
developmental perspective, academic achievement, particularly but not exclusively reading
and writing skills, represent the culmination of a process that begins early in a childs
development, with the emergence of oral language (Lyon, 2004). This developmental process
includes experiential exposure to concepts, cultural information, and vocabulary;
development of phonemic awareness; rapid and automatic access to vocabulary; and letter-,
word-, paragraph- and book-level orthographic skills. Orthographic skills subsume basic
concepts of print including understanding that print conveys information, that print is read in
a predictable direction; that books are used in predictable ways, and especially that written
symbols correspond to speech sounds termed the alphabetic principle (Lyon, 2004;
Lindquist, 1982; Nichols, Rupley, Rickelman, & Algozzine, 2004; Scarborough, 1990;
Torgesen, 2000; Torgesen & Wagner, 1994; Wolf, Bowers, & Biddle, 2000).
Reading and written language disorders are the most frequently diagnosed learning
disabilities (Gonzales & Nelson, 2003; Robinson, Menchetti & Torgesen, 2002). Relatively
fewer students present with math disabilities, and approximately 4 or every 10 students with a
mathematics disability demonstrates a co-morbid reading disorder (Robinson et al, 2002).
Students with mathematics disabilities, including those without co-morbid reading disorders,
frequently display deficits in foundational language skills, including assigning semantic and
phonetic meaning to numerals, semantic retrieval, and verbal fluency which contribute to poor
mathematics achievement (Desoete & Roeyers, 2005; Mazzocco, 2005; Mazzocco &
Thompson, 2005; Robinson et al, 2002).
Standards for Screening Tools
Screening tools that focus on early vulnerabilities for learning disabilities should quickly and
unambiguously screen for both organic and language differences that confer vulnerability for
learning disabilities before child attain school age. While screening tools are by definition not
as comprehensive as diagnostic assessment, they can provide information about individuals
cognitive strengths and weaknesses and may be used for selecting children for further
assessment or for preventive interventions (Lonigan, 2005). A screening tool should ideally
incorporate interview questions for parents or other caretakers about demographic risk factors
as well as tasks administered to children that screen for weaknesses in foundational language

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skills including rapid access to vocabulary and phonemic awareness. The advantages of
combining parental report with tasks presented to children include enlisting parents as active,
respected participants (AAP, 2001). Finally, screening tools should provide a written record
for each screening, conferring two advantages; first, directing the screeners attention to each
domain assessed, and second, providing benchmarks for comparisons over time. While each
screening tool item should be referenced to a risk factor, the tool may not necessarily produce
a norm-referenced summative score as a child who has one or more risk factors should be
referred for further assessment and be considered for preventive interventions.
Table 1 provides a list of dimensions that should be represented in a screening tool with
examples of items.
Table 1
Sample Screening Questions and Tasks, Risk Factor Assessed
Parent Demographic Interview Questions
Was your childs birth weight less than 5 pounds or 2500 grams?

Risk Factor
Low Birth Weight

Does your child have a mother, father, sister, or brother with a learning
Disability, ADHD, or an Autistic Spectrum Disorder, even if it was not
formally diagnosed?
Does your child have a diagnosis of ADHD?

Heritability of Cognitive
Disorders

Was your child combining words into short sentences or phrases by the
time s/he was 2 years old?

Delayed Speech

Parent Reading Observations Interview Questions

Does your child read signs like Coke or McDonalds?
Does your child recognize parts of a book such as the cover, title, and
end?
Does your child point to words or letters he or she knows when reading a
book?
Does you child recognize or write the letters of his or her name or other
words?
Sample Tasks Administered to Children
Rhyme Detection

Comorbidity of LD with ADHD

Orthographic Skill/
Environmental Print
Print Knowledge

Risk Factor
Phonemic Awareness

Segmenting Words into Phonemes

Blending Phonemes to Form Words
Letter Naming

Orthographic Skill

Letter-Sound Correspondence

Alphabetic Principle

Rapid Categorical Naming

Rapid Access to Vocabulary

Currently available screening tools for prediction of learning disabilities are primarily used
with children age 4 years or older (e.g., National Center for Learning Disabilities [NCLD},
2001). Two comprehensive reviews of these measures are provided by Jenkins and OConnor
(Jenkins & OConner, 2002; OConner & Jenkins, 1999). The tools they reviewed have some
important limitations: Most include assessment of beginning reading skills such as alphabet
knowledge, in addition to developmentally earlier language functions. Combining
surveillance for demographic risk factors with direct assessment of foundational language
skills appropriate for 3 year-old children would provide optimal opportunities for early
prevention. According to OConnor and Jenkins (1999), some predicative assessments take as
long as one hour to administer. Because developmental screening typically needs to be
repeated over time due to the dynamic nature of development, lengthier assessments have
limited utility in most practical settings where screening is likely to occur.

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An example of a brief (less than 10 minutes to administer) screening tool is Get Ready to
Read! (NCLD, 2005). The 20 questions that comprise Get Ready to Read! do not require oral
responses, and children are asked to choose one of four pictures to answer each item. This
tool was designed so that it can be administered by individuals without specialized assessment
training. In a review of the tool by Lonigan (2005), its purpose is described as providing a
snapshot of foundational language skills that can become targets for preventive intervention.
Lonigan differentiates between this purpose and diagnostic evaluation which would provide
more detailed information about cognitive strengths and weaknesses. Domains assessed
include letter, word, and book level orthographic skills and phonemic awareness. Concurrent
and predictive validity for Get Ready to Read! screening at age 4 years have been
demonstrated through correlation with other preschool measures and with reading measures
(word recognition and phonetic decoding skills) at age 7 years. Get Ready to Read! provides
norm-referenced scores. Cut-off scores for decision making are not provided. Spanish and
English versions of the tool are available (Lonigan, 2005).
Preventive Services for Children Identified as Vulnerable
Logically, to have any value screening needs to lead to effective preventative services. While
empirically validated preventive interventions are preferable, consensus standards for
evaluating prevention programs have not emerged (Biglan et al, 2003). Proposed standards for
evaluating intervention effectiveness consider an intervention to be well-established when two
or more well-conducted and well-described group-design studies demonstrate the
interventions superior effectiveness to placebo treatment, or equivalent effectiveness to an
already established treatment. Additionally, an intervention can be deemed well-established
when its effectiveness is supported by a large number of single-case design studies by
multiple researchers at multiple sites. Probably efficacious interventions are supported by
more limited evidence, such as two or more studies that do not provide comparison to placebo
or already established treatment, or a small number of single-case design studies (Shepard &
Carlson, 2003). Further, Justice and Kaderavek (2004) propose that interventions likely to
confer benefit to children include combinations of direct intervention by professionals, and
indirect interventions which are collaboratively planned by professionals and parents to occur
in naturalistic settings. Justice and Kadervek argue that combining direct and collaborative
interventions increases the amount of childrens time devoted to intervention as well the
ecological validity of interventions. Further, Shepard & Carlson (2003) propose that effective
early-childhood preventive interventions are collaboratively planned with parents, view
parents as important resources, respect cultural differences, and flexibly accommodate
parents schedules. A set of proposed preventive interventions that may have utility for
children identified as at risk for learning disabilities is briefly described below. The selection
of preventive interventions is influenced by the perspective that language deficits that
contribute to learning disabilities are observable in early childhood and further that these early
language deficits place children on a developmental trajectory associated with later learning
disabilities. Consequently, remediation of early language deficits represents the most
appropriate target for intervention for children at increased learning disabilities risk. The
interventions described target language development during early childhood using an
ecological view of language development as occurring in natural contexts such as home,
preschool, and community. These proposed interventions incorporate the recommendations
offered by Justice and Kadverek (2004) and Shepard and Carlson (2003) that programs
emphasize parent-professional partnership, and are supported by group-design effectiveness
studies. However, a limitation associated with empirical support for these interventions is the
selection of outcome variables in their effectiveness studies. Typically, these interventions
demonstrate benefit in terms of language skill development. This does not directly imply that
preventive interventions would change either the subsequent incidence of learning disabilities
or the severity of disability among those who receive the interventions. Intervention outcome
studies that directly assess the relationship between language intervention in early childhood

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and learning disabilities rate and severity would represent a gold standard for intervention
effectiveness.
Indirect Interventions: Parent Education and Consultation
Improving Parental Language Models. Language development is mediated by experience
with language models, and parents provide apprenticeship experiences for language
complexity. Critical parent skills for improving childrens language include responsiveness
and sensitivity to the social and affective intention of childrens communication. Parents
facilitate childrens language growth when they imbue communication with positive affective
tone, and provide affirmation for childrens communicative intent, and by modeling rich,
complex use of language (Dodici, Draper, & Peterson, 2003). Parent behaviors that improve
language development are teachable skills and professional-parent consultation can improve
parents length of utterances, responsiveness to childrens communication, contingent use of
praise for childrens communication, use of language expansion, modeling of language
pragmatics such as attentive listening and turn-taking in conversation, and understanding of
the differences between childrens and adults language development. Developmental
awareness includes, for example, the need for parents to pause before responding or
interrupting during conversation to accommodate their childrens slower processing speed.
Systematic intervention through parent-professional partnership can increase childrens
spontaneity of language, length of utterances, and variety of language forms, while decreasing
yelling and oppositional behavior (Hancock, Kaiser, & Delaney, 2002).
Improving Childrens Creative and Narrative Play. Interventions designed to improve the
complexity and maturity of vulnerable childrens play also confers substantial and measurable
benefit in terms of their vocabulary development, length of utterances, and language
complexity and diversity. Teaching adults, including parents and other caretakers, to
systematically guide complex, imaginative, and social play with peers through introduction of
ideas and themes for play, providing ideas for roles and narratives, unobtrusively moderating
play through modeling, prompting, and providing feedback, and by aiding in recall and
discussion of play experiences when play is over, facilitates childrens practice of language
pragmatics, sustained social interaction, problem solving through negotiation, and exposes
children to language models provided by peers during play. As well, facilitating mature,
imaginative, and social play can increase the likelihood that children will derive satisfaction
from play and social interaction, reinforcing communication attempts (Craig-Unkefer &
Kaiser, 2002). Parent-child word games can also play an important role in facilitating
language development (Hornby & Jensen-Proctor, 1984), including old games such as I spy,
or 20 Questions.
Improving Orthographic and Phonemic Skills through Shared Reading. Shared reading
provides children, even at very young ages, with models of reading, exposure to the
phonological system of language, and information about how books and print are organized to
convey information. As well, parents who read with their children provide them with
important opportunities for interaction using language and encourage competence and active
engagement in both communication and literacy (Woude & Barton, 2003). Thus, shared
reading confers a double benefit of increased opportunities to practice listening and speaking
with an adult model as well as opportunities to learn about written language through books.
Unfortunately, several studies that assessed the frequency of shared reading in homes revealed
that a minority of parents read to their children (Celano et al., 1998; Heubner, 2000), perhaps
as few as one in four (Klass et al., 2003). Hypothesized obstacles to shared reading include
role strain experienced by parents who cope with financial stressors and increased work
demands in a turbulent economy (Huebner, 2000). This has a disproportional affect on shared
reading in families who are at risk due to poverty, limited parental education, or membership
in ethnic or language minorities (Celano et al., 1998; Huebner, 2000; Klass et al., 2003;
Washington, 2001). As well, the frequency and quality of shared reading varies between

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families and depends on parents own literacy skills, beliefs about literacy, and their childrens
enthusiasm for reading (Celano et al., 1998).
Despite the obstacles parents and children face, collaborative interventions that teach parents
to enhance shared-reading experiences can increase both the frequency of shared reading and
the quality of shared reading. Demonstrations of effective interventions based upon parent
education have been as brief as three one-hour sessions (Hockenberger, Goldstein, & Haas,
1999). The common elements of effective intervention across studies include increasing
frequency and duration of shared reading, and teaching parents to intentionally and
reflectively use specific questions and prompts. Enriched adult questioning and prompting can
focus on expanding the complexity of childrens use of language for communication and
concept formation, as in Dialogic Reading created by Whitehurst and his colleagues
(Zevenbergen, Whitehurst, & Zevenbergen, 2003), and on focusing childrens attention on
orthographic and phonemic information conveyed by literature including book-level,
paragraph-level, word-level, and alphabetic information. Prompts aimed at developing preliteracy skills typically instruct children to locate, identify, or name characteristics of book
organization, such as left to right and top to bottom organization of text, recognition of words
in context, and letters and their sounds (Celano et al., 1998; 2002; Hokenberger et al., 1999;
Huebner, 2000; Justice, Weber, Ezell, & Bakerman, 2002). Shared reading can be encouraged
through use of books with strong rhyming patterns and repetition of sounds, celebration of
reading through activities linked to books (Allor & McCathren, 2003), and building on
families existing communication and literacy patterns and strengths (Justice & Kaderavek,
2003). Importantly, both parent and professional readers can enrich their shared reading skills
during shared reading, with measurable benefits for children, especially when interventions
are implemented both at home and by professionals (Crain-Thoresen & Dale, 1999;
Whitehurst & Lonigan, 1998).
Reach Out and Read provides an example of shared reading intervention provided within a
primary health care context (Klass et al., 2003). Assessment of childrens print knowledge by
handing books to preschool children during well visits is an essential element of Reach Out
and Read. In-office assessment offers direct observation of how children handle books as well
as the quality of their verbal, motor, and affective responses to print. Reach Out and Read
intervention additionally provides volunteer readers who model shared reading in pediatric
waiting rooms; guidance for parents and other caretakers that provide specific information
about child development, literacy development and shared reading; and a gift of a
developmentally appropriate book at each visit. Program evaluations demonstrated increased
frequency of shared reading, particularly among families at lower income levels and families
who are members of language minorities. In addition to increasing frequency of shared
reading, the Reach Out and Read program enhanced the emotional valance of shared reading,
with parents reporting greater satisfaction with shared reading as an activity and greater
responsiveness to shared reading among their children. Most importantly, Reach out and Read
children experienced significantly greater receptive and expressive language gains compared
to age-matched controls (Klass et al., 2003).
Direct Interventions Provided by Professionals
Direct intervention for young children at risk for learning disabilities or other poor reading
outcomes from pre-school through first grade is considered a promising approach to catch
them before they fail (Hus, 2001). However, preventive interventions typically demonstrate
effectiveness for groups of children while individual children experience widely disparate
outcomes (Gonzales & Nelson, 2003). This variation may result from differences in severity
of deficits evident among children identified as at-risk, with children having the most severe
impairments experiencing the smallest gains from prevention programs (Torgesen, 2000).
Although the elements required for successful preventive services are not well understood,
Torgesen (2000) advises that preschool prevention provide instruction that is explicitly related
to literacy as opposed to language development more generally. Because acquisition of

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phonemic and orthographic skills appear to represent mutually dependent processes (Castles
& Coltheart, 2004; Christensen, 1997; Korkman & Peltoma, 1993), typical interventions
focus on explicit instruction in phonemic skills, including rhyming, segmenting, and blending
sounds; letter recognition; and letter-sound correspondences, mirroring Torgesens
recommendation. Evaluations of preventive interventions which included control or
comparison groups that received no or nonspecific intervention indicate that intervention is
associated with improvements in precursor language skills (Allor & McCathren, 2004;
Rvachew, Nowak & Cloutier, 2004), as well as later improvement in reading and spelling
outcomes up to two years following intervention (Allor & McCathren, 2004; Hus, 2001;
Korkman & Peltoma 1993; Schneider, Ennemoser, Roth, & Kuspert, 1999; Vadasy, Jenkins, &
Pool, 2000). Effective preventive practices have been demonstrated in diverse settings using a
variety staff to provide intervention. Examples include adding explicit reading prevention
instruction to speech and language therapy provided by speech and language pathologists
(Pokorni, Worthington, & Jamison, 2004; Rvachew, Nowak, & Cloutier, 2004), small-group
intervention carried out by psychologists, educators, and speech and language pathologists in
mental health, medical, and school settings (Korkman & Peltoma, 1993) and by college
students with several hours of training (Allor & McCathren, 2004), as well as by volunteers
with similarly minimal training (Vadasy et al., 2000) . As well, the duration of intervention
programs vary, with successful programs lasting as few as 9 weeks (Hus, 2001) and as long as
one school year (Allor & McCathren, 2004), with session lengths as brief as 15 minutes
(Schneider et al., 1999). Vulnerable children are best served by programs which ensure
fidelity of intervention practices by providing staff training prior to and during intervention,
as well as those that use structured and packaged formats that explicitly guide intervention
(Allor & McCathren, 2004; Korkman & Peltoma 1993).
Discussion
Academic skills represent the culmination of a continuous process of language development
beginning in early childhood. Genetic liability for learning disabilities, low birth weight, and
delayed development of early language skills can predispose children to learning disabilities
thus mediating the language development process. Viewed from a developmental perspective,
professionals working with vulnerable children and their families can provide early
intervention that offers opportunities to facilitate the language development of children with
increased risk for learning disabilities, possibly mitigating their risk for later developing
learning disabilities. Specifically, professionals who have daily interaction with children can
help parents and other caretakers identify childrens vulnerabilities through use of screening
tools, and promote through education and collaboration development of home literacy
environments (Payne, Whitehurst & Angell, 1994) that offer enriched opportunities to develop
foundational language skills associated with literacy. In addition to collaborative, indirect
interventions, screening to identify vulnerable children can lead to appropriate referral for
direct services including diagnostic assessment, an educational, speech and language, and
related programs.
While empirical support provides evidence for the efficacy of preventive services in
enhancing foundational language skills, this evidence does not establish that rates of learning
disabilities diagnosis would decline as a result of preventive services. Approaches to
demonstrating the benefits of prevention on disability frequency or severity are suggested in
the broader prevention literature and are relevant to learning disabilities prevention efforts.
These include establishing registries of prevention trials to collect and aggregate longitudinal
and outcome data for children who receive preventive services, with emphasis on
documenting the relationship between prevention and disability, on collecting long-term
follow-up data , and on establishing local monitoring systems to describe both how researchbased interventions are carried out locally in practice settings and the effectiveness of the
programs (Biglan et al, 2003; Shepard & Carlosn, 2003).

119

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INDIVIDUAL, FAMILY, AND SCHOOL FACTORS ASSOCIATED WITH THE

IDENTIFICATION OF FEMALE AND MALE STUDENTS FOR SPECIAL
EDUCATION
Donald P. Oswald
Al M. Best
Virginia Commonwealth University
and
Martha J. Coutinho,
East Tennessee State University
The purpose of this study was to investigate factors related to placement
in special education for males and females. The conceptual approach
included individual, family, and school characteristics believed to
influence educational performance and outcomes with emphasis was
given to variables for with evidence of differential effects for males and
females. Using the nationally representative, longitudinal NELS-88 data
set, a logistic regression model examined the extent to which individual,
family, and school characteristics were differentially associated (for male
and female students) with identification for special education. The model
identified a variety of characteristics associated with identification for
special education, but only one individual characteristic, self-concept,
for which the effect was different for male and female students.
Recommendations for secondary education and transition practices and
research were offered related to self-concept with respect to differences
across gender, racial/ethnic, and disability status.
Placement in special education holds lifelong significance for a child. For children with
disabilities not making satisfactory educational progress, IDEA (P.L. 105-17, as amended)
provides for nondiscriminatory eligibility procedures and the opportunity for an
individualized education. However, many now argue that special education identification for
too many leads to a second-class education, and for other students, identification itself is
unwarranted (Donovan & Cross, 2002). Related concerns about discrimination and bias
continue to impact public opinion adversely about a service intended to assure a high quality
education for individuals with disabilities (Presidents Commission on Excellence in Special
Education (PCESE), 2002; Donovan & Cross, 2002).
Among the factors are known to influence placement in special education are significant
developmental delays; achievement deficits, particularly in reading and math; and behavioral
problems, poverty, and the disability definition (Coutinho, Oswald & Best, 2002;
Del'Homme, Kasari, Forness, & Bagley, 1996; Fujiura & Yamaki, 2000; Halfon & Newcheck,
1999; MacMillan, Gresham, Lopez, & Bocian, 1996). Other variables associated with
identification as disabled include race and gender (Oswald, Coutinho, Best, & Nagle, 2002).
Racial and ethnic disproportionality in special education is now widely recognized, but
controversy about the basis for the disproportionality complicates public efforts to provide
students with disabilities with equity in their education experience (Donovan & Cross, 2002;
Losen & Orfield, 2002).
Surprisingly, interest in gender disproportionality in special education is relatively recent
(Gender differences impact learning and post-school success, 2003; U.S. Department of
Education, 1998). This contrasts sharply with regular education where controversy has existed

124

since 1972, when females were found on the wrong side of the gender gap because of deficits
in math, science, and the lower likelihood of placement in the college track (Lee, Chen,
Smerdon, 1996). Substantial evidence now points to the emergence of gender differences in
middle school favoring females in some instances (Willingham & Cole, 1997). However,
attention is more often drawn to how educators may shortchange females (Lee, et al., 1996;
Orenstein, 1994; Sommers, 2000).
For a long time, evidence has existed about the over representation of males in special
education. The overall male to female ratio in special education has been reported between
2:1 and 3:1, although this varies depending on the disability condition (Bentzen, 1966;
Hayden-McPeak, Gaskin, Gaughan, 1993; Mumpower, 1970; Oswald, et al., 2002; Valdes,
Williamson, & Wagner, 1990). Longitudinal analyses of the nationally representative data
base of school aged children collected by the U.S. Office for Civil Rights reveal that
disproportionality is greatest for the category of Serious Emotional Disturbance (SED), where
the proportion of males to females, since 1976, has been about 3.5:1. The variation in state
male:female ratios is also greatest for students with SED, ranging up to nearly 6:1 (Coutinho
& Oswald, in press).
The National Longitudinal Transition Study of secondary aged youth has also reported
proportions of males and females identified for LD, MR, SED, and several other disability
conditions (U.S. Department of Education, 1998; Valdes, et al., 1990). The proportions of
males and females identified as LD and SED were comparable: 73% and 76%. The greater
disproportionality for LD obtained by Valdes et al., (1990) as compared to Oswald et al.,
(2002), may reflect differences in the ages analyzed. Male students made up about 58% of
students identified with mental retardation (MR), sixty percent (60%) of those identified as
having speech impairments, and about 65% of students with multiple disabilities. Between
52-56% of those identified for a number of sensory and physical conditions, including
hearing, orthopedic, deafness, other health impairments, and visual impairments were male.
There was no gender disproportionality for the condition of deaf/blindness.
Males are identified at higher rates than females for almost all childhood psychiatric
disorders. Male disproportionality is greatest for the conditions of attention deficit
hyperactivity disorder (4-9:1), autism (4-5:1), and stuttering (3:1). More males than females
are also identified for several other conditions, including mental retardation, reading disorder,
language disorder, Asperger syndrome, oppositional defiant disorder, conduct disorder,
Tourettes syndrome, encopresis, and enuresis. Females are more likely to be identified for the
conditions of separation anxiety and selective mutism, and there are is no gender
disproportionality for feeding disorders. Only females are diagnosed with Retts disorder
(American Psychiatric Association, 2000).
There is some concern that males are over referred for special education evaluation and
inappropriately identified because of behaviors that are difficult to manage, but do not reflect
a disability (Donovan & Cross, 2002; PCESE, 2002). However, the controversy about gender
differences most often centers on gender disparities that affect females, particularly the equity
and effectiveness of the special education process of referral, evaluation, and services
(Hayden-McPeak et al., 1993; Wehmeyer & Schwartz, 2001a). At the point of identification,
there is evidence that females are older, more severely disabled, demonstrate lower IQ scores,
and after identification, are served in more restrictive placements (Gillespie & Fink, 1974;
Gottlieb, 1987; Kratovil & Bailey, 1986; Mercer, 1973; Phipps, 1982; Wagner, et al., 1991;
Wehmeyer & Schwartz, 2001b).
After exiting school, females with disabilities further lag behind males. Although females
with disabilities do better while in school (higher rates of academic performance and school
completion, fewer suspensions and expulsions), they are less likely to work, have less job
stability, and earn lower wages than males (Doren & Benz, 1998; Doren & Benz, 2001;
Harvey, 2003; Valdes et al., 1990; Wagner et al., 1991). Young adult females who were served

125

under IDEA are less likely to pursue postsecondary training (U.S. Department of Education,
1998).
Increasingly, the demand for a globally competitive workforce will be met by women,
minorities, and individuals with disabilities (Bennett & McLaughlin, 1988; Mau, 1995). The
relatively poor educational performance and outcomes of females, minorities, low achieving
students, and those with disabilities is a major concern in that about 85% of the labor needed
must be skilled or professional workers (Brustein &Mahler, 1994). Employers are not
enthusiastic about the skills and preparedness of typically achieving youth and have even
more reservations about the skills of women, minorities and those with disabilities (Bennett &
McLaughlin, 1988; Secretarys Commission of Achieving Necessary Skills (SCANS), 1991).
Information about gender differences in special education is needed to implement successful
and differentiated secondary transition planning and activities.
Conceptual Framework
The purpose of this study was to investigate factors related to placement in special education
for males and females. The NELS-88 data set includes a rich set of information about
students, families, and schools. The conceptual framework for the selection of potential
predictors was developed to investigate gender differences in education and to recommend
how to improve educational effectiveness and equity (Lee, et al., 1996).
Three classes of characteristics are hypothesized to influence students educational
performance and outcomes: the individual, family, and school. Particular emphasis was given
to variables for which there are indications in the literature of differential effects for male and
female students. Individual characteristics include race/ethnicity, educational performance,
school engagement, and psychological characteristics. Educational performance and other
indicators differ across racial/ethnic groups, and in some studies, significant gender
differences have been observed within racial/ethnic groups (Burbridge, 1991; Mau, 1995;
Riordan, 1998; Riordan & Galipeau, 1998). Significant gender differences are reported for
some educational performance variables, including grades, achievement, and academic
background (Riordan, 1998; Riordan & Galipeau, 1998). Gender differences have been found
for school engagement, which includes time spent doing homework, student aspirations,
retention, and absenteeism (Lee, et al., 1996; Mau, 1995). Females still do more homework,
and work less part-time, although the gap is narrowing (Riordan, 1998). Mau (1995) found
Black male and White male students had significantly higher educational aspirations than
Hispanic and Native American males. Differences in locus of control and self-concept may be
important for understanding identification for special education. Males often attain modestly
higher scores than females on global measures of self-concept (Feingold, 1994; Hanes,
Prawatt, & Grissom, 1979; OBrien et al., 1996; Quatman & Watson, 2001; Robinson-Awana
et al., 2001).
Family characteristics include parent and household variables (e.g. socioeconomic status
[SES]). SES variables in the NELS data set include fathers education, mothers education,
mothers occupation, and family income. SES is often observed to exert a main effect on
education indicators (Capraro, Capraro, Wiggins, & Barrett, 2000; Peng & Lee, 1992), but in
some studies SES also interacts with gender (Burbridge, 1991; Lee et al., 1996). Lee et al.,
(1996) found 8th grade males are slightly, but significantly, more advantaged than females on
SES. Burbridge (1991) reported SES influenced educational outcomes more than any other
factor, and described findings that differed by SES, gender, and race. Low SES males are
more likely than low SES females to score below basic in math, whereas among high SES
students, the scores of males exceed those of girls across all racial/ethnic groups. Several
other household characteristics that are known to influence educational outcomes and
performance are also included in the family characteristics component: single parent status,
low parent education, sibling dropping out, being home alone three or more hours after school
without supervision, and Limited English Proficiency (Pallas, Natriello, & McDill, 1989;

126

Peng & Lee, 1992; Ralph, 1989). The influence of parent involvement has been found to vary
for students of different socioeconomic backgrounds and race/ethnicity, and there is some
evidence for gender differences as well (Catsambis, 2000; Singh et al., 1995). Parent
involvement as included in the present model is defined as the frequency with which a parent
helps the student with homework.
School characteristics make up the third group of hypothesized predictors. Lee et al. (1996)
described gender difference in the association between school climate measures and a variety
of educational measures, and in some instances (e.g., social studies achievement), school
characteristics that significantly influenced effectiveness were associated with gender
inequity. Gender and racial differences in educational and vocational planning help-seeking
behaviors have been reported. Mau (1995) observed that male students were more likely to
ask a counselor about jobs or careers or for help in improving academic work, but females
were more likely to ask a teacher, or friends and relatives when selecting courses or programs
at school.
Method
Sample
The National Education Longitudinal Study (NELS) program was instituted by the National
Center for Education Statistics with the aim of studying the educational, vocational, and
personal development of students at various grade levels, and the personal, familial, social,
institutional, and cultural factors that may affect that development. (NCES, 1994) The
program began with a twelfth-grade cohort in the National Longitudinal Study of the High
School Class of 1972 and was continued in the 1980s with the High School and Beyond with
a cohort of tenth- and twelfth-graders. NELS-88, the data set analyzed below, involved a
sample of students who were in the eighth grade in 1988. The study included a follow-up in
1990, a second follow-up in 1992, and a third follow-up in 1994. The variables included in
the present study were all drawn from the initial (1988) round of data collection and selected
variables were taken from each of the four Base Year components: student surveys and tests,
parent surveys, school administrator surveys, and teacher surveys.
The Base Year sample was recruited using a two-stage stratified probability design to create a
nationally representative sample of eighth grade schools and students. The first stage yielded
1,052 participating schools, 815 public schools and 237 private schools. The second sampling
stage (student sampling) produces a random selection of 26,432 students from the
participating schools, of whom 24,599 participated in the 1988 data collection. (NCES, 1994)
The NELS sample analyzed in the present study consisted of 23,926 subjects with usable data,
including 11,890 males and 12,036 females. The race/ethnicity distribution of the sample was
as follows: 1.2% American Indian (AI; n=286), 6.2% Asian/Pacific Islander (AS; n=1,486),
12.4% Black (BK; n=2,972), 12.8% Hispanic (HI; n=3,067), and 67.4% White (WH;
n=16,115).
Subjects in the NELS sample were divided into four status groups: special education (SE),
low achieving (Low), typically achieving (Typical), and gifted and talented (GT). SE students
(n=3,575) were extracted from the pool first and were defined as those students whose parents
answered affirmatively to the question: Has your eighth grader ever received special services
for any or all of the following? Visual handicap (not correctable by glasses) [n=284],
Hearing problem [n=434], Deafness [n=65], Speech problem [n=1,468], Orthopedic problem
(for example, club foot, absence of arm or leg, cerebral palsy, amputation, polio) [n=247],
Other physical disability [n=194], Specific learning problem (for example, dyslexia or other
reading, spelling, writing, or math disability) [n=1,750], Emotional problem [n=759], Other
health problem [n=596]. The total of special services received is greater than the total number
of SE students because many students had received more than one type of special service. The
SE sample includes 1,545 female students (43.2%) and 2,030 male students (56.8%).

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Table 1
Distribution of Males and Females in Each Status Group
Group

N
Female

Male

SE
Low
Typical
GT
all

1545
2752
6347
1392
12036

2030
2995
5693
1172
11890

SE
Low
Typical
GT
all

1169
1260
4754
888
8071

1551
1510
4208
775
8044

SE
Low
Typical
GT
all

163
673
501
183
1520

200
662
456
134
1452

SE
Low
Typical
GT
all

144
627
638
165
1574

189
584
618
102
1493

SE
Low
Typical
GT
all

52
129
399
147
727

69
172
362
156
759

Percent M:F
Percent
Male Odds Female
Race: All
56.78
1.31
12.84
52.11
1.09
22.86
47.28
0.90
52.73
45.71
0.84
11.57
49.69
0.99 100.00
Race: WH
57.02
1.33
14.48
54.51
1.20
15.61
46.95
0.89
58.90
46.60
0.87
11.00
49.92
1.00 100.00
Race: BK
55.10
1.23
10.72
49.59
0.98
44.28
47.65
0.91
32.96
42.27
0.73
12.04
48.86
0.96 100.00
Race: HI
56.76
1.31
9.15
48.22
0.93
39.83
49.20
0.97
40.53
38.20
0.62
10.48
48.68
0.95 100.00
Race: AS
57.02
1.33
7.15
57.14
1.33
17.74
47.57
0.91
54.88
51.49
1.06
20.22
51.08
1.04 100.00

group
Male
17.07
25.19
47.88
9.86
100.00

*
*
*
*

19.28
18.77
52.31
9.63
100.00

*
*
*
*

13.77
45.59
31.40
9.23
100.00
12.66 *
39.12
41.39
6.83 *
100.00
9.09
22.66
47.69
20.55
100.00

SE
Low
Typical
GT
all

17
63
55
9
144

21
67
49
5
142

Race: AI
55.26
1.24
51.54
1.06
47.12
0.89
35.71
0.56
49.65
0.99

11.81
43.75
38.19
6.25
100.00

14.79
47.18
34.51
3.52
100.00

* The 95%CI of the group percentage for females does not

overlap the 95%CI of the group percentage for males.
1) Because of small sample size, AI subjects are excluded
from the final analyses.

GT students were extracted next and were defined as subjects whose parents answered
affirmatively to the question: Is your eighth grader currently enrolled in a gifted or talented
program? Low achieving students were defined as those who, among the remaining subjects,
fell into the lowest quartile of standardized achievement testing scores for either reading or
math. Typical students comprised the remainder of the sample. The number of male and
female students in each of these groups is summarized in Table 1 (above).
Procedure
Including SEX and RACE, 24 variables were selected from the NELS-88 Base Year data set
to reflect the three components of the conceptual model: individual characteristics, family
characteristics, school characteristics. Each of these covariates is described briefly in Table 2
(below). In order to test the combined effects, all covariates were included in a multinomial

128

logistic regression predicting the probability of being in special education (or one of the other
groups). Multinomial logistic regression models the odds of group membership compared to a
reference group (defined as: Typical, White, Female), with all covariates at the median value.
Because the covariates were expected to be related to one another, a stepwise logistic
regression procedure was used first to determine which covariates remained significant when
the effects of other variables were considered. The initial multinomial logistic regression
included the following: a) SEX, RACE, and SEX*RACE were forced into the model, b) all
nominal variables were included along with their interactions with the variables included in
a), and c) all continuous variables were included as linear and quadratic effects along with
their interactions with the variables included in a). Nonsignificant effects were removed from
the initial model to yield a final logistic regression model.
The final model characterizes the relationship between the covariates and the probability of
being in special education. The effects of primary interest for the present purpose are those
interaction effects that include SEX. These effects identify those covariates that work
differently for boys and girls and thus may serve to explain the basis of gender
disproportionality in special education. If, for example, the GRADES by SEX interaction
were significant, the inference might be that, while GRADES are related to the probability of
being in special education for both boys and girls, the nature or extent of that relationship
varies depending on the students SEX.
Table 2. Summary of Covariates
Group
SE
Me an

other
Characte ristics
Min Max Me dian
N
Std
N
Me an
Std
School
Percent minority in school-midpoint (MINORITY)
Males
1962 21.462 26.390
9485 27.434 30.140
0
95
15
Females
1498 23.312 27.340
10142 27.400 30.160
0
95
15
Percent of students in special ed. (SPED)
Males
1975
6.344
5.298
9580
5.886
5.159
0
38
6
Females
1496
6.550
5.110
10188
5.990
5.205
0
38
6
Percent of students in gifted, talented ed. (GT)
Males
1929
5.965
7.596
9263
6.071
8.181
0
73
4
Females
1476
5.747
7.211
9916
5.825
7.940
0
73
3
Family
Socio-Economic Status composite (SES)
Males
2008 -0.075
0.795
9734 -0.026
0.799 -2.97 2.56
-0.03
Females
1528 -0.164
0.788
10363 -0.073
0.811 -2.97 2.30
-0.08
Number of risk factors for dropping out of school (RISK)
Males
2009
0.805
0.992
9739
0.668
0.932
0
5
0
Females
1528
0.862
1.041
10364
0.702
0.970
0
6
0
How often parent talks to child about school experiences (EXPERIENCES:1=not;4=regularly)
Males
1981
3.777
0.509
8677
3.762
0.504
1
4
4
Females
1504
3.735
0.555
9325
3.744
0.537
1
4
4
How often parent helps child with homework (HWKHELP:1=seldom;4=daily)
Males
1966
2.426
1.030
8635
2.188
0.999
1
4
2
Females
1501
2.382
1.001
9254
2.188
0.969
1
4
2
No one is home when child returns from school (ATHOME:1=usually,4=never)
Males
1879
3.085
0.959
8162
3.082
0.981
1
4
3
Females
1408
3.065
0.975
8781
3.090
0.983
1
4
3

129

Table 2 Contd
Group
SE
Mean

Other
Characteristics
N
Std
N
Mean
Std
Min
Community
Percent minority in school-midpoint (MINORITY)
Males
1962 21.462 26.390
9485 27.434 30.140
0
Females 1498 23.312 27.340
10142 27.400 30.160
0
Percent of students in special ed. (SPED)
Males
1975
6.344
5.298
9580
5.886
5.159
0
Females 1496
6.550
5.110
10188
5.990
5.205
0
Percent of students in gifted, talented ed. (GT)
Males
1929
5.965
7.596
9263
6.071
8.181
0
Females 1476
5.747
7.211
9916
5.825
7.940
0
Family
Socio-Economic Status composite (SES)
Males
2008
-0.075
0.795
9734
-0.026
0.799 -2.97
Females
1528
-0.164
0.788
10363
-0.073
0.811 -2.97
Number of risk factors for dropping out of school (RISK)
Males
2009
0.805
0.992
9739
0.668
0.932
0
Females
1528
0.862
1.041
10364
0.702
0.970
0
How often parent talks to child about school experiences (EXPERIENCES:1=not;4=regularly)
Males
1981
3.777
0.509
8677
3.762
0.504
1
Females
1504
3.735
0.555
9325
3.744
0.537
1
How often parent helps child with homework (HWKHELP:1=seldom;4=daily)
Males
1966
2.426
1.030
8635
2.188
0.999
1
Females
1501
2.382
1.001
9254
2.188
0.969
1
No one is home when child returns from school (ATHOME:1=usually,4=never)
Males
1879
3.085
0.959
8162
3.082
0.981
1
Females
1408
3.065
0.975
8781
3.090
0.983
1

Max

Median

95
95

15
15

38
38

6
6

73
73

4
3

2.56
2.30

-0.03
-0.08

5
6

0
0

4
4

4
4

4
4

2
2

4
4

3
3

Min

Max

Me dian

Group
SE
Me an

Characte ristics
N
Std
Individual
Grades composite (GRADES:F=0.5;A=4)
Males
1973
2.545
0.763
Females
1500
2.683
0.751
Standardized test composite (reading, math) (TESTCOMP)
Males
1945 46.791
9.565
Females
1480 47.086
9.734
Locus of control t-score (LOCUSCONTROL)
Males
1981
-0.092
0.650
Females
1521
-0.174
0.639
Self concept t-score (SELFCONCEPT)

Othe r
Me an

Std

9620
10276

2.911
3.035

0.755
0.713

0.5
0.5

4
4

3
3

9438
10066

51.203
51.695

10.370
10.040

30.71
31.02

75.81
75.81

49.18
50.02

9658
10324

0.049
0.017

0.604
0.615

-3.01
-2.77

1.52
1.52

0.03
0.02

Results
The top portion of Table 1, which ignores race and all other student characteristics besides
gender, shows clear evidence of gender disproportionality (chi-square = 130, df = 3,
p < .0001), i.e., the 17% male identification rate for SE is different from the 13% female
identification. However, the extent of male over representation in the SE group varies across
the five race groups (chi-square = 25, df = 9, p =0.0029). Among AS SE students, 57% are
male; again a rate only marginally different than the 51% expected (OR=1.46, p-value =
0.0542). Among BK students, 55% are male, a rate significantly higher than the 49% expected
(OR=1.34, p-value = 0.0158).Among HI students, 57% are male, a rate significantly higher
than the 49% expected (OR=1.35, p-value = 0.0144), Finally among WH students, 57% are
male, a rate clearly above the 50% expected (OR=1.50, p-value < .0001). So, although there is
evidence of gender disproportionality overall, the effect does not appear to be constant among
the race groups. Because of the small number of AI students in the sample, they were
excluded from all subsequent analyses. Because gender disproportionality may be associated
with any of the covariates in Table 2, the covariates, sex, and race were all entered as
predictors in the logistic regression model.
Initial Model
After the nonsignificant effects were removed from the initial logistic regression the number
of the variables in the model was reduced to fifteen. Several covariates were dropped from
subsequent analyses because they yielded no effect in the prediction of status group. Although

130

significant when considered separately, the following covariates were not significant when the
fifteen others were taken into account: RURALITY, EXPERIENCES, ATHOME, WORK,
DISRUPTIVE, and CAREER. Thus, of the initial group of covariates included in the
conceptual model, the variables in the final model are those that display a unique contribution
to the prediction of group, when considered simultaneously with all other covariates.
Final Model
The final model included SEX; RACE; the fifteen covariates described above; quadratic
effects for some of the continuous covariates; and interactions with SEX, RACE, and SEXby-RACE. The final model yielded 27 significant effects though not all were significant with
regard to distinguishing SE students from other students. The remainder of the paper focuses
on interpretation of the SE results.
The results of the final model indicate that, when the effects of significant covariates are taken
into account, gender disproportionality remains significant (p<.0001). Although there are race
differences in gender disproportionality, these effects are taken into account but are not the
primary focus of our results. The presence of interactions in the model require the cautious
interpretation of effects.
Bivariate Relationships
It is instructive to consider the bivariate relationship between each of the covariates in the
final model and the probability of being in special education. Because the effect was similar
for all four RACE groups for all of the twelve covariates in Figure 1, the RACE groups are
combined. In the first panel of Figure 1, the probability of being in special education is shown
to decrease as the percentage of minority students in the school increases. Two other
covariates, GRADES and LOCUSCONTROL, were also inversely associated with the
probability of special education, i.e., a higher grade-point average and more internal locus of
control were associated with a decreased probability of special education. Four covariates
were directly associated with probability of special education; higher SES, more risk factors,
having been retained, and being frequently absent are associated with increased probability of
special education. The other five covariates in Figure 1 were significantly related to the other
group membership not reported in this paper (low, typical, or GT) but not with special
education.

0.30

0.30

0.25

0.25

0.25

0.20

0.20

0.20

0.15

P rob[S E ]

0.30

Prob[SE]

Prob[SE ]

For each of the above covariates, the relationship to special education status was consistent
across the four race groups. However, for two covariates the relationship depended upon race.
Among WH students, whether or not teachers talked with them about courses was unrelated
to the probability of being in special education. However, for BK students, talking about
courses in school was associated with a decrease in SE proportion while, for the other two
race groups, talking about courses in school was associated with an increased probability of
special education.

0.15

0.15

0.10

0.10

0.10

0.05

0.05

0.05

0.00

0 10 20 30 40 50 60 70 80 90
Minority

0.00

10
SpEd

15

20

0.00

10

15
GT

131

20

25

0.25

0.250

0.25

0.20

0.200

0.20

0.15

0.15

0.100

0.10

0.05

0.050

0.05

-1.5

-1

-0.5

0
.5
SES

0.000

1.5

2
Risk

0.00

0.30

0.30

0.25

0.25

0.25

0.20

0.20

0.20

0.15

P rob[S E ]

0.30

P rob[S E ]

0.15
0.10

0.10

0.05

0.05

0.05

0.00

4
5
HwkHrs

0.00

1.5

2.5
3
Grades

3.5

0.00

0.30

0.30

0.30

0.25

0.25

0.25

0.20

0.20

0.20

0.15
0.10
0.05
0.00

4
Plan

0.15

0.10

0.05

0.05

.5
Retained

2
3
HwkHelp

-1

-0.5
0
.5
LocusControl

0.15

0.10

0.00

0.15

0.10

P rob[S E ]

P rob[S E ]

0.150

0.10

0.00

P rob[S E ]

Prob[SE]

0.30

Prob[SE]

0.300

P rob[S E ]

Prob[SE]

0.30

0.00

.5
Absent

Figure 1. Final model: Bivariate relationships for covariates

Legend: Males = filled circles, Females = empty circles

132

0.30

P ro b[ S E ]

0.25
0.20
0.15
0.10
0.05
0.00

1
Co urses

0.3 0

P ro b [S E ]

0.2 5
0.2 0
0.1 5
0.1 0
0.0 5
0.0 0
35

40

45

50
55
60
Te stCo m p

65

70

Figure 2. Final model: Bivariate relationships for covariates that vary by race
Legend: Males = filled circles, Females = empty circles; Green = white students, Red = black students,
Black = Hispanic students, Blue = Asian students.

As seen in the second panel of Figure 2, the relationship with reading and math standardized
test composite is more complex. There is a general overall trend for lower test scores to be
related to higher probability of SE identification. While the interaction involving RACE was
significant, interpretation of the relatively minor differences among RACE groups is unlikely
to be fruitful. There is an apparent trend toward higher probability of SE identification among
student with test composite scores greater than 60.

133

In the final model, only a single covariate worked differently for male and female students in
the prediction of group (i.e., yielded a significant interaction involving SEX) and that
covariate was CONCEPT. The implication of this result is that while there are many other
main effects in the model (i.e., covariates that are associated with the likelihood of being
identified as a student in special education), those effects are statistically identical for male
and female students. The exception is that boys and girls differ with regard to the manner in
which student self-concept is associated with identification for special education.
The nature of the interaction between CONCEPT and SEX in predicting the probability of
special education status is illustrated in Figure 3. For each RACE group, the solid circles
represent the predicted probability of special education status (Y axis) across the distribution
of CONCEPT values (X-axis) for male students while the open circles represent that
probability for female students. Thus, as Figure 3 illustrates, the relationship between selfconcept and the probability of being in special education for both male and female White
students is inverse and linear; students with more positive self-concepts have a lower
probability of being in special education than do students with a more negative self concept.
The relationship for Black students is also generally inverse but is not linear and differs for
male and females students such that, among Black students with the most negative selfconcept, males are markedly more likely to be in special education (probability = about .35)
than are females (probability = about .13).
0.40

P ro b [S E ]

0.30

0.20

0.10

0.00

-2

-1
Self Concept

Figure 3. Final model: Adjusted relationship between self-concept and student group
Legend: Males = filled circles, Females = empty circles; Green = white students, Red = black students,
Black = Hispanic students, Blue = Asian students.

For Asian and for Hispanic students the relationship is even more complex. Among Hispanic
female students, the relationship is virtually nil; the line is horizontal, indicating that the
probability of being is special education is the same at all levels of self-concept. For Hispanic
male students and for Asian female students, however, there is a modest, direct relationship;
those with more positive self-concept tend to have a higher probability of being in special
education than those with more negative self-concept. This pattern is exaggerated among

134

Asian male students; more positive self-concept is associated with a substantially higher
probability of being in special education, compared to more negative self-concept.
In an effort to further explore the relationship between self-concept and special education, the
sample was divided into tertiles in which the one-third of the sample with the lowest (i.e.,
most negative) CONCEPT is designated the first tertile and the one-third of the sample with
the highest CONCEPT is designated the third tertile. The probability of being in special
education was computed for each RACE by SEX group within each tertile. This calculation
answers questions like the following example: What is the probability of being in special
education for Black, male students with low self-concept? (see Table 3)
Table 3.
Self-concept tertiles
SELF CONCEPT

Proportion in SE

Relative

Tertile
Lowest
Mid
Highest

Males
0.054
0.081
0.113

Females
0.074
0.078
0.082

Risk
0.734
1.046
1.377

p-value
0.3505
0.7364
0.1585

Lowest
Mid
Highest

0.134
0.082
0.049

0.078
0.064
0.052

1.709
1.292
0.944

0.0646
0.1473
0.8399

0.1245

Lowest
Mid
Highest

0.042
0.052
0.064

0.043
0.043
0.043

0.975
1.205
1.491

0.8075
0.3548
0.1314

0.2353

Lowest
Mid
Highest

0.144
0.135
0.127

0.111
0.102
0.095

1.304
1.321
1.340

0.0001
<.0001
0.0003

0.9673

0.1226

Included in Table 3 is a relative risk (RR) ratio for male and female students in each RACEby-CONCEPT tertile group, providing a single metric for characterizing male
disproportionality. As is clear in Table 3, gender disproportionality is approximately equal for
White student across the CONCEPT tertiles; males are about 1.3 times as likely as females to
be in special education regardless of self-concept. For Asian and Hispanic students, male
overrepresentation increases as self-concept increases; that is, for these two RACE groups,
males in the highest CONCEPT tertile are substantially more likely than females to be in
special education (RR = 1.39 and 1.5, for Asian and Hispanic students respectively), while, in
the lowest tertile gender disproportionality disappears for Hispanic students (RR = 1.00) and
males are underrepresented among Asian students (RR = .78). For Black students, the pattern
is reversed. Among Black students with the lowest CONCEPT, males are 1.67 times as likely
as females to be in special education, and there is virtually no gender disproportionality
among Black students with the highest CONCEPT (RR = .96).
Discussion
Based on the results of this study, differences between males and females in self-concept may
be important for understanding identification for special education. Positive self concept
formation is regarded as a significant milestone of adolescence (Richman, Clark, & Brown,
1985), and low self concept has been long seen as a correlate or antecedent for many
emotional or behavioral disorders later in life, including anxiety, depression, and conduct
disorders (Harter, 1990; Quatman & Watson, 2001). With respect to students with disabilities,

135

lower self-concept has been reported for students with LD, even after controlling for gender,
ethnicity, age, achievement, placement, and age at which the disability was established
(Heyman, 1990).
The results of this study are consistent with those of other studies that found males attain
modestly higher scores on global and sub-component measures of self-concept, and these
differences persist into adult life (Feingold, 1994; Hanes, et al., 1979; OBrien, et al., 1996,
Quatman & Watson, 2001; Robison Awana, et al., 1986). Quatman & Watson (2001)
observed a difference .22 standard deviation unit difference favoring males for global self,
and scores equal or higher than females for several sub-components of self-concept. Despite
the small differences favoring males, similar subcomponents have been found to predict
global self-concept in males and females (Quatman & Watson, 2001). Results from a twin
study indicated similar genetic factors influence self-concept in both males and females
(Kendler, Gardner, & Prescott, 1998) and about 30% of the variance in self concept was
attributable to genetic factors, whereas only about 4% was related to gender.
In the present study, Black students with low self-concept were at substantially higher risk of
special education placement but the direction of the relationship cannot be determined. Some
students, particularly black males, may demonstrate low self-concept early on. which puts
them at higher risk of placement in special education. Conversely, the special education
experience may contribute negatively to self-concept. Student perception of self-concept in
NELS was measured in 8th grade, years after most of the students were most likely identified.
Though evidence indicates that self-concept is relatively stable (Quatman & Watson, 2001),
the impact of the special education experience on self-concept is unknown.
Gender by race interactions related to self-concept have been reported frequently (Dooley &
Prause, 1997; Martinez & Dukes, 1991; Wade, Thompson, Tashakkori, & Valente, 1989).
Richman et al., (1985) reported that White females have lower a self-concept than other
race/gender groups. Self-concept, gender differences and SES relationships have also been
reported. Richman et al., (1985) observed that generally the self-concept of students from low
SES was lower than that for high SES students, but high SES white students were lower on
self-concept measures than black students and white middle class students.
Many studies find black students report higher global self-concept than white students
(Richman et al., 1985; Dukes & Martinez, 1997; Tashakkori, 1993). However, school related
subcomponents of self-concept may follow a different pattern. Hare (1985) observed that
black self-beliefs in school related areas were lower than white students. This was consistent
with findings obtained by Richman et al., (1985) who found white females less confident
about their school ability than white males and black females, but black males were the least
confident. Richmond hypothesized that school and academic achievement may be of
secondary importance to black students, whereas the ability to assume adult life roles as early
as possible or street wisdom may be more important in the development of self-concept
(Richman et al., 1985). The self-concept measured in a school context may be highly
influenced by perceptions about academic competence. If true, the higher probability of
placement in special education obtained for black males in this study may relate to a
perception that success in school is of relatively lower importance in the formation of beliefs
about self for male students who are black.
Limitations
Generalization of these findings is limited by the fact that the sample of students in special
education is unlikely to include adequate representation of students with moderate to severe
disabilities. The sample is limited to students able to participate in the self-report survey for
more severely impaired students are not included. In addition, the special education is defined
by parent report rather than a school record review and it is possible that a small number of
students are misclassified based on faulty parent report.

136

Self-concept, in general, has been difficult to describe and interpret for students with
disabilities (Gresham, Lane, & MacMillan, 1999). Many studies report students with learning
disabilities and emotional and behavioral difficulties (internalizing or externalizing)
demonstrate low self-esteem (Barkley, 1990; Callahan, Panichelli-Mindel, & Kendall, 1996;
Heyman; 1990; Hinshaw, 1987; Patterson, 1986). Other studies have found that some students
with behavioral, learning, or attentional difficulties report unrealistically high or inflated
views of themselves (Bear & Minke, 1996; Diener & Milich, 1997; Gresham, MacMillan,
Bocian, Ward, & Forness, 1998). In a recent study, students with behavioral difficulties,
appeared to have adequate self concepts despite poorer peer acceptance, greater loneliness,
poorer school adjustment, and several other significant difficulties (Gresham et al., 1998)
Recommendations for Secondary Education and Transition Practice and Research
Based on the findings in this study, schools investment in the psychological well being of
males and females may be important for several reasons. Gender differences in self-concept
have lasting effects. High school aged males with average or above average self-concept were
substantially less likely to be unemployed after school, whereas the risk only slightly
decreased for females (Dooley & Prause, 1997). The magnitude of the effect for self-concept
was comparable to that of aptitude or that obtained by graduating from high school. As
students move from elementary through secondary grades, we suggest teachers implement
transition planning activities that recognize the potential role self-concept may have on the
achievement, aspirations, and outcomes of females and Black males, in particular. We also
recommend teachers conduct self-evaluations of teacher-student interactions to examine how
teacher beliefs may differentially influence self-concept formation or who is referred for
special education.
Research is recommended to investigate the higher probability of placement in special
education obtained for black males in this study and whether this finding relates to a
perception that success in school is of relatively lower importance in the formation of beliefs
about self for male students who are black. Research among nondisabled students has pointed
to an apparent need for different strategies to improve self concept across racial and ethnic
groups (Tashakkori, 1993). Comparable research is needed among students with disabilities.
Findings obtained in this study indicate differences between males and females in self concept
across racial/ethnic groups may be important if teachers are to accurately refer, identify, and
serve students with disabilities.
Finally, the efficacy of interventions to improve self-concept should be investigated.
Disability, gender, and race/ethnicity must be considered explicitly in the design of research
and intervention strategies. Student outcome variables are needed that reflect recent public
policy related to improved literacy and preparedness for adult life.
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PARENTS AND SPECIAL EDUCATION TEACHERS PERSPECTIVES

OF IMPLEMENTING INDIVIDUALIZED INSTRUCTION IN P. R. CHINA
-AN EMPIRICAL AND SOCIOCULTURAL APPROACH
Yi Ding
Kathryn C. Gerken
and
Don C. VanDyke
University of Iowa
and
Fei Xiao
Beijing Normal University
The purpose of this study was to explore the opinions and perspectives of
special education teachers and parents of children in special education
regarding the implementation of individualized instruction within the special
education system in the Peoples Republic of China. The study group
consisted of a random sample of 344 parents of children in special education
and 100 special education teachers in Beijing. Valid and reliable
questionnaires were developed. Analysis of data from questionnaires showed
that special education teachers had a positive attitude towards utilizing and
providing individualized instruction, but also had concerns. Analysis of data
from parents questionnaires showed that parents needed to learn to
advocate for their children, wanted improved parent-teacher communication,
but also had concerns. This study revealed potential barriers for
implementing individualized instruction in China. American and Western
educational programs and services may benefit the development of special
education in China, but they need to be culturally sensitive and appropriate
for the economic, social, and cultural realities and individualized and
localized to China and its education system. Challenges and difficulties in
the process of implementing specific imported educational programs should
be addressed. Recognition of and attention to parents and special education
teachers responses will assist Chinese colleagues, politicians, and school
leaders in this process.
Individualized instruction for children with disabilities in the schools has long been advocated
in the United States (Meyen, 1995). Only since the 1990s has there been a focus on
individualized instruction in the special education system of China. Many Chinese researchers
and educators (e.g., Xiao and Liu, 1996) have stated that individualized instruction has better
educational outcomes than traditional group instruction. However, they have not always had
empirical support for their statements and the implementation of individualized instruction in
China has encountered some challenges. Additional support for such an approach is needed if
legislation to mandate such services is to occur.
It is difficult to arrive at a precise definition of individualized instruction, which would satisfy
all educators. A general emphasis rooted in individualized instruction is to match student
needs to instructional options with concern for adapting resources by altering the instructional
environment (Meyen, 1995). In 1975, The Education of All Handicapped Children Act (PL
94-142) was passed in the United States. This law and its various reauthorizations (e.g.,
IDEA, 2004) guarantee that all children with disabilities have the access to a free and
appropriate public education. Thus, the American education system is striving to ensure that
all children receive an education that is appropriate for their level of functioning.

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Individualized instruction is not a new concept in China, however, a large-scale introduction

and learning of individualized instruction has not been evidenced until the end of the Cultural
Revolution in China (Ding, 1997). In Dings (1997) review of individualized instruction in
China, several innovative education approaches in China were presented. Following the
Cultural Revolution, the policy of classifying students based on their abilities had been
implemented for years, but it was terminated in 1982, due to the negative impacts on students
who were significantly below the average level in ability. The model of mastery learning
developed by Benjamin S. Bloom was implemented in Lin Hu District Central Elementary
School during the 1987-1988 academic year (Wu, 1989). In 1991, a program aimed at
developing students individual academic interest was implemented at Shanghai Tan Wan
Central Elementary School. Comparison of students pretest and posttest grades predicted
positive outcomes (He & Gu, 1997). However, most of these empirical studies of individual
instruction focused on children with an average level of intellectual ability.
The theoretical orientation of individualized instruction for populations with special needs has
been gradually introduced to China. Over the past two decades, increasing attention has been
given to individualized instruction in terms of research, training, and implementation for
exceptional learners. Xiao and Liu (1996) systematically introduced the theories, functions,
and implementation of individualized instruction used in the United States to China. Xiao and
Liu (1996) also focused on the implementation of individualized instruction for students with
mental retardation. In Lius (1996) work, he described the historical and legislative issues of
the individualized education plan (IEP) in the United States, compared and contrasted the
differences between the U. S. education system and the China education system, and
advocated for future study of the Chinese efforts on application of IEP. Xiao and Wang (2000)
introduced Individually Prescribed Instruction (IPI), Individually Guided Education (IGE),
Program for Learning in Accordance with Needs (project PLAN), etc. Xiao and Wang (2000)
stated that the idea of individualized instruction should be perceived as a theoretical and
innovative orientation, which might promote the educational reform of the traditional groupinstruction in the special education system of China.
A similar development of theoretical approaches to individualized instruction has taken place
in Taiwan. For example, in Huangs (1996) edited book, Individualized Instruction, a variety
of individualized instruction models, which were primarily developed by European and
American scholars and educator are summarized. The text emphasizes the general educational
theories and methodologies of individualized instruction and provides specific strategies to
assist the educators in using individualized instruction across different subjects. In addition,
Lin (1999) introduced a comprehensive procedure for developing an IEP and provided
specific recommendations for implementing IEPs.
Researchers and educators in China and Taiwan have made great strides in translating,
introducing, and advocating the theories and models of individualized instruction from the
United States and other Western countries (Huang, 1996). However, up to the present time,
little is known how parents and special education teachers perceive and accept the idea and
implementation of individualized instruction. This study explored parents and special
education teachers perspectives regarding the implementation of individualized instruction in
local special education schools. In so doing it revealed potential barriers to implementing
individualized instruction in China. In comparing the differences between the U.S. and China
education systems, it made recommendations and suggestions for future study of
individualized instruction in China.
Method
Participants and Setting
Participating in this study were 400 parents of students with disabilities from 4 randomly
selected urban special education schools in Beijing; 344 questionnaires of the 400 sent were
identified as valid. Of the valid parent questionnaires, 24.4% of the parent participants had

143

college or graduate degrees; 44.2% had high school diplomas; and the remainder had at least
an elementary or above. Teachers questionnaires were collected from 103 voluntary special
education teachers; 100 out of 103 questionnaires were identified as valid. Among the valid
teachers questionnaires, 55% of them had college or associate degrees, and 45% had
professional training in special education. In addition, 59% of teachers had worked more than
6 years and 23% had less than two years of teaching experience.
Instruments
As part of the study a parent questionnaire was developed to examine possible factors that
may have impacted the implementation of individualized instruction in China. The major
factors included: (1) parents understanding and perspectives towards individualized
instruction; (2) parents evaluation of current special education in China; (3) parents attitudes
towards special education teachers qualification and expertise in implementing
individualized instruction; and (4) parents perspectives of home-school communication and
cooperation.
In addition, the teachers questionnaire was constructed to explore: (1) the special education
teachers perspectives towards individualized instruction; (2) the possible challenges that
teachers have encountered or may encounter in the process of implementing individualized
instruction; and (3) teachers understanding of current special education procedures in China.
All questionnaires included demographic questions were hand-written answers, multiple
choice, and questions in the Liker scale format. Critical reviews of the questionnaire were by
two experts in the Department of Special Education at the Beijing Normal University and
three experienced special education teachers. The final instruments were field-tested using 5
special education teachers and 5 parents of children with mental retardation. Analysis of the
data conducted by using descriptive statistics, t-test, one-way ANOVA, and chi-square.
Results
The results will be presented for each research question or combined for parents and teachers
when the questions were the same.
Parents and Special Education Teachers Understanding of Individualized Instruction
Individualized instruction was viewed as the same as individual instruction by 13.4% of the
parents. Basic understanding and knowledge of individualized instruction was demonstrated
by 24.1% of the parents with 62.5% demonstrating an accurate understanding. The majority
(79%) of the teacher participants showed accurate understanding; 7% of them believed that
there was no difference between individualized instruction and individual instruction.
Table 1 shows that although 67.6% of the parents reported that individualized instruction
could promote their children learning, only 22.2% of them believed that individualized
instruction should be a mandatory requirement for their childrens education. We
hypothesized that Chinese parents had limited exposure to and understanding of
individualized instruction utilized in developed countries, even though they had a positive
attitude towards it.
Table 1
Parents and Teachers Overall Impression of Individualized Instruction
Items
II will promote better learning.
II should be mandatory for special education.
II will produce better education outcomes.
II will compensate for limitations of group
instruction.
II is ideal, but hard to be implemented.
(II= individualized instruction)

Percentage saying true

Parents Feedback
Teachers Feedback
67.6%
22.2%
93%
51%
21%

The majority (93%) of the teachers reported positive attitudes towards individualized
instruction; 51% of them believed that individualized instruction could compensate for the

144

limitations of group instruction. It is important to note that 21% of the teachers believed that it
was challenging to implement individualized instruction in China.
Several similar questions were designed to explore the differences between parents and
teachers attitudes and understanding of individualized instruction. In terms of the definition
of individualized instruction, teachers demonstrated more accurate understanding than parents
did. In addition, teachers displayed more advanced desire to individualize the instruction than
parents did (Table 2).
Parents and Teachers Evaluation of Current Special Education in China
Approximately one-fifth (21.6%) of the parents reported that current instruction was not
appropriate for their children; 17.8% of them advocated the improvement of the teacher
training; and approximately 30% of them believed that teachers were overwhelmed by their
current work. Half (49.9%) of the parents demonstrated a strong need to gain access to
teachers extended support for their childrens education and 60.9% of them wanted to gain
access to knowing more about their childrens occupational development. We hypothesized
that the home-school communication may play an important role in family education and may
provide resources for parents to develop their childrens occupational skills. In addition, there
Table 2
Comparison of Parents and Teachers Responses toQuestions About Individualized Instruction
Items
Individualized Instruction is (multiple
choices)
Pace of instruction within a class should be
uniform.
Students in the same class should be given the
same test.

Parents
(n=344)
M
SD
2.45
0.829

Teachers
(n=10)
M
SD
2.70
0.659

2.50

1.498

3.80

1.119

2.24

1.392

3.63

1.331

T Test
T
3.114
9.403
8.880

2-Tailed Sig
0.002***
0.000***
0.000***

(P<0.05*, P<0.01**, P<0.001***; Questions were in a multiple-choice format or in a liker scale.)

are 33.2 % of the parents advocated an education reform within the special education system.
By applying a chi-square test, parents with different education levels demonstrated significant
discrepancy in evaluating current special education instruction, teachers workload, and
supervision of teachers improvement of instruction (Table 3).
Table 3
Parents Attitudes towards Current Special Education
Items
Current instruction is appropriate.
Instruction methods need to be improved.
Teachers qualification has to be desired.
Teachers are overwhelmed by their current work.
Teacher-centered philosophy dominates special education.
School managers should supervise teachers instruction
improvement.
Government should make more efforts for education reform.
More communication with others should be desired.
Teachers should provide more assistance for parents.
Acknowledging more about childrens career development is
necessary.

Percentage
saying true
21.6%
18.66%
17.8%
27.4%
4%
14.3%

Chi-Square/Sig.

33.2%
19.8%
49.9%
60.9%

6.437/0.169
7.338/0.119
2.507/0.643
8.821/0.066

13.913/0.008**
9.076/0.059
6.094/0.192
12.817/0.012*
4.841/0.304
10.679/0.030*

(Questions were designed in a multiple choice format.)

The survey of teachers focused on the specific challenges that occurred in the existing special
education system. About three-fifth (61%) of the teachers agreed that the discrepancy between
students placed them at a very challenging position guarantee an appropriate education for
each student. Three-fourths of the teachers desired an education reform of current instruction
and 41% of them reported that they were overwhelmed by their work and not satisfied by

145

their current payment. Teachers with different education levels did not show significant
difference in evaluating current special education (Table 4).

Items

Table 4
Teachers Attitudes towards Current Special Education
Percentage

The discrepancy between students is significant.

Instruction reform is warranted.
Workload is heavy and payment needs to be improved.

61%
75%
41%

ChiSquare/Sig
2.336/0.311
0.353/0.838
0.182/0.913

(Questions were in a multiple choice format.)

There was a significant difference (0.000***, x test) between teachers desire for education
reform in instruction and parents desire for education reform. We hypothesized that teachers
worked within the special education system and were more aware of the limitations of current
instruction than were parents (Table 5).
Table 5
Comparison of Parents and Teachers Desire for Education Reform
Item
Parents (n=344)
Teachers (n=100)
Chi-Square
The government should increase M
SD
M
SD
the impact on education reform.
0.000***
0.34
0.48
0.76
0.43
Teachers Perspectives of the Barriers of Implementing Individualized Instruction
Chinas education law has not guaranteed individualized instruction yet, and approximately
half of the teachers believed that a legislative guarantee is warranted. A strong
support (74%) revealed teachers need to gain access to preservice and inservice
professional training regarding individualized instruction. Individualized
instruction is not a well-developed methodology in China and it was possible that
most special teachers merely heard about this idea, but lacked experiences to
apply it (Table 6).
Table 6
Teachers Reports of Barriers to Implement Individualized Instruction
Items
Legislative guarantee is warranted.
Preservice and in-service training are desired.
Schools should provide teaching assistants.
Teachers need more independence to modify instruction.
Parents may provide after-school assistance and relieve teachers
workload.

Percentage
43%
74%
60%
44%
50%

Chi-Square/Sig
0.241/0.886
4.741/0.093
2.127/0.345
6.512/0.039*
0.431/0.806

(Questions were in a multiple choice format.)

Three-fifth of the teachers reported the need to gain the access to assistance from teacher
associates or assistants. In addition, half of the teachers reported the desire to gain assistance
from parents. Compared with the special education system in the United States, special
education in China was equipped with uniformed instruction textbooks and assigned
instructional outlines, which were designed by the Department of Education in China.
Approximately half of the teachers wanted to gain more independence of modifying the
instruction to meet specific individuals needs, which revealed that the highly uniformed and
structured instruction did not guarantee an appropriate education. Based on their educational
level, the teachers varied in their desire to have more independence in modifying instruction
to meet specific individuals needs. Teachers with higher education level demonstrated more
need for independence to modify instruction (Table 6).
Parents Evaluation of Special Education Teachers

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Generally, the majority of the parents reported positive or neutral attitudes towards teachers
professional training, organization skills, and professional spirit. However, approximately
30% of the parents worried about the extended support and resources for teachers
professional development. In other words, the availability of resources and professional
support might have a significant impact of educational outcomes, even though teachers
overall qualifications were not a big concern. Meanwhile, 23.6% parents reported that the
teachers had little independence to accommodate the instruction, which corresponded to
teachers self-report (Table 7).
Table 7
Parents Evaluation of Special Education Teachers
Teachers Education
Teachers Organization Skills
Teachers Professional Spirit
Resources and Help
Teaching Independence
Teachers Qualification

Excellent

Adequate

Average

15.5%
15.5%
17.2%
30.3%
29.4%
13.4%

31.8%
33.5%
46.9%
14.3%
17.5%
24.7%

39.4%
40.2%
26.8%
25.1%
29.4%
45.8%

Not
Adequate
13.1%
10.5%
8.2%
25.7%
21.0%
12.5%

Poor

Mean/SD

0.3%
0.3%
0.9%
4.7%
2.6%
3.5%

1.51/0.917
1.47/0.887
1.29/0.875
1.63/1.400
1.50/1.206
1.68/0.974

Note: Weights of 0, 1, 2, 3, and 4 correspond to the categories of excellent, adequate, average, )

(.not adequate, and poor

Teachers Attitude of Implementing individualized instruction
Strong support (92%) by teachers was given to the implementation of individualized
instruction. However, approximately 40% of the teachers demonstrated dissatisfaction of
current group-instruction within the special education system. The majority (78%) of the
teachers disagreed with utilizing uniformed examination system to evaluate special education
students (Table 8). By utilizing Oneway ANOVA, teachers with different education
backgrounds did not demonstrate significant differences in terms of their attitudes towards
implementing individualized instruction.
Table 8
Teachers Attitude towards Individualized Instruction and Current Special Education
Items
Most
Likely Neutral Unlikely Most
Mean/SD
Likely
Unlikely
II is possible to implement.
51%
36%
6%
4%
3%
1.54/0.989
We should implement II.
58%
34%
2%
5%
1%
1.52/0.785
II is similar to GI.
10%
8%
13%
42%
27%
3.65/1.313
GI satisfies educational goals.
11%
17%
34%
32%
6%
2.45/1.274
SE has good outcomes.
2%
30%
24%
34%
10%
2.95/1.175
Instruction pace should be unified.
5%
9%
5%
60%
21%
3.63/1.331
Tests should be unified.
5%
13%
4%
50%
28%
3.05/1.132
Note: Weights of 0, 1, 2, 3, and 4 are correspondent to the categories of most likely, likely, neutral, )

(unlikely, and most unlikely. II=Individualized Instruction, GI=Group Instruction, SE=Special Education
Teachers Attitudes towards Current Educational Policies and Teacher Training
Two-fifth of the teachers believed that current educational policies encouraged teachers to
implement individualized instruction, however almost half of them demonstrated desire to
gain the access to teaching assistants and other support to assist them implement the idea of
individualized instruction in real world. About half (44%) of the teachers reported the need to
Table 9
Teachers Attitudes towards Current Educational Policies and Teacher Training
Items

Most
Likely

Likely

Neutral

Unlikel
y

Education policy encourages utilizing

II.

3%

37%

47%

9%

Most
Unlikel
y
4%

Mean/MD
1.64/0.847

147

Teaching assistants are warranted.

Teachers should voice their options
and suggestions towards instruction.
Comprehensive evaluation system is
necessary for II.

3%
4%

43%
40%

47%
53%

6%
3%

1%
0%

1.59/0.698
1.55/0.626

4%

42%

45%

8%

1%

1.60/0.739

voice their opinions and suggestion about instruction and school reform. In addition,
approximately half of the teachers believed that a comprehensive evaluation system is
warranted for implementing individualized instruction (Table 9).
Parent Participation and Home-School Communication
Parents indicated moderate support (50.9%) of the access to participation in their childrens
education and school administration. A moderate support (62.5%) indicated parents desire to
communicate and cooperate with teachers. Approximately half (44.8%) of the parents liked to
provide assistance for teachers, which may relieve teachers workload. It showed that 37.8%
parents demonstrated parents desire to voice their suggestion and the access to have an
impact on their childrens formal education. Utilizing chi-square test, parents with different
education levels revealed significant difference (0.016*) in terms of giving suggestions and
having impact on school education. Parents with lower level of education demonstrated high
level of desire than parents with higher level of education (Table 10).
Table 10
Parents Attitudes towards Home-school Communication
Items

Most
Likely

Likely

Neutral

Unlikel
y

Mean/MD

Sig.

8.7%

Most
Unlikel
y
1.7%

Parents have the right to participate

in childrens education and school
administration.
Parents should communicate and
cooperate with teachers.
Parents may function as teaching
assistants.
Parents should voice their
suggestion and have an impact on
school education.

9.3%

41.6%

38.4%

1.52/0.847

0.028

14.0%

48.5%

29.1%

4.7%

3.5%

1.35/0.912

0.142

14.0%

30.8%

36%

14%

5.0%

1.66/1.067

0.319

15.1%

22.7%

42.2%

16.6%

3.2%

1.70/1.028

0.016*

Interpretation and Discussion of the Findings

This survey revealed parents and special education teachers attitudes regarding current
special education and the implementation of individualized instruction in China. The
interpretation of the reported concerns follows.
Parents attitudes towards current special education
A number of parents reported that they believed that the current special education instruction
did not meet their children needs and that there was a need for education reform. An obvious
limitation of the current special education curriculum in China is its inflexibility. Most of the
special schools utilize a uniform curriculum and teachers are required to follow the
curriculum outlines, which were designed by the Department of Education of China. Without
taking into account of the special education childrens individual needs and the characteristics
of local schools, the uniform curriculum used nationwide could produce instructional
challenges for teachers who want to meet childrens needs. In addition, some uniform
textbooks may not be appropriate for developing the occupational skills of children who are
mentally retarded.
A small portion of parents indicated that there was need to improve teachers overall skills
and teaching methods. In most Asian countries, teaching is perceived as a serious process and
the most common form of teaching is lecturing. A variety of teaching techniques (e.g., group

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discussion, peer tutoring, instruction with the technological assistance) may be best in helping
teachers motivate their students to work on tasks.
In Beijing, it is not surprising to see a special education teacher simultaneously teach 10-14
exceptional students without a teacher associate or assistant. Compared with special education
teachers in the United States, who usually have access to assistance from other school
personnel, Chinese special education teachers tend to be exhausted by their instruction and
class management routine. Moving to an individualized instruction model appears to be
impossible, without extended assistance. According to the history of educational reform
movement in the United States or other European countries, political impact and legislation
play an important role in promoting appropriate education for students with disabilities. For
example, in the United States, the Individuals with Disabilities Education Act (IDEA) acts as
an education law that was enacted to ensure equal educational opportunities and high
expectations for students with disabilities. Approximately one third of the parents indicated
that there was a need for a special educational reform, which would be advocated by the
government. In other words, intensive political impact and a guarantee in education law is
necessary for the modification or reform of current special education in China.
The parents desire for support from other parents demonstrates that communication and
interaction between parents is not well developed. In the United States, parent associations
play a crucial role in advocating special education students education and services. However,
Chinese parents with children who have disabilities have limited communication and
interaction with each other. Mental retardation is a condition that results in pain and
bewilderment in many families. Most parents with children who have mental retardation lack
extended support from other parents, community, etc. There are a few parent associations for
exceptional learners in China; however, the functions of these associations are not well
developed. More than half of the parents also expressed a need to focus more on their
childrens career development. They currently lack access to adequate occupational guidance
to assist their children. Limited home-school communication may contribute to the parents
concern. Although most Chinese parents are invited to participate in teacher-parent
conferences on a semester basis, more frequent communication should be promoted in order
to keep parents informed about their access to extended resources and assistance from school
and local education agencies.
Teachers attitudes towards current special education
The majority of the students from these four special education schools were students with
mild and moderate mental retardation and they were usually placed in classrooms for children
with educable and trainable mental retardation. However, the large teacher: student ratio, such
as 1/10, places these special education teachers in a position to encounter failure. An
assumption of group instruction is that the learners demonstrate similar cognitive functioning
and have similar learning skills. The significant discrepancy between these students cognitive
development (e.g., thinking, problem solving), learning style, attention span, etc. makes group
instruction inappropriate for much of the instruction. Most of the special education teachers
realized the limitations in the current curriculum, instruction techniques, and supporting
services.
Compared with American special education teachers, Chinese special education teachers have
very limited independence to modify the curriculum since the Department of Education of
China determines the national curricula. In addition, the curriculum must be conducted based
on the curriculum outlines, which are distributed by the Department of Education. In other
words, the curriculum and its delivery are mandated by outside personnel and very limited
adjustment/modification is allowed.
At least 41% of the special education teachers have concerns about their pay and workload,
since their salary is usually lower than the average salary for regular education teachers

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(Ashman, 1995). Low salaries may play a crucial role in motivating teachers to do a good job.
In China, general education and special education have been perceived as separate systems
and they are funded by different sources. Fewer financial supports are allocated to special
education; therefore, fewer teachers are attracted to the special education system.

Parents Perspectives Towards Individualized Instruction

Strong parental support (67.6%) for individualized instruction indicated that parents have
realized the limitations of current group-instruction and believe that individualizing the
instruction to meet students needs would produce better educational outcomes. Over 60% of
the parents believe that it is very likely or likely that parents should communicate and
cooperate with teachers which might release teachers from certain kinds of routine tasks. For
example, parents might volunteer to provide supervision for their childrens after-school care,
offer help for their childrens assignment and homework, and act as teacher assistants when
the lead teacher wants to provide individualized instruction to a student.
In terms of individualizing students learning, parents feedback and suggestion might provide
teachers with valuable information to modify the curriculum. Parents are always the first
teachers of their children and understand the strengths and weaknesses of their children.
Therefore, communication and interaction between parents and teachers may help teachers
and parents to work together to modify instruction or educational expectations to fit each
childs need. The majority of parents reported positive attitudes towards special education
teachers expertise. However, they reported concerns that the teachers may not have the
professional training and resources they need to implement individualized instruction
successfully.
Teachers Perspectives Towards Individualized Instruction
The teachers reported strong support for utilizing individualized instruction. However, they
also had specific concerns about implementing it in real world. One half of the teachers
indicated a need to modify the current curriculum. A very large number of teachers (74%)
displayed concerns about implementing individualized instruction, due to their limited
exposure to specific knowledge and training in individualized instruction. In the United
States, every student with a disability must receive services under IDEA and must have an
individualized education plan. This is a vital document because it contains key information
about the student and the special education and related services he or she needs. However,
individualized instruction for children with disabilities has not been guaranteed by related
education legislation in China. Teachers believe that the implementation of individualized
instruction in China require progress in legislation and governmental advocacy.
During the procedure of developing an IEP, it is mandatory that a team of people, including
the student parents and school professionals, write the IEP. The parent involvement in
disabled students education has not been guaranteed by legal documentation in China.
However, though school systems have strived for improving home-school communication.
This survey revealed that many special education teachers desire to cooperate with parents
and improve parent involvement in the procedures for individualizing students curriculum. It
is known that an IEP for each exceptional student in the United States should be developed or
reviewed annually. A systematic and consistent evaluation or review is an important
component to update student special education and related services. We found that about half
of the teacher desired an evaluation/review system to supervise the implementation of
individualized instruction.
A Comparison of the Education System in China and the United States
Beyond the survey, the researchers believe that the significant differences between the
education systems of China and the United States have made it difficult for the special

150

education teachers in China to carry out individualized instruction. An understanding of the

educational differences related to the culture, politics, and social expectation may be
beneficial to Chinese special education teachers when they attempt to modify the
individualized instruction models rooted in the United States. Based on the understanding and
experiences of working in special education systems both in the United States and China, the
major cultural and social differences between these two countries are highlighted below:
Learner-centered vs. Knowledge-centered
A learner-centered educational philosophy has played an important role in American
education reforms (Bransford et al., 2000). The learner-centered environment emphasizes
knowledge, skills, attitudes, and beliefs that the learners bring to the educational setting and
integrates them into the learning process. Therefore, the occurrence of individualized
instruction corresponds to the need to make sure materials match exceptional students
specific cognitive or physical functioning. Both general and special education systems in
China have deep roots in knowledge-centered education. Generally, knowledge-centered
environments focus on promoting students knowledge acquisition and helping students
understand the content in existing interaction. However, pure knowledge instruction may
result in an under-development of exceptional students personal needs. A combination of
learner-centered and knowledge-centered educational philosophies may contribute to the
improvement of education and services for Chinese students with special needs.
Teacher Training and Resources of Other Professionals
The United States plays a leadership role in both general education and special education.
Every special education teacher in the United States is required to have a college degree and
receive temporary or regular certification. Most special education classrooms have smaller
teacher: student ratio, which make it easier for the teachers to modify or individualize the
curriculum. The assistance from other professionals or teaching assistants has become a
necessary component of current special education in the United States. In China, a significant
discrepancy in special education teachers qualifications occurs in urban and rural areas.
Generally, urban special education teachers have a higher educational background than rural
special education teachers. However, in terms of educational background, there is a
significant discrepancy between Chinese and American special education teachers. Therefore,
in-service training or workshops will be an important addition for Chinese special education
teachers to improve their professional expertise.
In addition, different special education professionals, such as speech pathologists, school
psychologists, occupational therapists, etc., provide American special education teachers with
access to different professional resources. In China, the limited professional support from
different special education personnel has made education even more challenging for special
education teachers. A number of responsibilities that should be given to other professionals
are usually assigned to special education teachers. In addition, the limited number of
associates or teaching assistants has made individualized instruction extremely hard to
implement in a classroom with a large teacher: student ratio. The development of a team of
professional personnel and teaching associates/assistants may partially relieve Chinese special
education teachers from overloaded educational routines. Rural special education teachers
need more attention and support from local education agencies.
Flexible Curriculum vs. Uniformed Curriculum
Individualized instruction requires a flexible curriculum system, which can be modified to
meet students special needs. In the United States, textbooks and curriculum are usually
determined by local schools or local education agencies, which take into account their own
local circumstances; recognize the requirements of their students and community; and meet
the needs and expectation of all learners. In China, a uniform curriculum has been utilized
across the country for several decades, except in experimental schools that have a specific
aim. The original aim of unifying curriculum across the country is to standardize the

151

instruction and make it easier to supervise the national elementary and secondary curricula.
However, a uniform curriculum may lack the flexibility to fit the needs of students with
disabilities, due to their diverse cognitive functioning and learning styles. Redesigning or
modifying the curricula may meet the needs of exceptional learners.
Comparison of Parent Advocacy Movement and Parent Involvement
Special education programs throughout the United States resulted from a bottom up approach.
They were initiated by parents of children with disabilities who provided leverage in the
communities and states, then litigation, and finally federal legislation to ensure that every
child with a disability received access to appropriate educational services. American parents
have always led the fight for better services for their children (Heward, 2003). They have
always been in the forefront of change, often nudging and promoting the professionals along
with them. Parents across the country were making connections with one another. With
American parents efforts, changes have occurred in many areas that have improved the lives
of children and adults with disabilities and their families. Chinese parents have realized the
need to ask for better systems of service for children with disabilities. However,
underdeveloped parent associations and lack of cooperation among parents have led to
fragmented efforts. Along with the fast-developing economy in China, increasingly families
have been making more efforts to advocate for improving education and related services for
their children. Forming alliances or coalitions with organizations for exceptional individuals
may be an effective way for parents to cooperate with one another. An advanced and
consistent parent advocacy movement may accelerate the pace of special education reform in
China. It is important to remember that the Education for All Handicapped Childrens Act
(PL94-142, 1975) guaranteed parent participation in nearly all phases of the special education
planning process (Simpson, 1990). However, there is no clear guarantee of parent
involvement in the Compulsory Education Law of the Peoples Republic of China.
Comparison of the Legislation Impact
American federal legislation on disabilities has played an important role in advocating the
rights for exceptional learners. The 1964 Civil Rights legislation made American parents think
about the need for civil rights protection for people with disabilities. Sections 503 and 504 of
the Rehabilitation Act became law in 1973, which extended basic civil rights to qualified
individuals with disabilities in federally assisted (public) programs. In 1975, P. L. 94-142, the
Education for All Handicapped Children Act (now the IDEA) was passed, which was
developed with input from parents and professionals. It opened the doors of the public school
system to all children with disabilities. In addition, it acknowledged the need for parental
involvement in order to maximize the benefits of education.
Similarly, legislative mandates have accelerated the development of special education in
China. For example, the Resolution on the Reform of the School System was published in
1951 and required education for children, youth, and adults with disabilities (cited in YearBook of Education in China 1949-1981, 1984, p. 385). In the 1980s and 1990s, Compulsory
Education Law of the Peoples Republic of China (1986) and Law of the Peoples Republic of
China on the Protection of Disabled Persons (1990) were passed, both of which guarantee a
free education for individuals with disabilities. However, neither of the above laws guarantees
an appropriate education or an individualized education plan to each exceptional student. Li
and Altman (1997) argued that the China Compulsory Education Law is basically a civil
rights law, rather than a program law, which should include specific programmatic
stipulations.
Limitations and Recommendations
While this is the first study to investigate the perspectives of Chinese parents of children with
disabilities and special education teachers towards implementing individualized instruction in
China, there are several limitations of the study that warrant further discussion. Our sample
was limited to parents and special education teachers from 4 urban special education schools

152

in the City of Beijing in China. It is unknown whether the characteristics of parents and
special education teachers from this region might be shared by samples from other regions in
China. Thus the generalization of these findings to other areas in China should be done with
caution. Future research should explore the perspectives of Chinese parents and special
education teachers in other urban and rural areas as well.
Secondly, the differences between the American education system and China education
system were addressed by the authors understanding and observation of the educational
systems in both countries. This discussion is also limited. Further study should address the
discrepancy of the educational systems in the U.S. and China by implementing cross-cultural
comparisons.
The researchers believe that the recognition and understanding of parents and special
education teachers perspectives towards individualized instruction warrant further attention
and study. Government and public agencies, which fail to recognize parents and teachers
concerns, may fail to provide assistance and intervention in accelerating the pace of education
reform in China.
In conclusion, education reform and programs that are implemented successfully in developed
countries do not guarantee the same successful outcomes in countries that have a very
different economy and culture. American and Western education programs and services may
serve as a model of special education in China, but the transfer needs to be culturally sensitive
and appropriate for the economic, social, and cultural realities, which individualize and
localize China and its educational system. Challenges and difficulties in the process of
implementing specific imported educational programs should be addressed. Recognition of
and attention to parents and special education teachers responses will assist Chinese
colleagues, politicians, and school leaders in learning from the successes and failures.
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PARENTS AND LOCAL EDUCATION AUTHORITY OFFICERS PERCEPTIONS

OF THE FACTORS AFFECTING THE SUCCESS OF INCLUSION OF PUPILS
WITH AUTISTIC SPECTRUM DISORDERS
Emma M. Waddington
and
Phil Reed
Swansea University
The past ten years have seen a growing drive towards full inclusion of
children with Autistic Spectrum Disorders (ASD) in schools. However,
concerns about whether inclusion for children with ASD is synonymous
with their right to appropriate education have been raised amongst
researchers. The current study aimed to ascertain the views of both
professionals, and parents of children with ASD, regarding inclusion of
children with ASD into mainstream schools by using a series of focus
groups. A content analysis was used, and the results showed that parents
and professionals agreed that school factors, such as school
commitment; and LEA factors, such as funding, were fundamental to the
success of inclusion. Professionals felt that child factors such as
behavioural problems, and learning difficulties, were the primary reason
for exclusion from mainstream. Significantly, both groups agreed that in
order to improve successful inclusion, there needed to be more openness
to alternatives to mainstream for children with ASD.
Over the past ten years there has been a growing drive towards full inclusion. This drives
results, in part, from the Salamanca Statement (Unesco, 1994), and, in the United Kingdom,
from a rights agenda (see Evans & Lunt, 2002; Gallagher, 2001). In contrast to this full
inclusion position, there have been moves towards more cautious forms of inclusion (e.g.,
Vaughn & Schumm, 1995), which argues that individuals have a prevailing right to the best
education.
The policy framework for inclusion in the United Kingdom has been set up by a number of
documents. For example, the Government White Paper (Department for Education and
Employment, 1997), which asserts the right of the pupil with special educational needs (SEN)
to be educated in mainstream schools wherever possible, as well as the Code of Practice
(DfEE, 1994), and the Government Programme of Action (DfEE, 1998). The latter document
promotes inclusion: where parents want it and where appropriate support can be provided.
This phrasing appears to acknowledge that inclusion will not necessarily benefit all children.
Despite the recognition that full inclusion may not be beneficial for all children, there are no
guidelines as to when inclusion will be favourable, and where it will hinder the childs
education.

155

The Warnock Committee (1978) shifted the focus from separate or alternative
provision, to that normally available at mainstream schools. Since the implementation
of the 1981 Education Act, there has been a trend towards the greater use of
mainstream placement. The Audit Commission (1998) found that the number of
children with Statements of Needs being educated in mainstream schools had risen
from 40% to 55% since 1992. Current government targets encourage further
development of inclusive provision (Frederickson & Cline, 2002). However, many
critics fear that inclusion for some children will never be beneficial (e.g., Simpson & Myles,
1990). Others argue that the case for inclusion is driven by ideological approaches, leading to
an overemphasis on ethical and moral imperatives, and a relative lack of concern in meeting
the childs individual needs (Burack et al., 1997). Such concerns have lead to a call for the
replacement of full inclusion with a more responsible inclusion
(OBri
en,2001 ; Vaughn & Schumm,1999) One of the main concerns is how to include children with
behavioural problems, such as those displayed by children with Autistic Spectrum Disorder
(Downing, Morrison & Berecin-Rascon, 1996). Although the number of children being
included is increasing (Norwich, 2000), the number of pupils being excluded from school,
mainly for unacceptable behaviour, has also steadily increased (Parsons, 2000).
Unfortunately, there has been little work examining the factors that promote successful
inclusion of children with ASD. One recent study looked at the attitudes of parents and
professionals about the various educational provisions available for children with autism
(Jindal-Snape, Douglas, Topping, Kerr & Smith, 2005). They found that parents considered
that autism specific training for teachers was critical to the success of a mainstream
placement. In addition, parents and professionals felt that in all provisions the quality of
delivery, staff training and effective adaptation of the curriculum was fundamental to creating
an inclusive environment (Jindal-Snape et al., 2005).
The importance of the views of staff involved directly with the inclusion process to the
success of that inclusion practice has been referred to regularly in the literature (Avramidis,
Bayliss & Burden, 2000; Frederickson, Osborne & Reed, 2004; Vaughn, Schumm, Jallad,
Slusher & Saumell, 1996). Frederickson et al. (2004) found that there were commonalities in
the views of the definition of successful inclusion amongst teachers involved in the process of
inclusion. The authors argued that this would have implications when the teachers came to
design support and skill development programs for the pupils. Therefore, assessing the
opinions, concerns and perspectives of those staff involved in the process of inclusion will
have a significant impact on the success or otherwise of inclusion. These views, in addition to
those of the carers of children with Autistic Spectrum Disorders (ASD), will be the topic of
the current study.
Individuals who work, and are in close contact, with children diagnosed with ASD will have
valuable insight into the factors that promote successful inclusion, and may help to develop a
better understanding of what determines successful inclusion for children with ASD. The
same is the case for parents of children with ASD. Parents have the ultimate say on whether
their child is included or not into a mainstream school, as stated in the code of practice (DfEE,
1994). Consequently, their views will influence the success of inclusion. Given this the
views of both parents of children with AD and professionals involved in the inclusion process
were sought.
Method
Participants.
Parents of children with ASD, and local authority workers, were recruited from three local
authorities in the South East of England. All participants were randomly selected from lists of

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parents who had a child with a diagnosis of ASD, and local authority officers with experience
of working with children with ASD. Letters were sent inviting participants to attend focus
groups discussing their experiences of inclusion. The participants received no payment for
the participation in this study. Eight focus group interviews were conducted in total; four
groups with parents, and four with local authority workers. The composition of the groups is
given in Table 1.
Table 1
Number of participants in each focus group
Local Authority Workers

Parents

Group 1
Group 2
Group 3
Group 4
Group 5
Group 6
Group 7
Group 8

Participants
5 females
6 females, 2 males
7 females
4 females, 1 male
7 females, 1 male
4 females
3 females, 1 male
6 females, 1 male

Focus Group Sessions.

Each focus group was conducted by a trained moderator. The focus groups were structured
by a scripted set of instructions consisting of the questions to be asked, and the prompts to be
used when participants were unsure about how to answer. In this way, all questions were
consistent in every focus group interview, and each group was conducted, as far as possible,
under the same conditions. Table 2 displays a skeleton of the questions that were asked by the
moderator during the focus group interviews.
Table 2
Questions asked in the focus groups
1.
2.
3.
4.
5.
6.
7.
8.

Who decided when your child was ready to be included in a mainstream school?
What factors lead to the decision to place a child in mainstream?
What factors are most beneficial for inclusion?
What is less beneficial?
What could be improved?
What are the advantages of having a child placed in a mainstream school instead of a special
school?
What types of help have been offered by the professional services and when?
If advice is to be given, when is the best time?

The length of the focus groups varied depending on the number of participants involved. The
shortest focus group lasted approximately 45 minutes, and the longest focus group lasted
approximately 90 minutes.
Content Analysis.
All focus groups were audio-taped, and later transcribed for analysis. The transcripts were
analysed using a content analysis of the text as recommended by Vaughn, Schumm and
Sinagub (1996). This procedure has been used previously by Frederickson et al. (2004), and
Osborne and Reed (in press). The stages of the analysis are outlined in Table 3.
Table 3
Stages in Content Analysis (as cited in Vaughn et al. 1996)
_________________________________________________________________
1. Identification of key themes from reading and re-reading the transcripts

2. Creating units of information from the data (phrases and /or sentences)

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3. Categorisation of the units into themes or categories

4. Negotiation of categorisation between two researchers until all categories have been exhausted.

Once transcribed, all statements from the individual focus groups were broken down into the
smallest units of information that were interpretable by themselves. A unit of information
could be either a sentence or phrase. This was completed for the transcripts of all the focus
groups. Once the units were established, category headings were created by reading through
all the units that were suggested for each question. The category headings represented the
general themes stemming from the units of information. After all units from a particular
question were placed into the categories for this question, this list was passed to another
assessor, who read the comments to check agreement with the unitisation and categorisation
of the statements.
In order to confirm the reliability of the coding of the results, a Cohens Kappa analysis was
used for inter-rater reliability. In order to do this, two experimenters rated all the data. A high
mean level of reliability was identified between their two separate judgements for each
question. The figures ranged from a low of 0.92 for Question 2, to a high of 1.00 for
questions 1, 4, 5, 6, 7, & 8.
Results
In total 430 units were collected for the eight focus groups. Responses for each question have
been categorised into themes and these are displayed in Tables 5 to 11.
Question 1: Who decided when your child was ready to be included in a mainstream school?
Table 4
Percentage of participants responses falling into the different categories for Question 1
Themes
Professionals
Parents %
Examples
%
Parent decided
44
47
the decision was always ours
Joint decision with school and
The school, myself, everyone
11
29
LEA
involved [made the decision]
Depends if they have a
statement or not

12

if the child has a statement then it

would be the decision that was reached
following an annual review

Never thought of anything

else/didnt realise he needed
help

22

We had never considered anything

other than mainstream.

No other option/forced decision

11

It was a forced decision because they

[children] would not qualify for
anything else, regardless of their need.

I decided, even though in the

statement it said he should go to a
special school, I thought no way, I
didnt want to send him there.

12

As it happens, had we taken a

different route and sent him to a state
primary school, had we chosen not to
send him to the independent, the
decision may not have been in our
hands.

Parents decide against LEA

recommendation

Depends on child factors (age

& school)

Table 4 summarises the responses made by participants from both the parent and local
authority groups to Question 1. The participants identified seven main themes. When it came

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to deciding whether to place a child in mainstream the majority of statements from both
groups agreed that the parent had the overriding say in this decision. Parents said that they:
wouldnt want anything else other than mainstream school because I think that it is right
for my children and in the case of my children I am their mom and I decide. The local
authority workers agreed, and said that: . the views of the parents are overriding, suggesting
that even if the local authority felt that the child wasnt going to be placed suitably in
mainstream, the child still would be placed in mainstream. Parents also felt this, saying that:
I decided, even though in the statement it said that he should go to a special school, I thought
no way, I didnt want to send him there.
Over a quarter of the local authority workers statements suggested that the decision to place a
child in mainstream was a joint decision, in contrast to only a small group of statements made
by parents. These parents and local authority workers felt that the decision was jointly made
between all those involved, as described by a parent, the school, myself, everyone involved.
The second most common response from the parents was that they didnt realise that there
was a problem and, hence, did not think of anything but mainstream: we never knew he had
any problems. We just took him to nursery.
A considerable number of statements from local authority workers suggested that who made
this decision depended on whether the child had a statement: if they already have a statement
then it goes through annual review and within that everyone participate. However, no parents
felt that statementing had an impact. Another group of parents statements suggested that they
felt that they had no other choice but mainstream for their child because of lack of
alternatives, and felt that although the decision: was mine but it was a forced decision
because they would not qualify for anything else, regardless of their need. Another parent
said that: because he is at the able side of the spectrum, we wont be able to get him into a
special school.
Question 2: What factors lead to the decision to place a child in mainstream?
Table 5
Percentage of participants responses falling into the different categories for Question 2.
Theme
Professionals
Parents %
Examples
%
his needs were not profound enough to
Choose the school that
take him into a specialist school so it
32
24
meets needs of child
was a good compromise to get him a
place in the unit
mainstream is the right place for my
Academic levels
10
12
children because of their academic
levels
I thought it would be good for him to
model off other kids which were
Socialisation
21
12
normal and that is the main reason
why we sent him to mainstream school
Lack of alternative
provision

37

44

it is very difficult to find specialist

provision. Its not a choice for many
parents. The expectation is mainstream
from most of the cases we see.
it varies in provisions as well because
if you want to keep your child local you
have to look at the range of provisions
there is

Local school

Behaviour

I just think its down to the individual

whether they can cope with the

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situation

For Question 2, six different themes were identified when parents and local authority workers
were asked what factors led to their decision to place their child in mainstream. Both groups
agreed that the most important factor leading to place a child in mainstream was a lack of
alternative provision for the child. One professional said that: in an authority that talks very
much about value for money it is very difficult to find specialist provision. Its not a choice
for many parents. Parents felt that they had no choice but to place their child in mainstream:
they would no way get into any kind of special school, because they havent got learning
difficulties.
Just over a third of the parents statements, and a quarter of the local authority workers
statements, suggested that a childs needs should be addressed when deciding the best
provision. One parent describes her childs case as: his needs were not profound enough to
take him into a specialist school so it was a good compromise to get him a place in the unit .
One authority worker said: progress made and behaviour. They need to show that they can
work independently. Both parents and local authority workers felt that academic levels were a
factor leading to the decision to place a child in mainstream, as one parent said: mainstream is
the right place for my children because of their academic levels.
Another important factor for the parents was the socialisation of the child. Parents felt that
mainstream placements would: be good for him to model off other children. For the local
authority workers, socialisation was also important and they felt that children: need to know
what to do when something goes wrong, so its part of the social skills. The authority workers
also felt that the decision on mainstream could depend on the location of the school and
therefore school placement decisions would vary because: if you want to keep your child local
you have to look at the range of provisions there is.
Question 3: What factors are most beneficial for inclusion?
Table 6
Percentage of participants responses falling into the different categories for Question 3
Theme
Professionals
Parents %
Examples
%
there needs to be an acceptance by the school
setting that the child has a right and belongs there
and there should be an acceptance as well that
School factors
42
38
that child has particular and individual needs and
its the responsibility of all the people working
there to help meet those as they would any other
child

LEA factors

38

25

Peer factors

13

11

Child Factors

26

preparing the mainstream class teacher first

through training courses which we run as a team
every term, and more than that, and preparing
them with the sort of strategies that the child will
need in school
His friends are translators for him between the
autistic world and the mainstream world and the
wonderful thing is that it has been a two-way
thing, it has enriched their lives as much as his
Its about the individual needs

The responses to Question 3 show a strong similarity between both parents and local authority
workers across the four themes identified. Both groups felt that school factors, such as
school commitment and willingness (the school has to want to [include the child]), and good

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communication between the school and parents, where: sharing information and making sure
everybody is working consistently through out the school and at home, were the most
pertinent factors in moderating the success of inclusion.
The second most important factor for parents was LEA factors, such as funding and teacher
training. One parent said that it was all about: the people involved and getting them involved
at a very early stage whilst another parent felt: you need somebody either with professional
experience, really good experience [and] qualified. The local authority workers prioritised
child factors over LEA factors, like addressing the childs needs and social skills. One
professional considered that: their level [the childs] of communication skills that is a key
indicator to how they can cope, because if they cant understand the language in the
classroom, then they will just get bombarded and their anxiety level will get high. Local
authority workers regarded social skills as important and felt that: some of our pupils are very
peer orientated so they are able to moderate their behaviour because they dont want to be
different and so they sort of fit in better.
Parents and authority workers agreed that peer factors, such as peer training and peer relations
played a role in promoting the successful inclusion of children with autistic spectrum
disorders. One parent said that wonderful friends made it possible for her child to be in
mainstream: his friends are translators for him between the autistic world and the mainstream
world and the wonderful thing is that it has been a two-way thing. Another parent described
peer training as an important tool: if they have been educated about it then his classmates will
become a team.
Question 4: What is less beneficial?
Table 7
Percentage of participants responses falling into the different categories for Question 4
Theme
Professional
Parent %
Examples
%
If you dont have a supportive school you
School factors

might as well not bother with inclusion because

its not going to work.
The problem because we are not getting
funding, that it is extremely difficult for him to

LEA factors

70

31

stay in mainstream school because the teachers

havent got the time or the resources to cater for
his needs.

Peer factors

10

Child Factors

12

47

Parental factors

[child] was subjected to quite a lot of bullying

the more aggressive ones are harder to include
than the passive ones
: Some parents dont want your children there. I
have had parents say to me get your ***** child
out of our school.

The responses to Question 4 show a number of discrepancies between the two groups. The
categories of responses to this question covered five main themes. The majority of statements
by the parents indicated that they felt that LEA factors, such as funding, were the most
important causes of failure to include a child. One parent said that the problem, because we
are not getting funding, that it is extremely difficult for him to stay in mainstream school
because the teachers havent got the time or the resources to cater for his needs.

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In contrast, the local authority workers statements indicated that they felt that child factors,
such as not meeting the childs needs or individual characteristics of the child such as social
skills, language abilities and behaviour were principal to the failure of inclusion. One worker
mentioned the importance of knowing a childs individual needs: in primary a lot of children
get through it because they are in a small supportive environment mostly the same teacher all
daythey know their needs and theyve known them from when they were tiny. Another
authority worker mentioned language abilities as important as: language could be
overwhelming in which case they would be better in a special school. Local authority
workers also felt that social skills were fundamental: one of the reasons for children being
excluded is not having those adequate social skills, that is the core of it.
Question 5: What could be improved?
Table 8
Percentage of participants responses falling into the different categories for Question 5
Theme
Parent
Professional
Examples
%
%
Involve school members more when
I think it should be more
making placement decisions
the people in the school
11
0
(making the decisions). They
should have more of an
impact.
Be more open to alternatives other than
They are all obsessed with
mainstream
44
33
inclusion needing to work. I
want them to be honest.
More training on ASD
22

17

Peer training

More resources and support

Measure of best placement

11

11

17

33

I think that teachers

need more training in
ASD. Some of them dont
even know what they ASD
is.
Government should put it in
the curriculum to teach
children about different
people with different illness
and needs.
[children should] get more
one to one time.

Responses to Question 5 show a number of similarities between the local authority workers
and parents. Primarily, when discussing what factors need to be improved in order for
inclusion to be more successful, both groups agreed that the most important issue was to be
more open to alternatives other than mainstream. One local authority worker described it as:
we need to move away from needing to push our kids down the same route. Parents felt the
same way, saying: they are all obsessed with inclusion needing to work. I want them to be
honest. Parents also felt that there needed to be more training in ASD: I think that teachers
need more training in ASD, some of them dont even know what ASD is!.
The next most important factor for the local authority workers was to create a measure of best
placement, whereby professionals are: working towards some guidance and a measurement
that panels use. The authority workers felt that in the current situation: we are putting them
in a position of failing in order to provide an alternative environment. What we need to be
doing is making an appropriate judgement immediately.

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Question 6: What are the advantages of having a child placed in a mainstream school instead
of a special school?
The responses to Question 6 show considerable differences in perceptions between the two
groups when discussing the benefits of placing a child in a mainstream provision versus an
alternative provision. The categories of responses to this question covered five main themes.
Parents indicated that the overriding benefit was that mainstream schooling improved the
childs chances of a normal life: in special schools they could get more protected and would
feel more vulnerable when they left. For another parent mainstream meant that children: are
being forced into social situations that they are going to encounter for the rest of their lives.
Table 9
Percentage of participants responses falling into the different categories for Question 6
Parents
Professionals
Theme
Examples
%
%
Improve chances
normal life

of

42

14

I would prefer him to stay in

mainstream and I think it would
help him to have a normal life

Teaches diversity to other

children

14

I think there are benefits for the

other children, that they are around
children with different needs, and
you know, to celebrate diversity.

Social skills

25

58

they will kind of pick up normal

things and be with normal
children

Down to the individual

child/parent

33

I think that has to be the

individual choice of the parent

Academic

14

He wouldnt be pushed
academically in a special school

For local authority workers, the most important benefits were social skills: they will kind of
pick up normal things and be with normal children. For the authority workers this factor was
followed by the importance of teaching diversity to other children: I think there are benefits
for other children, that they are around children with different needs, and you know, to
celebrate diversity.
Question 7: What types of help have been offered by the professional services and when?
Table 10
Percentage of participants responses falling into the different categories for Question 7
Theme
Parent
Professional
Examples
%
%
If youre child hasnt been diagnosed
Only with diagnosis
16
0
you dont get access to any
information.
None. Ive just been having to read
Nothing
60
0
up about autism
Through out

20

50

I cant fault any of the external help

that I got. They gave me all the
information I could ask for.

Had to look for it

I had to look it all up in the internet.

50

You can recommend [schools]. But

youre not supposed to! I tell them
what they should be looking at, what
school.

Support in choosing
schools

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Overwhelmingly, parents said they had received no help or information from the LEA saying
that: we get nothing. In addition, only a small group of parents felt that they were given
support at diagnosis and none thereafter: I had to look it all up on the internet. Only 1/5
parents felt that they were given support through out diagnosis and the inclusion process, and
no parent felt that they were given help in choosing an appropriate school placement for their
child.
These results are in stark contrast with the opinions of the local authority workers, who felt
they had received and given support through out and had received and given support in
helping parents choose an adequate school for their child: we offer parent groups; we do have
parent groups at the moment, where parents come when their child is first diagnosed as they
get so much information, which will then reduce their anxiety.
Question 8: If advice is to be given, when is the best time?
Table 11
Percentage of participants responses falling into the different categories for Question 8
Theme

Parent
%

Professional
%

All the time

25

25

At least 2 terms prior to

inclusion

50

At diagnosis

75

25

Examples
The advice needs to be given before,
during, all the time really
at least two terms before the child
enters the provision. So that someone
can come and shadow the child in the
nursery and the child can visit the
mainstream
: Everything you should get at
diagnosis. You should get everything at
diagnosis.

When asked when would be the best time to receive information and help, parents
overwhelmingly agreed that it should all be given at the time of diagnosis: you should get
everything at diagnosis. Its staggering that we get nothing. Another group of parents felt that
the information should be ongoing: all the time. This pattern of results contrasts with the
local authority workers, as half of the workers opinions were that it was important to give
advice and information at least two terms prior to inclusion. A quarter felt that the support
should be ongoing, and the other quarter felt that the advice should be given: as early as
possible. As soon as they know that theyre child has an SEN, this way they know what to look
for.
Discussion
The present study was an attempt to ascertain the perceptions of parents/caregivers, and local
authority workers, concerning the factors that are beneficial to the inclusion of a child with
ASD, and to determine what can be improved about the process. Both groups are closely
involved with the process, either through teaching and delivering of provision, or by being the
carer of an included child. Both groups agreed that when it came to making the decision to
place a child in mainstream school, the decision was primarily the parents, even in cases
where the LEAs and professionals disagreed with the parent. This view would be consistent
with the code of practice, which states that parents have the ultimate say as long as this is
consistent with the best use of resources, and will not interfere with the education of the other
children (DfEE, 1994).
A quarter of parents felt that they made the decision to place the child in mainstream because
they didnt realise their child needed help. This could also suggest that children are not

164

getting identified early enough for parents to start making school choices appropriate to their
childs needs. Early diagnosis is regarded as critical, but diagnosis is often delayed until
school age due to lack of understanding or access to physicians (Mandell, Novak & Zubritsky,
2005).
Parents felt that they had chosen to place their child in mainstream out of lack of a better
option. They believed that their child didnt have the opportunity to enter an alternative
provision, either as they were too able to qualify, or because there was no alternative.
Consistent with this view, in Question 2 when discussing what factors that lead to the decision
to place a child in mainstream, both groups agreed that parents came to this decision primarily
due to a lack of alternative provision. Additionally, parents and local authority workers also
reflected this view when discussing what needed to be improved about the current inclusive
policy, saying more openness to alternatives to inclusion was essential. In a survey conducted
on teachers across the United Kingdom by the Times Educational Supplement (FDS
International, 2005), teachers advocated the continued availability of a range of school
provisions. Similarly more researchers are calling for responsible inclusion, whereby
alternatives to full time inclusion are sought. Warnock (2005) asks for a re-take on
inclusion, whereby specialist school are not disregarded as inferior education.
Both parents and local authority workers felt that finding a placement that met the childs
needs was important. In order to do this, authority workers felt that there needed to be a
measure of best placement to avoid placing children in mainstream to fail. Children with
autism have IQs that vary from severe learning disability, to superior intellectual functioning.
Their behavioural difficulties also vary tremendously, as do their social and cognitive
functioning (Burack & Volkmar, 1992). With such diversity, the insistence for inclusion for
all persons with autism seems short-sighted and simplistic (see Mesibov, 1990). In its place
there needs to be more emphasis on individual educational needs that can promote
development in all domains of functioning (Burrack, Root, & Zigler, 1994; Mesibov, 1990;
Zigler & Hodapp, 1987).
When discussing factors that promote the successful inclusion of children with ASD, both
groups felt that school factors, such as school commitment, and having the right people
involved, were the most significant promoters of successful inclusion. This is consistent with
Burrack, Root and Ziglers (1997) research that examined the attitudes of teachers. They
found that teachers play a crucial role in the success of integration programmes, and that, in
addition to teacher training, teacher and school commitment were critical to success. Kasari
et al. (1999), in line with the current study, found that parents of children with autism were
more likely to view specialised teaching and staff as important to their childs education.
Jindal-Snape, Douglas, Topping, Kerr and Smith (2005) also found that professionals and
parents felt that staff attitude played a very important role in creating an inclusive
environment.
The second most important factor benefiting inclusion for both parents and professionals were
LEA factors, such as teacher training and funding. This is also consistent with Burrack et al.
(1997). They found that, without support and training, only 33% of teachers were willing
participants of inclusive practice. A survey run by the Times Educational Supplement (FDS
International, 2005) found that training had an impact upon attitudes towards inclusion, and
those with no training in SEN showed the least positive attitude scores. Likewise, Avramidis,
Bayliss and Burden (2000) found that teachers with substantial training were more positive to
inclusion and also felt more confident meeting IEP (Individual Education Plans) requirements
as a result of their training. In accordance with the current study, Avramidis et al. (2000) also
report that funding was a mediating factor to inclusion, and found that teachers wanted more
non-contact time. Similarly, Diebold and Von Eschenbach (1991) noted that teachers reported
that they did not have sufficient time for inclusion. In line with the current study, JindalSnape et al. (2005) found that parents felt that teachers should have more autism specific

165

training to help support their children in mainstream schools, and Barnard, Prior and Potter
(2000) from a national survey reported that the most desired changes expressed by parents of
children with autism was more training about autism for teachers.
Professionals also focused on child factors such as behaviour, social skills and academic
abilities as beneficial for inclusion whilst parents didnt. This result is consistent with
Fredrickson et al. (2004) who also found that professionals rated behaviour such as being able
to follow instructions, obeying classroom rules and social progress as paramount in defining
successful inclusion. Also consistent with the current study, professionals in Fredrickson et
al.s (2004) study rated learning and academic progress as an important factor in determining
whether inclusion was successful. These concerns suggest that skills related to behaviour,
social skills and academic abilities should be taught in order to help the childs success in a
mainstream placement. In contrast, when it came to factors that were less helpful, although
the parents still felt that LEA factors such as funding and resources were the principal factors
in undermining successful inclusion of a child, local authority workers felt that child factors
such as behavioural problems or lack of social skills were more critical. This finding is
concordant with the literature which argues that successful placement in a typical classroom
may be dependent upon the display of appropriate behaviour (Downing, Morrison & BerecinRascon, 1996), and a lack of social skills may impede the integration of children with autism
as well as reduce their interaction with the peer group (Beckman 1983; Guralnick 1990;
Sherratt 2002; Strain & Danko, 1995).
Parents and local authority workers were also asked about the information/help they received
from LEA. An alarming majority of parents said that they had received no information or
help from the LEA. This finding is in accordance with Osborne and Reed (in press)
concerning lack of information at diagnosis. In contrast with the parents, an equal proportion
of local authority workers felt that they had given help through out and that they had helped
parents choose an appropriate school. Whether the parents feelings are a true reflection of
what they got, parents clearly perceive it as so, suggesting that work needs to be done
addressing these concerns.
In accordance with the literature, parents and local authority workers called for a more
responsible inclusive movement (Vaughn & Schumm, 1995) by recognising the alternatives to
mainstream. This is in concurrence with many researchers concerned that the movement
towards inclusion of children with ASD has been driven by ideological approaches (Bailey,
1998).
Although these results shed some light a number of different elements relevant to successful
inclusion, there are a number of limitations to this study. The sample size and
representativeness of the sample needs to be considered. Although only three boroughs were
involved in the study, it should be noted that there was reasonable consistency between the
perceptions of each parent and professionals group. Furthermore, all participants were
volunteers, and so their representativeness of all parents and professionals in general may be
an issue that limits the generalisation of the conclusions that can be drawn from the data.
However, it is also important to note that all participants were randomly selected. As with
any analysis of focus group data, these perceptions should be considered as a measure of the
strength of a feeling about the specific issues that were discussed and should not be regarded
as an indication of their frequency in the general population.
This is the first focus group to look at the view of parents and local authority workers on what
promotes successful inclusion of children with ASD. Parents clearly are the ones making the
decision to place a child in mainstream, primarily due to a lack of alternative provision. Both
parents and professionals agreed that this needed to change and that in addition to becoming
more open to alternatives, a measure of best placement should be introduced in order to place
children in provisions that will meet their individual needs. Consistent with earlier literature

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(see Burrack et al. 1997) both parents and teachers felt that the attitudes of teachers and
overall school commitment were the most significant promoters of successful inclusion.
Moreover both groups agreed that LEA funding, in addition to teacher training was essential
to success. Professionals felt that child factors such as behaviour and social skills could
undermine a successful inclusive placement, whilst parents felt that funding and resources
were most important. Finally, parents felt that they hadnt been given sufficient support or
information by LEA about the process of inclusion.
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EFFECTIVE INTERVENTIONS FOR INDIVIDUALS WITH

HIGH-FUNCTIONAL AUTISM
Ann X. Huang
John J. Wheeler
Tennessee Technological University
The diagnosis of high functioning autism (HFA) is not the end of
comprehensive assessments. Since the 1970s, although a great deal
of research has focused on developing effective educational
approaches and interventions for children with autism, there is an
increasing need to develop differentially effective educational
approaches or interventions that are specifically for children with
HFA. This paper reviews several effective, evidence based
interventions that are widely used by special educators and
professionals as best practices in the United States, including
structured teaching approaches, peer-medicated interventions, selfmonitoring or self-management strategies, video modeling, and
social stories, with a hope that people in other places of the world
can also find these interventions beneficial in teaching children with
HFA.
A lack of learning in any particular situation should first be interpreted as a result of the
inappropriate or insufficient use of teaching strategy rather than an inability on the part of
the learner (Gold, 1980, p. 15)
Autism is a complex, behavior-defined developmental disorder. The diagnosis of high
functioning autism (HFA) is not the end of comprehensive assessments. Having more up-todate knowledge of this population including their characteristics, strengths, needs and
interests is more important than simply a diagnosis (Kunce & Mesibov, 1998). Only with a
better understanding of these individuals can researchers design more effective interventions
to better serve their needs. This process requires on-going joint efforts of researchers from
multiple disciplines.
Since the 1970s, researchers have made great effort to develop individualized educational
programs and interventions, many of which have demonstrated their effectiveness in
improving the social communication abilities and daily functioning skills of the autistic
population. However, as it is evident in the available literature, most available publications
are focused on children with moderate to severe autism, individuals with HFA are relatively
underserved. There is an increasing need to develop differentially effective educational
approaches or interventions that are specifically for children with HFA. Fortunately, research
in this field in the past decade is on the rise. The following section will introduce several
evidence-based, effective interventions that are widely used by special educators and
professionals as best practices in the United States, including structured teaching approaches,
peer-medicated interventions, self-monitoring or self-management strategies, video modeling,
and social stories.
Structured Teaching Approaches
Structured teaching approaches were originally developed by researchers from the TEACCH
(Treatment and Education of Autistic & related Communication handicapped Children)

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program at the University of North Carolina, Chapel Hill. They are regarded as the most
effective individualized teaching approaches implemented in classroom settings for students
with autism and include such components as routines, schedules, adapted instructional
strategies, and modification of learning environments (Kunce & Mesibov, 1998). Structure
teaching approaches are effective because they make the classroom environments meaningful
to the target children and make necessary environmental modification to better cater for their
special needs (Kunce & Mesibov, 1998).
Routines & Schedules
Individuals with HFA are basically visual learners. Unlike ordinary people, they tend to think
in pictures and might not be able to follow verbal instruction, which actually work for most
typical students. Even with relatively unimpaired language ability (compared to other children
with moderate to severe functioning level autism), students with HFA might still fail to adapt
well in unmodified classroom environment because of pragmatic social communication
difficulties as well as more general social impairments (Kunce & Mesibov, 1998, p. 231).
Students with autism tend to insist on sameness and also find lack of predictability stressing.
The use of routines and schedules can help students with HFA better adapt to classroom
environment by establishing consistency and predictability (Kunce & Mesibov, 1998).
Researchers in the TEACCH programs found the development of systematic routines lessen
the feeling of anxious, decrease behavior problems and promote learning in students with
HFA (Mesibov, Scholper, & Hearsey, 1994). Accordingly, the use of individualized schedules
can help students with HFA stay on track, understand, accept and follow the sequence of
daily events (Kunce & Mesibov, 1998, p. 234) and adapt more flexibly and smoothly to the
inevitably changes in the daily routine (p. 236), as well as decrease transitional difficulty.
Adapted Instructional Strategies
In addition to routines and schedules, adapted instructional strategies can help children with
HFA better involve in classroom learning. Due to their unique characteristics, students with
HFA cannot benefit from traditional teaching methods. Kunce and Mesibov (1998) suggested,
to help students with HFA better understand instruction and requirements, teachers can apply
the following adapted instructional strategies:
(1) Adjusting instructional language. Despite their relative strengths in vocabulary,
reading ability and speaking skills, researchers found children with HFA actually have
difficulty understanding complex sentences because of the pragmatic impairments (Minshew,
Goldstein, & Siegel, 1995). Researchers suggested the use of simple languages and short
sentences with slower speed can help clarify instruction and expectation to students with HFA
(Kunce & Mesibov, 1998).
(2) Using written information. Basically, students with HFA are visual learners, so they
cannot benefit from traditional verbal instruction. Based on their relative strengths in visual
spatial processing, the use of written information may be one of the most effective ways to
teach this population (Kunce & Mesibov, 1998). Visual aids, including written task directions,
written cues, maps, pictures, handouts and checklists, provide the target students with a
lasting, visual reminder and are more effective than instructional languages and other
presentation styles (Kunce & Mesibov, 1998, p. 239)
(3) Taking advantage of the target students special interests. Students with HFA usually
have strong interests in some special objects or topics. Some researchers emphasized it is
important to utilize their special interests to develop academic and career skills, rather than
stamping them out (Siegel, Goldstein, & Minshew, 1996, p. 244). In addition, these special
interests can be also used to reinforce less preferred activities as well as to make the school
environment more appealing(Kunce & Mesibov, 1998, p. 245)
Modification of Learning Environments
Besides the adapted instructional strategies, environmental modification is also essential
(Kunce & Mesibov, 1998). Typically, students with HFA learn better in a structured

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environment. Researchers suggested when possible, arrange the learning materials and
furniture in ways that accommodate the students learning styles best and reduce potential
distractions (Kunce & Mesibov, 1998). For example, offering preferential seating and
providing an independent work area for students with autism are encouraged (Kunce &
Mesibov, 1998). Another way to modify learning environments is to use organizational work
system. For example, the use of containers with written labels is a simple but most effective
way to organize tasks for students with HFA (Dalrymple, 1995; Kunce & Mesibov, 1998).
Other organizational supports such as organizational notebooks and written task directions are
also very helpful in promoting independence in students with HFA.
Peer-mediated Intervention
The effects of peer-medicated interventions (PMI) have been well established in the literature
and regarded as one of the most promising approaches to educating individuals with autism
(Goldstein, Wickstrom, Hoyson, Jamieson, & Odom, 1988; Ostrosky, Kaiser, & Odom, 1993;
Robertson, Green, Alper, Schloss, & Kohler, 2003). Peer-medicated interventions (also refers
to as peer tutoring) can be divided in three levels: class wide, small group and one-to-one.
Matching a child with disabilities with typically developing peer partner(s) has the following
advantages:
(1) providing a reciprocal and more learner-friendly environment (Perske, 1988);
(2) presenting more opportunities to receive positive and corrective feedback,
individualized help and encouragement (Maheady, Harper, & Mallette, 2001, p. 7);
(3) students prefer peer-teaching practices to traditional student-teacher instruction
(Maheady, Harper, & Mallette, 2001);
(4) Typical peer is able to make adaptations when interacting with peers at lower
developmental levels, which increases the likelihood of successful
interactions(Ostrosky et al., 1993, p. 160);
(5) facilitating generalization of the learned skills across settings and people (Ostrosky et
al., 1993, p. 164);
(6) typical peers may also benefit academically and/or socially from such peer interaction
(Kamps et al., 1998).
Over the past two decades, many researchers devoted tirelessly to the exploration of more
effective PMI for individuals with autism and a great volume of such studies can be found in
the literature. They demonstrated the effectiveness of various PMI in facilitating both
academic growth and positive social interaction between individuals with autism and their
normal peers. For example, Kamps et al. (1994) examined the effects of class-wide peer
tutoring on three children with HFA in an inclusive general education classroom and results
revealed class-wide peer tutoring improved both the students reading skills and social
interaction. Another study by Goldstein et al. (1992) examined the effects of small group peer
tutoring on social interaction between children with autism and their typical peers and results
showed that 4 out of 5 target children demonstrated higher rates of social interaction. McGee
et al. (1992) evaluated the effectiveness of another PMI (i.e., one to one peer incidental
teaching) and found its effectiveness in promoting positive reciprocal interactions among
children with autism and their typical peers.
Morrison, Kamps, Garcia and Parker (2001) used a multiple baseline design to determine the
effects of an intervention package that combined peer mediation with monitoring strategies
and found that the package increased the target childrens rates of initiations and social
interaction time with typical peers. Little difference between self-monitoring and peermonitoring strategies was found. Similarly, Thiemann and Goldstein (2004) examined the
effects of another intervention package consisted of peer training and written text cueing on
five elementary school students with autism and results also revealed improved child-peer
interactions and social communication, as well as higher acceptance and friendship rating for
children with autism.

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When developing peer-mediated intervention, Ostrosky et al. (1993) suggested the best role
for typical peers to play is to be facilitator rather than primary interventionist (p. 170). That is
to say, peer-mediated interventions should support the childs acquisition of socialcommunicative strategies by providing appropriate behavioral models, providing
opportunities for successful communication, and facilitating generalization across
environments and individuals (Ostrosky et al., 1993, p. 170). They proposed the following
criteria for selecting typical peers:
(1) they demonstrate age-appropriate language and social skills;
(2) they are familiar with the target participants, and interact positively with the target
participants in the natural settings;
(3) they would like to follow adult direction and are willing to help the disabled peers
(Ostrosky et al., 1993). In addition, they also proposed the following seven principles to
guide the development of an effective intervention (Ostrosky et al., 1993):
1. Promote peer interaction and facilitate communication between children with
and without special needs.
2. Teach ALL children social-communicative strategies to maximize the effects of
an intervention.
3. As initial participants, choose children who are likely to be successful.
4. Provide individualized instruction to children with special needs, focusing on
initiation and response strategies.
5. Provide instruction to nondisabled children in conversational strategies known
to elicit verbal and nonverbal behaviors from children with special needs.
6. A direct instruction approach should be used to teach desired socialcommunicative behavior to all children.
7. Maintenance and generalization must be programmed for (p. 170).
Effective peer-mediated intervention should be able to maintain the target childs join
attention (Ostrosky et al., 1993). To maximize treatment efficacy of PMI, the target childs
preference, existing repertoires and strengths should be taken into consideration (Ostrosky et
al., 1993). Environmental management is another important component of such intervention
programs. Most individuals with autism learn better in distraction-free environments but have
difficulty generalizing the acquired skills to more natural settings. To maximize
generalization, Ostrosky et al. (1993) suggested multiple exemplars should be trained to
facilitate generalization to untrained stimulus conditions and to untrained responses (p. 179).
They also believed, consistently providing children with structured and unstructured
opportunities to interact with peers will facilitate generalization as children learn that there
are expectations for positive social-communicative interaction between age-mates (Ostrosky
et al., 1993, p. 179).
Self Monitoring/Management Strategies
According to Field, Martin, Miller, Ward, & Wehmeyer (1998):
Self-determination is a combination of skills, knowledge, and beliefs that enable a person to
engage in goal-directed, self-regulated, autonomous behavior. An understanding of one's
strengths and limitations together with a belief in oneself as capable and effective are
essential to self-determination. When acting on the basis of these skills and attitudes,
individuals have greater ability to rake control of their lives and assume the role of successful
adults (p. 2).
As one way of self determination, self monitoring, which also refers to as self management,
includes such strategies as self assessment, self regulation, self recording and self
reinforcement (Koegel & Frea, 1993). Koegel, Koegel, and McNerney (2001) believed self
monitoring is a great technique with tremendous influence on the development of
interventions for individuals with ASD. Its advantages include:
(1) less intrusive: this technique requires the student to manage his/her own behaviors,
rather than being controlled and managed by other people;

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(2) resource-saving: it demands less time and involves fewer resources such as
professionals or educators, training and other instructional materials;
(3) user-friendly: its procedures are simple and easy to master (Ganz & Sigafoos, 2005).
During the past two decades, self monitoring has been widely used as an effective
intervention for children and adults with various disabilities. According to the literature, self
management strategies can be applied to decrease undesirable, problematic behaviors in
children and adults with mental retardation (Gardner, Clees, & Cole, 1983; Reese, Sherman,
& Sheldon, 1984; Shapiro, McGonigle, & Ollendick, 1980), and to improve desirable
behavior, social skills and play skills in children with autism (Koegel, Koegel, Hurly, & Frea,
1992; Stahmer & Schreibman, 1992), as well as to decrease inappropriate, stereotypic
behavior in these individuals (Koegel & Frea, 1993; Koegel & Koegel, 1990).
Recently, Mancina, Tankersley, Kamps, Kravits, and Parrett (2000) reported they used a selfmanagement treatment program and successfully reduced inappropriate vocalizations in a
child with autism. In addition, Ganz and Sigafoos (2005) conducted a study to evaluate the
effectiveness of a self-monitoring procedure in two young adults with autism and severe
mental retardation in a vocational training program. Results showed that the use of self
monitoring procedure increases the independent task completion and verbal requesting in
these two individuals. Furthermore, other researchers (Agran, Sinclair, Alper, Cavin,
Wehmeyer, & Hughes, 2005) also demonstrated that the application of self-monitoring
strategy increase following-direction skills in 6 students with moderate to severe disabilities
(including autism) in general education settings.
Since individuals with HFA have relative unimpaired intelligence and language, they are the
best population to implement self-monitoring strategies and can achieve best outcomes.
Researchers (i.e., Koegel, Koegel, & Carter, 1999) suggested if individuals with autism are
taught and master the self-management technique, they might be able to generalize the skills
to various settings and behaviors. Thus, the ultimate goal of self-monitoring strategies is to
promote greater independence among individuals with HFA.
Video Modeling
Research has found that the use of video modeling (including self modeling and peer
modeling) can have a great positive impact in the areas of social communication, daily
functioning skills, and academic performance on children with various disabilities (e.g.,
Apple, Billingsley, & Schwartz, 2005; Charlop-Christy & Daneshvar, 2003; Goldstein &
Thiemann, 2000; Simpson, Langone, & Ayres, 2004). Video modeling is effective because:
(1) it focuses on the target childrens visual strengthen (Pierce & Schreilbman, 1994); (2)
children with autism prefer to learn from video modeling to live, real world (or in-vivo) peer
modeling (Charlop-Christy, Le, & Freeman, 2000). Over years, video modeling has been
widely accepted as the best practice in the literature and can be used in many different ways
(Sturmey, 2003).
Video modeling can be used to teach social skills to children with autism. For example,
Simpson, Langone, and Ayres (2004) used peer video modeling to teach three social skills to
four children with autism and results showed that all students gained evident improvement in
the targeted social skills in natural environments. Another study by Kimball et al. (2004)
demonstrated the effectiveness of video modeling in teaching autistic children activity
schedules. Furthermore, other researchers (e.g., Schreibman, Whalen, & Stahmer, 2000) used
a technique named video priming and successfully decreased the disruptive behaviors during
transition periods for children with autism.
In addition, video modeling can be also used to teach new daily functioning skills to
individuals with autism. For example, Alacantara (1994) used adult modeling (through task
analysis) to teach grocery shopping skills to three students with autism and results showed
they all acquired the target skills and also generalized the skills across settings. Another study

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by Shipley-Benamou et al. (2002) used video modeling to teach several functional living tasks
to three children with autism and found that video modeling significantly facilitate the
acquisition and independent performance of the target living skills.
Furthermore, video modeling can be also used to improve other behavior or skills in
individuals with autism. One such example is to use video modeling to teach perspective
taking successfully to children with autism (Charlop-Christy & Daneshvar, 2003). Recent
studies also suggested video modeling can be an effective strategy when implemented as part
of an intervention package because it can maximize the intervention efficacy and
generalization. For example, Apple, Billingsley, and Schwartz (2005) conducted a study of
two experiments to examine the effects of video modeling alone and with self-management
on compliment-giving behaviors of children with HFA. Results indicated application of both
video modeling and self-management strategies produce and maintain social initiations when
video modeling alone fails. Other researchers (i.e., LeBlanc et al., 2003) used another
intervention package including video modeling and reinforcement to teach perspective taking
skills to 3 children with autism and demonstrated positive outcomes. In addition, 2 out of 3
students can generalize their learned skills to an untrained task.
Social Stories
According to Baron-Cohen et al. (1985), theory of mind deficits is evident in children with
HFA. They have difficulty understanding others thoughts, mental states, desires and
intentions. These deficits are believed to be responsible for the poor social communication
skills in children with HFA (Baron-Cohen, 2000). Traditional educational approaches fail to
insure a meaningful improvement in their social performance. Research indicated the use of
social stories is a more effective intervention (Sansosti, Powell-Smith, & Kincaid, 2004). A
social story is a short story that is written from the students perspective and can be used to
help the target student better understand complex and confusing social situations (Gray &
Garand, 1993; Gray, 1997). According to Attwood (2000), social stories
provide information on what people in a given situation are doing, thinking or feeling, the
sequence of events, the identification of significant social cues and their meaning, and the
scripts of what to do or say; in other words, the what, when, who and why aspects of social
situations (p. 90).
Previous research has demonstrated the effectiveness of social stories in teaching children
with autism (e.g., Hagiwara & Myles, 1999; Noris & Dattilo, 1999). Social stories can be
used to educate individuals with autism across various behavior and settings. Firstly, social
stories have been proven effective in decreasing undesirable behaviors. For example, Kuttler
et al. (1998) used this method and successfully decreased tantrum behavior in an adolescent in
residential settings. Lorimer et al. (2002)s study showed that social stories implemented by
family members are effective in decreasing the precursors to tantrum behavior in a young
child in home settings. Similarly, a study by Brownell (2002) used musical social stories to
improve social behaviors in 4 primary students successfully in an inclusive classroom.
Recently, Scattone et al. (2002) used a multiple baseline across participants design to assess
the effectiveness of social stories in decreasing disruptive behaviors of 3 children with autism
and results revealed positive effects for all participants.
Social stories can also increase appropriate or more socially acceptable behaviors in
individuals with autism (Crozier & Sileo, 2005). Feinberg (2001)s study demonstrated the
effectiveness of social stories in increasing more socially acceptable behaviors such as
initiating social activity and increasing flexibility among autistic children during social
activities. A study by Romano (2002) also indicated social stories are effective in teaching
appropriate greeting behavior to individuals with autism. In addition, previous research
indicated the most effective and positive intervention outcomes are obtainable only when
social stories are used as one of the components of an intervention package, rather than being
used alone. Thiemann and Goldstein (2001) used a multiple baseline design to measure the
effects of an intervention package that combined social stories and video feedback on the

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social communication skills in five children with autism. Results showed that all participants
gained increase in their social communication skills, which are consistent with previous
findings.
Generally social stories are written in six basic types of sentences: descriptive, directive,
perspective, affirmative, control and cooperative (Gray, 1998, 2000). Gray (1998, 2000)
pointed out that these 6 types of sentences should be used at a balanced ratio: usually match 2
to 5 descriptive, perspective (or cooperative), and/or affirmative sentences with 1 directive (or
control) sentence in a social story (Gray, 1998, 2000). In addition, Swaggart et al. (1995)
proposed the following 10 steps necessary for creating a social story:
1. Identify a target behavior pr problem situation for social-story intervention.
2. Define target behavior for data collection.
3. Collect baseline data on the target social behavior.
4. Write a short social story using descriptive, directive, perspective and control
sentences.
5. Place one to three sentences on each page.
6. Use photographs, hand-drawn pictures, or pictorial icons.
7. Read the social story to the student and model the desired behavior.
8. Collect intervention data.
9. Review the findings and related social-story procedures.
10.Program for maintenance and generalization (p. 14-15).
Besides the above steps, educators or professionals should also take the following related
issues into consideration when developing social stories for children with autism: (1) make
sure the social stories being written are within the target students comprehension ability
(Crozier & Sileo, 2005; Gray, 1998); (2) incorporate the students preferences and interests
into the writing of social stories (Gray, 1998); use pictures to help the target student
understand the social story when appropriate and necessary (Crozier & Sileo, 2005); (3)
introduce a social story to the target student in a relaxed, distraction-free environment (Gray,
1998); (4) make ongoing revision to social stories in accordance with the target students
progress (Gray, 1998). Most social stories are developed or written by professionals or
parents. Research proposed the following two key ways to implement social stories: (1) read
by the target child independently, or by his/her caregiver; (2) presented through another
medium, such as audio equipment, computer-based program, or via videotape (Charlop &
Milstein, 1989; Sansosti et al., 2004).
Conclusion
It is evident that the interventions introduced in the previous section have been proven
effective in teaching children with HFA in the United States for years. We believe children
with autism in other places of the world can also find them beneficial. However, it is noted
every child is unique and has his/her own strengths and needs. One child may find one of the
above interventions especially beneficial while another child may experience no positive
behavioral change at all by using the same intervention. So it is impossible that one
intervention can fit all children, nor can all children gain the same degree benefit from these
interventions, either. Thus, meaningful intervention outcomes are obtainable only when
interventions are built on the students strengths and interests. The ultimate goal of different
interventions is the same: to enhance quality of life for children with autism. Like all typically
developing children, children with autism also desire and deserve better education and higher
quality of life. All interventions introduced previously have their limitations, and more
explorations need to be done in the future to better serve children with HFA.
References
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